‘Rubbish’ government Strep A comms blamed for flooding services

On Friday the UK Health Security Agency, successor to Public Health England, issued a warning on a higher than usual number of cases after the deaths of five children under 10 in a week.

Several senior sources in hospital, 111/ambulance, urgent care and primary care providers, told HSJ they were not warned UKHSA were making an announcement that would also see services flooded by the worried well.

NHS England’s clinical lead for integrated urgent care today issued a letter, seen by HSJ, saying a “considerable increase” in 111 demand over the weekend was “in part due to Group A Strep concerns”. Sources in the sector said the increase in demand was “heavily” Strep-related.

The NHSE letter sent at lunchtime on Monday said it, with others, was working with nhs.uk and 111 online to create a Group A Strep webpage to direct patients to. But NHSE did not indicate when this would be ready, and said the Department of Health and Social Care claimed UKHSA was responsible for communications on the issue.

One senior accident and emergency leader told HSJ that when parents could not get through on 111 they brought their children to emergency departments. “The media messaging has been handled terribly”, they added.

They added: “Huge numbers of ‘worried well’ makes the accident and emergency a much more dangerous place. We are just not equipped to deal with the volume of patients. [There is a] much greater chance we would miss one seriously unwell child when we are wading through a six-hour queue of viral, but otherwise well, kids.”

One senior leader in the sector said communications in such circumstances were “not easy”, but ideally UKHSA/NHSE would have alerted them they were planning an announcement which would create large demand from people likely to be well. Providers would then have a better chance of organising additional staffing and services, the person said.

A hospital CEO said it had been a “very, very difficult weekend”. Another said: “Children’s ED was very busy. Demand from parents with children with sore throats and temperatures [was] very high.”

One primary care source said on his patch: “The lines did not stop ringing. Our evening and weekend appointments went far faster than normal. There were very unhappy patients who couldn’t get in. Was rubbish comms from PHE [now part of the Department of Health and Social Care and the UKHSA]/NHS England.”

Another said: “We’ve got a huge queue in our urgent treatment centres.”

The letter added that to “protect clinical queue and maintain safety” some calls with care homes normally handled by a clinician could be taken by non-clinical staff. HSJ understands these calls comprise only a small proportion of the total.

UKHSA told HSJ there had been an urgent need to get information to clinicians, and that parental anxiety had already been growing due to media reports on the children’s deaths.

A spokeswoman confirmed that the situation had been classified as an “enhanced incident” under its business continuity rules, similar to when poliovirus was found in London sewage and the Monkeypox outbreak.