Devon is waiting: our health and social care system at the mercy of national incompetence – a report from Health Scrutiny
Exeter’s Nightingale Hospital – still on track for completion.
I attended (virtually) Devon’s Health and Adult Care Scrutiny Committee yesterday, the first meeting since the pandemic began.
The overall picture: things moving too slowly (which has cost lives), mainly because at every stage the local situation has been dependent on the deeply flawed national response.
Here are my key takeaways (and some of my inputs):
- Devon’s overall death toll is lower than the national average – but we still have had more deaths in Devon than they’ve had in Australia and New Zealand combined.
- The care home death toll (half of all deaths) is less would be expected given the community infections. This suggests that the County Council’s big operation to support care homes may have helped. But in March, Devon NHS still followed the infamous national directive to discharge hospital patients into care homes without testing. It is likely that this helped cause some outbreaks.
- Only when I pressed was there any acknowledgement of possible failings in the early part of the pandemic. Due to technical problems, the committee failed to hear Dr Cathy Gardner’s contribution about care homes in the public consultation session, although it was read out late in the meeting. I have published it here.
- Devon leaders have been arguing with other local government leaders for more local management of the crisis (as I and others were arguing in April) and this has influenced Government policy for the next phase of the pandemic.
- Although Devon is a ‘beacon council’ for the new tracing system which was supposed to be running by June 1st, we are still waiting for it to kick in. It sounds more likely to be August than July before it is fully functional.
- So although we now have very few cases of Covid-19 in Devon, and are at the stage where (in theory) we could effectively track, trace and isolate any new cases, we can’t actually do that – we are in limbo … .
- The big takeaway of the pandemic for the CCG is the advantages of e-consultations with both GPs and hospital consultants. While recognising that they can indeed help all concerned, I questioned (in the light of complaints made by constituents) whether they might not also exclude some people, and said research was needed on how they affected access to services. I worry that the shift to e-consultation might have contributed to the drop in demand for urgent non-Covid services, which may cause people to miss out on crucial treatments.
- I pressed on the need to separate care homes from clinical provision, and for regular testing of people coming into care homes, as well as staff and residents, to enable family visits to resume. I was assured that work on these issues is in progress … but yet again it depends considerably on national guidelines.
- It is recognised that the provision of services (and the Devon NHS Local Plan) will need to be revised in the light of the pandemic experience and post-pandemic challenges. There was a lot of emphasis in the papers on doing things locally … we didn’t get to discuss this, but this will be a big issue over the coming months.