Health

Sajid Javid working on radical plan to merge social care with health in England

Sajid Javid plans for a new national care service under which health and social care would be delivered by the same organisation are being actively considered by the government for inclusion in a white paper next month, according to senior Conservatives and Whitehall sources.

The idea of local authorities and the NHS taking joint responsibility for social care, perhaps working from a single combined budget for the first time, would amount to one of the most far-reaching reforms since the NHS was founded in 1948.

At present, local authorities have responsibility for running social care services in their own areas. Critics say there is, as a result, insufficient incentive for cash-strapped councils to develop better care for people in their homes or in the community, as it is cheaper for them if those in need go into hospital where the cost is met from the separate NHS budget.

The result is that many people who could be cared for at home or in the community end up occupying much-needed hospital beds.

Similar systems operate in Wales and Northern Ireland, although there are variations in how much care is paid for by the state. The Scottish government is holding a consultation, due to end next month, on proposals for a National Care Service.

It is believed that health secretary Sajid Javid is examining how a new integrated service that would deliver better care and free up NHS beds across England could be delivered. It is understood there would be national standards for care, and conditions for carers.

The Observer has been told that prime minister Boris Johnson was keen to announce plans to integrate health and social care services last month when he revealed that National Insurance contributions would rise by 1.25 percentage points from next April, to raise £12bn a year for the NHS and social care. But at that time Downing Street remained unclear about how an integrated system could best work, so an announcement was put back.

Under the most radical option of all, local authorities would be stripped of any involvement for social care, which would come entirely under the NHS. Sources say, however, that this would involve too great an upheaval and prove hugely unpopular with councils, many of which are Tory controlled. Councils have already lost much of their responsibility over education.

Last night Tory MP and former health under-secretary Dr Dan Poulter, who works part time as an NHS psychiatrist, said: “There is a growing expectation that a substantive health and social care white paper will emerge in the next few weeks aiming to establish a national care service.

“If integration is to be a success, it is essential that reform does not just deliver parallel commissioning of health and care services but also services commissioned through a single pooled budget. Unified health and social care budgets are the only way to deliver both a more efficient health and social care system as well as properly joining up for the benefit of patients what is currently a badly fragmented system.”

Former Tory Cabinet Minister Damian Green, who has written extensively about social care added: “Running social care jointly between local authorities and the NHS would be an interesting idea but would of course still leave big questions about how you attract a bigger and better paid workforce, how you ensure appropriate housing so that people do not go prematurely into residential care.”

In his party conference speech last week, Johnson hinted at integration. He said: “In 1948, this country created the National Health Service but kept social care local. And though that made sense, in many ways generations of older people have found themselves lost in the gap.” He added it was not just about providing more money but reforming the system. “This government that got Brexit done, that is getting the vaccine rollout done is going to get social care done.”

The Covid-19 pandemic brought the social care crisis even more sharply into focus. Currently a shortage of about 120,000 care workers means 300,000 people are waiting for local authorities to assess their needs or provide care. In addition, many elderly people who end up in hospital because of poor local provision of care cannot free up beds once they are better because there are no places in residential care homes.

There are about 17,000 homes in England, most run as independent small businesses funded by local authorities or paying residents, making coordination with the large hospital trusts difficult.

Shadow health secretary Jonathan Ashworth said: “Social care is in desperate need of wholesale reform but the cap Boris Johnson announced fails to provide the fix he promised. It’s vital care and health services are brought closer together to provide personalised care so people can stay at home and not be forced into a home.

“That’s why I’ve long advocated national care services, locally delivered within national standards, to provide the quality care people deserve.”

Sally Warren, director of policy at the King’s Fund, said: “In reality, people mean different things when they talk about bringing social care into the NHS. For some it means having social care services delivered by the NHS. For others, it means some shared accountability for how health and care services work together. Rather than spending energy shuffling responsibilities from local government to the NHS or vice versa, the important thing is to focus on improving the coordination of services so they work together to improve health and wellbeing.”

Health

Sierra Leone reports first case of monkeypox

Sierra Leone has reported its first confirmed case of mpox since the World Health Organization (WHO) raised its highest alert level for the potentially deadly viral disease last year.

According to the National Public Health Agency, the patient is a 27-year-old man from the rural district of the Western Zone, near the capital Freetown.

