Your essential update on health for the week — this week focused on the coronavirus outbreak. 

HSJ Catch Up

This weekly email gives HSJ subscribers a vital update on the biggest stories in health. If you have been out of the office or otherwise just too busy to keep up, HSJ Catch Up will ensure you are still in the know.

Clustered together

The government’s Thursday figures on coronavirus sadly revealed a rise in the number of deaths, including a spike clustered in three Black Country trusts — The Royal Wolverhampton Trust, The Dudley Group Foundation Trust, and Sandwell and West Birmingham Trust.

Royal Wolverhampton now has the most deaths of any trust in the country, with nine so far. Dudley Group’s seven deaths means it ranks third. 

As the coronavirus pandemic takes hold of the NHS, some of the rules healthcare professionals must usually follow are being relaxed. 

Under usual circumstances, all licensed doctors who practice medicine must renew their licence every five years. 

Given the current situation, the General Medical Council has told roughly 36,000 doctors who were due to revalidate their licence between now and the end of September to do so next year.

Barts takes the strain

Following Sir Simon Stevens’ announcement on Tuesday that all systems were working out how best to optimise resources, and that some hospitals could be used to exclusively treat coronavirus patients in the coming monthsHSJ revealed on Wednesday that London was beginning a major coronavirus-prompted reconfiguration

HSJ understands St Bartholomew’s Hospital, which is run by Barts Health Trust, will act as a “clean” site and be the urgent electives centre for the capital.

Meanwhile, covid-19 continues to place significant pressure on supply networks, particularly for personal protective equipment and hand sanitisers. NHS Supply Chain, which procures common consumables for providers, had been “managing demand” of some goods to maintain supplies where possible, with certain products sourced from China unavailable altogether.

But global supply chain problems are not the only issues impacting distribution. Some trusts are hanging on to roll cages longer than they should, with some getting lost in laundry networks. NHS Supply Chain has recently warned holding on to the cages not only frustrates its operations but — when roll cages are co-opted for linen — it creates an unnecessary cross-contamination risk.

The greatest challenge

As the country spent Tuesday grappling with what the latest guidance on covid-19 — announced by the prime minister on Monday night — meant for them, NHS England issued new guidance seeking to steer the NHS and its workforce through uncertainty: effectively new operational guidance for 2020-21.

Elsewhere, its chief Sir Simon Stevens went before the Commons health and social care committee.

In the guidance letter from Sir Simon and chief operating officer Amanda Pritchard declared it “arguably the greatest challenge [the NHS] has faced since its creation”.

The takeaways include:

  • NHS staff will be able to stay in NHS-reimbursed hotels to avoid a 14-day household isolation period, although the policy applies on “an entirely voluntary basis”;
  • NHSE is asking Public Health England to establish NHS targetted testing as a matter of urgency as more testing becomes available, in an effort to enable those with symptoms to unnecessarily avoid a seven-day isolation period;
  • NHS organisations have been asked to “make adjustments” for staff members at increased risk according to new guidance on isolation, which now includes pregnant women; 
  • The NHS is aiming to free up 30,000 beds by postponing all non-urgent elective surgery from 15 April and discharging all patients who are “medically fit to leave”; 
  • Trusts have been asked to “enhance” their ventilation capacity where possible;
  • The payment by results system has been suspended for 2020-21 — and all major policy aside from covid-19 delayed;
  • GP payment by performance suspended.

An inspector doesn’t call

As the UK moves to much more significant social isolation measures, the NHS has seen further shifts. 

It’s been confirmed that junior doctor rotations have been suspended. There remains uncertainty about NHS staff eligibility to be tested for covid-19. 

Last week, the Care Quality Commission came under pressure to call off its inspections while the NHS grappled with the coronavirus outbreak. NHS Confederation said it would be an “inevitable distraction” for staff at a time when their attention should be elsewhere. Sir Simon Stevens also spoke up, telling the chief nursing officer’s summit event in Birmingham “the bulk of [the CQC’s] routine inspection programmes is clearly going to need to be suspended”.

On Monday morning, the regulator’s executive team decided it was time to call it quits and suspend its inspections where there are no immediate safety concerns while the outbreak rumbled on.