Test and Trace – Time to Get it Right

taken from weownit.co.uk

Test and Trace is currently an absolute shambolic mess and there’s no point pretending otherwise. Over the weekend, a mum I know of in Morecambe was told to drive over 130 miles to have her children tested, only to find that the centre was shut when she got there! I know of another woman in Skipton (that’s in North Yorkshire, if you’re unsure), being sent to Northern Ireland! This cannot go on. It’s beyond ridiculous! It also massively undermines the idea of levelling up, because families who can’t afford to travel further then have to keep their children out of school for longer, causing further disadvantage to their learning opportunities. Imagine having a fever, feeling unwell and then being asked to drive a long distance to get a test, which should be available in your vicinity. It’s unsafe. It’s also unfair to blame people for booking tests unnecessarily when a) people are only able to get a test if the people employed by Serco allow them to have one, b) children can’t go back into school, once sent home until they are proven ‘negative’ and c) the Prime Minister has promised testing to pretty much everyone via his ‘Moonshot’ approach.

 

It’s vital, as we enter the winter months, to get this right. Our ability to provide safe staffing levels across the NHS and enable schools to function properly genuinely depends on it. Last week at the NHS Assembly we debated the issue and a possible way forward. The contract issued to Serco is clearly not delivering what is needed, and so it’s time to take an honest appraisal of where we are and how we’re going to fix this. I know the Assembly will be writing in an official capacity to Dido Harding, who is currently in charge of the programme. In the mean time, here are my thoughts about what needs to happen now.

 

  1. It’s time to value the brilliant local public health leadership we have in place across the UK and ensure these leaders are supported to lead this work by providing timely data. After investing in the training and expertise of our Directors of Public Health, why on earth at a moment for which they have been trained to provide leadership are we circumnavigating them and making it so much harder for them to do their jobs? It would be worth an apology for not trusting them to do this in the first place and to own up that ‘Serco Test and Trace’ (not ‘NHS Test and Trace’) has failed in its task.
  2. We must ensure that local councils and Directors of Public Health have the resources necessary to lead the local test and trace approach and ensure they have the necessary powers to intervene where needed.
  3. The whole system must work – so we need to create more capacity in the laboratories across the UK to turn around results in a timely fashion.
  4. It’s vital that we engage regularly with local communities of many different kinds and their leaders to ensure they understand where things are up to, how we can work together to keep people safe and debunk any myths that are developing, whilst holding space for the uncertainty of the moment.
  5. Therefore we need clear, comprehensible messages to the public – we need to empower/permission local teams to lead on this messaging in a way that makes sense for their communities without constantly needing to check back with the centre. This comes down to trust.
  6. The NHS and Local/National Government need to become much more comfortable with using different communication channels like WhatsApp – and for young people Instagram, YouTube and Tik Tok – because this is what young people are using now to the exclusion of nearly everything else…..if we have unclear messaging and then don’t even use the platforms that young people are using, we have no right to scapegoat them (which is terrible practice anyway!).
  7. It’s really important that testing capacity is available rapidly and flexibly in areas with outbreaks. With the R number rising as it is and the current farce around availability of local tests, we simply can’t afford for this to continue.
  8. We must recognise the value of and therefore ensure early intervention and action ,rather than delaying decisions. This has been highlighted by Sir Jeremy Farrar, CEO of The Wellcome Trust and member of SAGE in some current learning form Marseilles, where the hospitals are back at the point of saturation.

 

I’m not sure how or why it was decided that Serco should run this show in the first place. However it’s clearly not working. It’s time to make brave decisions. It’s time to get this local and focused. It’s time to get this right. Our lives may actually depend on it.

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Why The Loss of Public Health England Really Matters

from the HSJ

Yesterday, I tweeted that I think Dido Harding, the Chair of NHS Improvement and newly appointed head of the newly established National Institute for Public Protection (NIPP), which is to replace Public Health England (PHE), is a good leader. I say this, having met her and few times, through the NHS Assembly and her genuinely humble desire to listen and treat people with kindness.  It caused quite an interesting discussion and there has been widespread criticism of her appointment.

 

Last week I did my yearly updates of the mandatory online training required in the NHS. Part of this included my ‘fraud awareness’ and this focuses, particularly on the Nolan principles – an ethical framework under which we are required to work. If these principles are not followed, people can quite rightly lose their jobs and even be sent to prison. The principles apply to all people who work in public life, not just the NHS and are as follows:

 

1.       Selflessness

Holders of public office should take decisions solely in terms of the public interest.

