Winter NHS deaths rise a national scandal

The highest winter NHS deaths figures in almost 10 years should act as a "deafening wake-up call" for the labour Government, charities said today.

There were an extra 36,700 deaths in England and Wales from December 2008 to March 2009, compared with the average for non-winter periods, figures from the Office for National Statistics (ONS) showed.

This was the highest number since the winter of 1999/2000 and a rise of 49% compared with 2007/08.

Andrew Harrop, head of policy at Age Concern and Help the Aged, said: "It is a national scandal that the UK has more older people dying in winter, compared to the rest of the year, than countries with more severe weather, such as Sweden and Finland.

"Excess winter deaths of older people have remained stubbornly high in recent years, but last winter's huge spike sounds a deafening wake-up call about the older population's well-being if we have another cold snap.

"To end this national scandal, the Government must do much more to tackle fuel poverty, which currently affects one in three older households."

Fuel poverty charity National Energy Action (NEA) warned that a combination of high energy prices, low incomes and poor insulation will continue to pose a serious threat to the health of millions of people, especially pensioners, during the coming months.

Jenny Saunders, NEA chief executive, said: "The Government needs to step up action that will end these shameful statistics and comprehensibly tackle fuel poverty in the UK."

The winter of 2008/9 had the coldest average winter temperature since 2005/6, one of the factors which affects the number of so-called excess winter deaths, an ONS spokesman said.

He added that the Health Protection Agency (HPA) said influenza activity started early and reached moderate levels during the winter of 2008/9.

Temperature and levels of disease in the population are two of the key factors which contribute to the number of deaths.

The greatest number of excess winter deaths occurred in people aged over 85, the ONS figures showed.

Women accounted for the highest number of excess winter deaths, a fact mostly explained by the higher number of women than men aged over 85, the ONS said.

There were 21,400 excess winter deaths in women and 15,300 in men in the winter of 2008/9, the ONS said.

But the largest increase - 59% - was in men aged 75 to 84, with the overall rate for men 44% higher than the previous year.

Among women, the overall rate increased by 52% compared with 2007/8.

A Department of Health (DH) spokesman said: "The causes of excess winter deaths are very complex. Last year was a colder than average winter, which explains some of the extra deaths seen.

The NEA called for an extension of the winter fuel payments "to include other vulnerable households and not just those who are over 60".

It also urged the Government to increase the budget for the Warm Front Scheme - which provides a package of insulation and heating improvements up to the value of £3,500 - to £530 million next year.

Ms Saunders said: "As it stands, the budget for 2010 is set to be cut back by around 50% on this year's budget.

"I urge the Chancellor in his Pre-Budget Report on December 9 to increase support for the life-saving heating and insulation measures available to low income households under this flagship programme.

"People need to be aware of the help that is available to them through the various grants and schemes from DECC, energy companies and our own Warm Zones where we have established these with local authorities.

"Pensioners in particular are often anxious to avoid debt and turn their heating down or even off, often unaware that they are putting their health in danger."

She said there were more than five million households who cannot afford to heat their homes, putting them at risk of serious health problems like heart disease, strokes, respiratory illnesses - such as asthma and bronchitis - and exacerbating common ailments like colds and flu.

She added that the increase in excess winter deaths was "sadly expected but remains extremely worrying".

From:

http://www.independent.co.uk/winter-deaths-rise-a-national-scandal

Reverse e-auctions an invitation to cut standards

One company boss who took part in the London Procurement Programme’s reverse e-auctions in May called them depressing.

The chief executive, who wished to remain anonymous, said he thought that the company had completed the procurement process after submitting a 206 point questionnaire, with 9 attachments, followed by a 122 question tendering document with 18 attachments in February.

“We heard nothing for a month, which was odd given the contracts were to start on April 1. Suddenly we were told, ‘Congratulations. You have been selected to take part in a reverse e-auction’.”

On May 19 the chief executive sat down with his finance director, logged into the LPP website and waited for the bidding to start.

The company had submitted tenders to provide palliative care and care for physical frailty and dementia. It had made bids of more than £1,000 a week for places in its homes. To take part in the e-auction it had to drop its price by at least £8 at a time. When bidding began the company was told its price was in the bottom five in the shortlist of 20.

“We wanted to test the system so we gingerly put in a bid of £10 below what we had tendered. Our position didn’t change,” he said.

“After a few more bids our position had not changed at all. By then we had reached the point where we could not cut the price further without undermining the quality of care so we stopped.”

In all, the company took part in three e-auctions. “In the end we really pushed it and cut our price by over £100 really just to see what would happen. I think we moved up a few places to 15th. It was a very depressing experience.

“You are filled with dread about what you are going to have to cut back on to get within the winning price. It is devoid of any human consideration. It’s fine if you are supplying stationery, but we are talking about human beings. This is an open invitation to companies to cut standards.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401125.ece

Health Direct points out that reverse auctions are the result of the desire to get something for nothing.

They very rarely work as the winning company often has to come back for more money when they find they cannot provide the service to the standard required for the winning bid. It is a fallacy that it saves money!!

Labour breaks promise to care home residents funding

A high profile group of organisations have written to Care Minister Ivan Lewis after the Department of Health reneged on its promise to consult on increasing the Personal Expenses Allowance (PEA) for more than 250,000 care home residents.

The organisations, which include Age Concern England, the Local Government Association and MENCAP, have also criticised the Department’s decision to raise the allowance paid to care home residents by a mere 70p.

