Health Direct » 2005 » March

2 blatant MRSA lies

Dr Search- Principal Consultant at the Search Clinic — Thu, 31 Mar 2005 14:34:00 +0000

The DoH’s pathetic statement in the article below “MRSA rates are falling – they’re at their lowest level since recording began in 2001″ contains two blatant lies in their desperation to cover their own fatal incompetence:
Lie Number One: MRSA was first discovered in 1964 and since it’s infection can be fatal it is a “modifiable disease.”
As the Lancet states in it’s article on ” Hospital infection past and present” stated:
In 1999, a UK NHS Executive Health Service Circular instructed health-care providers to strengthen the prevention and control of communicable disease and infection-control processes. Specifically they were asked to “put infection control and basic hygiene where they belong, at the heart of good management and clinical practice with appropriate resources”: fine words, but actions speak louder than words.

http://www.thelancet.com/search/search.isa

Lie Number Two: Cases of MRSA have doubled not declined in the last 4 years of labour’s misrule- please see the independent National Audit Offices report at:

http://www.healthdirect.co.uk/MRSA-kills.html

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MRSA found on maternity ward

Dr Search- Principal Consultant at the Search Clinic — Thu, 31 Mar 2005 13:25:00 +0000

An investigation has found alarming evidence that the NHS is failing to win its battle against MRSA. Traces of the superbug were discovered in five out of six samples taken at the hospital where a two-day-old baby was killed by MRSA last month.
Swabs taken at Ipswich Hospital revealed high levels of MRSA on a corridor pay phone, a hospital trolley, and in the men’s toilets.
Low levels of the bug were found in the lifts and on the maternity ward. A sample taken from the urology laboratory was negative.
Baby Luke Day, who died at the hospital aged 36 hours, is believed to be the youngest ever victim of the bacterium.
He was born an apparently healthy 7lb 7oz child, was dead two days later.
His parents, 17-year-old Glynis Day and Kevin Fenton, 24, were alarmed at the results of the Sky News probe.
Mr Fenton said: “It’s not surprising the results have come back like this. It shows the bug is still there and it’s a big worry.”
Miss Day blamed the hospital for the infection. “I hope they can find a cure and pay the cleaners more so they clean the hospital properly,” she said.
Sher added: “Luke had no symptoms or anything. As far as they were concerned he was just a normal healthy baby. There was no warning at all.”
Luke’s grandmother Cathy Day, quit her job as a family support worker at the hospital in disgust.
When the family went to sign Luke’s death certificate they were shocked to find there was no mention of MRSA. They refused to sign the certificate until it had been changed.
A spokesman for Ipswich Hospital said: “Our biggest priority is is to minimise the risk to patients from MRSA and other infections through stringent cleaning and hygiene in all areas.”
A Department of Health spokesman said: “MRSA rates are falling – they’re at their lowest level since recording began in 2001.
“We’ve introduced a number of measures, but we’re not complacent and there’s still more to do.”

http://www.sky.com/skynews/article/0,,30000-13318199,00.html

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Data protection promise broken

Dr Search- Principal Consultant at the Search Clinic — Wed, 30 Mar 2005 00:53:00 +0000

Privacy fears over NHS database- there are fears patients will have no say over what details are stored. A new NHS computer database may threaten the privacy of patients’ medical records, the BBC has learnt.
A senior Department of Health civil servant said people would not be able to decide what details are stored.
Critics say this goes against earlier government assurances that patients would be able to veto the information.
The DoH said people can still discuss with their doctor what details are recorded and control who can access them – except in an emergency.
The database, which is being installed as part of the NHS’s £6.2bn IT upgrade, allows staff to access medical records wherever someone is treated.
Experts have warned the final cost of the system could hit £31bn.
Phil Walker, the DoH’s head of digital information policy, made the privacy claims in an email to a Warwickshire GP.
The BBC’s Andrew Hosken said Mr Walker stated patients do not have any right to determine what information is recorded about them by doctors, or to veto how it is recorded.
” I believe very few people will opt out of the records” John Hutton
The British Medical Association said this appears to contradict earlier ministerial assurances that patients will be able to withhold sensitive information from the database, to be introduced later this year.
Health Minister John Hutton has said patients would have the right not to have their medical records stored electronically at all.
A second option of sealing the most sensitive data in an “electronic envelope” for use only in emergencies is also being offered.
However, Mr Hutton said: “I believe very few people will opt out of the records. I hope and believe that patients will want to be part of this because it will help to save people’s lives.”
Richard Granger, director general for NHS IT, said the scheme was more secure than the old paper records system.

http://news.bbc.co.uk/1/hi/health/4392555.stm

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Milburn scan deal hurting NHS

Dr Search- Principal Consultant at the Search Clinic — Tue, 29 Mar 2005 10:35:00 +0000

Labour orders MP to keep quiet over Milburn scan deal. The Labour Party has attempted to gag one of its own MPs who strongly criticised a £90 million deal between the NHS and a private health company linked to Alan Milburn, Labour’s general election supremo.
Kevan Jones, the MP for North Durham, was rebuked by local party officials after revealing that patients from his constituency were being sent 20 miles for private MRI scans, even though their own local hospital had a machine standing idle.
Mr Jones came out strongly in support of John Saxby, the chief executive of the University Hospital of North Durham, who complained about the purchase of scans from Alliance Medical, while his own NHS scanner was “considerably under-employed”.
The row originally appeared to be little more than a local furore. However, it led to serious concerns in the higher reaches of the Labour Party because of the links between Alliance Medical and Mr Milburn.
Mr Milburn was paid £30,000 for a six-month stint as a consultant to the venture capitalists Bridgepoint, which owns Alliance Medical. While he was on the company’s books, during the period between his departure as Health Secretary in 2003 and his return to the Government last September, the £90 million scanner deal was signed.
The contract was announced by John Hutton, the health minister and a close friend and former flatmate of Mr Milburn.
Mr Saxby originally wrote to Mr Jones, claiming that money poured by the Government into the private sector with the aim of reducing waiting lists, could have been better spent on the NHS.
Mr Jones went public with a furious assault on the policy of private-sector involvement in the health service, which had been championed by Mr Milburn when he was Health Secretary.
He described the situation that saw patients told to travel 20 miles to a hospital in Middlesbrough as “frankly ridiculous” and warned ministers to put their plans for a greater private-sector involvement “to one side”.
He added: “If it is the case that the zeal of certain people in the Government to continually push the boundaries of the private sector in the health service has led to a poor service for my constituents, then I think it does need a closer examination.”
His comments, The Telegraph understands, provoked a telephone call to the MP from a Labour Party official demanding an explanation and warning him that they should not be repeated.
Mr Jones last night refused to comment on the revelation that Labour had tried to lean on him. However, he insisted that he would continue to ask ministers questions about the scanner deal.
He said: “There are a lot of questions to be answered. I can’t believe this arrangement is in the interests of patients in my constituency or anywhere else.”
In total, he has tabled 20 parliamentary questions to health ministers.
While he was out of office, Mr Milburn had to manage without his former £71,433-a-year minister’s salary. However, he made use of his extra spare time to earn £85,000 from speeches, articles and advice, including his Bridgepoint role.
Since his return, with the official Cabinet title of Chancellor of the Duchy of Lancaster, he has been paid £130,347 a year, a figure that has provoked a political row. The Conservatives argue that the taxpayer should not have to fund Mr Milburn’s salary because he is engaged almost exclusively on Labour Party, and not Government, business.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/03/27/nmilb27.xml

