One Flu over the Cuckoos Nest. Boris and Matts’ economy with the actualite. NHS Spin running on Lean #Covidstroika #WhathappenedtoFlu Where did all the beds go?

PArt of the Just in time Lean delivery model of the NHS is to foster efficiency and also to focus on prevention and averting demand all laudable goals.
The Lockdown and Mask narratives sit uneasily though, with the data which sees the NHS in seasonal crises and high occupancy levels on a regular basis. All of this against a backdrop of a precipitous fall in Acute and General hospital bed spaces over the past 10 years.

The other noticeable aim of the Managed demand Customer pull model is to encourage vaccinations and also digital interaction. Such measure whilst every technocrats idea of common sense efficiency do not sit well where they are Mandated, Compulsory or the subject of coercion. The degree of Coercion evident in the Narratives from Mr Johnson’s Government’s handling of the Epidemic do seem more sensibly explained by the notion of not letting a good crisis going to waste. Sneaking in a health cuckoo in the democratic freedoms nest as it were.

One final observation is the apparent disappearance of Flu and pneumonia at what would be the usual expected average seasonal levels the Data for those can be found in the general Sheets spreadsheet I have put together with the relevant figures as I have extracted them to make this simple case which is an indictment of a failure in the planning to provide for Black Swan events and not even a regular flu season as there was in 2019.
The NOMI site provided the flu figures below based upon the answer to this freedom of information request.

Number of people who died from seasonal flu January to June 2019:
All our mortality data comes from the information collected at death registration. All of the conditions mentioned on the death certificate are coded using the International Classification of Diseases, Tenth Revision (ICD-10). From all of these causes an underlying cause of death is selected using ICD-10 coding rules. The underlying cause of death is defined by WHO as:

a) the disease or injury that initiated the train of events directly leading to death, or

b) the circumstances of the accident or violence that produced the fatal injury

In the ICD-10 revision, Influenza is coded J09-J11.

Please see the following link to our explorable data webservice: NOMIS webservice. Annual influenza figures can be extracted using the query builder function. Please note, that ICD-10 Codes J09-J11 will need to be selected to produce influenza deaths. Please see the following instructions for this service:

Select the geography (England and Wales, regional or by local authority).

Select Age – All ages or 5 year age bands.

Select Gender – Total or Male/Female

Select rates – All deaths, rates or percentage of population for example.

Select cause of death (ICD10 code search is available).

Select format (Excel or CSV for example)

This will provide you with a dataset showing the number of deaths from influenza in 2019.

Please also see the following dataset: Deaths registered in England and Wales. Table 8 of this publication categorises deaths by cause, which includes ‘Diseases of the respiratory system’. However, this includes ICD-10 codes J00-J99, and therefore does not show the number of deaths just from influenza.

This one beats around the bush somewhat and the NOMI data and Deaths and bed occupancy comparisons in the charts below provide the Context of the Charge I am making about Johnson and Hancocks spinning of the situation in the interests of saving their own political bacon!

1.11. To support this new way of working we will agree significant changes to the
GP Quality and Outcomes Framework (QOF). This will include a new Quality Improvement
(QI) element, which is being developed jointly by the Royal College of GPs, NICE and the
Health Foundation. The least effective indicators will be retired, and the revised QOF will also
support more personalised care. In 2019 we will also undertake a fundamental review of GP
vaccinations and immunisation standards, funding, and procurement. This will support the
goal of improving immunisation coverage, using local coordinators to target variation and
improve groups and areas with low vaccines uptake.

2.26. To support local planning and ensure national programmes are focused on
health inequality reduction, the NHS will set out specific, measurable goals for
narrowing inequalities, including those relating to poverty, through the service
improvements set out in this Long Term Plan. All local health systems will be expected
to set out during 2019 how they will specifically reduce health inequalities by 2023/24 and
2028/29. These plans will also, for the first time, clearly set out how those CCGs benefiting
from the health inequalities adjustment are targeting that funding to improve the equity of
access and outcomes. NHS England, working with PHE and our partners in the voluntary and
community sector and local government, will develop and publish a ‘menu’ of evidence-based
interventions that if adopted locally would contribute to this goal. We will expect CCGs to
ensure that all screening and vaccination programmes are designed to support a narrowing of
health inequalities.

3.40. From September 2019, all boys aged 12 and 13 will be offered vaccination
against HPV-related diseases, such as oral, throat and anal cancer. This will build on
the success of the girls’ programme, which has already reduced the prevalence of human
papilloma virus (HPV) 16 and 18, the main cancer-causing types, by over 80%. This will reduce
cervical and other cancers in both men and women in the future.

5.25. By 2022, technology will better support clinicians to improve the safety of
and reduce the health risks faced by children and adults. An integrated child protection
system will replace dozens of legacy systems and we will deliver a screening and vaccination
solution that is worthy of the NHS’ world leading services.

Going Lean in the NHS.

More Detail

I sent this earlier to a Friend who is an NHS doctor.

Extraordinary times they certainly are. For doing what I do the confusion etc is no bad thing
but the Lockdown and effect on small businesses and overall employment prospects cause
huge unpredictability.
With Moduloft we have a robust business case and it has applications across different tenures
The uncertainties are making equity raising tougher just as it takes longer to figure out which way things will head when all the Fuss passes.
We are somewhat isolated from the worse of it here in Sweden, Outcomes here seem less bad than UK but I suspect the overall population is slightly better off and healthier than in the UK.
The Care home fiasco back at the start of it all has passed and to be fair to the Swedes they have done a full Mea Culpa.
I have been wading through a ton of NHS statistics on Bed availability and just read the Long Term Plan. This idea of Running lean is all well and good until a black swan comes along.
That’s the trouble with the short term business school guys and gals they really can’t get that you need some slack to cover for unforeseen things, the digital computer modelling tendency to massage your contingencies is a temptation that all Spreadsheet Jockeys have to overcome. Where there is no Skin in the game accountability the discipline does not develop, I suspect this has happened with the overpriced Management consultants who have made the NHS perfect in their business models without listening to the Coal Face experiences of those that Do the real work.
Hope you are bearing up, what I do is not stressful, what you do is heroic! thank goodness for folk like you Steven.With what I do, no one dies , unless they do a shit corrupt job like they did at Grenfell. Look forward to having a beer with you when I am next over, Brexit coupled with Peak Lockdown suggests that might not be until March, meanwhile I will continue to Play myself in on a tricky wicket, but hope to get some runs on the board fairly soon just fancying that we are getting our eye in with Moduloft.
All the best