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Dr Cathy Gardner’s statement, which she was unable to make to Devon Health Scrutiny yesterday because of technical difficulties

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040 (2)Here are the notes for the statement which Dr Cathy Gardner tried to make to yesterday’s Health & Adult Care Scrutiny Committee meeting. Due to problems with Microsoft Teams, she couldn’t be heard, and the statement was read out much later in the meeting. This lost much of its impact, although I and other committee members raised some of the issues.

Cathy has raised £46,000 towards £50,000 to get a judicial review of Government policy towards care homes – please help get her over the line!

(Photo – Cathy with her late father.)

Good morning, my name is Dr Cathy Gardner. I am speaking today because my father died of probable COVID-19 in an Oxfordshire care home

  • Here in Devon, we may have had a lower number of COVID-19 deaths than elsewhere, but it’s still a scandal that we had ANY deaths in care homes 
  • It’s a scandal that half of all recorded COVID-19 deaths in Devon have been in care homes
  • Some of these were people who were infected when patients were discharged from hospital, without any regard for the consequences. Around the country, some patients were discharged to care homes with proven COVID, others had not even been tested.
  • Did this Council act to protect residents rather than simply complying with government orders?  
  • How will the Council respond if it’s challenged by the relatives of those who died?
  • Outbreaks have continued to develop since new guidelines were published on April 15th , why is this?
  • Care homes should be relaxed, secure places – they shouldn’t be used for treatment and recuperation of people with highly infectious diseases.
  • It is not difficult to isolate care homes to protect residents. Regular testing of staff is essential, including agency workers.  Has this Council done all that it can to ensure that this is happening in Devon?
  • The NHS should provide separate ‘step-down’ care for people who need to be discharged from hospital: has the Council helped with this?
  • What is being done to ensure that care home residents are protected NOW and in the future so that no more COVID-19 infected people are moved into care homes? This virus is not going away anytime soon but we can protect the most vulnerable in our society if we want to.
  • Thank you

Devon is waiting: our health and social care system at the mercy of national incompetence – a report from Health Scrutiny

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image-4Exeter’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.

Three charts that show gradually rising risks of Covid-19, from 40 to 80+

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Three excellent charts in Prospect magazine, based on the largest study yet of patients in UK hospitals, show the ‘rocketing risk by age’ of death in a hospital setting. If the risk of death in care homes and at home had been included, the risk to the oldest groups would be much larger still.

Although the risks to the oldest are the most striking, the substantial increases in risk in all decades over 40 is worth remarking: 40-49 are 5x as likely to die as under-40s; 50-59 are 20x more likely; 60-69 are 30x; 70-79 are 50x.

However it’s worth looking at the reduced risks for people without serious underlying conditions: ‘only’ 14x greater than the under-40s for the 50-59 group, 20x for 60-69, and 30x for 70-79. The most serious risks from underlying conditions are shown at the bottom: diabetes, obesity, stroke, dementia, cancer, heart disease (asthma is also significant, but not shown).

Covid age risks3-12-1

Figures for local deaths from Covid-19 are finally revealed: Seaton and Axminster had the highest tolls in East Devon

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photo-1583324113626-70df0f4deaabThe Office for National Statistics has finally made local death tolls for Covid-19 available, summarised (if a little confusingly) in this article on East Devon WatchHere are the figures for the Axe Valley:

  • Seaton 10 (all but one in April)
  • Axminster 10 (half in April, half in May)
  • Beer 1
  • Colyton 1
  • Kilmington 1
  • Offwell 1

These are for deaths where Covid-19 was on the death certificate. Including all excess deaths (i.e. extra deaths above the level expected for the time of year), the totals are likely be larger.

Although figures for different locations of death are not given, it is known that most of the Seaton and Axminster deaths took place in care homes.

For comparison, there were 9 deaths in Exmouth, 6 in Sidmouth and 3 in Honiton, all of which are larger towns. Taking this into account, Axminster and Seaton have had considerably higher levels of recorded Covid-19 deaths.

Take back control?

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Peter Brookes in The Times

The South West’s rising R number – Devon’s director of public health says it ‘should be treated with caution’

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virginia-pearsonAs the R number (rate of reproduction for Covid-19) for the South West region is estimated to be around 1 (which means the epidemic is no longer declining), Dr Virginia Pearson, Devon’s director of public health, has issued a statement pointing out the region covers from the Scilly Isles to Bristol and beyond, and arguing that it should be ‘treated with caution’ as the evidence is still that the epidemic in Devon is at a low level.

East Devon Watch has also argued that the East Devon picture remains a low level of infection.

Clearly, however, the Government’s loosening of the locked down with mixed messaging is likely to be having an effect here, as well as nationally, in slowing the decline of the virus.

The fact that the track and trace system is not as developed as it should have been at this stage is also worrying. We should all continue to follow the guidelines and be very careful with social distancing.

Cathy Gardner, who lost her father, takes Government to court over care home deaths

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Sidmouth EDA councillor Dr Cathy Gardner, whose father died in a care home after a suspected Covid patient was brought into it, is launching a judicial review of Government, NHS and Public Health England policies over care homes in March.

Papers were delivered yesterday to the Secretary of State, Matt Hancock, and the heads of NHSE and PHE.  The case is being crowdfunded and needs to raise a minimum of £10,000. Please DONATE HERE and spread on social media!

The story is on Sky News and in the Daily Telegraph.

Paul Arnott, EDDC’s new leader, is making changes to how the Council is run

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The change which people voted for last May, when voters end the Conservative majority on EDDC, is finally being reflected in the administration. After a year in which a group of Independents tried to rule in unofficial alliance with the Tories, a new majority has formed including the East Devon Alliance, Liberal Democrats, Progressive Independents and Greens.

EDA leader, Paul Arnott (who represents Colytonpaul-arnott-image) is the council’s new leader and has made impressive changes to the way EDDC will be run: see this account in East Devon Watch.

Jack Rowland and Dan Ledger, two of Seaton’s councillors, are in the Cabinet. I wish the new administration all the best.

 

Meanwhile, in another important development for Seaton and Colyton, a new news web site, Seaton Nub News, has been launched. I have a regular column – the first one is here.

The Government and the NHS are STILL not doing everything they can to protect care home residents

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EWryPrkXQAAcUEoIt has been revealed that the Government rejected a PHE proposal on 28 April to “use NHS facilities and other temporary accommodation to quarantine and isolate residents before returning to their care home”.

So PHE was advocating part of what I have been suggesting since mid-April. But PHE doesn’t appear to have realised that it isn’t just residents who are returned, but ANY patients, including Covid-positive patients, who have been in a potentially Covid-infected hospital environment, who need temporary care until they return to their own homes.

Anyone doubt that hospitals are major centres of infection – Weston has been closed because of an outbreak among staff. If hospitals find this difficult to prevent, why are we pushing the task onto care homes?

Ministers told councils to “ensure that there is sufficient alternative accommodation as required to quarantine and isolate residents” – why isn’t Devon NHS using part-empty community hospitals, including Seaton and Axminster, for this purpose?

I was promised a written explanation of Devon CCG’s policy 11 days ago, but am still waiting.