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750,000 UK flu pandemic deaths predicted

Dr Search- Principal Consultant at the Search Clinic — Mon, 28 Mar 2005 10:31:00 +0000

Mortuaries and emergency services are to be put on alert and told to prepare for up to three-quarters of a million deaths from a bird flu pandemic, The Independent on Sunday can reveal.
Emergency planners have begun to look for sites for special mortuaries, each capable of storing 1,000 bodies, and the Home Office is to hold an exercise this summer to practise coping with mass fatalities. The instruction, to go out from the Civil Contingencies Secretariat, the Cabinet Office body in charge of emergencies, explodes the Government’s public position that the pandemic could be expected to kill only “around 50,000″ people in Britain.
It shows that its true expectation is closer to the prediction made by Professor Hugh Pennington, the president of the Society for General Microbiology, in The Independent on Sunday two weeks ago that up to two million Britons could perish. The Secretariat also believes that a quarter of the country’s workforce could fall ill, paralysing economic life.
A senior government official told a private seminar in London last week: “It may be somewhere between 20,000 and 750,000 extra deaths and it may be 25 per cent of the population off work. That is the shape of the event we are going to have to deal with.”
He added that plans had been drawn up to confirm that emergency services and coroners had the staff and equipment to cope with such a crisis. Senior emergency planners said last week that they received official instructions at the end of last year to prepare for mass mortuaries to cope with a flu pandemic or a biological terrorism attack.
They said that most police authority areas normally had emergency mortuaries to hold 100 to 200 bodies, but they had now been asked to make provision for up to 1,000.
The authorities were now identifying greenfield sites and beginning to enter into contracts with firms to provide marquees and buildings to put on them. The planners said that these would be cooled to about the same temperature as household refrigerators, to store bodies.
The scale of the preparation suggests that the Government fears that the 14.6 million doses of anti-viral drugs it has ordered may not arrive before a pandemic. Even in a year’s time, less than half of the order will have been met. The drugs have been delayed partly because ministers waited for months before making the order.
Last November an official flu exercise involving health bodies, emergency services and government – Exercise Icarus – identified the lack of anti-viral drugs as a key concern. The order was placed this month.
Dr John Simpson, of the Health Protection Agency’s emergency response division, said the Government was planning more exercises, including preventing public gatherings, to stop the disease spreading.
Senior officials at the World Health Organisation (WHO) told the IoS that they predict the flu virus could circle the globe within two months.

http://news.independent.co.uk/uk/this_britain/story.jsp?story=624058

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Shortage of key IT skills in public sector

Dr Search- Principal Consultant at the Search Clinic — Fri, 25 Mar 2005 10:26:00 +0000

Public sector information technology projects and their suppliers are grappling with a shortage of key skills on which their successful delivery depends, Richard Granger, director of the National Health Service’s £6.2bn IT programme has warned.
He said the IT industry had lost between 100,000 and 250,000 jobs since 2000 so there was now “real difficulty” in getting core software written and assembling “the high quality teams needed to deliver complex programmes”.
Mr Granger told the Healthcare Computing conference in Harrogate that the shortage stemmed from the huge expansion of the business in the late 1990s needed to deal with the millennium bug.
That brought forward the replacement of older IT systems that subsequently produced a slowing in spending compounded when the dotcom bubble burst. The job losses meant “succession planning”, in which junior staff moved up to become team leaders and project managers “has fallen apart in our industry and that is causing real problems with major programmes,” he said.
The issue had not been helped by the revival in demand for IT projects in the private sector, which had come on top of a big expansion in public sector programmes, he said.
He had discussed the issue with the chief executives of the big NHS suppliers and with the trade association Intellect, adding: “There are massive demands for resources that just aren’t in the market. That bodes ill for the medium term.”
He said that 10 years ago all the software for big public sector programmes was written in the UK. The NHS project, however, was having to use programmers in the US and in India to develop core software.
And while the staff were high quality, and in the case of India low cost, that still led to difficulties with time zones and different cultures, which mattered when programming for health.

http://news.ft.com/cms/s/ed413da0-9c08-11d9-815d-00000e2511c8.html

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Current ID card legislation must be abandoned- LSE urges

Dr Search- Principal Consultant at the Search Clinic — Thu, 24 Mar 2005 10:08:00 +0000

The current identity card bill proposals are ‘too complex, technically unsafe, overly prescriptive and lack a foundation of public trust and confidence’, according to a new report published by academics from the London School of Economics and Political Science.
The report, The Identity Project: an assessment of the UK Identity Cards Bill- which labour claims is essential for the NHS reforms- and its implications, is a major is a root and branch analysis of the Identity Cards Bill. It involved more than 100 academics and outside experts in the fields of law, technology, information systems, government policy, business, economics and security and is the most comprehensive analysis yet produced during the two-year gestation of the proposals.
While the report supports the concept of a national identity system for the UK, it recommends that the current legislation should be replaced with a different model. The consequences of the current proposals might include ‘failure of systems, unforeseen financial costs, increased security threats and unacceptable imposition on citizens.’
Professor Ian Angell, head of LSE’s Department of Information Systems and a member of the report’s advisory group, commented: ‘This is rigorous and balanced research that has highlighted substantial flaws in the Home Office identity card proposals. The report has proposed a more sensible model for a national identity scheme. The government should seriously consider this alternative.’
Another member of the report’s advisory group, Professor Patrick Dunleavy of LSE’s Government Department, said: ‘The report very clearly shows that an identity card must be a real benefit to the citizen rather than being a costly imposition. We have an opportunity right now to develop an identity system that people genuinely want to use in their day-to day-lives. It has to be secure and it has to be user-friendly.’
The report was initiated and hosted by the Department of Information Systems of LSE and has involved senior academics from ten centres and departments across the School.
The authors say: ‘The success of a national identity system depends on a sensitive, cautious and cooperative approach involving all key stakeholder groups including an independent and rolling risk assessment and a regular review of management practices. We are not confident that these conditions have been satisfied in the development of the Identity Cards Bill. The risk of failure in the current proposals is therefore magnified to the point where the scheme should be regarded as a potential danger to the public interest and to the legal rights of individuals.’
The report goes on to warn that, rather than increasing UK security, the Bill may create greater security dangers than before. ‘The proposed system unnecessarily introduces, at a national level, a new tier of technological and organisational infrastructure that will carry associated risks of failure. A fully integrated national system of this complexity and importance will be technologically precarious and could itself become a target for attacks by terrorists or others.’
It is arguable, say the report’s authors, that the legislation may contravene the European Convention on Human Rights, the right of free movement for EU citizens, the Disability Discrimination Act and the Data Protection Act. And they warn that the overall cost of a national identity scheme may be well in excess of government projections.

http://www.lse.ac.uk/collections/pressAndInformationOffice/newsAndEvents/archives/2005/IDReport.htm

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Syphilis crisis continues as sex diseases rise

Dr Search- Principal Consultant at the Search Clinic — Wed, 23 Mar 2005 11:17:00 +0000

