Was the NHS overwhelmed last winter?

Nuffield Trust

Throughout the pandemic, politicians and other policy-makers have emphasised the need to protect the NHS from collapse or overwhelm but even before Covid-19, the health service struggled to stay above water given worsening capacity, staffing and demand issues, especially during the colder months. This briefing looks at what happened to urgent and emergency hospital care last winter, when another wave of the virus hit the country during a time when it would be stretched to its absolute limits even without a pandemic.

Public Health

Current Awareness

Vaccines and immunization for monkeypox: Interim guidance, 14 June 2022.
World Health Organization (WHO); 2022.
(This interim guidance, developed with the advice and support of the Strategic Advisory Group of Experts (SAGE) Ad-hoc Working Group on smallpox and monkeypox vaccines, provides the first WHO recommendations on vaccines and immunization for monkeypox.)

COVID-19 health information needs of older adults from ethnic minority groups in the UK: a qualitative study.
Paudyal P. BMJ Open 2022;12:e059844.
(The study highlights that health information interventions should recognise the intersection between multigenerational living, family structure, and the health and well-being of older adults, and should promote intergenerational discussion.)

Abortion statistics for England and Wales: 2021.
Office for Health Improvement & Disparities (OHID); 2022.
(Statistics and commentary on abortions carried out in 2021.)

The educational burden of disease: a cohort study Nordmo M, Kinge J, Reme B , Flato M et al, The Lancet; June 1 2022 (Students with health disorders might be at risk of disengaging from education, which can reinforce socioeconomic inequalities in health. This study aimed to evaluate the associations between 176 diseases and injuries and later school performance in Norwegian adolescents and to estimate the importance of each disorder using a novel measure for the educational burden of disease (EBoD)).

Public Health

Current Awareness

Bringing baby home: UK fathers in the first year after the birth Father Institute, June 2022

(This review of empirical evidence about UK fathers and fatherhood in the first postnatal year, explores who fathersare; what they do as caregivers, and what influences this; what impact they have (on children and mothers); and how services engage with them. The review finds that NHS systems are not set up to engage with, assess and support new fathers, despite clear evidence that there is a strong case for routine engagement with them in the perinatal period.)

Public attitudes towards institutions involved in tackling the Covid-19 pandemic King’s College London

(According to this international study of six countries three in four (74 per cent) people in the UK think the government is motivated by building or protecting its own reputation when it comes to Covid-19, while six in ten (61 per cent) believe it is motivated by making lots of money in relation to the pandemic. However, majorities in other nations share the same perceptions. These perceptions also extend, although to a lesser extent, to scientists involved in tackling coronavirus.)

Investigating factors associated with loneliness in adults in England National Centre for Social Research (NatCen)

(The DCMS commissioned the National Centre for Social Research (NatCen) to explore factors associated with loneliness in adults in England. The research investigated: the characteristics of those at risk of loneliness; whether the risk factors for loneliness have changed over time; whether any factors predict the alleviation of loneliness over the short term; and the relationship between loneliness and mental wellbeing.)

Make Every Contact Count (MECC) for Menopause training session The Royal Society for Public Health

(MECC for Menopause is aimed at front line health, social, wellbeing, care staff and volunteers, who have direct contact with women accessing services. It aims to raise awareness within the workplace as women often find it difficult to discuss menopause related health problems. This session is delivered by Health Education England and Royal Society for Public Health on Wednesday 13th July 2022.)

Volunteering in NHS Trusts

A new strategic vision

Source: The King’s Fund

The Covid-19 pandemic has highlighted the huge potential and contribution of volunteers and both the NHS Long Term Plan and the most recent workforce plan recognise and commit to maximising the value of volunteers in the NHS. There is now an opportunity for NHS trusts to consider the role of volunteers, develop a strategic approach to volunteering and identify how to move volunteering from an ‘added extra’ to making an integral contribution to the delivery of health care.

Their latest research draws on the current evidence, analysis of NHS trust volunteering and the experiences of trust volunteering services and is presented in two reports:

Public Health

Current Awareness Updates

Young Changemakers tackling mental health inequalities in racialised communities.
Centre for Mental Health; 2022.
https://www.centreformentalhealth.org.uk/publications/voice-change
[It is well documented that people from racialised communities face inequalities in mental health. Young Changemakers is a programme created by UK Youth, The Diana Award and Centre for Mental Health to equip young people with the tools to produce youth-led social action projects aimed at tackling these mental health inequalities. This is a three-year programme funded by the People’s Postcode Lottery and Comic Relief to support mental health in young people from racialised communities.]

