Delivering Core NHS and Care Services during the Pandemic and Beyond

Health and Social Care Committee Closed Inquiry
Opened: 22 Apr 2020 Closed: 10 Feb 2021 Parliament page
The Committee held its last oral evidence session in connection with this inquiry on Tuesday 30 June 2020.
15 Recommendations
16 Conclusions
1 Report
4 Oral sessions
16 Letters
4 Events
Activity timeline 22 events
15 Jan
2021
Report published
16 Dec
2020
Correspondence
15 Dec
2020
Correspondence
30 Nov
2020
Correspondence
24 Nov
2020
Correspondence
24 Nov
2020
Correspondence
24 Nov
2020
Correspondence
12 Nov
2020
Correspondence
10 Nov
2020
Correspondence
5 Nov
2020
Correspondence
1 Oct
2020
Report published
8 Sep
2020
Correspondence
Oral evidence sessions 4 sessions
30 Jun 2020
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Amanda Pritchard · NHS England Chris Hopson · NHS England Professor Andrew Goddard · Royal College of Physicians Professor Stephen Powis · NHS England Sir Simon Stevens · NHS England and NHS Improvement
16 Jun 2020
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Delivering core NHS and care services during the pandemic and beyond
Charlotte Augst · National Voices Daloni Carlisle, cancer treatment patient Dr Katherine Henderson · Royal College of Emergency Medicine Dr Layla McCay · NHS Confederation Mick Armstrong · British Dental Association Professor Derek Alderson · Royal College of Surgeons Rob Martinez, joint replacement patient Sir Robert Francis · HealthWatch England
14 May 2020
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Oral evidence
Chris Hopson · NHS England Jennifer Dixon · Health Foundation Nigel Edwards · The Nuffield Trust Richard Murray · The King's Fund
1 May 2020
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Claire Murdoch · NHS England Dame Cally Palmer · NHS England Gill Walton · Royal College of Midwives Professor Martin Marshall · Royal College of General Practitioners
Title HC No. Published Items Response
Second Report - Delivering core NHS and care services during the… HC 320 1 Oct 2020 31 Responded
Recommendations & Conclusions
31 results
1 Conclusion Not Addressed
Second Report - Delivering core NH…
The pandemic has presented an unprecedented challenge to the NHS and the Government.
The pandemic has presented an unprecedented challenge to the NHS and the Government. Whilst we have no doubt that often communication to patients was as effective as could reasonably be expected in the context of a pandemic, this was not … Read more
Government Response
The government's response addresses a different recommendation regarding workforce burnout and inclusive recruitment, and does not engage with the committee's conclusion about poor patient communication and anxiety.
Department of Health and Social Care
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2 Recommendation Accepted
Second Report - Delivering core NH…
Notwithstanding the actions taken to date, we recommend that NHS England & Improvement review, as...
Notwithstanding the actions taken to date, we recommend that NHS England & Improvement review, as a matter of priority, the directions given to NHS Trusts about how to communicate with patients about the progress of their treatment and important medical … Read more
Government Response
The government recognizes the importance of effective communication and dignity, stating that existing NHS Standard Contracts mandate this and NHSE/I will reinforce these requirements. It notes ongoing work with patient groups to develop resources, but does not explicitly commit to the recommended priority review, assessment, or specific update to the committee by October 2020.
Department of Health and Social Care
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3 Conclusion Accepted
Second Report - Delivering core NH…
The pandemic has placed an unprecedented burden on the delivery of core NHS and care...
The pandemic has placed an unprecedented burden on the delivery of core NHS and care services. This has resulted in the delay, suspension or cancellation of services which in turn has inevitably led to a significant increase in waiting times, … Read more
Government Response
The government recognizes the pandemic's burden and the committee's concern, stating that NHSE/I has already launched campaigns to reassure patients that NHS services are safe to access, detailing steps like social distancing and face masks.
Department of Health and Social Care
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4 Conclusion Not Addressed
Second Report - Delivering core NH…
We recognise the commitment of policy makers and the NHS leadership to restoring core NHS...
We recognise the commitment of policy makers and the NHS leadership to restoring core NHS services and the ongoing efforts to manage the backlog. We are also grateful for the hard work of all staff and the use of innovative … Read more
Government Response
The government's response only reiterates the committee's initial recognition of commitment and gratitude for staff's efforts and innovations, failing to address the expressed concern about core health services operating with limited capacity or instructions not being adhered to.
