National lockdown -for pity’s sake use it to get ‘test and trace’ working – Dr John Puntis

National lockdown

On the 31st October 2020, the prime minster announced that England would once again come under a national lockdown for coronavirus five and half weeks after this was first recommended by the government’s own Special Advisory Group for Emergencies (SAGE). Over that period of dithering, daily new cases of Covid-19 infection increased from 4,964 to 21,915, hospital in patient cases from 1,502 to 10,000 and deaths from 28 to 326. Scientists, campaigners and many members of the public expressed anger and amazement at the slow response by ministers and their delay in taking decisive action. Exclusion of schools from the lockdown is now causing concern to both parents and teachers, with the National Education Union (NEU) alarmed by evidence of surging infection among pupils calling for them to be closed.

Fatal slowness – lessons not learned

On the 30th January 2020, having considered the situation in China, the World Health Organisation declared Covid-19 a Public Health Emergency of International Concern. Such a declaration equates to an assessment of a situation as ‘serious, unusual, or unexpected; carries implications for public health beyond the affected State’s border; and may require immediate international action’. The following day, a team of scientists at the University of Hong Kong recommended that ‘draconian measures that limit population mobility should be seriously and immediately considered, as should strategies to drastically reduce within-population contact rates through cancellation of mass gatherings, school closures, and instituting working from home . . . .preparedness plans should be readied for deployment at short notice, including securing supply chains of pharmaceuticals, personal protective equipment, hospital supplies, and the necessary human resources . . ‘. The same day, the first cases of Covid-19 were identified in the UK. We must not forget that the Westminster government then chose not to heed these warnings, consistently underestimated the risks involved and dragged its feet in making important decisions. This has lead to the UK having the highest death toll in Europe, and provides an urgent and compelling basis to call for an immediate inquiry into the handling of the pandemic so that lessons can be learned and put to use.

No convincing exit strategy

There is no end to the pandemic in sight. A vaccine might become available and might be effective, but only time will tell. Some Conservative politicians
such as John Redwood have become medical experts, feeling able to advise the ‘Today’ programme on BBC Radio 4 that new treatments had changed the outlook for patients. He is, however, appropriately more guarded on his website,
mentioning only the role of steroids and requesting information from ministers on other drug trials. Steroid treatment in critically ill patients on a breathing machine has been shown to decrease the risk of death by a third, but this is small comfort if the number of very sick patients requiring intensive care exceeds the number of beds available. Trials of other drugs have been disappointing so far, with a number of agents including the much touted Remdesevir showing no effect on improving survival. NHS England claim overall improvements in management of patients has produced a modest increase in survival for those needing life support, from 72% to 85%.

Serco and the failed privatised ‘test and trace’

Astonishingly, Redwood makes no criticism of the disastrous and privatised national ‘test and trace’ system, which recently had it worst week ever, reaching only just over 60% of its target 80% of contacts. Of course, all contacts reached should also self isolate, but in reality only around 1 in 5 do so because ‘support’ is not integral to the ‘test and trace’ strategy, as it should be. Serco’s hopeless management of the whole system continues to beggar belief, and now includes the fact that untrained 18 year olds were magically transformed from level 3 call handlers to level 2 clinical contact caseworkers – a position previously reserved largely for qualified doctors. The predictable consequences were described as “a shit show” by one of the distressed employees. Serco claimed it was acting on instructions from the Department of Health and Social Care, which confirmed this was indeed the case.

For Redwood to acknowledge the incompetence of Serco would be an admission that contracting out to a private sector provider is not in fact a guarantee of success, something conservative ideologues find impossible to concede. How much further evidence is required to open the eyes of those who will not see? Most recently, the contract for operation and development of the UK’s nuclear weapons is being taken back into public management after criticism by the National Audit Office of the hundreds of million of pounds being wasted, one of the companies involved being Serco!

Close the schools – support the NEU

School is vitally important for children and loss of educational opportunities may have devastating long term consequences in terms of life chances. Conversely, there are risks of increased community viral transmission when schools are open. Risk reduction and an increase in distance learning should be part of the ongoing Covid-19 management plan. School reopening after the first lockdown was not supposed to happen until the number of new Covid-19 cases had been driven down to a very low level, and an efficient ‘test and trace’ system was in place. Both of these commitments were abandoned by a government obsessed with playing down Covid’s threat to our health while constantly highlighting its potential to cause economic harm. Sadly, the government’s commitment to children’s education and the ‘levelling up’ agenda can be gauged by the fact it has recently slashed funding allocation for laptops to disadvantaged families by 80%
as well as its refusal to continue to provide free school meals during the holidays for children from low income families.

