22 June 2023

With the COVID inquiry very much in the news at the moment I have been reflecting on the legacy of the pandemic. It is of course a very recent event and health services are still seeing the consequences, however in some respects it also feels like ancient history with new pressures and crises to handle. A proportion of our patients though remain at risk and a significant number have struggled to shed the anxiety and narrowing of their lives that accompanied the arrival of COVID 19. There will no doubt be much to learn from the inquiry.

Personally, I lost trust in our political leadership, perhaps naively I had always assumed that the individuals in high office would be considered in their approach and listen to trusted advisors. It has become clear that this was not always the case. I will also recall what happens in healthcare when clinical teams are unleashed to collaborate, plan and execute rapid change in an environment where the many frustrating barriers we contend with have fallen away and the organisations that employ us facilitate rather than obstruct. Other key issues were the strengthening of team bonds in adversity. As I think about such topics it occurs to me that many of the lessons so apparent at the time have been rapidly unlearnt: For example, how far have we progressed in dealing with race and class disparities in healthcare and outcomes? How has the importance of staff well-being been taken forward? Have we reversed the trend of disinformation and misinformation that contributed to vaccine hesitancy and COVID denial?

Avoiding my tendency to accentuate the negative, there were of course positives; the Recovery trial, rapid vaccine approval and rollout, the admirable manner with which UK haematologists raised the alarm about VITT, conducted research and delivered a consensus approach. But overall I suspect we may not have learnt as much as we could.

I see the DHSC has committed to investing £121 million to speed up clinic trial set up, a measure we will no doubt all celebrate bearing in mind the declining entry into haematology clinical trials. (Read the DHSC blog here).

As many hospitals and patient groups celebrated World Sickle Cell Day last week, NHSE announced the development of 24hr Hyperacute Sickle Cell Units across England. Loosely based on the concept employed for stroke care this will allow ease of access to rapid pain control and expert care. But will it though? If I have learnt anything then it’s that patients prefer local care wherever possible.  Although I would always welcome additional investment for this neglected group there are a few factors, which to my mind, suggest this scheme may not achieve its desired aim. How would such a service operate outside patient population dense areas in London or Birmingham? Patients with sickle cell disease are now widely dispersed across the country and there is a risk that new inequalities of access are introduced, across the UK ambulance services are struggling with emergency response times with no clear solution to the problem so will an arrangement which depletes local care hinder or help? It would seem better to invest appropriately in the underfunded structures we have already established. This is of course a personal view and if I’m wrong and the plan is a roaring success I will apologise, eat my hat or indeed any other suitable item of clothing.

I’m pleased to report that within a contentious Kings Honours list there were at least two that no one would object to. On behalf of BSH I’d like to take the opportunity to congratulate Dr Farrukh Shah who received an MBE for services to Sickle Cell and Thalassaemia and Professor John Pasi who was awarded an MBE for services to the NHS.

I had the pleasure of sitting in a BSH  “meet the expert” session with Professor Paul Moss at the ASM in 2022. It’s not often you get the opportunity to interact directly with world-leading scientists and Paul has the ability to communicate complex issues in an accessible manner. Paul received an OBE last year for services to immunotherapy and COVID research, he led and coordinated a national programme which contributed much to our knowledge and saved many lives. Paul has recently been appointed as Chair of the Medical Research Foundation where he will doubtless make a significant impact.

Finally, there is still time to consider applying for the post of BSH Research Fellow in Haematology Workforce Modelling. The closing date is July 2nd For more information and to apply for the role click here