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5 Conclusion Accepted
Second Report - Delivering core NH…
During our session on 30 June 2020, Sir Simon Stevens told us that he “expects”...
During our session on 30 June 2020, Sir Simon Stevens told us that he “expects” waiting times for and referrals to core health services to “go up quite significantly over the second half of the year.” We also heard from … Read more
Government Response
The government provides details on measures to address the backlog, including increasing elective activity via 'phase 3' guidance and allocating £1bn from the 2021/22 Spending Review to tackle the elective backlog and fund up to one million extra procedures.
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6 Recommendation Accepted
Second Report - Delivering core NH…
We recommend that the Department of Health & Social Care and NHSE/I provide an update...
We recommend that the Department of Health & Social Care and NHSE/I provide an update on what steps they have, individually and collectively, taken and are planning to take to quantify and address the overall impact of the pandemic on … Read more
Government Response
The government provides a detailed update on waiting times for elective care and cancer treatments, detailing recovery efforts, and outlines specific steps to manage demand, including a new £150 million fund for GP capacity expansion and adaptations for remote care.
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7 Recommendation Accepted
Second Report - Delivering core NH…
We also recommend that NHSE/I provides us with a more broader update on what positive...
We also recommend that NHSE/I provides us with a more broader update on what positive innovations or changes have taken place in the NHS during the pandemic, and how it seeks to ensure all the positive changes that have occurred … Read more
Government Response
The government outlines its "Adopt & Adapt" approach, including hub working models and £1bn funding for elective recovery in 2021/22, to support positive changes and tackle the elective backlog.
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8 Conclusion Acknowledged
Second Report - Delivering core NH…
We further conclude that the delivery of dental services in England has been significantly hindered...
We further conclude that the delivery of dental services in England has been significantly hindered by the pandemic. This has been largely due to the need to protect both patients and staff from COVID-19 which has, in turn, presented financial … Read more
Government Response
The government acknowledges the pandemic's impact on dental services and is working to increase service levels, noting updated guidance allows reduced room resting time. They are also exploring future use of Point of Care testing to increase patient throughput, but this is in early stages.
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9 Recommendation Deferred
Second Report - Delivering core NH…
We are concerned that there does not appear to be a plan for the restoration...
We are concerned that there does not appear to be a plan for the restoration of dental services in England. We recommend that Sara Hurley (Chief Dental Officer for England) sets out her assessment of the challenges facing dentistry services … Read more
Government Response
The government redirects responsibility for operational delivery and contracting of dental services away from the Chief Dental Officer, stating it lies with DHSC and NHS. It references an existing plan for resumption of dental services published in June 2020 and ongoing work on future contract mechanisms.
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10 Conclusion Accepted
Second Report - Delivering core NH…
We recognise the unprecedented scale of the challenge facing the Government and NHSE/I to keep...
We recognise the unprecedented scale of the challenge facing the Government and NHSE/I to keep NHS and care staff safe during the pandemic. As in other countries facing the pandemic there were, however, persistent failures with the procurement and supply … Read more
Government Response
The government expresses confidence in a consistent PPE supply for winter, detailing substantial items on order and a strategic stockpile, and reiterates its commitment to addressing practical difficulties and incorporating user feedback, implying ongoing efforts address the concerns.
Department of Health and Social Care
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11 Recommendation Acknowledged
Second Report - Delivering core NH…
We request an update from the Department of Health & Social Care by the end...
We request an update from the Department of Health & Social Care by the end of November 2020 on what steps are being taken to ensure that there is a consistent and reliable supply of appropriately fitting PPE to all … Read more
Government Response
The government is confident in a consistent PPE supply for winter, citing 32 billion items on order and a 4-month strategic stockpile. They are committed to addressing fitting difficulties by understanding user needs and incorporating feedback, especially for face masks.
Department of Health and Social Care
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12 Conclusion Acknowledged
Second Report - Delivering core NH…
We are grateful to Professor Chris Whitty (Chief Medical Officer) and his expert colleagues for...