Managing risk in schools

Preconditions that should have been observed for schools to re-open were set out by Independent SAGE: drive community transmission down to low levels; wear masks in secondary schools; additional teachers and spaces and smaller class sizes so that social distancing is feasible; monitoring of ventilation (given aerosol spread in classrooms); provide resources necessary for study at home; clear guidance regarding when to get tested and what to do about isolation; local testing with rapid turnaround of results. We now have a situation where in one week over half a million people were infected, with the highest rates in teenagers and young adults and the most steep rise in school children. The overriding risk factors for spreading infection are known to be closed spaces with poor ventilation, mingling in crowds and settings where there is close contact (a good description of schools!). To be serious about driving down infection once again, schools must be closed and only re-opened when the above preconditions have been met; an urgent task for the Department for Education.

Back to basics – we must have a public test, trace and support system

With cooperation from the public, a second national lockdown is likely to be effective in driving down numbers of cases once again, however, there is no point going back to the previous situation and repeating the exponential increase in cases that followed the ending of the first lockdown. Together with increased surveillance at borders and quarantine for travellers, an effective ‘find, test, trace, isolate and support’ system as outlined by Independent SAGE is the only thing that is likely to make a major difference. This should also incorporate ‘backward’ contact tracing (not being done in the UK at present) where the origin of infection is sought in order to find those super-spreaders – the 10% of people who cause 80% of infections.

The fact that the current privatised system will not and cannot work effectively has not yet been recognised by the government despite all the evidence. Until this issue is grasped and an effective local public health system put in place, we are doomed to repeat cycles of rising infection followed by lockdown with disastrous consequences for both health and the economy. Just as the provision of clean drinking water and sewerage in the 19th century was ushered in only when hundreds of thousands of cholera deaths spread from poor to rich communities, perhaps it is only a grotesquely rising death toll that will prompt decisive action? In the light of what we already know, this would not only represent more criminal foot dragging, but further highlight the callous disregard of this government for its people and their wellbeing.

John Puntis

2nd November, 2020

Save Richmond House care home in Farsley

Richmond House is the lovely unit where one of our members was sent for rehab a couple of years ago.  It was new build and absolutely lovely.  The staff were great and the care they received second to none.  The beds in Richmond House must be in demand, is it calculated policy which is keeping them empty?

We must do everything we can to save this Home, please sign the petition and support this campaign to stop the Council using cuts as a reason for closure. We need this more than ever.

Full details https://westleedsdispatch.com/petition-launched-to-save-threatened-farsley-care-home/

Public Meeting: “What will Happen to the Supply of Medicines after 31st Oct”

Please share. More details or press enquiries please get in touch

Leeds Hospital Alert have organised a public meeting on 17th October, 7.30pm at St. Margaret’s Parish Church ,Church Lane, Horsforth LS18 5LA

Everyone is concerned about the supply of medicines now and after 31st October. Please share the meeting details with everyone you know.

Minutes

Tuesday 21 May 2019

Updates:- We received a thank you e-mail from Phil Corrigan.  She had enjoyed being with us, thanked us for the flowers, wished us well and said carry on fighting.

We are invited to a preview of the Exhibition Many Happy Returns, 70 years of memories of the NHS. Thursday 13th June @Room 700 Leeds Central Library 4 – 6 pm.  The Exhibition runs until July 5th

KONP have booked a stall at the Kirkstall Festival Saturday July 13. Any help we can give will be most welcome. LHA will NOT be having a stall.

Conference, Social Care, Saturday June 29 at St Georges. We did say we would like to help.  I will forward details when I have them from Gilda. Gilda forwarded an invitation to join discussion groups in Leeds June 1st. Bronwen & Beatrice agreed, if there are places still available, to attend the group in Pudsey concentrating on the attacks on our public services.  I did e-mail the invitation to all members.