Senior MPs warn of a crisis in sexual diseases among the young with the prospect of a 50% rise in cases within the next three years. A report by the House of Commons Health Select Commitee reveals that the number of people attending clinics for diseases ranging from chlamydia to gonorrhoea has more than doubled in 10 years.
Government plans to tackle ‘Health Tourism’ may have serious effects on public heath and the fight against HIV. The concludes that failed asylum seekers and illegal immigrants with HIV should receive free treatment to reduce the likelihood of onward transmission of HIV.
Under new Government rules, individuals who are in the UK without proper authority, including failed asylum seekers, visa overstayers and illegal immigrants, are no longer able to access free treatment on the NHS.
Treatment for certain infectious diseases is free of charge on public health grounds – but while this includes treatment for TB and sexually transmitted infections, it does not include treatment for HIV.
The reports concludes that if free treatment is not available, people may be deterred from taking an HIV test, and will remain in the community undiagnosed and infectious. Evidence also suggests that HIV treatment can in fact significantly lower an individual’s infectiousness, reducing the potential for onward transmission.
Committee Chairman David Hinchliffe said “The Committee does not underestimate the difficulties the Government faces in combating ‘health tourism’, and it’s vital that the UK does not become a magnet for HIV positive individuals seeking to emigrate to this country to access our health care. However, we have seen no evidence that this is happening. The Government has no estimates of the numbers of people likely to be involved in health tourism, or of what they might be costing the NHS.
Evidence actually suggests that HIV positive migrants do not access NHS services until their disease is very advanced, sometimes years after their arrival in the UK.
The public health issue is a real concern – the Health Protection Agency, the Government’s own public health advisory body, said that if these individuals are not treated, and they remain sexually active in this country, then ‘transmission is bound to go up’.”
The report also notes that rates of sexually transmitted infections have continued to rise, as have waiting times for sexual health clinics. In fact, according to one of the Committee’s witnesses, there is a “continuing crisis in sexual health”.
To reduce the risk of onward transmission of sexually transmitted infections, the Government is aiming for all patients to be seen within 48 hours of requesting an appointment. However, the latest figures indicate that only 38% of people get an appointment within 48 hours, and over a quarter have to wait more than two weeks.
Commenting, David Hinchliffe said, “Rates of sexually transmitted infections are still rising, and sexual health services are more overstretched than ever. The Government has announced extra investment and new targets around sexual health, which we welcome, but they will need to monitor the situation closely over the coming years to ensure the extra investment actually reaches clinics to enable them to deliver better services.”
“It is particularly important that sexual health services are able to meet the extra demand that will be generated by the Government’s planned health education campaign. “Educating young people about relationships and sexual health is one of the most powerful tools we have to promote better sexual health. However, young people are still being taught about sex and relationships by teachers who lack both competence and confidence in this area.”
The Health Committee recommends:
* Government’s sexual health education campaign should not begin until it is certain that sexual health services will be able to meet increased demand
* Government should conduct a financial audit to ensure that extra sexual health funding actually reaches sexual health clinics
* Chlamydia screening should focus on men as well as women
* The Government should give GPs better incentives to provide sexual health services. A dedicated sexual health training programme should also be established for those working in primary care
* By 2007, all sex and relationships education in schools should be taught by a specialist teacher rather than a form tutor.
* Sex and relationships education should be a statutory and assessed part of the national curriculum in schools.
* All HIV+ people regardless of their eligibility status should receive free treatment to reduce the likelihood of onward transmission of HIV

The report’s title is ‘New Developments in HIV/AIDS and Sexual Health Policy and is published as their third report of Session 2004-05 (HC 252).

http://www.parliament.uk/parliamentary_committees/health_committee/050318.cfm

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MRSA kills 2 day old baby

Dr Search- Principal Consultant at the Search Clinic — Tue, 22 Mar 2005 14:41:00 +0000

A baby of just two days has died after becoming infected with the MRSA superbug. Luke Day, who died in Ipswich Hospital aged 36 hours, is believed to be the youngest ever victim of the virus.
His parents, 17-year-old Glynis Day and 24-year-old Kevin Fenton, said he was first thought to have septicaemia. But a post-mortem revealed he died from septicaemia caused by MRSA (methicillin-resistant staphylococcus sureus)
Luke’s grandmother Kathy Day has quit her job as a family support worker at the hospital in disgust. She said: “We’ve got to make sure this terrible tragedy never happens again.”
Luke was born an apparently healthy 7lb 7oz child.
His mother Glynis said: “He had no symptoms or anything. As far as they were concerned Luke was just a normal healthy baby. There was no warning at all.”
When the family went to sign Luke’s death certificate they were shocked to find it did not mention MRSA. They refused to sign the certificate until it had been changed.
Mrs Day said: “A baby has died from MRSA in an NHS hospital. People need to know.
“Something must be done in eradicating this terrible superbug. We do not want other families to go through the pain we have suffered over the last few weeks.”
A hospital spokeswoman said staff were doing all they could to get to the bottom of Luke’s death.
She said tests on the ward, maternity facilities, staff and family members had found no trace of MRSA.
The bug is resistant to methicillin and many other types of antibiotic.

http://www.sky.com/skynews/article/0,,30100-13314803,00.html

This raises two further worries:
1) The hospital is clearly not in control of the situation as they can not find the source of the MRSA infection,
2) The attempt to mis- describe the reason for death on the death certificate once again questions how far one can trust Tony’s statistics.

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Revealed: where the extra NHS cash is really spent

Dr Search- Principal Consultant at the Search Clinic — Mon, 21 Mar 2005 12:12:00 +0000

Tony Bliar has failed to transform the National Health Service despite the biggest government spending spree in the 60-year history of the welfare state, according to an independent audit.
The “unprecedented” injection of more than £30 billion of taxpayers’ money into the service has achieved “significant” benefits, says the study, but has yet to translate into clear gains in the nation’s health. “There has been significant improvement in most areas the government has focused policies on,” concludes an analysis published this weekend by the King’s Fund, an independent health research group. “However, the NHS as a whole has not yet been transformed.”
The report, commissioned by The Sunday Times, states that “important problems” remain and that “there is as yet no firm evidence to show that Labour’s reforms have produced a marked difference in health outcomes”.
The findings come as public spending emerges as a key election battleground between Labour and the Conservatives. Blair has accused the Tories of planning to cut spending by £35 billion; the Tories argue that they will maintain spending increases but at a more prudent rate than Labour.
Since Blair declared that he would “save” the health service, spending on the NHS in England has jumped from £34 billion in 1997-98 to £69 billion this year.
The soaring budget has reduced waiting times and increased the number of doctors and nurses, say the authors; most patients now get to see their GP promptly and are treated within four hours if they attend an accident and emergency department.
“Overall the results of the audit undertaken by the King’s Fund are positive,” said Niall Dickson, its chief executive. “Is the NHS service better than it was in 1997? The answer is yes — but so it should be since the budget has more than doubled.”
By 2008 Britain will be devoting 9% of its gross domestic product to health, a level comparable with other European nations. Yet standards of care remain better in other leading European Union countries. The King’s Fund believes that many improvements are still feeding through the NHS but gives warning that flaws remain.
The audit’s findings include:
# The bulk of new funding for the NHS is being eaten up by pay increases for staff and other “cost pressures”.
# The funding increase left for new hospital services in 2004- 05 was only 2.4% despite an overall increase of 12%.
# Figures for new doctors and nurses are overstated because more NHS staff are working part-time.
# Waiting lists are coming down but some waits for diagnostic tests for cancer and other diseases are increasing.
# MRSA infections are still a “significant problem” for the NHS.