“Health teams are actively tracing and investigating to identify potentially exposed persons and to prevent further spread,” the agency announced in a social media post.

The confirmed case was detected on January 10, though health officials have not specified the variant affecting the patient.

Mpox, caused by a virus from the same family as smallpox, presents with high fever and skin lesions known as vesicles.

The disease was first identified in the Democratic Republic of Congo in 1970 and had mainly been limited to a dozen African countries before spreading more widely in 2022, including to regions where the virus had not previously circulated. The WHO declared its highest alert level for the disease in 2024.

In response, Sierra Leonean health authorities have swiftly activated containment measures. The infected patient has been placed in isolation while contacts will be monitored for 21 days. Surveillance efforts have been increased in all areas visited by the patient.

A public awareness campaign has been launched, and health workers are being equipped with protective gear and trained in prevention techniques to curb further spread.

Sierra Leone was previously one of the hardest-hit countries during the Ebola epidemic, which claimed around 4,000 lives, including nearly seven percent of the nation’s health workers, between 2014 and 2016.

Health

Risk of HMPV infection in Nigeria moderate- NCDC

The Nigeria Centre for Disease Control (NCDC) says the risk of the human metapneumovirus (HMPV) in the country is moderate.

HMPV, which was first reported in 2001 in the Netherlands, is a single-stranded ribonucleic acid (RNA) virus that causes symptoms similar to the common cold and influenza including cough, fever, nasal congestion, and fatigue, with an incubation period of three to six days.

It causes severe complications like pneumonia in infants, the elderly, and those with weakened immune systems and spreads through respiratory droplets or contact with contaminated surfaces.

China is currently experiencing an outbreak of the virus, sparking global concern. India has also reported at least two cases of the virus.

In an advisory issued, the NCDC said the agency, in collaboration with the ministry of health, is closely monitoring global developments. The agency said as of January 6, 2025, data from surveillance does not indicate any unusual increase in respiratory infections, including those caused by HMPV.

“However, given the global trends in HMPV cases, the Nigeria Centre for Disease Control and Prevention (NCDC) is proactively implementing measures to strengthen the country’s preparedness and response capacity.

In collaboration with the Federal Ministry of Health and partners such as the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (USCDC), and the UK Health Security Agency (UKHSA), conducted a dynamic risk assessment for Human Metapneumovirus (HMPV).

The assessment classified the risk of HMPV for Nigeria as moderate. This evaluation will inform and guide preparedness efforts, decision-making, and response strategies to mitigate potential impacts.”

The NCDC said it is also collaborating with port health authorities to ensure robust preparedness at all international points of entry (PoEs).

“In addition, quarantine facilities are being identified and prepared to manage any suspected or confirmed cases if required. Infection Prevention and Control (IPC) materials are being deployed to PoEs to ensure adherence to hygiene and safety protocols. Information, Education, and Communication (IEC) materials are being developed and distributed to raise awareness and provide clear guidelines for frontline staff and travelers at PoEs.

The National Influenza Sentinel Surveillance (NISS) sites across the six geopolitical zones monitor Influenza-like Illness (ILI) and Severe Acute Respiratory Infections (SARI) which is already testing for COVID-19, will now also start testing for HMPV. Provisions will be made to increase the number of tests conducted. Additionally, laboratories in states with international airports will be supported to enable them to test for HMPV.”

Health

WHO declares new COVID outbreak in China global health emergency

The World Health Organization, WHO, has declared the outbreak of a new coronavirus in China, a global health emergency.

The WHO Director-General Tedros Ghebreyesus made the announcement at a press conference in Geneva.

WHO’s emergency committee on the epidemic had reportedly met Thursday afternoon and recommended designating the outbreak a Public Health Emergency of International Concern, PHEIC.

The decision had been “almost unanimous,” Didier Houssin, chair of the emergency committee, said at the press conference.

“The main reason for this declaration is not because of what is happening in China, but because of what is happening in other countries,” Tedros said at the press conference.

“Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it. Let me be clear, this declaration is not a vote of no confidence in China. On the contrary, WHO continues to have confidence in China’s capacity to control the outbreak.”

Tedros also outlined recommendations made by the emergency committee to control the outbreak, including accelerating the development of vaccines and drugs and combatting the spread of misinformation.

This is the sixth time WHO has used that label, Public Health Emergency of International Concern, PHEIC. since the designation was introduced 15 years ago.