Shop Mobility:  progress is so slow you can’t help wondering if it will ever be restored BUT there are people trying very hard to move the issue on—–The Disability Hub, The Older Peoples Forum.  Lucy Graham at Forum Central plus Cllr Kevin Ritchie and representing the Council Sinead Cregan Commissioning Programme Leader for the Council and  Bairbra McKendrick  Unison Access Officer After significant delay talks are ongoing with the William Merritt Centre and the Merrion Centre. Leeds is not the best city for the disabled. We can only hope that this time something good will happen.

Home Care Networks.  The document was e-mailed to all members and copies sent to all 8 Leeds MPs.  As yet no response.

Unison retired members group has been alerted to debt collectors being used to collect arears of social care charges.  Asked that a letter be sent to Judith Blake.

Jeremy sent a message to say that at last he has received a letter from Judith Blake highlighting the costs of bringing services back in house.  Having taken

Expert advice he will reply.  Also, he is meeting with UNISON officers to discuss the failure of Leeds City Council to implement The Ethical Care Charter

STOP PRESS Friday May 24

Meanwhile, the Financial Time reports on an existing digital healthcare scheme. The app, GP at Hand, has proved so popular that it is straining the finances of the NHS body which runs it.

Since 2017 it has operated through the Hammersmith and Fulham clinical commissioning group – but is available to people even if they do not live in the area. That has created a £22m funding gap.

Next meeting Tuesday June 18

To be discussed:

Is there a future for Leeds Hospital Alert; if yes how do we progress with so few members and increasing age?

Leeds Hospital Alert Minutes

pdf version LHA Feb 19

We have received a fun thank you card from Nicola.

Bronwen received a reply from Simon Stevens in response to the letter expressing our concerns concerning further privatisation of the NHS and expressing our support for changes to the Lansley Act.

Alex Sobel asked at PM Question Time about the supply of insulin post Brexit.  It is all in hand he was told but we must keep a sharp eye on what happens next.

Concerns about the lack of staff in the NHS causing real problems in all services.

Must keep track of NHS England’s demand for increased use of electronic consultations and services.  We especially need to know what happens for those who do not have internet access.  Many GPs unhappy about recent developments. They could be dangerous.

Social Care Report:  Bronwen, Sylvia, Jeremy, Gilda attended the Social Care meeting at the Central Library. Time was spent looking at the Preston Model, the Foundation Economy Unit at Manchester University, the Sheffield Civic Society model.  All concerned about the cost of outsourcing, its effect on budgets and on patient services.  Good contact was made with Charles Dannreuther at Leeds University.  He would like to know more about LHA.  Sylvia to contact him. We need to know how to move the Council on from their current entrenched position.  Ought we to contact the Centre for Disability Studies at the University?  There will probably be a Northern Conference as follow up to the Birmingham Conference.  Gilda will keep us up to date.

Community Mental Health Services.  Sylvia gave a brief report. The Service is returning to working in teams with the aim of keeping patients out of hospital and in their own homes.  All day units have been closed including Malham House. Intensive home care treatments go live March25. There will be a transition period with re-design of homecare teams.  There will be an on line questionnaire for service users but not for their carers. Further report at our next meeting.

Leeds CCG would like your views on the proposal for urgent treatment centres in Leeds.  Closing date for feedback 15 April 2019.  Contact the CCG on 011 3 843 5470 on leedsccg.comms@nhs.net

KONP: Urgent Care- 111 Service- to be provided by Yorkshire Ambulance Service.  New targets from April.  Could be put through straight to a GP.

Vascular services.  Lack of trained staff means either Huddersfield or Bradford will lose their department.  Leeds working to full capacity.

Combating loneliness.  Aim to rekindle community spirit.  See the e-mail forwarded   from John.  Jan’s cautionary tale about   the threat to her tai chi class not very encouraging. To discuss at the next Yorkshire meeting the possibility of a Northern Conference probably in June.

There will be a workshop at SUMMAT March 9 in Notre Dame Sixth Form College

NHS March 30th March.  Please help with distributing postcards as widely as possible. Cards available from Gilda.

Next meeting Tuesday March 12 Muir Court 7.30

April 9 come to say thank you to Phil Corrigan before she retires in July.  Would be good to have as many members as possible at this meeting.