http://www.timesonline.co.uk/newspaper/0,,176-1533370,00.html

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Hospitals in cash crisis

Dr Search- Principal Consultant at the Search Clinic — Fri, 18 Mar 2005 14:25:00 +0000

Hospitals are becoming financial victims of their own success by meeting their targets, an increase in A&E; patients and higher doctors’ pay are all to blame- but how can hospitals be in financial trouble at a time when NHS spending is rising so quickly?
One reason is that they have been successful at meeting government targets to shorten waiting lists and hasten patients’ progress through Accident and Emergency departments.
This has increased their workload, without a comparable increase in funding.
If a hospital completes a year’s planned operations in 11 months, it does not get paid for the extra month, so is forced either to cancel operations — as in the case of Great Ormond Street — or to go into deficit.
A&E; targets have generated a second pressure: to meet the target that patients should not wait more than four hours in A&E;, many hospitals have admitted patients to wards. The numbers admitted through A&E; rose 23 per cent, year-on-year, increasing costs.
At the same time, A&E; attendances rose sharply, for reasons that are less easily explained. One suggestion is that patients believe that GP out-of-hours services are unavailable and have taken to going straight to A&E; instead. But this can only be part of it.
Some trusts, particularly those of the Avon Strategic Health Authority, including Bristol and Bath, face special and longstanding difficulties.
Attempts to balance their budgets have failed for several years. Yesterday a spokesman for North Bristol NHS Trust, said that in 2003-04 the trust had broken even after receiving support from the NHS Bank.
Another factor, overlooked by some hospitals, was the new consultant contract, which raised pay significantly. Consultants may have worked harder — nobody really knows — but if they did, it could make things worse: if a hospital is being paid for a given number of operations and does more, then it will run up a deficit. In principle, this problem should be eased by payment by results, a new arrangement which means that extra work will be matched by extra resources.
In a recent poll in the Health Service Journal, 80 per cent of finance directors said that they regretted the fact that the phasing-in of this new policy was being delayed.
They clearly believe that payment by results will get them out of the present financial difficulties. But, according to Nigel Edwards of the NHS Confederation, they may be being too sanguine.
Payment by results is paired with Patient Choice, which means that patients can choose where to go for their operations and the money will follow them.
Potentially, this is the most destabilising policy launched by the NHS. “It means that every case you lose, you lose the full payment,” Mr Edwards said. “So hospital income could fall if lots of patients chose to go elsewhere, but hospital costs cannot possibly be reduced as quickly. Their costs simply aren’t that variable.”
If he is right, then today’s deficits may quickly be dwarfed by tomorrow’s.

http://www.timesonline.co.uk/article/0,,8122-1530947,00.html

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Cot crisis in birthing cutbacks

Dr Search- Principal Consultant at the Search Clinic — Thu, 17 Mar 2005 10:18:00 +0000

Dozens of women due to give birth to seriously premature babies are being sent hundreds of miles around Britain each week because of an NHS crisis over intensive care cots.
The problem has seen women from Hemel Hempstead sent to Great Yarmouth and Nottingham, and a woman from London sent to Brighton. Another was flown from Plymouth to Manchester by the RAF. It follows a £70m government initiative to provide better care for premature babies which experts say has failed.
Under the scheme, the number of centres caring for fragile babies has been reduced. The aim was to centralise the best experts and equipment, but critics say its main effect has been to cut the number of beds.
Research by Bliss, the premature baby charity, found that in the West Midlands and London more than 30 mothers a month were being sent around the country in a search for cots.
Rob Williams, chief executive of Bliss, said more than 100 women nationwide faced the same problem every week.
“Neonatal mortality rates are increasing and the number of babies that need care is on the increase,” he said. “We are among the worst countries in Europe for infant mortality.”
The problem has been highlighted by the cases of two 18-year-old girls from Hemel Hempstead in Hertfordshire. They were forced to have their premature babies in hospitals in Nottingham and Great Yarmouth, Norfolk, because of a shortage of intensive care cots at Watford General, their local hospital.
In another case, Joanne Taylor, 34, from London, had to be rushed by ambulance to Brighton. Her daughter was born on Christmas Day and spent 68 days in an intensive care neonatal cot.
After 12 days, however, Taylor was told her own bed in the neonatal unit was needed and she had to move to a hostel. “The treatment was fantastic but the system is crazy,” she said.
Her 60-mile journey was minor compared with Tracey Harrison’s expedition. She was 28 weeks pregnant with triplets when complications developed. There were no cots available locally so Derriford hospital in Plymouth arranged for the RAF to fly her to St Mary’s in Manchester in a helicopter. After 10 days she was brought back to Plymouth and gave birth on January 4. “I was very distressed. The system is rubbish,” said Harrison.
The Department of Health said: “In 2003 we announced an extra £70m over three years. It takes time to train neonatal intensive care nurses and develop clinical networks. That is why this funding will take time to take effect.”

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PFI rip-offs- Ex-hospital manager reveals high cost

Dr Search- Principal Consultant at the Search Clinic — Wed, 16 Mar 2005 11:37:00 +0000

A whislteblower in the NHS is threatening to lift the lid on alleged falling standards and hidden costs at Britain’s first Private Finance Initiative (PFI) hospital.
Elaine Butler, formerly a professional facilities manager at Darent Valley Hospital in Kent, is bringing an unfair dismissal case before an employment tribunal under whistleblower guidelines. She alleges that she became the victim of a hate campaign by managers at Carillion, the stock market- listed contractor, after she questioned their performance in providing cleaning and catering facilities to Darent Valley.
Mrs Butler, 47, a mother of two who has worked for the NHS for 27 years, alleges that she was unfairly dismissed by the Dartford & Gravesham NHS Trust after Carillion managers labelled her a troublemaker and claimed that she could endanger the hospital’s three-star rating.
Mrs Butler will argue that the trust was put under pressure to get rid of her because she had the professional knowledge to expose alleged shortcuts that Carillion was taking.
“My problem was that I was the bringer of bad news. But from what I could see PFI is not in the best interests of the public and is not value for money,” Mrs Butler told The Times.
“I joined the NHS in 1977 and I considered it a privilege. I’ve had many offers from the private sector over the years but I remained loyal to the NHS. I was trying to bring higher standards but I had to go because I threatened the reputation of Carillion and of the whole system.”
The case, which is being supported by the GMB union, could be highly embarrassing for the Department of Health and the NHS trust, which are desperate to portray Darent Valley, Britain’s first PFI hospital, as an unalloyed success. It will also raise eyebrows because the National Audit Office last month revealed that the companies involved had 56 per cent returns on investment.
Mrs Butler was a professional facilities manager at the hospital from June 2002 and had to make sure that Carillion, the main service provider, fulfilled its cleaning and catering obligations. She had to justify invoices for up to £2 million a month.
Her expertise was praised by a Cabinet Office party in January 2003 and a team from the National Audit Office highlighted her role’s importance.
However, her relationship with the Carillion team and her own managers became strained after she marked down Carillion’s cleaning performance in the summer of 2003 and penalised the contractor financially. The relationship deteriorated further when she questioned variable expenses — including the price of fitting light switches — which were escalating rapidly. Variable facilities costs rocketed from £14,000 a month to £163,000, with a noticeable increase when Mrs Butler was off sick with stress.
The first sign of trouble came in November 2003 with an anonymous letter to the trust’s chief executive, criticising Mrs Butler’s personal and professional capabilities. That resulted in suspension and investigation over unnamed allegations.
She was exonerated by internal investigation before Christmas 2003 but on returning to work was told to distance herself from the service providers. A short time later she received the first of several suspicious packages — a kipper. “Someone wanted to suggest I had been strung up like one,” she said.
In the following months she felt ostracised before being given redundancy and three months’ notice. She claims the stress caused by her treatment made her physically sick, with symptoms similar to meningitis and temporary hearing loss.
After complaining about her case to the Secretary of State for Health, Mrs Butler’s concerns have been referred to the NHS Counter-Fraud and Security Management Service.
A spokesman for the NHS trust declined to comment on the case but said: “We have an excellent relationship with our PFI partners and have service-level agreements in place to ensure the highest levels of service. Recently the patient environment action team again gave the trust the highest green rating and the trust retained its maximum three-star performance rating for the second consecutive year.”
A spokesman for Carillion said he was unable to comment on the details of the case.
SHEDDING LIGHT ON DIY COSTS
Hanging a mirror: £201.53
Fitting a twin-amp socket: £192 to £423
Adding/modifying a light switch: £333
Hanging a picture: £18.25