Evaluating a community programme to promote young Black men’s mental health.
Centre for Mental Health; 2022.
https://www.centreformentalhealth.org.uk/publications/shifting-dial
[Young Black men are overrepresented in restrictive mental health settings, but are less likely to get early community-based mental health support. Shifting the Dial shares learning from a three-year project to promote the mental health and wellbeing of young Black men in Birmingham. The project built upon the findings from an earlier pilot, Up My Street. Shifting the Dial has worked with over 500 young Black men, offering peer support, mentoring, skills development and community events.]

The People and Nature Survey.
Natural England; 2022.
https://www.gov.uk/government/collections/people-and-nature-survey-for-england#full-publication-update-history
[The People and Nature Survey for England gathers evidence and trend data through an online survey relating to people’s enjoyment, access, understanding of and attitudes to the natural environment, and its contributions to wellbeing. 13 April 2022: New data for February 2022 added to monthly interim indicators data section. Also new data for year 2 quarter 2 (1st April 2020 – 30th September 2021) added to Adult Survey section.]

Daily Insight: Infection control calls heeded.
HSJ: Health Service Journal (Daily Insight) 2022;:7032315.
[NHS England has relaxed the isolation period for inpatients with covid-19 after the UK Health Security Agency changed its recommendations. Also: Although describing integrated care system ratings as a “bit of a distraction” in an interview with HSJ the CQC chief executive Ian Trenholm set out what systems could soon expect to see over the coming months. 20 April.]

The public’s experience of monitoring their blood pressure at home.
Healthwatch; 2022.
https://www.healthwatch.co.uk/report/2022-04-26/publics-experience-monitoring-their-blood-pressure-home
[People with high blood pressure are increasingly being asked to monitor their condition at home. The NHS programme ‘Blood Pressure @Home’ (BP@Home) enables people with high blood pressure to measure and share their blood pressure readings with their GP from home. This report evaluates that programme to see how it is working for patients and how GPs use their readings, and suggests steps the NHS can take to improve support and outcomes for people who monitor their blood pressure from home.]

Adult tier 2 weight management services provisional data for quarters 1 to 3, 2021 to 2022 (experimental statistics).
Office for Health Improvement & Disparities (OHID); 2022.
https://www.gov.uk/government/statistics/adult-tier-2-weight-management-services-provisional-data-for-quarters-1-to-3-2021-to-2022-experimental-statistics
[Provisional data from the adult tier 2 behavioural weight management services data collection from quarter 1 and 3 of the 2021 to 2022 financial year.]

Public Health

Current Awareness Updates

Reducing the spread of respiratory infections, including COVID-19, in the workplace UK Health Security Agency; April 14 2022

(Public health principles for reducing the spread of respiratory infections, including COVID-19, in the workplace.)

Out of Area Placements in Mental Health Services, January 2022 NHS Digital; April 14 2022

(Publication of adult acute mental health patients being treated outside their provider of usual treatment in January 2022. Statistics are presented nationally and at regional, sustainability and transformation partnership (STP) footprint, clinical commissioning group (CCG) and provider level.)

Mental Health Services Monthly Statistics , Performance January, Provisional February 2022 NHS Digital; April 14 2022

(This publication provides the most timely statistics available relating to NHS funded secondary mental health, learning disabilities and autism services in England. This information will be of use to people needing access to information quickly for operational decision making and other purposes. These statistics are derived from submissions made using version 4.1 of the Mental Health Services Dataset (MHSDS))

Thunderstorm asthma and public health – looking back to move forward UK Health Security Agency; March 18 2022

(In June 2021, the UK Health Security Agency detected a potential episode of
thunderstorm asthma; an increase in people reporting asthma symptoms linked to thunderstorm activity. In this blog post they look at the interplay between the weather and our health and how they can use their scientific surveillance systems to inform future public health responses.)

Integrated health and care services for people experiencing homelessness NICE Talks

(In this episode of NICE Talks they discuss NICE’s recently published guideline on integrated health and social care services for people experiencing homelessness.

The guideline was developed in partnership with the Centre for Homelessness Impact and the Office for Health Improvement and Disparities. The guideline outlines how people experiencing homelessness can access services tailored for their needs. It highlights that more effort and targeted approaches are often needed to ensure that people experiencing homelessness have access to the same standard of health and social care as the general population.)

Covid 19

Current awareness updates

Developing the nursing research agenda during the COVID-19 pandemic.
Froilan P. British Journal of Nursing 2022;31(5):294-295.
[The COVID-19 pandemic has highlighted the indispensable role of nurses in providing professional care and technical help to patients and their families. However, nursing science’s contribution to the body of knowledge in COVID-19 management, from its unique perspective, is not fully reflected in the existing literature. A preliminary review of studies noted that nursing seems to be subsumed into the knowledge of other disciplines.

Coronavirus Act report: March 2022.
Department of Health and Social Care (DHSC); 2022.
[The twelfth two-monthly report on which powers in the Coronavirus Act 2020 are currently active.]

