1/6 There has been an ongoing debate on the degree to which hospital discharges were responsible for the high mortality rates in care homes in the first phase of covid-19. This paper, considered by SAGE on 25 Sept, provides important new evidence: assets.publishing.service.gov.uk/government/upl…
2/6 It says that retrospective genomic analysis and serpositive studies found evidence for multiple routes into care homes. Staff, visitors, visiting professionals, hospital discharges, new admissions and persistent infections may have all contributed to introduction of covid-19.
3/6 However, and here is the key para (para 4.3 in the document): Weight of evidence is stronger in some areas than others. Evidence of staff to staff transmission has emerged in the genomic analysis (high confidence)......
4/6 .....Weak evidence on hospital discharge and modelling the impact of visitors does not suggest a dominant causal link to outbreaks from these sources.
5/6 @NHSProviders argued from mid May, as soon as the first such suggestions were made, that NHS hospital discharges were not the main cause of excess mortality in care homes (see here for example: nhsproviders.org/media/689548/s…).
6/6 We therefore feels vindicated in the argument we made / stance we took. It would be good to see greater public acknowledgement and media coverage of this important document. (Particularly from those who argued that we were wrong!)
Sorry, that should read 24 not 25 Sept.

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More from @ChrisCEOHopson

12 Oct
1/14 Important new blog for @timesredbox on why the NHS needs the Government and local authorities to now move quickly and decisively to create tougher local lockdowns wherever required:
thetimes.co.uk/article/hospit…
2/14 Increasing numbers of coronavirus cases have translated into rapidly rising hospital admissions, especially in NE, NW and Yorks. For a few trusts, the number of COVID-19 hospital patients is now at the same level they had reached at the height of the first phase.
3/14 Trust leaders clear about lessons from the first phase of COVID-19. The virus strikes at very different rates in different localities, so appropriate local responses are needed. The only way to control the spread of COVID-19 is by reducing social contact.
Read 15 tweets
16 Sep
1/14 NHS financial allocations for second half of the year released overnight. Thread of initial thoughts below. Probably of most interest to those steeped in, and fans of, the delights of NHS finances. But some potentially big issues depending on how this plays out.....
2/14 NHS frontline been waiting for allocations for some time, so good that they have finally arrived. There is a lot of complexity here. These allocations have been made at system level for the first time and they also include some detailed calculations on individual items.
3/14 Four specific areas of concern that we expect trusts to raise. First, some ambitious assumptions about recovering non-NHS income that will be a significant issue for a number of trusts who are a long way off from seeing their non NHS income return to pre-COVID levels.
Read 14 tweets
15 Sep
1/14 Widespread media pick up this morning of our press comment on trust leaders' concerns that current test shortages are impacting negatively on NHS staff and patients. Press comment can be found here: nhsproviders.org/news-blogs/new…. Thread follows.
3/14 Trusts are concerned that current test shortages mean NHS staff are having to self isolate because they, and their family members, who need a test, can't access one. Worries this will affect vital service delivery, service recovery and winter preparations.
Read 14 tweets
16 Aug
1/11 @NHSProviders response to reports on future of PHE. Quick thread summarising the argument below - we all need to learn lessons from covid-19 in a spirit of learning, not blame apportionment. Government included. Much that we can do better, together, in public health. ImageImage
2/11 Five obvious issues on public health that NHS trust leaders think COVID-19 has highlighted. We look forward to seeing whether the Government's plans for the future of @PHE_uk reflect these lessons.
3/11 Lesson 1: Years of underfunding for Public Health England, and public health more widely, resulted in UK not being properly prepared to tackle pandemic like COVID-19. E.G. local authority public health grant has been cut by 25% in real terms over the last five years.
Read 12 tweets
12 Aug
1/12 Trust leaders frustrated and disappointed to see the service they have been providing over the last few months described, and widely reported, last week as "covid only". It's untrue, unfair and potentially dangerous. My new blog here: nhsproviders.org/news-blogs/blo…. Thread follows.
2/12 Even at the height of coronavirus, for every one COVID-19 patient in hospital, there were two non-COVID inpatients being treated for other conditions. More than three million urgent tests and checks were provided over the pandemic and 3.6 million people were treated in A&E.
3/12 NHS has continued to deliver, on average, 1,800 babies a day every day since the pandemic started. Although cancer referrals did drop, 65,000 patients started treatment for cancer during the pandemic. Yes, 14% fewer than same three months last year. But hardly covid-only.
Read 12 tweets
30 Jun
1/17 Today, we're launching results of first major survey of NHS trust leaders since covid-19 started. The report - "Recovery Position, What Next for the NHS" looks at challenges facing NHS to treat covid 19 patients and restart services. Report here: nhsproviders.org/media/689775/r…
2/17 You can find the press release (good summary) of our new report on the challenges facing the NHS as it restarts services here: nhsproviders.org/news-blogs/new…. Linked blog can be found here: nhsproviders.org/news-blogs/blo….
3/17 Four key messages from first member survey post covid-19: lot more patients now needing treatment; trusts losing lot of capacity due to covid-19 (up to 40%); trusts going as fast as they can to restart services; but it will take some time to resume full range of services.
Read 18 tweets

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