http://www.timesonline.co.uk/article/0,,8122-1514481,00.html

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Government’s A&E target puts patient care at risk, says BMA survey

Dr Search- Principal Consultant at the Search Clinic — Tue, 15 Mar 2005 10:42:00 +0000

Despite the colossal efforts of accident and emergency (A&E;) staff to improve waiting times for patients, the pressure to meet the Government’s 4-hour waiting target can put patient care at risk, according to new figures published today (14/3/05) by the British Medical Association (BMA).
The BMA’s survey of A&E; waiting times, which was distributed to A&E; consultants in the first week of January 2005, found that staff had worked extremely hard towards meeting the Government’s target that by 31 December 2004, 97% of patients were seen, treated and discharged within four hours. The survey also found that some trusts had received extra money from the Government, in return for delivering on waiting times, allowing them to buy new equipment and bring further benefits for patients.
However, the survey also revealed a number of areas of concern, including risks to patient care and bullying of staff, as hospital managers attempted to meet the 4-hour target.
Eight out of 10 A&E; departments* in England who replied to the BMA’s survey said that clinical concerns had arisen because of pressure placed on them to see patients within four hours. Complaints included:
* Just over half (52%) said that patients were moved to inappropriate areas or wards
* Two out of five (40%) said patients had been discharged before they were adequately assessed or stabilised
* Just over one in four (27%) reported that care of the seriously ill or injured was compromised because of the pressure to the meet the 4-hour target.
Commenting on the BMA’s A&E; survey, Mr Donald MacKechnie, chairman of the BMA’s A&E; committee, said: “A&E; doctors, nurses and support staff have all been working exceptionally hard to meet the Government’s 4-hour waiting time target despite an overwhelming increase in attendances. Our survey shows that waiting times for patients visiting A&E; have significantly fallen since 2003 and this is a fantastic achievement.
“But I am appalled to hear that some A&E; staff are being put under intolerable pressure, even bullied, by their trusts as they attempt to treat and discharge patients within four hours. It is absolutely right that patients visiting A&E; are seen and treated as quickly as possible but not if staff are being forced to make inappropriate decisions and patient care is any way compromised.”
Just under a half of A&E; departments failed to meet the Government’s 97% end of year target because there were not enough beds on the wards, delays in accessing specialist opinion or diagnostic services and inadequate numbers of A&E; staff. Mr MacKechnie said: “Adopting a hospital-wide approach can help trusts to solve many of the delays in A&E.; The job of A&E; is made even harder when there is insufficient availability of in-patient beds for emergency admissions or there are delays in patients receiving the diagnostic tests they need as part of their treatment.”
Mr MacKechnie questions whether the Government’s final target of 98% – the figure that trusts must meet by 31st March 2005 – is realistic or sustainable. He said: “Cutting A&E; waits has become a key policy for the NHS and it has been good news for many departments who were often seen as the ‘Cinderella’ service. It has attracted more resources and patients are benefiting from being seen more quickly and efficiently. But these improvements need to be sustainable. Staff cannot continue working at this pace.
“A&E; consultants are telling us that the 98% target is a bridge too far and that 95% would be much more realistic given the level of resources. Consideration should also be given to having different expectations to reflect the severity of patients’ injury or illness.”

http://www.bma.org.uk/pressrel.nsf/wlu/SGOY-6ADDSS?OpenDocument&vw;=wfmms

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Hospital’s “systemic failures” killed patient

Dr Search- Principal Consultant at the Search Clinic — Mon, 14 Mar 2005 12:14:00 +0000

A Bristol hospital’s “continued system failure” contributed to the death of a patient, an inquest jury has ruled.
John Stratton was wrongly given an overdose of Heparin, an anti-blood clotting drug, at Bristol Royal Infirmary in January 2004. Mr Stratton, 57, of Easton-in-Gordano, in North Somerset, later died from a brain haemorrhage. The inquest heard the hospital had been busy and staff were under pressure. A narrative verdict was returned.
The inquest was told that when Mr Stratton was admitted to hospital after suffering a heart attack, staff nurse Kelly Cousins told a fellow nurse to administer 1,400 units of Heparin per hour. This was over the maximum dosage. The error was noticed by a nurse after Mr Stratton’s transferral to the hospital’s coronary care unit, but the inquest was told she forgot about it.
Staff nurse Cousins, who admitted misjudging the dosage, said: “There was the immense pressure of management problems placed on me.”
Siobhan Goodrich, for the United Bristol Healthcare Trust, accepted an overdose was given but argued this had not caused Mr Stratton’s death. Consultant histopathologist Dr Edward Sheffield carried out a post-mortem examination and concluded Mr Stratton’s brain haemorrhage was due to the anti-clotting treatment.
The jury said hospital staff were working under extreme pressure and this resulted in nursing errors but it did not excuse the lack of staff intervention which could have prolonged Mr Stratton’s life. “The continued system failure, combined with the increased dose of Heparin, contributed to Mr Stratton’s death,” the jury said.
In a statement, Lindsey Scott, the United Bristol Healthcare NHS Trust’s director of nursing, said that however good the staff and systems at the hospital were, there was always room for human error.
“We have learnt from this case and implemented changes to further reduce the opportunity for human error,” she said.
In a statement to the inquest, Mr Stratton’s wife, Christine, said a nurse at the BRI likened the A&E; department on the morning he was admitted to Beirut. Mrs Stratton wrote: “It was a series of blunders that could have been avoided if protocols were used throughout the hospital.”

http://news.bbc.co.uk/1/hi/england/bristol/4341065.stm

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Consultants fight closures

Dr Search- Principal Consultant at the Search Clinic — Fri, 11 Mar 2005 09:43:00 +0000

