Dentists are still encouraging patients to return for excessive appointments and follow-ups, putting income ahead of care, research suggests.Data gathered by the Conservatives shows dentists to be “gaming the system”.

The Tory analysis, based on figures for 2008-09, suggests that 6.8 million slots could have been made available to those without access to an NHS dentist had they not been used for excessive appointment-setting or needless splitting of courses of treatment into separate sessions.

The Tories calculate the cost to NHS patients of “unnecessary charges” at £117 million, up from £109 million the year before. The burden represents a fifth of the £572 million charged each year for treating NHS patients.

Andy Burnham, the outging Health Secretary, acknowledged last year that dentisty remained “unfinished business” after the failure of a new dentists’ contract to address problems with a so-called drill and fill culture.

An independent review ordered by the labour Government, led by Jimmy Steele, of Newcastle University, found that dentistry was too preoccupied with treatment rather than prevention, and that dentists should be paid according to the number of patients on their list and penalised for poor work that leads to repeated visits.

Professor Steele’s proposals, which were accepted by the Government and put into pilot schemes, include rewarding dentists for registering new patients and building relationships with existing ones. Income is determined by the size of the patient-list, quality of care and the number of courses of treatment.

Andrew Lansley, the Tory health spokesman, who acquired the figures from parliamentary questions in February, said that the lack of political drive to rectify problems with dentistry was shown by its absence from the manifestos of Labour and the Lib Dems.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7115298.ece

A report highly critical of the labour Government’s alcohol strategy was published quietly the same day that a ban on the recreational drug mephedrone was recommended.

Changes are proposed in the report by the Advisory Council on the Misuse of Drugs (ACMD), which also accuses ministers of being insufficiently “pro-active” in their efforts to curb excessive drinking.

The report says pubs and restaurants should use a standard measure, so drinks contain similar amounts of alcohol.

Instead of measuring drinks in terms of volume – a “large” or “small” glass of wine – they should be measured in units of alcohol, so customers understand how much they are drinking.

The report was submitted nine months ago but published only on 29 March, after the council issued its recommendation for the ban on mephedrone. It was ignored due to the outcry surrounding the drug.

Strong beers and lagers should attract higher taxes and a ban on drinking games in colleges and universities should be considered, the report says. A lower blood alcohol limit should also be imposed for drivers under 25 because of their high accident rate, it adds.

The report, Pathways to Problems, provides a detailed look at progress on recommendations made by the council in 2006 on hazardous drug use.

A foreword by Caroline Healy, chair of the Pathways to Problems group who works for the Department of Health, and Professor David Nutt, former chair of the ACMD until he was sacked last November, says the council is “still concerned” about young people’s use of alcohol.

“The ACMD has already made known its concerns that the Government did not go to consultation on its alcohol strategy, and we believe the Government should take a more pro-active approach towards discouraging the culture of excessive drinking and promoting the ‘less risky drinking’ message,” it says.

The proposal to switch from measures of volume to measures of alcohol is aimed to halt the trend of serving wine in larger glasses. The report says: “Nowadays, even a small glass of wine represents a large quantity of alcohol, and this encourages ever greater quantities of alcohol to be consumed.”

Professor Nutt, a specialist in addiction at Imperial College, London, said: “If you order a glass of wine and you don’t get a schooner you think you are being overcharged. If you are given a standard glass you think that’s very small. There has been a slippage in public attitudes. People still think one glass of wine is one unit of alcohol when it might be two or four.”

Professor Nutt cited the example of the Labour Party in Scotland which voted against a proposal by the ruling Scottish Nationalist Party to tax beers and lagers according to their strength. “They [labour] opposed it [saying] it would be an unfair tax on the poor. But [low taxes] just encourages them into a state where they become alcohol-dependent.”

In the Netherlands, he said he had been served a Belgian beer in a small glass containing a third of a litre. The barman said it was not available in larger glasses on account of its strength.

A spokesman for the British Beer and Pub Association said: “There are standard serving sizes for beer, cider and spirits. As for wine, 85 per cent is drunk at home, and in restaurants it is mainly bought by the bottle. In pubs, there should be a choice of 125ml or 175ml glasses and there are 250ml glasses available in some.”