We are grateful to Professor Chris Whitty (Chief Medical Officer) and his expert colleagues for their continued and constructive engagement with our work. We also recognise that the Government, following the advice of the Chief Medical Officer and others, has … Read more
Government Response
The government acknowledges the committee's gratitude to Professor Whitty and reiterates its intention to use the SIREN study to inform the frequency and circumstances of NHS staff coronavirus testing.
Department of Health and Social Care
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13 Recommendation Not Addressed
Second Report - Delivering core NH…
We accept the advice we have received from many eminent scientists that there is a...
We accept the advice we have received from many eminent scientists that there is a significant risk that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. We therefore urge the Government … Read more
Government Response
The government acknowledges the committee's concerns about the risks of not routinely testing NHS staff and states that asymptomatic testing is an important protective measure, but does not explain why weekly testing has not been implemented as urged.
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14 Conclusion Acknowledged
Second Report - Delivering core NH…
We note that Professor Chris Whitty has said that the testing of asymptomatic staff may...
We note that Professor Chris Whitty has said that the testing of asymptomatic staff may be necessary in the future and that if there is a “surge in winter” of coronavirus cases then he would be likely to advise that … Read more
Government Response
The government recognizes the Committee's concerns regarding routine asymptomatic testing of NHS staff and acknowledges its importance as a protective measure for staff, patients, and visitors from COVID-19 infection.
Department of Health and Social Care
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15 Recommendation Not Addressed
Second Report - Delivering core NH…
We ask that Professor Whitty sets out to what extent testing capacity has impacted the...
We ask that Professor Whitty sets out to what extent testing capacity has impacted the advice he and his colleagues have provided to the Government on routine testing of NHS staff. We further ask Professor Whitty to clarify whether he … Read more
Government Response
The government acknowledges the concerns regarding routine testing for NHS staff and states its importance as a protective measure, but does not provide the specific information requested about Professor Whitty's advice on testing capacity or routine testing in hotspots.
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16 Recommendation Acknowledged
Second Report - Delivering core NH…
We conclude that the case for routine testing of all NHS staff in all parts...
We conclude that the case for routine testing of all NHS staff in all parts of the country (including clinical staff as well as cleaners, porters and so forth) is compelling and should be introduced as quickly as capacity allows … Read more
Government Response
The government recognises the committee's concerns and acknowledges that routine asymptomatic testing is an important component of protecting NHS staff and patients, but does not commit to introducing it rapidly or expanding capacity as recommended.
Department of Health and Social Care
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17 Recommendation Not Addressed
Second Report - Delivering core NH…
We recommend that, by the end of October 2020, the Government and NHSE/I set out:...
We recommend that, by the end of October 2020, the Government and NHSE/I set out: i) what current capacity there is for testing all NHS staff, ii) what further capacity (if any) will be required and iii) how long it … Read more
Government Response
The government acknowledges concerns about routine testing for NHS staff and states its importance as a protective measure, but fails to provide the requested information on current testing capacity, future requirements, or timelines for securing sufficient capacity.
Department of Health and Social Care
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18 Conclusion Accepted
Second Report - Delivering core NH…
We are extremely grateful to all NHS and care staff for their hard work and...
We are extremely grateful to all NHS and care staff for their hard work and dedication in trying to meet patient needs in such exceptional circumstances. This includes those who have returned to the NHS (such as clinicians returning from … Read more
Government Response
The government responds by highlighting the NHS People Plan 2020/21, which emphasizes staff wellbeing, mental health, and addressing inequalities, stating that these existing commitments align with the committee's concerns about staff burnout.
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19 Conclusion Acknowledged
Second Report - Delivering core NH…
We are grateful for NHSE/I’s continued support of NHS staff and welcome the further measures...
We are grateful for NHSE/I’s continued support of NHS staff and welcome the further measures set out in the People Plan (July 2020) for the 2020–21 period. In particular, we welcome the important and ambitious measures set out in the … Read more
Government Response
The government acknowledges the need to mitigate the psychological impact of pressures on staff and to increase workforce supply and improve retention, promising to provide further details on these efforts in another section of the letter.
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20 Recommendation Acknowledged
Second Report - Delivering core NH…
We recommend that NHSE/I set out in detail what further specific steps it would like...