A group of 35 consultants from Cheltenham General Hospital have taken a stand against closing childrens’ wards. They have sent a letter to Health secretary Dr John Reid asking him to call in proposals to move children’s inpatient services to Gloucestershire Royal. They say the move is the thin end of the wedge and that it will lead to more services leaving Cheltenham and going to Gloucester.
The doctors are worried that the move will put a strain on the A &E; department, reduce the skill levels of Cheltenham clinicians to deal with sick children and lead to a decline in care.
The letter has been sent just days before Battledown campaigners will confront Dr Reid when he visits Gloucester next Tuesday to open the Royal’s new children’s ward.
The signatures on the letter include some of the hospital’s top consultants from every speciality: anaesthetists, surgical, medical, opthalmology, orthopaedics, peadiatrics and radiology.
It is an astonishing show of strength and gives the lie to the Trust’s claim that the closure is in the patients’ best interests.
In the letter they say: “The proposed removal of inpatient paediatric services will lead to the removal of comprehensive maternity services and affect critically our ability to deal with severely ill children.
“Sick children brought by their parents to A &E; and those involved in major accidents will continue to arrive in our hospital. The necessary infrastructure and theatre equipment required for children are unlikely to be maintained when the proposed changes take effect. The loss of acute paediatrics and maternity services will inevitably affect our ability to deliver acute services to our local people.”
Last month, Primary Care Trust board members agreed to move children’s inpatient care to Gloucestershire Royal.
They ignored a vigorous protest, a 24,000 signature petition and objections from politicians of all parties
The letter continues: “The recent local consultation process did not mention relocation of maternity services let alone the threat to acute services in general. We implore you to call in and reconsider the proposals carefully as they will lead inexorably to major reductions in care that can be delivered to our local population.”
Last week it was revealed that the Battledown ward was used to back-up Gloucestershire Royal’s new children’s unit 20 times in the past three months. Gloucestershire Royal’s new flagship children’s hospital couldn’t cope because it didn’t have enough nurses. Children were sent to the Battledown ward instead.
Retired surgeon and Battledown campaigner Dr Geoffrey Fox believes the letter is serious indictment of the proposals from key players at the hospital.
He said: “The consultants all agree the move could be the end of acute services at Cheltenham General. It’s a commonly held opinion that the proposals are part of a bigger plan to move services from Cheltenham. Many believe the hospital will be left to deal with cancer therapy, cold surgery such as hip operations and geriatrics. Each time you take specialities away from a hospital it tends to weaken it.
“This is a powerful letter made even more significant by the people who have signed it. They see Cheltenham as being downgraded and are worried for its future. The fact that Gloucestershire Royal has struggled recently backs up their calls for the proposals to be called in.”
A spokeswoman for Cotswold and Vale Primary Care Trust, which oversees children’s services in the county, said: “Gloucestershire Hospitals NHS Foundation Trust is committed to a continuing future with two thriving district general hospitals.
“During the public consultations in in 2002, Trust directors stated that there were no plans for the kinds of wholescale changes to services at Cheltenham General Hospital which are suggested in this letter. The concerns about children being treated at the A &E; department at Cheltenham General have been widely discussed and it’s true that children will still be seen in the A &E; Department.
“Currently one quarter of all A &E; Department patients are children, and the vast majority of these are treated by A &E; staff – this will continue.
The spokeswoman said Battledown would still be actively caring for children with an extended children’s assessment unit facility operating from 9am to 10pm daily) at Cheltenham General Hospital.

http://www.thisisgloucestershire.co.uk/displayNode.jsp?nodeId=139307&command;=newPage&contentPK;=12010558

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Great Ormond St hospital cancelled operations and wards

Dr Search- Principal Consultant at the Search Clinic — Thu, 10 Mar 2005 10:25:00 +0000

Great Ormond Street hospital has revealed they have had to cancel operations, close beds and close wards because of a funding crisis. The famous children’s hospital blamed a systemic financial crisis.
This year nearly 100,000 sick children entered for world-renowned care, hundreds more than the hospital was paid to treat – so the hospital needs to make up £1.7m.
A small sum when its budget is a hundred times that – but to balance the books by April, it has closed beds, offered nurses less money for extra shifts and cancelled some operations.
Critically ill children who can only be looked after there will not be turned away but morale is low.
Nurses have briefed a newspaper that the cuts are devastating for a hospital that has never wasted money. One parent’s experiences appear to back up the claims.
The hospital is an example of the paradox at the heart of the politics of health.
The government says Great Ormond Street and the NHS has more money than ever before. The hospital gets £50m more – nearly a third of its budget – than six years ago.
This year, English hospitals and community health get an extra £5.1bn – but more than three quarters is eaten up on higher pay and new working practices.
The reduction in junior doctors’ hours and indexing staff pensions all cost more. It also costs £900m on running new buildings and hospital drugs, leaving just over a billion pounds left of the extra money.
The Conservatives have hammered NHS failure this week -Michael Howard is now pushing further on what’s traditionally been seen as Labour territory.
On Tuesday, he will announce plans to allow patients who do not get a rescheduled operation within four weeks to move to another hospital thereby denying the original hospital the fee it would have got for the surgery.

http://www.channel4.com/news/2005/03/week_1/06_ormond.html

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£200m vaccine will be just a stopgap against flu outbreak

Dr Search- Principal Consultant at the Search Clinic — Wed, 09 Mar 2005 10:22:00 +0000

More than 53,000 people could die, but antiviral jab will not prevent all the deaths the Government took out a £200 million insurance policy yesterday against an epidemic of flu that could kill more than 50,000 people.
Under political pressure and on the eve of a World Health Organisation meeting in Luxembourg to discuss flu preparedness, the Department of Health rushed out a plan based on buying 14.6 million courses of the antiviral drug Tamiflu.
The plan says that more than 53,000 people could die in a pandemic in Britain unless precautions are taken. The only sure defence is a vaccine, but that cannot be made until the precise make-up of any pandemic strain is known.
Tamiflu is a stop-gap measure but should reduce the severity of the disease and prevent some deaths, said Professor Maria Zambon, head of the National Influenza Centre at the Health Protection Agency.
Yesterday’s announcement came after warnings from WHO that a strain of bird flu with the ability to spread rapidly in people could develop, turning the few cases of human infection that have occurred in Asia into a global epidemic. John Reid, the Health Secretary, said: “We are working closely with other governments and WHO to ensure the international community is as well prepared as it can be to spot and address the early signs of a pandemic. However, it makes sense to ensure that we in the UK . . . have drugs against an influenza pandemic.”
Other countries had ordered stocks of Tamiflu and the Conservatives were pressing the Government to act. Andrew Lansley, the Tory health spokesman, said: “The Government’s response is late and incomplete. We needed a stockpile of antiviral drugs to be produced months ago and action to promote vaccine production. The Labour Government once again failed to act and to give public health the priority it requires.”
For several weeks the Department of Health has been fending off questions about flu preparedness by saying the plan would be published in the spring. Paul Burstow, the Liberal Democrat spokesman, accused the Government of being slow to tackle a threat that experts believe “is not simply a question of ‘if’ but ‘when’ ”.
The quantity of the drug ordered is based on the assumption that one in four people will catch the disease. The estimated 53,700 deaths assumes a one in 300 mortality rate among those infected, as in the 1957 Asian flu pandemic.
In Asia, the death toll from bird flu has been much higher, at 75 per cent of those infected. But an avian flu virus that has developed the ability to infect people easily is expected to lose some virulence in the process, becoming much less lethal than pure bird flu which infects only those in direct contact with birds.
There are, however, many uncertainties. The 1918-19 flu virus killed 1 per cent of those it infected, and if this were reproduced in a new pandemic the death toll in Britain would reach 141,800 in the absence of effective action.
In the extreme case considered, where half the population catches flu and the mortality rate is 2 per cent, more than 700,000 people would die. But the 50,000 figure is considered much more likely.
Sir Liam Donaldson, the Chief Medical Officer, said: “Wherever in the world a flu pandemic starts, perhaps with its epicentre in the Far East, we must assume we will be unable to prevent it reaching the UK. When it does, its impact will be severe in the number of illnesses and the disruption to everyday life.”
In a typical year, between 12,000 and 18,000 people die from “seasonal” flu, mainly among high-risk groups such as the elderly. Pandemic flu occurs when the virus changes sufficiently to attack people who have acquired immunity to the regular strains.
http://www.timesonline.co.uk/article/0,,8122-1507087,00.html