Briefing for Rachel Reeves MP

pdf version

Young people’s mental health is a ‘worsening crisis’. 

Action is needed writes Mary O’Hara in The Guardian 31/7/2018 ‘Whatever the language deployed to describe the scale of mental health challenges facing Britain’s young people, it has to be addressed immediately.’

NHS figures published last month revealed that almost 400,000 children and young people aged 18 and under are in contact with the health service for mental health problems. According to the figures, the number of “active referrals” by GPs in April was a third higher than the same period two years prior. Those seeking help for conditions such as depression and anxiety showed a sharp increase….

Demand for help is up, but services are diminishing…. The revelation in November 2017 that two-thirds of children referred for specialist mental healthcare are not receiving treatment ………………………………………………………………………………………………………….

Current situation in Leeds:  Children and Adolescent Mental Health (CAMHS) are provided by the Leeds Community Healthcare NHS Trust says the CAMHS website. CAMHS is a specialist mental health service for children and young people. Staff are highly trained in a range of different assessment techniques and evidence-based therapies. Staff work closely in teams so that they can offer services tailored to the needs of children, young people and families.

For a very small number of young people, highly intensive assessment and treatment packages are needed. Leeds CAMHS has both intensive outreach and inpatient services. Little Woodhouse Hall is the adolescent inpatient unit in Leeds. It is for young people up to the age of 18. There are 8 residential places there but there is are no Psychiatric Intensive Care Unit (PICU) in Leeds. Some years ago, 16 and 17-year-olds even 15-year-olds with challenging behaviours used to be put on adult mental health in-patient wards but we campaigned against that.

More recently young people are sent to Out of Area Treatments (OATs), mainly to the Cheadle Royal Priory, a private hospital in Cheadle, Greater Manchester or to an NHS adolescent unit at Middlesbrough if they need to be in a PICU, both of which are about 50 miles away from Leeds. This distance must put great strain and cost on families, as well as create difficulties in continuity of treatment and care planning.

Plans for new £13m CAMHS unit to be shared with public

Leeds Community Healthcare NHS Trust is inviting the public to a drop-in information session where proposals for a new inpatient Child and Adolescent Mental Health Service (CAMHS) unit will be unveiled.

The proposed new unit will provide crucial specialist support to young people with mental health problems on the St Mary’s Hospital site in Armley.

The drop-in event is to be held between 3.30pm and 7pm on Thursday 13 September in the Class Room, Holly House, St Mary’s Hospital, Green Hill Rd, Leeds, LS12 3QE. Free parking, including disabled parking, is available directly outside the Holly House building.

It is an opportunity for people to view and comment on plans prior to submission of a planning application. Service, construction and design representatives will be on hand to answer any questions.

Earlier this month it was confirmed that Interserve Construction Limited had been appointed as the Trust’s construction partner for development of the prospective £13m unit – which got the go ahead following a successful bid for NHS funding led by Leeds Community Healthcare.

Thea Stein, Leeds Community Healthcare NHS Trust Chief Executive, said: “It is very important to the Trust that the voice of young people, families, staff and the local community has a strong presence in the development of the new unit and we will continue to work together to make sure we get it right.”

If you can’t attend the event but would like further information, or if you have any special requirements, please contact Samantha Hirst, Communications and Engagement Manager on 0113 843 1204 or email Samantha.Hirst2@nhs.net

You can also keep up-to-date with the latest on the project by visiting: https://www.leedscommunityhealthcare.nhs.uk/

………………………………………………………………………………………………………………………………………………………………….

What is proposed. This is fantastic news for the development of children’s and young people’s mental health services in West Yorkshire, at last. The new residential unit, proposed for the Leeds and York Partnership Trust’s site, but run by the Leeds Community Healthcare Trust and funded by £13 million from NHS England, will have 18 residential places and 4 in a PICU, totaling 22 for West Yorkshire. It is to be built on part of the St Mary’s Hospital site on Greenhill Road in Armley which has mainly been cleared of services in recent years. It is likely that the old hospital in the centre of the site which is a listed building will be sold for apartments, perhaps for hospital staff. Unfortunately, although space has been provided there is no funding for a crisis assessment unit for children and young people.

