We have seen varying estimates of the case fatality rate from Covid-19 (Coronavirus) infection. The case fatality rate is the percentage (or proportion) of patients with a disease who die. We should be cautious about accepting the estimates that have been published in medical journals as valid because many people will have undiagnosed infections. This is particularly likely in children, who often have mild symptoms (or no symptoms) when they contract a viral infection. Hence, the reported case fatality rates we have seen published in medical journals will overestimate the true death rate. As testing for Covd-19 infection becomes more widespread, we will get better estimates of the true infection rate in the population from the virus, and hence better estimates of the complication rate and death rate from the illness. In England, the new testing programme in people with respiratory tract infections announced by Public Health England will provide some of ths information.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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