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Letting staff know that ‘it’s OK not to be OK’ and that the NHS ‘has their back’ is the best way of ensuring that they will be able to care for our nation during this crisis and beyond, writes Professor Neil Greenberg The whole health and care workforce is due a well-earned rest at the same time the mammoth tasks of reopening services that are adapted to necessary infection prevention and control measures and responding to physical and mental needs that have been suppressed during lockdown need to be tackled.
With the focus fixed firmly on coronavirus, important and urgent issues in healthcare are going under the radar. In this week’s HSJ Health Check, we look at those things which are going unnoticed, or under-noticed. You can listen below, or subscribe on Spotify, Apple Podcasts, and all the other popular podcast platforms. Four of HSJ’s expert journalists — Annabelle Collins, Rebecca Thomas, Matt Discombe and Dave West — discuss issues including: NHS finances, including mental health trusts, unusually, missing their surplus target; The quality of care for covid-19 and other patients, with most independent inspections on hold; Persisting problems with medical consultants refusing to do extra work, due to pensions changes, as the elective waiting list grows
In recent weeks, we have seen a rise in coronavirus casualties within Black, Asian and Minority Ethnic (BAME) communities. The Intensive Care National Audit and Research Centre reported that 35% of almost 2,000 patients were non-white. This is a troubling statistic, especially when considering that minority ethnicities make up 13% of the UK population, but one-third of casualties. Head of the British Medical Association, Dr Chaand Nagpaul, has also reiterated that “at face value, it seems hard to see how this can be random”. An inquiry has been launched by Parliament’s Women and Equalities Committee to look into why people with protected characteristics, including ethnicity, have been disproportionately affected by Covid-19.
The charity which runs the national domestic abuse helpline has had a 10-fold increase in visits to its website in the past two weeks. Refuge said numbers have “spiked again significantly” since it started recording rises during lockdown. The charity said the lockdown itself does not cause domestic abuse but “can aggravate pre-existing behaviours in an abusive partner”. Police figures suggest a wide regional variation in calls about abuse. Fears that social conditions created by the coronavirus lockdown could result in a spike in domestic abuse led the government to boost funding for services by £76m
A BBC team tracking coronavirus misinformation has found links to assaults, arsons and deaths. And experts say the potential for indirect harm caused by rumours, conspiracy theories and bad health information could be much bigger. “We thought the government was using it to distract us,” says Brian Lee Hitchens, “or it was to do with 5G. So we didn’t follow the rules or seek help sooner.” Brian, 46, is talking by phone from his hospital bed in Florida. His wife is critically ill – sedated, on a ventilator in an adjacent ward.
As COVID-19 leads to a “cash crunch” for the private health sector in developing countries, Mark Hellowell (University of Edinburgh), Andrew Myburgh, Mirja Sjoblom and Srinivas Gurazada (World Bank Group) and Dave Clarke (World Health Organization), consider the opportunities and risks of providing state support to health care businesses. The World Health Organization is calling on countries to adopt a whole-of-government and whole-of-society approach in responding to the COVID-19 pandemic. Among other things, this requires policymakers to include the private health sector in efforts to contain, control and mitigate the health impacts of the outbreak. However, data gathered from a series of interviews with key informants in 12 low- and middle-income countries (LMICs) (Ethiopia, Kenya, Nigeria, Uganda, South Africa, Thailand, India, Sri Lanka, Pakistan, the Philippines, South Korea and Iran) has highlighted a surprising finding. Just as pressure is increasing on countries to ramp up health system capacity, measures designed to “flatten the curve” are reducing the demand for care and creating a “cash crunch” for the private health sector – one that is forcing providers to scale back their businesses and even lay off health workers.
At times of crisis, expert opinion is crucial to formulate policy and direction. The Covid-19 pandemic has demonstrated the life-saving importance of medical leadership at national as well as operational levels. Innovation and rapid re-organisation have enabled healthcare systems to cope with the unprecedented demands placed on services in both primary and secondary care settings. While there have been genuine issues picked up in the media, this should not detract from the enormous value gained from medical engagement and the real and present opportunity to capture and change the way we lead healthcare over the coming months.
The Great Plague hit London in the spring of 1665 and scythed away full a quarter of its population. In the built-up area between the City, Westminster and Southwark, 100,000 died. It was the last gasp of a fatally persistent pandemic that had first struck the timbered medieval metropolis in 1348. What follows are some extracts from my book London: A Travel Guide through Time, in which I bring — hopefully in an uncomfortably vivid way — to life what it was like to live in, or at least visit, the capital at the height of the Plague, when buboes were sprouting on people’s necks, armpits and groins like there was no tomorrow.

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