The PEA is all that state-funded care home residents are allowed to keep for spending on day-to-day items such as newspapers and toiletries. Under regulations recently approved by Parliament, it has been uprated by just 70p to £21.15 per week.

This has also provoked anger among MPs. Lib Dem Leader Nick Clegg MP has led Parliamentary opposition by signing a Commons motion ‘praying against’ the regulations introducing the increase, alongside a number of Front Bench colleagues.

Following a concerted campaign over the last year to highlight the inadequacy of the PEA, the Department of Health pledged to consult on increases to the payment. However, this promise has not been kept, prompting the organisations to take the step of joining together to write a strongly-worded letter to Ivan Lewis. In the letter, they call on him to honour the Department’s pledge to consult and announce an acceptable level for the PEA in this year’s Pre-Budget Report.

The organisations who signed the letter are Age Concern England, Counsel and Care, Help the Aged, the Local Government Association, MENCAP, National Association of Financial Assessment Officers, NHFA Care Fees Advice and the Residents and Relatives Association.2

The letter states:

“From our discussions with older people, we know this is an issue they are deeply concerned about. We therefore hope you will take the opportunity provided by the forthcoming public consultation on social care to seek the views of older people about this. We would then hope the Government could be in a position to announce an acceptable level for the PEA by the time of the Pre-Budget Report.”

Signed by:
* Gordon Lishman OBE, Director General , Age Concern England
* Paul Cann, Director of Policy and External Relations, Help the Aged
* Dame Jo Williams DBE, Chief Executive, MENCAP
* Philip Spiers, Managing Director, NHFA Care Fees Advice
* Stephen Burke, Chief Executive, Counsel and Care
* Anne McDonald, Programme Director Community Wellbeing, Local Government Association
* Gillian Dalley, Chief Executive, Relatives and Residents Association
* The National Association of Financial Assessment Officers
From:
http://www.ageconcern.org.uk/AgeConcern/62E9AC0FB0C1434B80C62B771AF7C1EF.asp

NICE's Alzheimer's court win condems thousands to more suffering

NICE has thwarted campaigners who have failed in their High Court bid to force the NHS to fund Alzheimer's drugs in people with early stage disease. However, the National Institute for Curbing Expenditure (NICE) has been told to rewrite guidance on how the disease is assessed.

The Court upheld NICE's decision that the drugs are only cost effective in later stage disease. It is the first time a judicial review had been sought on NICE guidance.

Drugs company Eisai brought the case to the High Court with support from fellow drugs firms Pfizer and Shire and the Alzheimer's Society and are now planning to appeal the decision.

They were successful on one count - that tests to assess Alzheimer's are discriminatory in people with learning difficulties or those who speak English as a second language.

But claims that NICE did not properly evaluate the impact of the drugs on the quality of life of carers and that the figures on the cost of long term care used in their analysis were too low were not upheld by the court.

The judge dismissed two further claims of irrationality and procedural fairness.

That means patients with early-stage Alzheimer's will still not be recommended for funding.

NICE guidance in 2001 recommended the drugs - which can make it easier to carry out everyday tasks - should be used as standard.

But guidance published in November 2006, after months of appeals, stated that the drugs should only be prescribed to people with moderate-stage disease.

NICE said the drugs, which cost about £2.50 a day, did not make enough of a difference to recommend them for all patients and were not good value for money.

The Alzheimer's Society said they had won a very important point that NICE guidance is unlawful because it discriminated against significant groups of people. But called the overall ruling "insulting and devastating news".

Andrew Dillon, chief executive of NICE said: "Our guidance stands and the drugs continue to be recommended only for people with moderate Alzheimer's disease, but the court has asked us to clarify our guidance when it is used for certain groups.

Dr Paul Hooper, Managing Director of Eisai UK, said: "The guidance NICE has issued is morally reprehensible. "They are denying patients access to early treatment and that is wrong."

Harriet Millward, deputy chief executive of the UK's largest dementia research charity, the Alzheimer's Research Trust, said: "We are devastated that these drugs will remain unavailable on the NHS to people with early-stage Alzheimer's when they might benefit from them.

"We urgently need to do more research to find better treatments, but research is currently hugely underfunded - we are scraping for every penny to fund vital work."

But Mervyn Kohler, Help the Aged special adviser said the ruling represented "some progress".

"It is important that NICE examines its guidance on these drugs, not just in the light of the ruling today but bearing in mind the public concern which the case has demonstrated."

Gordon Lishman, director general of Age Concern, said the ruling was disappointing.

"The drugs can cost as little as £2.50 a day per person and could make day-to-day life far more manageable for thousands of people."

But Professor Richard Gray, director of the University of Birmingham Clinical Trials Unit, said the court made the right decision.

From:
http://news.bbc.co.uk/1/hi/health/6939950.stm

NICE's Alzheimers drug ban is abhorrent the High Court is told when Health Direct posted on 26 Jun when the health watchdog NICE's decision to deprive 100,000 mild Alzheimer's victims of a £2.50 a day drug that can delay the onset of the disease was condemned as "abhorrent and disgusting" in the High Court yesterday.

There are about 100,000 new cases diagnosed each year. They claim Nice has ignored the proven benefits of the drugs. They want Nice to be forced to reconsider its decision that the drugs be given only to moderate and severe Alzheimer's sufferers.