1/13 Possible Government will announce approach on mandatory NHS staff vaccination this week. Consultation has now closed. A complex issue. Tweet thread follows, based on conversations with, and intelligence from, trust leaders. There are differing views in trust sector…
2/13 Our intelligence suggests c2/3 of senior trust leaders - hospitals, mental health, community & ambulance - favour mandation & 1/3 don't. Everyone agrees there are two risks to manage here, not one. Not just the risk of covid/flu cross infection from unvaccinated NHS staff….
3/13 …It’s also about managing the risk of losing unvaccinated staff when the NHS is at full stretch and carrying 93,000 vacancies. The issues currently facing social care providers illustrate the very significant scale of risk to care / patient safety if we get this wrong.
4/13 Trusts have worked incredibly hard over last few months to encourage staff take up of covid and, more recently, flu vaccination. On covid-19 jabs it’s gratifying these efforts have led to significantly higher take up rates across NHS staff vs population as a whole but…
5/13 …We know that there are still a number of staff who have yet to take up vaccinations, despite a lot of encouragement and support. There are some groups – for example women thinking of having children and staff from black communities - where take up rates are lower.
6/13 We recognise that, if Government does mandate vaccination, the messaging will need to be clear and unequivocal. That NHS staff must get vaccinated to protect patients and colleagues and that experts are clear it is safe to do so. But four other things are needed….
7/13 A. Government needs to explicitly acknowledge the risk to patient care and safety from the NHS losing unvaccinated frontline staff and publicly say they’ll do all they can to work with the NHS to manage this risk. Trust leaders want to hear Government understands this risk.
8/13 B. The Government needs to explicitly commit to working closely with trust leaders to maximise voluntary take up before any mandatory vaccination deadline is reached. With a particular emphasis on reaching staff groups with lowest current vaccination take up.
9/13 C. Government needs to get timing right. We need to maximise time available to drive voluntary take-up. Working on the basis that setting a clear deadline could, if used carefully and well, provide a new helpful spur for further conversations with those not yet vaccinated…
10/13 …We also need to avoid setting the mandatory deadline during winter months when NHS is at its most stretched. And when we cannot afford to lose staff. And when there is less time for complex, difficult, conversations on the consequences for staff of not being vaccinated.
11/13 …The Government announced in mid June that it was mandating covid vaccination for social care staff with a deadline of mid November. For reasons above, trust leaders want at least as long as this for any new NHS mandation deadline, ideally to April 2022.
12/13 D. The overall tone and approach must avoid scapegoating or denigrating those who are not currently vaccinated. Trust leaders are clear that progress up to now with vaccine hesitant staff has been based on encouragement and explanation, not coercion and control.
13/13 I'm currently due to be interviewed on these issues on @BBCBreakfast at 0710.

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More from @ChrisCEOHopson

2 Nov
1/14 Brilliant visit to @SurreyDownsHC, part of @SurreyHeartland ICS today. Very impressed with the excellent progress they have made in actually integrating services on the ground, delivering better care and improving outcomes. Thread below with what particularly impressed me.
2/14 Impressed with the way that the @SurreyDownsHC’s vision for integration starts with concrete action to improve services. Of course governance, finances and structures are important. But they start with a data driven understanding of the needs of their population…
3/14 …And they then put the relevant professionals together to work out how they can improve the relevant service or pathway. Strong emphasis on enabling right collaborative relationships between different people from different disciplines and organisation to drive improvement.
Read 14 tweets
1 Nov
1/5 Thanks for everyone's responses to my thread / your contributions to this important debate. They show how complex this issue is and how there are strong views here, understandably. Three quick thoughts in response to some of the comments that have been made.
2/5 A. The patient perspective is, of course, vital. There will be many patients who will feel very strongly that they have a right to be treated by staff who have been vaccinated. Equally, there are some staff who feel very strongly it is their right not to be vaccinated...
3/5 ...One of the complexities here is that there is a potential conflict between people who believe, equally strongly, that their fundamental rights are at stake and should not be breached. B. Thinking further about the patient perspective and the NHS looking after patients...
Read 5 tweets
2 Sep
1/19 Media reports suggest Govt now finalising health & care part of spending review and we're heading for a potential £5 billion NHS funding gap next year. We've issued a new report today with @NHSConfed showing why frontline NHS needs £10bn extra next year. New thread follows.
2/19 Bit of background context first. The NHS budget for five years, including next year and the year after, was set in June 2018, before covid. Over the last two years the Government has suspended those plans and given the NHS the extra money it needed to deal with covid…
3/19 ...Last year NHS received £18bn extra on top of original plan. In 1st half of this year NHS received an extra £7bn with more to come for 2nd half of year. According to Monday's Times (thetimes.co.uk/article/nhs-bo…) Govt now wants to return to pre-covid budget plan next year...
Read 19 tweets
12 Aug
1/10 Important new joint report with @AACE_org on ambulance services released today.

Report: nhsproviders.org/media/691897/r…

Blog by @daren_mochrie & me here: hsj.co.uk/quality-and-pe…

News story by ever wonderful @AliJaneMoore here: hsj.co.uk/service-design…

Quick ( 🤣) thread follows.
2/10 It’s a very good time to talk about ambulance services given the unprecedented pressure they have been under for the last two months. This is a clear warning sign that we have to address the underlying demand / capacity mismatch ambulance services face. Risks increasing..
3/10 ...Growing risk of ambulance staff burnout given constant pressure. And growing risk of harm to patients because, despite best efforts of frontline staff, demand/capacity mismatch means ambulance services can't always provide quality/speed of care they want & need to.
Read 10 tweets
11 Aug
1/12 NHS monthly stats due out tomorrow. Although the number of covid hospital cases is significantly lower than many were predicting/fearing, the NHS is still under huge pressure due to a combination of six factors. Stats will show this tomorrow. Shorter thread (🤣) follows!
2/12 Particularly important to understand that every part of NHS is under pressure. Hospitals, ambulance, community & mental health services and general practice / primary care. Many CEOs saying that although the shape of the pressure is different, it feels as busy as Jan/Feb…
3/12 …Striking that some CEOs are saying that their trust is under the highest pressure they have ever known. Don’t measure overall NHS pressure by looking at covid-19 caseload. Vital to look at all demand and capacity pressures, particularly the latter at the moment.
Read 12 tweets
8 Aug
1/23 Health and care funding now centre stage as Govt sets 2nd half 2021/22 & longer term Spending Review settlements. Great article by @michaelsavage & @denis_campbell here: theguardian.com/society/2021/a…. My accompanying comment piece here: theguardian.com/society/2021/a…. Thread follows.
2/23 Health & care budget central to spending review, given the size of spend, so strong case to settle early. NHS budget for second half of 2021/22 must be set by end September. Increasingly likely this could be a single NHS money discussion, concluded relatively rapidly.
3/23 Decisions made here, over next two months, likely to set health and care funding for next three years. They will impact the health of our nation for a generation. So they’re very important to get right. They could also have a significant impact on the next General Election!
Read 23 tweets

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