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25,000 die from preventable VTE

Dr Search- Principal Consultant at the Search Clinic — Tue, 08 Mar 2005 10:10:00 +0000

Each year over 25,000 people in England die from venous thromboembolism (VTE) contracted in hospital. This is more than the combined total of deaths from breast cancer, AIDS and traffic accidents, and more than twenty-five times the number who die from MRSA. The figures are alarmingly high.
Even more alarming is the fact that many of these deaths are preventable. There is a safe, efficacious and cost effective method of preventing venous thrombosis which is not being as widely administered as it should be.
There are various reasons for this situation. Witnesses told us that many physicians and surgeons were not aware of the extent of VTE. A substantial number of patients who develop VTE first show signs that they have the disease after they have been discharged from hospital. As a result the original physician or surgeon who treated the patient in hospital is often not informed that their patient suffered from the condition after leaving their care.
Moreover, there are no national guidelines which would ensure that doctors consider the risk of VTE and the availability of prophylaxis.
The Department of Health has now commissioned the National Institute of Clinical Excellence to produce a set of guidelines for the administration of preventative measures which are expected to be published in May 2007. This is a remarkably tardy response to a serious situation and, moreover, the scope of the guidelines commissioned by the Department is limited to a subset of surgical patients, while the majority of sufferers are non-surgical patients. In contrast, in the United States the American College of Chest Physicians has recently published the 7th revision of their guidelines which were first produced in 1986.
Based upon the effectiveness of the intervention and the cost effectiveness of applying that intervention, routine thromboprophylaxis for appropriate potential groups in hospital was ranked the number one most important safety practice in that country by the US Health Agency for Research and Quality.
We recommend that the NICE VTE guidelines be extended in scope to cover the majority of hospital patients. We further recommend that on admission to hospital all patients, both medical and surgical, be counselled about the risks of VTE and undergo a risk assessment to determine if prophylaxis, to help prevent the onset of venous thrombosis, should be administered. To raise awareness among medical practitioners of the extent of the problem we recommend that all physicians and surgeons are informed if their patients contract VTE after they have been discharged from hospital.
During the inquiry we heard serious doubts as to the extent to which the guidelines will be implemented when they finally become available. This is a recurring problem which the Committee has come across in several inquiries. Accordingly, our report makes recommendations to ensure their effective implementation. The Department, NICE and the Royal Colleges should work together to raise awareness of the extent of VTE and to audit the use of the guidelines. Our most important recommendation is that thrombosis committees and thrombosis teams should be established in each hospital to promote best practice now, using accepted guidelines adapted for local practice, and to be a source of education and training for all staff dealing with patients at risk of VTE. When NICE guidelines are published the committees and teams will be in place to ensure adherence.
They should be modelled on the effective teams and committees dedicated to improving the use of blood transfusion. Finally we recommend that the Healthcare Commission audit the availability and use of venous thrombosis prophylaxis in hospitals.

http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhealth/99/99.pdf

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NHS needs foreign Doctors

Dr Search- Principal Consultant at the Search Clinic — Mon, 07 Mar 2005 10:42:00 +0000

The NHS is so short of doctors that it would stop running if it didn’t bring in doctors from abroad. The British Medical Association said last year that 70% of accident and emergency departments across the country were short of doctors.
Many left A&E; departments to become General Practitioners – where there’s also a shortfall.
Some 14,736 new doctors appeared on the medical register last year, according to the General Medical Council (GMC). Of these, 10,005 came from other countries.
Bringing in skills from abroad is proving cheaper than training new doctors, as each one costs an estimated £200,000.
And with fewer than 8,000 new medical students in Britain last year, more are needed to fill the gaps.
According to the GMC’s figures, the majority of new doctors registering in Britain came from India – a total of 3,644.
Pakistan accounted for nearly 1,000 new doctors.
But there are also large numbers from other European countries, for example, 771 came from Germany.

http://www.sky.com/skynews/article/0,,30000-13305447,00.html

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Nine-month delay for ‘common solution’ IT implementation

Dr Search- Principal Consultant at the Search Clinic — Fri, 04 Mar 2005 13:39:00 +0000

Delivery of the ‘common solution’, the standardised clinical IT system being developed for London and the south of England, will be delayed by at least nine months. The delay is the latest to affect the national programme for IT, following problems with the delivery of choose and book and the NHS ‘data spine’. Originally due by this October, the ‘common solution’, which will eventually deliver a fully integrated patient records system, now looks unlikely to be available until June 2006 at the earliest.
Trusts that had been planning to implement the new system from this autumn were suddenly informed of the delay only two weeks ago. An e-mail, seen by HSJ, from Thames Valley strategic health authority chief information officer Mike Part, describes the delay as ‘extremely bad news’.
The e-mail goes on to state: ‘The earliest possible go live date for this release now appears to be the middle of June 2006. This date is well outside the window that had previously been signalled’.
An national IT programme spokesperson confirmed that some systems for London and the South ‘may now be delayed from autumn 2005 to late spring 2006′. He said the delays had arisen because consultation with clinicians had ‘identified the need for additional testing to be carried out and therefore dates for deployment are being reviewed’.
One hospital IT director told HSJ: ‘We had been planning to go in October 2005, but now won’t be going until June 2006 at the earliest.’ He said the delay would ‘have a huge impact on clinical support’.
Surrey and Sussex SHA chief information officer Tad Matus said the IT plans of three trusts in the area, due to have gone live by late spring 2005, would be delayed. Mr Matus said new deployment dates were being worked on. ‘The issue is that if we concertina up timings we can’t all go live at the same time.’
The delays affect the Carecast clinical system being provided by US-based IDX Systems as a standardised ‘common solution’ for London and the south of England. The system development is being managed by BT, but will be implemented in the south by Fujitsu Services.
This ‘common solution’ is meant to be delivered in five progressively more advanced software ‘releases’ leading to a fully integrated electronic patient records system. It is the second of these releases that has been delayed.
Only at this stage will the system move beyond basic patient administration and provide new clinical tools, beginning with order communications, which enables hospital doctors to electronically order tests and receive results.

http://www.hsj.co.uk/nav?page=hsj.news.story&resource;=1990648

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Ten government IT projects hit ‘red light’ status

Dr Search- Principal Consultant at the Search Clinic — Thu, 03 Mar 2005 09:41:00 +0000