From:http://www.independent.co.uk/news/uk/politics/critical-alcohol-review-hidden-by-mephedrone-row

Women should be tested for chlamydia every time they have a new sexual partner to cut their chances of pelvic disease, UK researchers say.

A study of 2,500 students found that annual screening is not enough to prevent cases of pelvic inflammatory disease, which can cause infertility.

In those who were found to have chlamydia, treatment cut the risk of pelvic disease by 80%.

The National Chlamydia Screening Programme backed the findings.

The researchers from St George’s, University of London, concluded that most cases of pelvic inflammatory disease were in women who did not have chlamydia when they were tested a year earlier.

The findings, published in the British Medical Journal, suggested they may have become infected in the 12 months after screening.

Chlamydia is the most common sexually transmitted disease in the UK and the number of cases is steadily rising.

The researchers recruited sexually active female students between the ages of 16 to 27 from 20 universities and colleges in London.

They were swabbed at the beginning of the study and tested for pelvic inflammatory disease, which as well as infertility can cause chronic pain and increase the risk of ectopic pregnancy, a year later.

The researchers found that most cases of pelvic inflammatory disease occurred in women who tested negative for chlamydia when they were initially tested.

Study leader Professor Pippa Oakeshott, who also works as a GP, said: “The crucial message is that individuals should get tested every time they have a new sexual partner.”

But she added that chlamydia was not the only cause of pelvic inflammatory disease.

“It’s probably several bacteria that cause it, and we should probably be screening for other things, but chlamydia and gonorrhoea is a good start.”

She also said testing needed to be more accessible to young people, with kits being given out in colleges and youth clubs.

A spokesman for the Health Protection Agency said the findings reinforced the testing policy of the National Chlamydia Screening Programme, which was launched in 2003.

“The study, looking at a single annual test, shows the importance of the programme’s approach to testing annually or on change of sexual partner because most cases of pelvic inflammatory disease occurred in women who initially tested negative for chlamydia.”

Last year the National Audit Office criticised the screening programme for duplicating effort and failing to test as many of the under-25 target group in England as it should have.

From: http://news.bbc.co.uk/1/hi/health/8609354.stm

The NHS is facing upheaval and cutbacks as a decade of budget increases comes to an end and £20 billion of savings must be found over the next five years.

Despite pledges from Labour and the Conservatives to protect front line services, there is evidence that their promises may have come too late.

A list of cuts has already been identified – including job losses, banning certain operations, closing casualty departments, downgrading maternity services and reducing the number of junior doctors. But these have been mostly quietly ignored by the three main parties.

The Conservatives pledged to stop all closures until they could be reviewed but, with billions of pounds of savings needed to cope with growing demand, cuts and closures are almost inevitable.

David Cameron emphasised that he was personally in favour of the NHS, after his experiences with his disabled son Ivan, who died last year, to combat arguments that the health service was not safe in Tory hands. The party manifesto contained promises about dentistry and round-the-clock GP services which appear too expensive in the current climate.

Both the major parties were accused of chasing the “fear of cancer” vote. The Tories said they would fund cancer drugs turned down by Nice, the health rationing watchdog, but did not mention drugs for other illnesses such as arthritis or dementia.

Labour said cancer patients would see a specialist and have test results back within a week. The party was criticised for unveiling its manifesto at a new hospital in Birmingham. It is against the rules to use NHS premises for election events.

But Labour pointed out that the hospital was still in the hands of the private finance initiative organisation – a policy which means the NHS will be repaying billions of pounds for new hospitals for decades.

Nick Clegg refused to ring-fence NHS spending given the size of the national debt.

The Liberal Democrat campaign focused on cutting waste on managers, scrapping regional strategic health authorities and pledging more power to communities to direct the health service locally.

From: http://www.telegraph.co.uk/General-Election-2010-cuts-inevitable-as-NHS-must-make-savings

The NHS is sending millions of patient records and confidential medical notes to India for processing — despite a pledge by Labour that personal information would not be sent overseas.
It is the first time that databases of names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments.

