The must read stories and talking points in the NHS

Flu planning scrutinised

Two months ago, HSJ revealed that, ahead of this year’s flu season, CCGs and NHS England regional officials told GPs they should buy a cheaper, less effective flu vaccine.

This was due to a lack of clarity around whether quadrivalent – the more expensive vaccine – gave the NHS enough bang for its buck.

This prompted some strong words from the president of the Society for Acute Medicine, who said commissioners’ advice might have increased the risk of flu admissions.

Since then we’ve seen NHSE make an unprecedented move by sending national directions to GPs about which vaccines they should be ordering. The timeliness of this advice was perhaps not ideal, considering the letter was sent in February and most GPs aim to conclude their flu vaccine orders in January. However, NHSE was able to get suppliers to promise to play nice with GPs needing to change their orders.

NHS England’s advice was likely prompted by two things: GPs’ confusion over whether to buy quadrivalent or trivalent vaccines; and the introduction of a brand new one that is more affective for elderly patients.

All this confusion begs the question – does the NHS take the right approach when it comes to flu planning?

It is a question MPs have decided they want to answer, so earlier this week the Commons science and technology committee launched an inquiry into the national flu vaccination programme.

It has had its first panel session and those in the spotlight included the medical directors from NHS England, the Department of Health and Social Care and Public Health England.

They were all quizzed on the advice given to GPs last year and whether different advice may have better prepared the NHS for this winter’s flu onslaught.

Patient death at A&E under ‘extreme’ pressure

The death of a patient in an A&E department was “due entirely to the dangerous overcrowding of the department”, the trust’s medical director has said.

An email to medical consultants at Northampton General Hospital Trust from medical director Matthew Metcalfe, leaked to HSJ, said the patient died on Wednesday night.

Dr Metcalfe said: “Last night a patient died due entirely to the dangerous overcrowding of the department.

“The risk we have all been aware of, but may have felt hypothetical, has just happened.”

The man presented at the A&E with stomach pain and was initially seen and assessed within an hour. He was waiting on a chair to be seen by senior staff after a blood test suggested he may have heart problems. He deteriorated and suffered a cardiac arrest before being seen.

Trust chief executive Sonia Swart told HSJ today that staff at the trust were working hard under extreme pressure.

She said: “This is a national issue. This is increasingly obvious from all the reports that are coming out this winter. This winter has clarified more than anything else that this is a national issue. We are not trying to say there is nothing we can do about it. We are saying we can do better and we will do.”

Earlier this week, the trust said it had been on the highest level of alert for the three days.