Whitehall has revealed some details of its 10 most ‘at-risk’ IT projects, following a Freedom of Information request. The Office of Government Commerce (OGC) has released details of IT projects found to be most at risk across Whitehall, but is keeping the projects’ identities secret.
The OGC has listed 10 IT projects to receive consecutive red lights under its Gateway Review process which checks for signs of failure during an initiative’s development.
In response to a Freedom of Information request submitted by Government Computing News, the OGC revealed that over the last three months, two IT projects have received consecutive red lights. However, it would not give details of their identities.
The two projects are in addition to eight IT initiatives revealed by the National Audit Office in November last year to have received consecutive red lights. The 10 represent IT projects which the OGC is most concerned about. According to the OGC’s official guidance, a red signifies that “remedial action” must be taken immediately – although it does not necessarily mean that a project must be stopped.
The OGC revealed the stages at which the projects had received a second red. One project received two reds at ‘gate zero’, while the others were given between gates one and four. Gate zero is the initial sanity check for a project. It assesses the funding, leadership and purpose of an initiative.
Two initiatives failed at gate four, which means they were unready for service after earlier stages of development.
The OGC refused to release further details as it judged the “public interest in disclosure was significantly outweighed by the public interest in non-disclosure”.
In justifying its decision to withhold information, the OGC said: “An important general consideration in the balancing exercise was the clear public interest in maintaining the integrity of the Gateway Process as an effective and prompt peer review process producing reports based on candid interviews for the benefit of Senior Responsible Owners and which has led to demonstrable VFM [value for money] gains.
“Gate interviewees must be able to be candid about matters which could lead to serious recommendations being made to the Senior Responsible Owner of the projects/programmes. This would particularly be the case with the recommendations and RAG [red, amber, green] statuses that you have requested.”

http://management.silicon.com/government/0,39024677,39128275,00.htm

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MPs told prescribers plans may jeopardise patient choice

Dr Search- Principal Consultant at the Search Clinic — Wed, 02 Mar 2005 10:46:00 +0000

Pharmacist representatives have told MPs that plans to allow GPs and other prescribers to nominate a patient’s pharmacy for electronic transmission of prescriptions (ETP) will jeopardise patient choice.
The Pharmaceutical Services Negotiating Committee (PSNC) is lobbying the Department of Health and the National Programme for IT (NPfIT) to change the system so that choice of pharmacy lies solely with patients. Lindsay McClure, head of information services for the PSNC, told an All Party Pharmacy Group meeting on NPfIT last week that patients should continue to have the choice of which pharmacy to have their prescriptions dispensed at and not have that decision made for them.
She told EHI Primary Care: “We do have concern that prescriber nomination of a patient’s pharmacy will lead to direction of prescriptions rather than patients having a genuine choice. We don’t believe any prescribers, including GPs, nurses or pharmacist prescribers, should be able to nominate a pharmacy and if that does go ahead there needs to be systems in place to prevent abuse.”
Current plans for ETP, which began implementation at one early adopter site this week, are that patients will eventually be able to nominate a pharmacy via the internet, in their GP surgery or at their pharmacy. Those who do not wish to nominate a preferred pharmacy will be given an ‘e-prescription token’ – currently a prescription with a barcode – that can be presented at any pharmacy for the prescription to be dispensed.
An NPfIT spokesperson told EHI Primary Care that prescribers will also be able to nominate pharmacies. He added: “The ETP model supports the nomination of pharmacies by prescribers. The process surrounding nomination has yet to be defined and is currently under discussion with both GP and pharmacy user groups.”
McClure told the All Party Pharmacy Group meeting that the PSNC was also concerned that during the roll- out of ETP a level playing field was maintained between ETP-enabled and non-ETP-enabled practices.
Later she told EHI Primary Care: “There is a risk there but we have been talking to the National Programme about this and we do feel slightly more positive about that.”
McClure also told MPs that NPfIT needed to improve clinical engagement with pharmacists and called for the programme to appoint a national clinical lead for pharmacy.
She added: “ETP itself is only the tip of the iceberg of what the National Programme can offer pharmacies. The NHS Care Records Service and access to patient information has the potential to realise many more benefits for the profession.”
She said the PSNC was expecting the Department of Health to consult shortly on community pharmacy access to patient records.
Harry Cayton, chair of the Care Record Development Board, also spoke at the All Party Pharmacy group meeting. He told MPs that the Care Record Guarantee is currently awaiting ministerial approval. This will lay down a framework for how records will be created and shared, how they will be used, how consent will be obtained and confidentiality achieved.
The All Party Pharmacy group is writing a report to ministers following the meeting which it expects to finalise by the end of the week. A spokesman for APPG said the report is likely to share concerns expressed at the meeting about the implications of prescribers being able to nominate pharmacies.
He added: “A system in which electronic scrips are sent to a central point for pharmacies then to pull down would maintain patient choice and avoid the potential problems associated with nomination.”
The report will also back calls for a national clinical lead for pharmacy. A spokesperson for NPfIT said the appointment of a clinical lead for pharmacists was currently being considered.

http://www.e-health-insider.com/news/item.cfm?ID=1069

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Hundreds of babies hit by MRSA hospital superbug

Dr Search- Principal Consultant at the Search Clinic — Tue, 01 Mar 2005 10:24:00 +0000

HUNDREDS of babies, many just a few days old, have been infected with the deadly superbug MRSA in hospitals across Britain. A study by the Patients Association has found that it is now commonplace for babies aged from a few days to four weeks to catch MRSA.
The Department of Health is so concerned about the increased number of cases of babies with MRSA — methicillin-resistant staphylococcus aureus — that it has commissioned a £140,000 study into the problem.
Some babies have caught the infection from their mothers but others have picked it up in neonatal units. The trend has surprised health experts because neonatal units are considered to be the cleanest wards in a hospital.
Professor Hugh Pennington of Aberdeen University, a microbiologist and expert in hospital-acquired infection, said: “If babies are getting MRSA, that is of concern because it shows there is something seriously wrong with the infection control procedures.”
He said it was likely the infection had been carried into the neonatal units by people walking from ward to ward. “If we had been more aggressive in tackling the problem, like the Dutch and the Scandinavians, this would not have happened.”
Hospitals in the survey refused to say whether any babies had died from the bug, citing patient confidentiality.
Babies who catch MRSA from their mothers carry the bug from the moment they are born. This only puts them at risk, however, if the MRSA gets into a wound or the bloodstream.
But hospitals questioned by the Patients Association have disclosed that babies are being infected with wound and bloodstream infections while being treated on neonatal units. A baby being cared for by Portsmouth Hospitals NHS Trust was found to have MRSA at just eight days old. In the past three years the trust said 38 babies aged under four weeks had been found to have MRSA while being treated by the trust.
At the University Hospital of North Staffordshire NHS Trust, the youngest baby found to have MRSA in the bloodstream was 19 days old. Over the past three years two other babies of less than four weeks had contracted MRSA in their bloodstreams while being treated.
The picture is similar in hospitals across England. Eastbourne District General hospital admitted it had to close its baby unit for a week last year because five babies were carrying MRSA.
The Patients Association questioned the 30 NHS hospitals with the worst MRSA records to gather information for its Clean Hospital Summit due in April. The conference is being chaired by Claire Rayner, the association’s president, who herself became infected with MRSA during a routine operation at an NHS hospital.
Katherine Murphy, communications director of the association, said: “We would not previously have contemplated that babies being treated in neonatal units, which we think of as being scrupulously clean, could be infected with MRSA.
Dr Mike Sharland, a paediatric infectious disease consultant at St George’s hospital in south London, where six babies aged less than a year old have caught MRSA in the past year, said the NHS accepted that infant infections were a growing problem.
Earlier this month it emerged that a boy aged three who banged his head in a playground accident died five weeks later after picking up the MRSA superbug in hospital.
The number of people dying from MRSA has doubled in the past five years from 487 to 955, according to the Office for National Statistics. Experts believe the actual number is much higher as MRSA is not always mentioned on death certificates. The National Audit Office has estimated 5,000 deaths a year from hospital-acquired infections.

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