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

The rising rate of blunders in IVF treatment ‘may be systemic’, says leading patient safety expert

The number of reported mistakes a t the 138 fertility clinics in England and Wales nearly doubled in the year to April 2009, rising to 334 from 182 the previous year. One leading patient safety expert has now warned that blunders which have occurred as record numbers of women seek treatment, may be “systemic”.

The increase comes as one clinic, IVF Wales, is at the centre of a fresh scandal after losing the last two remaining embryos it had frozen for one of its patients. It is the second time in less than 12 months that a mix up at the centre, based at University Hospital of Wales in Cardiff, has left patients devastated.

The Cardiff-based couple has had their eight-year quest to have a baby put on hold as a result of the blunder, which followed an initial, unsuccessful course of IVF. The pair, identified only as Clare and Gareth, are suing Cardiff and Vale University Health Board, which last year paid out a five-figure sum in compensation for negligence after another mix up.

Guy Forster, a solicitor at the law firm Irwin Mitchell who is representing the couple, said the incident raised questions about the Government’s IVF watchdog, the Human Fertilisation and Embryology Authority.

“This raises concerns about the HFEA’s ability to regulate the IVF industry properly. I think it should be doing a lot more to follow up when an incident occurs, especially at a clinic with a poor track record,” he said, adding: “These problems appear to be on the rise.”

An official review last year found that the HFEA was failing to punish badly run fertility clinics by not using the “full range of sanctions” at its disposal. Professor Brian Toft, a patient safety expert at Coventry University, said: “If the HFEA fails to clamp down when something has gone wrong then things will continue to go wrong.”

He said the rise in reported incidents, uncovered by BBC Radio 5 Live, implied clinics were not learning from their mistakes, adding: “I have been told there are not enough qualified staff doing the work. HFEA do not make any recommendations for staffing levels per number of patients. If you have a lot of patients and not enough staff, this could account for an increase in errors. This problem may well be systemic.”

Professor Sammy Lee, an IVF expert, said the watchdog must ensure clinics comply with regulations. “They need to obtain staff that have experience of enforcement and are able to make sure that regulations are put into place,” he said.

An HFEA spokesman played down the increase in blunders, which he said was partly due to new rules requiring clinics to include incidents when patients suffered from ovarian hyperstimulation syndrome (OHSS). “The number of reported incidents has increased as the sector has responded positively to the opportunity to share lessons learned from incidents which have been reviewed and investigated,” the HFEA added in a statement.

From: http://www.independent.co.uk/errors-at-ivf-fertility-clinics-double-in-just-one-year

On election day Health Direct quotes this cancer specialist- The internal market has been a costly disaster. Let the professionals manage medicine.

It’s election time, and our glorious political classes are marching forward on the massed ranks of the electorate with banners that claim that their party, only their party, will save the NHS.

Politicians clamour to praise its world-class status and laud the dedication of nurses and the skill of its doctors. And all parties are united in the view that, despite the need for austerity measures, frontline staff and services will not be cut. So where are the savings planned? Watch the hand and not the mouth.

When I started in medicine, the hospital was run by about three people. Things were so much more simple when doctors and nurses treated patients, doing their best without the guidance of guidelines and targets, doing their best … yes … to make the patients better.

How did we manage without forms to fill and waiting times compliance? Quite well actually. The medical director ran the medical side of things while matron and the accountant handled the rest. It wasn’t much of a business then: it didn’t have to be, because there was no internal market to manage.

The internal market — Mrs Thatcher’s plan to introduce efficiency by having hospital compete against hospital to provide patient treatment — has wreaked havoc. It has spawned a nation of administrators, here today and gone to another post tomorrow — while doing nothing to bring costs under control.

The internal market’s billing system is not only costly and bureaucratic, the theory that underpins it is absurd. Why should a bill for the treatment of a patient go out to Oldham or Oxford, when it is not Oldham or Oxford that pays the bill — there is only one person that picks up the tab: the taxpayer, you and me.

And there are big problems with the billing process. For example, if a patient is seen in an outpatient clinic then there is a charge made by the hospital for his or her first attendance — but follow-up appointments are not charged. And if many treatments are given in a hospital to a patient, only the most expensive of the treatment episodes is charged.

