this week FLU page 339 • COVID AND INEQUALITIES page 340 • VIRUS VARIANTS page 342 KRISTOFFER TRIPPLAAR/ALAMY KRISTOFFER Legal threat over £23m patient data deal NHS England is facing a legal challenge claimed the initial ‘datastore’ deal was a Cori Crider (top), of non-profit against its decision to award a two year short term, emergency response to the group Foxglove, and Mary £23m contract in December to the US data pandemic,” editor in chief Mary Fitzgerald Fitzgerald, of openDemocracy, mining fi rm Palantir Technologies. wrote on the openDemocracy website. “But are leading the court action against NHS England’s The media platform openDemocracy, December’s new two year contract reaches contract with Palantir which is bringing the action, claims the far beyond covid to Brexit, general business contract with Palantir to build a software planning, and much more.” platform to handle patient data was The statement was also signed by Cori awarded before a data protection impact Crider, director of Foxglove, which describes assessment was carried out to ensure that itself as a “non-profi t organisation that exists health information was protected. to make tech fair.” It is bringing the legal The case is the latest challenge to the challenge on openDemocracy’s behalf. The handling of contracts involving millions two groups are crowdfunding the case. of pounds of taxpayers’ money during the “Striking quiet deals with fi rms like pandemic. The High Court has already Palantir, especially with no real public LATEST ONLINE ruled that the Department of Health acted dialogue, risks demolishing trust in the Record drug unlawfully in failing to publish details NHS among the very communities where deaths need radical within the time required by law of dozens of the government now urgently seeks to response, says contracts awarded without competition. shore up trust,” wrote Fitzgerald and Crider. Scottish college Last September Palantir, which “It doesn’t help that, under the new Palantir Researcher specialises in analysing huge volumes contract, we have no idea what is going into broke embargo of data to fi nd insights, patterns, and the long term datastore: for the fi rst time, to leak BMJ connections, was criticised by Amnesty the government has completely redacted paper to Trump International for failing to conduct human the list of health data sources fed into it.” administration rights due diligence on its contracts with US A spokesperson for NHS England said GP academic can Immigration and Customs Enforcement. that a data protection impact assessment practise again after The company received an emergency had been done last April and that an suspension for UK contract last March to develop a data “update will be published in due course.” dishonesty is cut platform to help deploy resources in Clare Dyer , The BMJ short response to the pandemic. “The government Cite this as: BMJ 2021;372:n587 the bmj | 6 March 2021 337 SEVEN DAYS IN Home HPV kits will be off ered to women as part of screening trial Women in areas of London where attendance at screening for cervical cancer is low will be off ered HPV self-sampling kits they can use at home, as part of an NHS England trial. The scheme will send a kit to more than 19 000 women aged 25 to 64 and who are 15 months overdue for a cervical smear test, while 12 000 women who visit a GP for another reason and are at least six months overdue will also be off ered a kit. The rollout will start with 166 general practices in Barnet, Camden, Islington, Newham, and Tower Hamlets. NHS England hopes that the trial will increase uptake of cervical screening, as research indicates that embarrassment and fear, as well as cultural barriers, are oft en reasons why appointments are not taken up. Women who are sent the kits will be given access to a video explaining how to carry out the test and can post their swab to the NHS cervical screening programme’s London laboratory. If human papillomavirus is detected, women will be invited to see their GP for a standard smear test follow-up. The London trial will run until December 2021. Self-sampling HPV kits are recommended by the World Health Organization as a way to help reach the global target of 70% screening coverage by 2030. SPL Elisabeth Mahase , The BMJ Cite this as: BMJ 2021;372:n537 Covid-19 One dose of Pfizer vaccine UK adopts WHO code for Call for review of England’s cuts transmission by 75% recruiting health staff ICU bed capacity A 75% reduction in asymptomatic The UK updated its code of Chris Hopson, chief executive cases of covid-19 was seen in practice for the international of NHS Providers, called for a healthcare workers at Cambridge recruitment of health and social review of critical care capacity in University Hospitals NHS care