We recommend that NHSE/I set out in detail what further specific steps it would like to take over the coming years to support the mental and physical wellbeing of all staff and a plan to deal with the specific issue … Read more
Government Response
The government acknowledges the importance of mitigating psychological pressures and continuing to increase workforce supply and retention, stating that measures have been outlined and promising further details in another section of the letter, but does not commit to setting out a specific plan to the committee by the requested deadline.
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21 Recommendation Not Addressed
Second Report - Delivering core NH…
We further recommend that NHSE/I should develop a full and comprehensive definition of “workforce burnout”,...
We further recommend that NHSE/I should develop a full and comprehensive definition of “workforce burnout”, and set out how the wellbeing of all NHS staff is being monitored and assessed. This information should be made available to us by the … Read more
Government Response
The government's response focuses on mitigating psychological pressures, increasing workforce supply, and improving staff retention, without addressing the specific request for a definition of 'workforce burnout' or how staff wellbeing is being monitored and assessed.
Department of Health and Social Care
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22 Conclusion Deferred
Second Report - Delivering core NH…
We note, meanwhile, that there is no equivalent of the NHS People Plan for the...
We note, meanwhile, that there is no equivalent of the NHS People Plan for the social care workforce. We will have more to say about support for those working in social care in our forthcoming report on Social care: workforce … Read more
Government Response
The government agrees with the Committee's comments that there is no equivalent of the NHS People Plan for social care and commits to addressing the social care workforce in the upcoming White Paper for Social Care Reform.
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23 Conclusion Acknowledged
Second Report - Delivering core NH…
The NHS is founded on the principle of equality and is one of the most...
The NHS is founded on the principle of equality and is one of the most diverse and inclusive organisations in the UK. It hugely benefits from the diversity of its staff as in turn so does the nation. In recent … Read more
Government Response
The government acknowledges the committee's comments by outlining its approach to eradicating racism and discrimination, which aligns with legal definitions from the Equalities Act 2010 and Race Relations Act 1976, stating that its work in this area is multi-faceted.
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24 Conclusion Acknowledged
Second Report - Delivering core NH…
We have also heard that some BAME NHS staff face discrimination and racism in the...
We have also heard that some BAME NHS staff face discrimination and racism in the NHS and that, across the NHS, the levels of diversity must be improved. We accept Sir Simon Stevens’ comments that “there are systemic features to … Read more
Government Response
The government aligns its definition of racism and discrimination with the Race Relations Act 1976 and Equalities Act 2010, confirming their approach to addressing the issues of discrimination faced by BAME NHS staff.
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25 Recommendation Accepted in Part
Second Report - Delivering core NH…
The NHS must increase its efforts to eradicate all forms of discrimination and racism from...
The NHS must increase its efforts to eradicate all forms of discrimination and racism from in its organisation. We therefore recommend that NHSE/I provide a full and comprehensive definition of the “racism and discrimination” that it seeks to eradicate from … Read more
Government Response
The government aligns its approach to racism and discrimination with existing legal definitions (Race Relations Act 1976 and Equalities Act 2010) and outlines current multi-faceted work, including the WRES and a programme to address the impact of COVID-19 on BAME staff, but does not commit to developing new specific targets or deadlines for a future strategy.
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26 Conclusion Accepted
Second Report - Delivering core NH…
Historically, accident and emergency departments have been over-stretched, over- burdened and running over capacity.
Historically, accident and emergency departments have been over-stretched, over- burdened and running over capacity. We have heard that the initial decline in patient attendances at A&E departments during the pandemic to some extent “cured” the problem of “corridor care”. However, … Read more
Government Response
The government recognises the importance of managing A&E demand and states that NHSE/I has been working with NHS Trusts on plans including increasing capacity, improving patient flow, and reducing unnecessary admissions.
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27 Recommendation Acknowledged
Second Report - Delivering core NH…
We welcome the news that the Government and NHSE/I are piloting a ‘111 dial first’...
We welcome the news that the Government and NHSE/I are piloting a ‘111 dial first’ scheme to support the triaging of patients before they attend A&E departments. The introduction of an expectation that a patient will call first before walking … Read more
Government Response
The government welcomes support for the ‘111 dial first’ scheme and states that pilots are being monitored and evaluated to inform wider rollout, but does not provide the requested update or specific plans for A&E departments.
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28 Conclusion Acknowledged
Second Report - Delivering core NH…
We welcome the support of the Secretary of State and the Chief Executive of NHSE/I...
