HSJ Weekly Catch Up: Legal eagles, speaking out and Turkish flights

Return to sender

Correspondence errors in the NHS are not unusual.

The last four years have seen incidents from NHS Shared Business Services and Capita, the Royal Free London Foundation Trust and Walsall Healthcare Trust — ranging from large to small in scale.

The latest incident occurred at NHS Digital, where 10,000 deceased patients were wrongly contacted to warn them they were at higher risk of covid-19.

The error occurred during the rush to draw up the shielded patients list — a complex challenge for which staff had little time to prepare.

Meanwhile, the government must be kicking itself over announcing it was expecting 400,000 gowns from Turkey over the weekend. After days of scrutiny and speculation, a RAF plane finally delivered a batch of personal protective equipment on Wednesday.

But now HSJ sources say just 32,000 gowns actually ended up in the UK. It’s not yet clear exactly what went wrong with the shipment, but it’s thought the Turkish government stepped in after the original supplier fell through.

It’s good to talk

Matt Hancock told the daily coronavirus briefing on Tuesday that NHS staff should “feel free” to talk about what is happening at work, such as PPE shortages.

That’s despite HSJ hearing from several senior local NHS leaders they have been given strong warnings not to speak out about the covid-19 response.

Asked whether he would guarantee no NHS staff will be punished for publicising legitimate concerns, Mr Hancock said: “Yes, of course people should be able to talk about the problems that there are.”

Meanwhile, it’s becoming clear the temporary Nightingale hospitals will not be widely used to tackle the initial peak in coronavirus cases.

The original facility in east London remains largely empty, as do the Manchester and Birmingham equivalents.

On Tuesday, another Nightingale in Harrogate, Yorkshire, was given a big opening ceremony. But it will not start taking patients for the time being.

In many ways this is good. The NHS planned for the worst, and the worst didn’t happen.

The hospitals’ time may also come in the coming months, as the NHS looks to restart some of its normal services.

This is certainly the plan in London, where regional leaders believe the Docklands Nightingale will be vital in getting normal services up and running, by taking pressure off the intensive care units in the primary hospitals.

After the fanfare

The continuing crisis in PPE is showing no sign of abating. Shortages persist and bottlenecks in the systems intended to supply the crucial kit do not help matters.

Two weeks ago, the government announced a new online channel for health and care organisations to access the kit, run by commercial logistics firm Clipper. It was going to be open to primary, community and social care providers as well as secondary care. The system for out of hospital providers to access the service will be fronted by a website built by Ebay — but, a fortnight on from the fanfare, it is still being tested and has yet to be rolled out around the country.

Meanwhile, analysts working for the Institute and Faculty of Actuaries have estimated that, by now, there have been 26,654 to 31,419 “excess deaths” during the covid-19 outbreak in the UK.

“Excess deaths” represent the difference between the number of people who are dying, versus what would have been the case if age-adjusted mortality rates remained the same as recent years.

It is clear the death count is well above what has so far been officially counted. Rapid counting is inhibited for a number of reasons about practicality and accuracy.

Reporting issues have, however, for some time, masked the impact of the virus outside of hospitals.

HSJ analysis shows large numbers of “excess deaths” are taking place in care homes and at home — but, in these settings, the majority of fatalities are not being directly attributed to covid-19.

Courtroom drama

Once the coronavirus peak has been overcome, NHS organisations should expect the legal challenges to roll in, according to two legal firms that specialise in health and social care.

Speaking to HSJ’s Health Check podcast, two lawyers told listeners there will “inevitably” be a “huge number” of legal challenges against the decisions clinical commissioning groups and providers have made during the course of the pandemic.

The message was clear — NHS organisations should consult on changes as much as they can and create an audit trail of what, when and why decisions were made, including the challenging context in which they were made.

Meanwhile, Paul Deighton has been given the mammoth task of helming PPE production as the health service battles to get hold of the gowns, masks and gloves it desperately needs.

Lord Deighton is best known for his work organising the London 2012 Olympic Games.