There are savings to be made. It is alleged that there are just 75,000 administrators at work in the NHS but this figure is laughably mythological. Doctors and nurses know that there are many more than this. They look around and see the numbers increasing.

One report by the Centre for Policy Studies published in 2003 indicated that there were 250,000 administrative staff employed in the NHS: at least one administrator for every nurse. In recent times the rate of increase of admin staff within the NHS has exceeded that of nursing staff.

There is a general feeling in the NHS of disempowerment of the professionals. People can’t face up to the incredible struggle, the disapproval that faces any of them if they have the temerity to suggest that things should be run differently.

The principle of care for all from cradle to grave is worthy and wonderful. But the current reality is a cradle rocked by accountants who are incapable of even counting the number of times that they have rocked it. The reality is gravediggers working with a cost improvement shovel made of rust.

Over the years politicians have made dramatic changes to the way that the NHS has been run. Recent changes have caused fragmentation and not led to any cost saving. Moving patients from one place to another does not save the nation’s money, though it might save a local hospital some dosh. So the internal market has failed because it does not consider the health of the nation as a whole, merely the finances of a single hospital department, a local hospital or GP practice.

So what should we do? Let us go back to the old discipline of the NHS. Let the professionals manage medicine, empower the professionals, the doctors and nurses and shove the internal market in the bin and screw down the lid.

At this election time please let us hear from all political parties that they will ditch this absurd love-affair with the internal market. Instead let them help the NHS do what it does best — treat patients, and do so efficiently and economically without the crucifying expense and ridiculous parody of competition.

Professor Jonathan Waxman is a consultant oncologist

http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article7112167.ece

Heroin should be routinely prescribed on the NHS as a way of weaning drug users off their addiction, the head of the country’s top nursing union has said.

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two thirds over six months.

Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article7108342.ece

The NHS reported the highest number of serious data breaches of any UK organisation since the end of 2007, the Information Commissioner’s Office says.

David Smith, deputy commissioner at the ICO told the Infosec security conference the NHS had highlighted 287 breaches to it in the period.

That accounts for more than 30% of the total number reported.

The NHS – the UK’s largest employer with 1.7m staff – has only started the process of rolling out digital patient records.

Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.

Mr Smith said the problems were not confined to the public sector and that results could be skewed because the public sector has a culture of reporting all breaches whereas not all private sector firms did.

Richard Vautrey, the deputy chair of the British Medical Association’s GPs committee thinks the number of breaches reflect the size and complexity of the NHS as well as its culture of openness.

“So many people have access to data and often human error is to blame. There is an increased attempt to be open and honest about what happens to data,” he said.

He added that he was not aware of a specific case where a data breach had affected patient privacy or care.

“We need to keep their breaches in perspective,” he said.

As part of its plans to digitise patient records, the NHS is asking patients if they want their data stored on national databases. It is important that people are given the chance to opt out, said Mr Vautrey.

Currently the reporting procedure for data breaches in the UK is voluntary although the ICO is “moving towards” a compulsory system.

In April the ICO introduced fines of up to £500,000 for serious data breaches.

The European Union’s Telecoms Package requires telecom firms to report data breaches and Mr Smith said he expected this requirement to expand beyond telcos.

Data encryption firm PGP welcomed the tough new approach to data security.

“Finally the ICO, which has long demanded greater powers, will be able to severely punish those in serious breach of the Data Protection Act. For too long, organisations have continued to ignore the warning signs – risking both the privacy of their customers and the reputations of their brands,” said Jamie Cowper, European marketing director at PGP.

He anticipates “severe fines” for the next private sector company to be involved in a serious data breach although he does not imagine the ICO will pursue the NHS.

PGP calculated that data breaches cost companies, on average, £67 per piece of data lost.

From:

http://news.bbc.co.uk/1/hi/technology/10089066.stm

Health Direct asks- given that the NHS has the worst record of data security and that labour politicans have already sent 250,000 political letters to cancer sufferers- are you CERTAIN that your medical records will be safe on the Snoopers Charter database? If not OPT OUT NOW- whilst you still can!