Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.
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COVID-19 guidance and policy
The government has updated its guidance on the use of personal protective equipment in relation to COVID-19, clarifying the list of aerosol generating procedures (AGPs) considered to be potentially infectious. The update comes following review by the committee of an evidence summary by Health Protection Scotland which set out to establish an evidence base for which AGPs should be considered to pose a high risk of infection transmission.
The Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice on the priority groups for COVID-19 vaccination, as part of the planning for deployment of any safe and effective vaccine. The committee considered health and social care workers to be the highest priority group, based on their increased exposure and the risks of their transmitting the virus to patients. The next priority for vaccination would be those at increased risk of serious disease and death from COVID-19 infection. The advice will be updated as more information becomes available.
COVID-19 related news
Following claims of its being withheld from publication in a recent report, Public Health England (PHE) have released a summary of stakeholder insights into the factors potentially influencing the disproportionate impact of COVID-19 on BAME communities. The publication summarises the views elicited from over 4,000 people, during a total of 17 hosted sessions, and make a series of requests for action and recommendations to tackle the issue. The Health Foundation response to the publication questions the absence of any recommendation on tackling entrenched discrimination, while the Chartered Society of Physiotherapists and the Royal College of Paediatrics and Child Health are amongst the professional bodies to have called for real change, noting the failure of previous reports and inquiries on racism to deliver it.
Researchers are set to being human trials of the COVAC1 coronavirus candidate vaccine, following the completion of pre-clinical safety tests and animal studies. The trial is seeking approximately 120 healthy volunteers for phase I, with results expected around the end of August. The first phase will evaluate three different doses of the vaccine for safety and the ability to induce an immune response.
The RECOVERY trial, which last week suspended investigation of hydroxychloroquine as a treatment for COVID-19, has reported positive findings from the arm examining use of the steroid dexamethasone. Amongst ventilated patients the steroid reduced the risk of dying by one-third, in patients receiving oxygen only the risk was reduced by one-fifth, while no benefit was found for patients not requiring respiratory intervention. Following announcement of the results, the government has approved this use of dexamethasone across the NHS, and is taking steps to ensure and protect UK supply of the steroid which is typically used to reduce inflammation.
Research published today suggests that socioeconomic or behavioural factors, cardiovascular disease risk, or vitamin D status do not wholly explain the higher rates of severe COVID-19 infections amongst BAME populations. The results confirm that BAME ethnicity, male sex, higher body mass index, greater material deprivation, and household overcrowding are independent risk factors for COVID-19, but suggest that more research is required to understand the complex relationship between COVID-19 and ethnicity.
The Royal College of Nursing (RCN) has set out eight priorities which they consider to be vital for the safety of health care staff and the public, as the resumption of services is planned for. The priorities include providing counselling and psychological support, ensuring full and proper risk assessments for staff, and tackling the underlying causes which have contributed to increased risks for BAME staff.
The Royal College of Physicians (RCP) has set out its key priorities for the resetting and rebuilding of NHS services. To ensure effective services, the priorities include introducing improved ways of integrated working, encouraging protected time for quality improvement and research, and supporting education and development for all staff.
A psychological first aid course developed by Public Health England with support from NHS England and Health Education England, is available to all NHS staff and volunteers. The course is accessible through Future Learn, and is intended to support staff and volunteers in providing psychological support to people affected by COVID-19. The course takes approximately 90 minutes to complete, and is offered in three sections.
The King’s Fund offers thoughts on what a resilient health and care system would look like, as part of the consideration of restarting and recovering services. Acknowledging the relevance of stockpiles, supply chains and hospital beds as factors contributing to a resilient system, the author argues for additional issues such as flexibility in the workforce, better integrated care, and capacity in community organisations to be accounted for when thinking about a resilient system.
The Nuffield Trust considers the extent of the reduction in emergency department attendances during the height of the COVID-19 pandemic, some of the factors which might have contributed to the reduced numbers, and whether some of these reductions might be sustained as lockdown measures continue to be eased. The 29% reduction of A&E visits in March and the 57% reduction in April stand in contrast to the average yearly increases of 2-5% during the last two decades, and while concerns that patients with serious health conditions may have been avoiding hospital are undoubtedly part of the cause, the complete picture is likely to be more complex.
A series of online events hosted by the Royal College of Nursing will attempt to start the conversation about the nature of race, racism, structural discrimination and inequality in the nursing profession. The first event took place today, and details of future events will be available on the RCN website and Twitter account. The events will be open to non-members. The organisation has also created a new online resource drawing together information, advice and resources on diversity and inclusion in nursing.
NHS England and NHS Improvement’s LGBTQ+ Staff Network has announced it will be holding an NHS Virtual Pride on Friday 26 June, the day before Global Pride 2020. As an alternative to the celebrations that would typically be taking place, Virtual Pride will take be hosted on Teams from 6pm. NHS organisations and individual staff are encouraged to participate; for more information, follow @VirtualNHSPride on Twitter. Use the #proudatstgeorges hashtag if you want to get involved, or to share stories or experiences more locally.
The Faculty of Sexual & Reproductive Health have published an update to their Service Standards for Consultations in Sexual and Reproductive Health. The revised guidance includes standards for online and remote consultations, additional standards supporting patients where English is a second language, and updated standards for confidentiality, amongst statements on other aspects of consultations.
Responding to the CQC announcement that it intends to resume some routine inspections this autumn, the Chief Executive of the NHS Confederation, Niall Dickson, has suggested that the current moment offers an opportunity for rethinking the inspection, regulation and governance of the health and care sectors. Acknowledging the important role of regulation, Dickson has called for lessons to be learnt from this period, “…before than jumping back into the old inspection regime.”
Medtech innovation briefing
QS161 Sepsis Updated
- Weekly all-cause mortality surveillance: 2019 to 2020
- Diagnostic imaging dataset for February 2020
- Deaths involving COVID-19 by local area and socioeconomic deprivation: May 2020
- Potential Coronavirus (COVID-19) symptoms reported through NHS Pathways and 111 online
- CCG Outcomes Indicator Set – June 2020
- Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatient and Accident and Emergency data April 2019 – March 2020 (M13)