Covid 19

Current awareness updates

Student Space: An evaluation of a web-based intervention supporting student mental wellbeing over the pandemic.
Centre for Mental Health; 2022.
[This report is based on Centre for Mental Health’s independent evaluation of Student Space, which was launched by Student Minds in August 2020 to support the mental wellbeing of students during the pandemic. The report finds that the platform was a valuable extra resource for students’ mental health, and offered a high quality, rapid response to a crisis when it was set up in 2020.]

Understanding local patterns of volunteer activity during COVID-19.
The Young Foundation; 2021.
[This research, commissioned by the Department for Digital, Culture, Media and Sport, seeks to improve understanding of the ways in which volunteers were mobilised at local authority levels in England during the Covid-19 pandemic, with the overarching aim to support future policy development on volunteering. The findings reflect the experiences of community organisations, local authorities and funding bodies, among others, during the spring and summer of 2020.]

Covid 19

Current awareness updates

COVID-19 rapid guideline: managing COVID-19.
National Institute for Health and Care Excellence (NICE); 2022.
[This guideline covers the management of COVID-19 for children, young people and adults in all care settings. In February 2022, NICE added recommendations on molnupiravir and remdesivir for people with COVID-19 who do not need supplemental oxygen.]

A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field.[Abstract]
Linardon J. International Journal of Eating Disorders 2022;55(1):3-38.
[Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations, and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective.]

Growing problems: What has been the impact of Covid-19 on health care for children and young people in England?
Quality Watch; 2022.
[This analysis from QualityWatch (a Nuffield Trust and Health Foundation programme) shows that the pandemic has led to an unprecedented increase in demand for mental health services for children and young people. Despite children and young people being 10 times less likely to be hospitalised with Covid, the period has had a heavy toll on them. The briefing explains the findings and discusses the potential implications for the younger generation.]

Beyond recovery: the case for transforming UK clinical cancer research.
Cancer Research UK (CRUK); 2022.
[This position paper finds that Covid-19 has worsened pre-existing barriers to clinical cancer research, and recovering to a pre-pandemic ‘normal’ for research won’t be enough to deliver world-class cancer outcomes. Instead, the UK government must choose to go beyond recovery by expanding clinical research capacity, transforming how research is delivered, and supporting innovative cancer research.]

Living with Covid-19.
House of Commons Library; 2022.
[This page provides an overview of the Government’s strategy on Living with Covid-19 and a summary of the relevant policy changes.]

Social care reform: an independent review by Baroness Cavendish.
Department of Health and Social Care (DHSC); 2022.
[A report looking at how the government can lock in the lessons of the COVID-19 pandemic to build a more robust, sustainable and joined-up system of social care.]

The rollout of the COVID-19 vaccination programme in England.
National Audit Office (NAO); 2022.
[According to this report, the Covid-19 vaccination programme met stretching and unprecedented targets, helping to save lives and reduce serious illness and hospitalisation. However, it concludes that there are risks to be managed as the programme continues to evolve in response to the Covid-19 pandemic and to new clinical advice and evidence about vaccines. The report concludes that the programme has provided value for money to date.]

Coronavirus (COVID-19) vaccination uptake in school pupils, England: up to 9 January 2022.
Office for National Statistics (ONS); 2022.
[Figures on vaccine uptake in school pupils aged 12 to 17 attending state funded schools, broken down by demographic and geographic characteristics, using a linked schools and vaccinations dataset, up to 9 January 2022 (experimental statistics).]

The response of the scientific community to a global crisis: a systematic review of COVID-19 research in 2020.
Srivastava PR. British Journal of Healthcare Management 2022;28(2):1-7.
[This article provides a bibliometric analysis of the direction of research relating to COVID-19 during the first year after the virus was first identified as a potential threat to public health.]

Covid 19

Current awareness updates

JCVI update on advice for COVID-19 vaccination of children aged 5 to 11.
Department of Health and Social Care (DHSC); 2022.
[JCVI advises a non-urgent offer of two 10 mcg doses of the Pfizer-BioNTech COVID-19 vaccine (Comirnaty®) to children aged 5 to 11 years of age who are not in a clinical risk group. The intention of this offer is to increase the immunity of vaccinated individuals against severe COVID-19 in advance of a potential future wave of COVID-19. Published 16 February 2022]

Growing problems, in depth: The impact of Covid-19 on health care for children and young people in England.
Quality Watch; 2022.
[“…The sharp increase in children and young people with mental health problems is a serious concern. Services are facing unprecedented levels of demand, and young people are waiting longer to receive mental health care. In particular, there has been a surge in eating disorder cases, and conditions are deteriorating to the extent that a greater number of children and young people are attending A&E departments…”]

Social care reform: an independent review by Baroness Cavendish.
Department of Health and Social Care (DHSC); 2022.
[A report looking at how the government can lock in the lessons of the COVID-19 pandemic to build a more robust, sustainable and joined-up system of social care.]