We welcome the support of the Secretary of State and the Chief Executive of NHSE/I for technological innovation in the NHS. The use of technology and digital alternatives (“telemedicine”), although it has had a mixed response from some patients and … Read more
Government Response
The government welcomes the committee's support for technological innovation and is committed to supporting wider technology deployment, but does not address the call for a comprehensive assessment of digital exclusion risks or methods to bring forward successful innovations.
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29 Recommendation Accepted
Second Report - Delivering core NH…
We recommend that NHSE/I and the Department for Health & Social Care set out their...
We recommend that NHSE/I and the Department for Health & Social Care set out their assessment of how effective the use of technology and digital alternatives (“telemedicine”) has been across all health and care services. As part of this assessment, … Read more
Government Response
The government states that NHS England and NHS Improvement are currently undertaking a review to assess the effectiveness of telemedicine and identify risks to patient wellbeing, including how to ensure patients are not digitally excluded.
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30 Conclusion Acknowledged
Second Report - Delivering core NH…
We commend the efforts of the Government, NHSE/I and the independent sector for stepping up...
We commend the efforts of the Government, NHSE/I and the independent sector for stepping up and securing independent sector capacity (i.e. beds, staff and facilities) which has been crucial to supporting the NHS during the pandemic. It is clear that … Read more
Government Response
The government agrees that independent sector capacity will be needed and states it has secured this capacity through agreements to ensure the NHS can meet patient demand.
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31 Recommendation Not Addressed
Second Report - Delivering core NH…
We recommend, in addition to our recommendations in Chapter 2, that the Government and NHSE/I...
We recommend, in addition to our recommendations in Chapter 2, that the Government and NHSE/I clarify what plans there are to continue to use independent bed capacity and other independent resources as the winter period approaches. We further recommend that … Read more
Government Response
The government provides a general statement about maximising treatment capacity and noting prior elective recovery, but does not clarify its plans for independent sector use or provide the specific capacity assessments requested by the committee.
Department of Health and Social Care
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Government Response AI assessment · 31 of 15 classified
Accepted 9
Accepted in Part 1
Acknowledged 12
Deferred 2
Not Addressed 7
Total 15 recs + 16 conclusions
Correspondence 16 letters
16 Dec 2020 To committee Letter from the NHS Chief Executive on core NHS services during the Covid pandemic
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15 Dec 2020 To committee Letter from the NHS Chief People Officer on recommendations in the Delivering core NHS and care services during the pandemic and beyond report
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30 Nov 2020 From committee Letter to the Secretary of State, Chief Executive of NHS England and Improvment and the NHS Chief People Officer on Delivering core NHS and care services during the pandemic and beyond
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24 Nov 2020 To committee Letter from Prerana Issar on staff burnout and resilience
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24 Nov 2020 To committee Response from Prerana Issar to the Committee's Report on Delivering core NHS and care services during the pandemic and beyond
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24 Nov 2020 To committee Letter from the Secretary of State for Health and Social Care and the NHS Chief Executive on the Committee's report into Delivering core NHS and care services during the pandemic and beyond
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12 Nov 2020 From committee Letter to the Secretary of State for Health and Social Care and the Chief Executive of NHS England and NHS Improvment on the recommendations to the Delivering core NHS and care services during the pandemic and beyound report
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10 Nov 2020 To committee Further letter from Prof Stephen Prowis on Covid-19 testing of NHS staff
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5 Nov 2020 Correspondence with Prof Chris Whitty and Prof Stephen Prowis on Covid-19 testing of NHS staff
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8 Sep 2020 Correspondence with Sir Simon Stevens on NHS third stage response to Covid-19
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2 Sep 2020 NHS England and NHS Improvement follow up response to 30 June evidence session
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2 Sep 2020 To committee Letter from the Secretary of State on the Delivering core NHS and care services during the pandemic inquiry
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23 Jul 2020 To committee Letter from Chair to Matt Hancock and Sir Simon Stevens on Delivering core NHS services during the pandemic
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3 Jun 2020 From committee Letter to Tim Farron from Dame Cally Palmer on radiotherapy
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5 May 2020 Correspondence with the National Cancer Director on proton beam therapy
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5 May 2020 Correspondence with the Chief Dental Officer on guidance for dental practitioners
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