2.       Integrity

Holders of public office must avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work. They should not act or take decisions in order to gain financial or other material benefits for themselves, their family, or their friends. They must declare and resolve any interests and relationships.

3.       Objectivity

Holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.

4.       Accountability

Holders of public office are accountable for their decisions and actions to the public and must submit themselves to the scrutiny necessary to ensure this.

5.       Openness

Holders of public office should act and take decisions in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for so doing.

6.       Honesty

Holders of public office should be truthful.

7.       Leadership

Holders of public office should exhibit these principles in their own behaviour. They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

 

from The Guardian

The decision to disband Public Health England, (which is recognised internationally as a world leader in the realm of Public Health) and the appointment of Dido Harding into her new role (even though I do really like and respect her) are not aligned with the Nolan principles and I believe therefore that the Secretary of State for Health and Social Care, Matt Hancock has some serious questions to answer, which are absolutely in the public interest. Each of those questions should be framed around the Nolan principles and are a part of the accountability required in such a momentous decision. It’s not that Dido Harding (who called for more integrity in NHS leadership) is necessarily the wrong person (although many feel that she is). It’s the way the appointment was made that makes everything so murky and this is a great shame.

 

Public Health England must not be used as a scapegoat in the forthcoming independent enquiry into the UK’s response to Covid-19. We must also better understand where and how its other vital functions will be performed. As Jeanelle de Gruchy, President of the Association of Directors of Public Health, has so eloquently argued, the NHS is not currently set up to do this work. There is the potential that the newly established Integrated Care Systems (ICS’) across England, which bring together public sector partners, including the NHS and local government could hold the responsibility, but this would need to be funded adequately and appropriately AND would require a legal framework, which is currently lacking. We simply cannot afford to lose the vital functions of prevention, child health and other huge programmes previously co-ordinated by PHE. With further financial issues ahead for local government, the idea that public health prevention will remain a priority, when we have already seen the roll back of this since 2010 is unrealistic. If this happens, rather than ‘levelling up’, the great promise of the Prime-minister, Boris Johnson, we will see a worsening health inequality gap and those in our poorest communities struggling even more.

 

We need urgent answers to urgent questions. But more than this, we need a government who are willing to act with integrity, openness and through the proper mechanisms of parliament. Announcing major changes to the functions of public sector organisations through the press and the refusal to follow good processes in redesign are seriously unwise and unfair. Trust in this government is waning and they could do a great deal more to rebuild that trust, if they care to do so. The loss of Public Health England matters, not only because it does such incredibly important work beyond public protection, but because of the manner in which it was disbanded and what this means about how government is functioning.

 

When Matt Hancock made his speech about his new NIPP yesterday, he finished his Q&A session by talking about the “Holy Trinity” of Academia, Government and the Private Sector. I see very little that is holy about this triad, especially if the Nolan principles are flouted. The Trinity I know is full of love and truth…..I wonder what the consequences of this clear ideology will have on the future of the NHS. I fear the answer is not in the public interest.

 

 

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The Future NHS and Care System – PCNs as Building Blocks

Tweet I recently wrote a blog about reimagining health and care in this apocalyptic moment. In this post, I want to put a bit more flesh on the bones of what that might actually look in the context of the NHS, here in the UK and particularly, England.   Let me just make a few [Continue Reading …]

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Reimagining Health and Care – An Apocalyptic Moment?

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Love Society – Part 1 – Prof Bev Skeggs

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The Rise of Antidepressants

Tweet The BBC ran a news piece today about the massive rise in use of antidepressants in England and Wales over the last 10 years. And depending on which study you believe between 1 in 11 and 1 in 6 people in England are now on an antidepressant (though we must remember, that antidepressants can [Continue Reading …]

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A Second Brexit Referendum Would be NO Failure of Democracy and is the Only Realistic Option Available

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Knife Attacks – Whose Crime Is It?

Tweet I find myself staring at the screen, unable to comprehend how utterly devastating it must be as a parent, to have a police officer knock on your door in the early hours of the morning, to be told that your darling child has been stabbed to death. My heart weeps for the senseless loss [Continue Reading …]

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The Black Swan Podcast

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Black Swans and Poverty

Tweet Here is a copy of the speech I recently gave at Morecambe Food Bank when Heidi Allen MP and Frank Field MP came to be with us and to listen to the community here in Morecambe Bay about our experiences of poverty. There were some incredibly moving testimonies from community commissioners of the poverty [Continue Reading …]

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