staff to align with WHO’s England, saying it was “neither Foundation Trust who received guidance on how health and safe nor sensible to rely on NHS one dose of the Pfizer-BioNTech social care employers can recruit hospital trusts being able to vaccine in the second half of ethically from abroad. The code double or triple their capacity at January, an analysis published says $90m is needed to tackle ensures that international recruits the drop of a hat as they’ve had as a preprint has found, adding immediate problems in up to will be treated fairly and be to over the last two months.” to the evidence that the vaccine 20 countries, including Malawi, provided with the appropriate The UK has 7.3 critical care beds reduces transmission. A Lancet Nigeria, and Afghanistan. support, provides safeguards per 100 000 people, whereas study previously found that the against active recruitment Germany has 33.8 and the US Oxford-AstraZeneca vaccine Workforce from 47 countries on the WHO 34.3. The review must look at the was 59% effective against Planning is a “joke” Health Workforce Support and distribution of beds, proximity asymptomatic transmission in without figures, says Hunt Safeguards List, and sets out how to patients, and concentrating some recipients. The government’s decision not to the UK is supporting countries expertise, Hopson said. publish precise figures on what with the most pressing health and WHO taskforce is set up to workforce numbers are needed social care workforce challenges. One in seven people in tackle oxygen shortages for the NHS and social care in the England have antibodies A Covid-19 Oxygen Emergency next 10, 15, or 20 years has made Medical defence Almost 14% of people in England Taskforce was launched by planning a “joke,” said England’s C linical negligence system had antibodies from infection or WHO’s partners, including former health secretary, Jeremy needs “urgent reform” vaccination between 26 January Unitaid and Wellcome, to Hunt, during a session for the The Academy of Medical and 8 February, up from 4.4% increase the supply of oxygen health committee’s inquiry into Royal Colleges, the Hospital between 27 October and 10 to low and middle income workforce burnout and resilience. Consultants and Specialists November, showed data from the countries, where it is estimated Care minister Helen Whately Association, and the Medical React-2 study. The researchers that more than half a million (below) replied, “There is a Defence Union wrote to the also found that 91% of people people with covid-19 need huge amount of complexity, prime minister and the health who had received two doses of 1.1 million cylinders of and workforce planning secretary, seeking urgent change the Pfizer-BioNTech vaccine had oxygen a day. Most of is not a simple thing to to the clinical negligence system antibodies, rising to 95.5% in these countries are in do. The other thing is the in England, which has seen the people aged under 60. Among Africa, where supply importance of joining estimated bill for outstanding those who had a single dose of problems have been up the plans for the claims rise to an “unsustainable” vaccine, antibodies were present worsened by surges in workforce with service £84bn. The letter calls for reform in 95% of people under 30 but covid-19 cases. planning and also to aid the recovery of the NHS only 35% of those over 80. The taskforce financial planning.” from the pandemic. 338 6 March 2021 | the bmj SIXTY SECONDS MMEDICINEEDICINE ON . FLU Vaccination FLU, IS THAT THING STILL AROUND? Canada approves Oxford- Of course, although to be fair there isn’t AstraZeneca vaccine much about right now. Neither Public Health The Oxford-AstraZeneca covid England nor the Royal College of General Practitioners Research and Surveillance vaccine has been approved Centre has detected a single case in England by Canada’s drug regulator in 2021. for use in adults, although the Canada’s advisers National Advisory Committee on recommended over WHAT SORT OF WINTER IS THIS? Immunization advised against 65s not be given A very unusual one. Simon de Lusignan, using it in people aged over 65 the AstraZeneca director of the centre and professor of because of a lack of evidence in vaccine primary care and clinical informatics this group. Early evidence from at Oxford University, told The BMJ the Scotland showed the vaccine unseasonably low rate of flu was in large reduced the risk of hospital Wellbeing part down to measures introduced to halt admission by up to 94%, four NHS England expands staff SCHOOLS transmission of covid-19, such as face masks, social distancing, and lockdown. weeks after the first dose. France mental health support One in seven staff reversed its original advice to NHS staff in England will be able WOW.