The must-read stories and debate in health policy and leadership.
On Tuesday, during a marathon session on covid-19 in the House of Commons, the secretary of state Matt Hancock said one of three lines of defence against the pandemic is “targeted local intervention,” releasing local areas from lockdown when virus rates drop.
He said he wants to build “local consensus with all elected officials” where possible.
The very next day he succeeded in forging a tight local consensus in the North West of England. Councils in Bolton and Trafford, as well as the mayor of Greater Manchester, were united in rejecting a decision by the Department of Health and Social Care. With rising infection rates they called for the government to reverse its decision from the previous week to lift local lockdown measures in their areas.
Mr Hancock successfully negotiated the U-turn and at midday on Tuesday he announced the government would not lift the restrictions in Bolton and Trafford after “a significant change in the level of infection rates over the last few days”.
The trusts in Greater Manchester Health and Social Care Partnership had 17 patients with a positive covid diagnosis die in the seven days up to 26 August, the latest date for which robust data is available.
There were 26 covid positive deaths in England’s other sustainability and transformation partnership areas.
Greater Manchester made up 40 per cent of the total covid deaths. The North West region, including Cheshire and Merseyside, and Lancashire, accounted for over half the total deaths in England.
Will 111 First be a lifesaver for A&E?
Trials of the new 111 First system for accident and emergency are gathering pace and are being introduced across the country.
HSJ can reveal that NHSE expects to roll out 111 First trials in trusts in every health system in England ahead of national implementation in winter.
The trials, which involve patients calling 111 to “book” urgent treatment, are currently being run in Portsmouth, Cornwall, Blackpool, Newcastle and five trusts in London, with many more to follow in the coming weeks.
But there is concern among some leaders about 111’s preparedness to take on the extra work. Local managers in Gloucestershire believe 111 sending too many patients to hospitals was a cause behind a critical incident last month, while other leaders have described it as a “risk averse” service.