Seven days in medicine: 27 January to 2 FebruaryBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n301 (Published 04 February 2021) Cite this as: BMJ 2021;372:n301
All care home residents in England offered vaccine
The SARS-CoV-2 vaccine has been offered to 10 000 residents at every eligible care home in England for elderly people, the NHS said this week. A small number of care homes have had their visits deferred by local directors of public health for safety reasons during a local outbreak and will be visited as soon as staff are allowed to do so, officials said. Vaccination staff are also returning to care homes to vaccinate any resident who was unable to have it during the previous visit.
People with learning disabilities “left behind”
Younger people with a learning disability in care homes or other social care settings are being left behind in the vaccination programme, the charity Mencap warned. Edel Harris, chief executive of Mencap, said, “People with a learning disability have died from covid at over six times the rate of the general population, yet not all people with a learning disability who receive care are currently on the vaccine priority list. The government must urgently give all people with a learning disability priority access to the vaccine—it will save lives.”
Vaccination does not require NHS number
The BMA has asked NHS England to ensure that all staff involved in vaccinating know “loudly and clearly” that healthcare workers, regardless of where they’re from, have a right to have the vaccine and “can be protected against covid-19 urgently.” NHS England confirmed that having an NHS number was not a requirement for staff or patients to receive a vaccine, after reports that some migrant workers were denied it on this basis. The BMA described the accounts as “extremely disturbing.”
Ethnicity data are published
Of 6 232 584 doses of the vaccine administered in England up to 24 January, 82% were to people who identified as white, 8% to those from ethnic minority backgrounds, and 10% to people whose ethnicity was not known or stated, showed figures on ethnicity from NHS England published for the first time. Reports that ethnicity of vaccine recipients was not being recorded led to concerns that this would hamper efforts to ensure good uptake in different ethnic groups and to counter misinformation about uptake.
Delay to reform is “far from reassuring”
The chair of the House of Lords Economic Affairs Committee rebuked the government’s promise to bring forward proposals “later this year” about how to reorganise social care in England. A report from the committee in July 2019 called for an extra £8bn a year to tackle the “national scandal” of underfunding in the sector. Committee chair Michael Forsyth said a government pledge to bring forward proposals later this year “is not really reassuring, given the urgency and the strength of feeling shown in this debate.” (Full story doi:10.1136/bmj.n289)
Ethnic minority health
Study reveals wide health disparity in England
Some people from ethnic minorities seem to have much poorer health than white people—which can be equivalent to being 20 years older than their actual age—a large observational study published in Lancet Public Health found. Lead author Ruth Watkinson, from the University of Manchester, said, “We need decisive policy action to improve equity of socioeconomic opportunity and transformation of health and local services to ensure they meet the needs of all people in the multi-ethnic English population.” (Full story doi:10.1136/bmj.n285)
Ethnic minority doctors feel unsafe at work
Just a quarter (28%) of doctors from black, Asian, and other ethnic minority backgrounds told a BMA survey that they felt fully protected from the risk of SARS-CoV-2 infection in their workplace, while 72% said they felt only partly or not protected at all. In comparison, 60% of white respondents said they felt fully protected. A third (29%) of ethnic minority doctors said that they had not been risk assessed for the virus or that assessment needed updating. Chaand Nagpaul, BMA chair of council, said, “We should not have a situation in this country where health and social care workers—BAME or otherwise—are feeling unsafe or at risk from death or disease in their workplace.”
Trust pays £7m in baby brain damage case
The NHS agreed to pay more than £7m in a settlement out of court for failing to properly treat a newborn baby’s eye infection, leaving him with permanent brain damage. The settlement, approved by the High Court, was disclosed on the legal information website Lexology by the boy’s solicitor, Jon Nicholson of the London law firm Anthony Gold. The NHS trust involved is not identified, and the boy, who is now an adult, has an anonymity order protecting his identity. (Full story doi:10.1136/bmj.n257)
Palliative and end-of-life care
Call for system reform as pandemic accelerates demand
Researchers from the charity Cicely Saunders International made an urgent call for changes to the UK’s palliative care system. More than half a million people in England and Wales were predicted to need palliative or end-of-life care by 2040, but this level of demand will have been reached in 2020, the charity said. It said that too many people who had life limiting illnesses or were approaching death were spending unnecessarily long periods in hospital without being offered alternatives, when most would prefer to die at home. (Full story doi:10.1136/bmj.n247)
New care tool is launched to help doctors
The Royal College of Physicians and the Society of Acute Medicine launched a new support tool to help hospital doctors improve the care and choices they provide to people at the end of their life. It aims to help doctors identify patients in their last days or weeks of life and ensure that patients’ choices are heard and supported. It includes guidance on starting the often difficult conversation with patients and their families or carers about care at the end of life, the role of advance care planning and specialist palliative care, and advice on clinical management and anticipatory prescribing.
Science and medicine most respected professions
Scientists came top of a list of professions that adults would be happy for their child to pursue, closely followed by doctors, found a YouGov survey of more than 22 000 people in 16 countries.1 Among the British respondents, four fifths (82%) backed a career as a scientist for their child and 80% supported a medical career. Architects, lawyers, and nurses were the next most respected professionals.
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