I attended the public drop-in for the new in-patient CAMHS unit and met the architects and various professionals and was impressed by the building, but I had some concerns about it being institutional, overlooking the cemetery, and isolated from the local community. Young patients had been actively involved with planning the interior and facilities of the building.

Opportunities for the local community

  1. This must be a good opportunity for employment in the development of jobs in both building and running the new unit. How can we promote this to ensure local people are trained to take up work?
  2. Young people and their families, and workers, are likely to travel to the unit from across the north of England, with consequent opportunities for the improvement of transport to St Mary’s Hospital. What financial support will be available to carers for traveling?
  3. The multinational out-sourcing company, Interserve, has been chosen to both build the unit and provide the staff to run it. I am concerned that Interserve appears to have financial difficulties, reminiscent of Carillion.

Interserve shares dive on rising concerns over future

Simon Jack, Business editor @BBCSimonJack 13/11/2018

“A former big shareholder in construction and facilities management company Interserve has told the BBC he is doubtful the firm can survive. Shares hit a 30-year low on Monday and are down a further 15% on Tuesday. “We could be looking at another Carillion. I don’t see how they can raise the £500m or so needed,” he said. However, two different sources close to the company denied the firm was close to bankruptcy and said it was set to ask new investors for more capital. Interserve, a major UK government contractor, sells services, including probation, cleaning and healthcare, and is involved in construction projects. The company is making more than £100m in cash and although the construction business has got a few problems, the core facilities management business is doing well, according to people who attended a recent management meeting. One source added that the sharp falls in Interserve’s share price reflected the growing realisation that existing investors will get a worse deal than those prepared to commit fresh cash.”

  1. The young people who are admitted to the unit will be some of the most distressed; experiencing for example, initial onset of schizophrenia, severe eating disorders and be at great risk of suicide and self-harm. I propose a local community centre, preferably on the hospital site which does not have a workers’ café anymore.  HMP Leeds has the Jigsaw voluntary organization on-site to welcome families at a distressing time, with activities for adults and children and food and drink. This might be a useful model.

14/11/2018

Leeds Hospital Alert responds to LGI Consultation

New Leeds Hospital

Several members of Leeds Hospital Alert attended the drop-in sessions to see the plans for the new hospital on the LGI site. These are our concerns: –
The cost —- there is still a huge gap between the money promised/secured and the amount needed.

Wonder if there is sufficient expertise available to ensure that LTHT doesn’t suffer the same costs/penalties of PFI.

Will there be sufficient safeguards to ensure that obtaining money from private sources doesn’t mean further privatisation within the Trust? Far too much NHS money is going into private hands instead of patient and staff care.

The size of the buildings and the site itself presents problems for many patients especially those arriving by public transport or have problems walking or are simply not well. Are you negotiating with the transport authority or considering the use of a hopper bus?

There can be serious problems too for wheelchair users especially when they are not allowed to bring their carer with them in the ambulance. Will there be an efficient porter service with wheelchairs at the point of access.

Can we assume that everywhere will have wheelchair and disabled access plus help for those hard of hearing?
Assume you will negotiate with and accept advice from the Department of Disabled Studies at the University

Members with nursing experience question the use of a day ward for children needing blood transfusions or chemo. There can be 7 or 8 at any one time on the ward. To be told they could be transferred to another ward isn’t considered to be satisfactory. Certainly not the best treatment of young people.

We were assured that there would be no reduction in beds but this fails to take into account a rising population, referrals from another hospital and whether these have been taken into account in modelling bed numbers. Rising demand must necessitate more beds not just maintaining the current number.

Bringing together all maternity services on to one site creates a very large unit. Is this best practice? We would recommend a public consultation a.s.a.p.

Very concerned about the proposed use of apps. Have you considered just how many people will not have an app? Not everyone has an i-phone or indeed a computer. Has any assessment been undertaken to discover just how many mistakes already happen with the computer services at LTHT? How many patients are blamed for faults in the system?

We can certainly give you some examples. What would you do in circumstances such as 02 closing down completely for 36 (?) hours? How would you contact all the patients who use that provider? What fall back procedures will you have in place?

Substantial buildings are to be put up for sale. Is there sufficient expertise in the Trust to organise these sales so that a fair price is paid with water tight safeguards? In the past this has been questionable.

What happens next if you don’t succeed in raising sufficient funding?

Will just part of the plan be implemented?