Measles cases triple with no backup vaccine stocks

Parents are being urged to give their children the measles, mumps and rubella jab before the start of the new school year after an unprecedented surge of measles cases was recorded over the summer holidays.

Experts fear that hundreds of thousands of children returning to school as early as next week may cause the highly infectious disease to spread.

Despite this the labour Government has ordered no extra stocks of the MMR vaccine and doctors may run out if they face a sudden rise in demand, The Times has learnt.

The Health Protection Agency (HPA) said that the number of confirmed cases of measles in children had more than trebled over recent months and was far higher than would normally be expected for this time of year.

By June 10 only 136 cases of measles had been confirmed. But just over 11 weeks later this number has risen to 480, with new cases being detected every day, the HPA said. This compares with 756 cases recorded during the whole of 2006 – the highest year on record.

Measles, which can be life threatening or cause severe disabilities, is most common among children aged 1 to 4 who have not been immunised, but can strike older children and adults, too.

It was difficult to explain the large increase this year, the HPA said, but parents not vaccinating their children and a lower uptake of a second MMR “booster” dose are thought to be key factors.

The triple vaccine has proved highly controversial in recent years over unfounded concerns that it may be linked to autism. The study that first sparked fears about its safety is currently being scrutinised in a hearing by the General Medical Council, the medical watchdog. Andrew Wakefield and two co-authors of his research are currently appearing before the GMC on charges of serious professional misconduct.

MMR coverage began to drop in the late 1990s, though uptake is rising slowly again. The latest figures show that 88 per cent of British children begin school having had one dose of MMR.

The latest data, for January to March 2007, showed particularly high numbers of measles cases in London and southeast England, East Anglia and Yorkshire and Humberside.

Mary Ramsay, a consultant epidemiologist at the HPA, said yesterday: “We’ve been very worried because the cases have stayed up over the summer holidays. This means it is crucial that children are fully immunised with two doses of MMR before they return to school.”

In previous decades, measles could cause an average of 20 deaths a year. Officials are nervous that the numbers could creep up again after gaps in vaccination coverage. “Although the numbers are still small, compared to the history of measles, we’re always worried about measles because very rarely it can kill,” Dr Ramsay added. “We hadn’t had any deaths from measles since the early 1990s, but unfortunately we had one death last year and we don’t want any more.

“Measles is a highly infectious and dangerous illness and, as there is increased close contact in schools, it can spread easily.”

Along with buying school uniforms and other preparations, “parents should think about adding the MMR vaccine to their back to school ‘to do’ list”, she added. “It is never too late to get vaccinated.”

But Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said that many doctors had not been warned to prepare for a sudden demand and could run out of supplies. “GPs will only have ordered as much vaccine as they would typically use at this time of year, so there may not be enough to satisfy a surge in demand,” he said.

“Doctors and nurses will do their best, but at this short notice, they will not be able to run any extra clinics on the weekend and when they run out of supplies there is not much they can do.”

Doctors’ surgeries at Hackney, East London, are dealing with the effect of reduced levels of vaccination, with more than 120 measles cases in the past three months. Most of those were in children under 5 who had not been immunised.

Michael Fitzpatrick, a GP in the borough, said that he was disappointed but not surprised by the latest figures: “Scepticism about the MMR vaccine results in outbreaks of measles like this,” he said. “This was inevitable and I think the only surprise is this hasn’t happened earlier, and on a bigger scale.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/child_health/article2358240.ece

How the Dept of Health and the government is going to clear up this sorry mess is not clear without extra vaccine stocks.

On June 19, 2006 Health Direct posted: Measles- how a spurious health MMR scare brought an old killer back as health chiefs last week reported the worst outbreaks of measles across Britain in 20 years, slow progress was being made in bringing to justice the doctor who sparked the MMR scare.

At the high court in London, lawyers for the General Medical Council (GMC) gave the first public hearing to disciplinary charges against Andrew Wakefield, whose scientific paper published eight years ago caused millions to shun the vaccination for fear that their children might contract autism.

As health chiefs revealed last week, Britain is now in the grip of what has every sign of becoming a measles epidemic. In March the first child in 14 years was killed by the virus. Clusters of infections, such as in Surrey and Yorkshire, have propelled the number of confirmed cases this year to 449, the largest number since the MMR jab was introduced in 1988.

The current preventable measles crisis is a disaster waiting to happen. On June 16, 2006 Health Direct posted: Scare over MMR vaccine safety causes cases of Mumps to soar

With the immunisation rates falling to around 50 per cent in Westminster and other parts of London Scare over MMR vaccine safety causes cases of Mumps to soar as immunisation postcode lottery grows one would think that the GMC would be moving faster than it is to clear up this sorry mess.

NHS deaths could be halved say doctors as 10,000 die needlessly every year

More than 10,000 people are dying needlessly each year after being denied intensive care treatment, according to senior doctors. They have written to the Health Secretary Alan Johnson, warning that many patients are dying after routine surgery because of a failure to identify them as high risk cases.

The result is that they are not monitored closely enough, causing at least 20,000 deaths each year. But consultants say that figure could be halved if high-risk cases were properly identified and transferred to intensive care.

They say the number of critical care beds devoted to post operative patients should be tripled from the 30,000 currently provided, while 50 per cent of patients should receive extra care. Britain has 0.6 critical care beds per 10,000 population compared to 4.4 per 10,000 in the US.

Shadow health secretary Andrew Lansley said: "This is a really critical issue for this country. We have chronically poor levels of intensive care compared with elsewhere."

In the letter to Mr Johnson, seen by this newspaper, 17 eminent anaesthetists demand an overhaul of NHS surgical practices, warning that four times as many patients die in Britain after surgery as in the United States.

The doctors say the health service has failed to introduce simple tests to identify high-risk patients and challenge the health secretary as to why technology proven to cut deaths is used in a fraction of NHS operations.

One of the co-signatories, David Bennett, Emeritus Professor of Intensive Care Medicine at St George's Hospital in London, said: "There are at least 20,000 patients dying after surgery across the UK - that is a very conservative estimate.

"We think we could halve the numbers dying, and save at least 10,000 lives a year, if patients were given the right support. This is a political decision. There aren't many interventions that could have such a dramatic effect."

Increased use of intensive care, combined with better monitoring, could save money by cutting patients' time in hospital and preventing emergency re-admissions, he said.

Prof Bennett said that most hospitals had failed to invest in equipment such as fitness bikes, which help to assess the patient's health prior to surgery, and blood-flow monitors, which maintain fluid levels and cardiac output during an operation.

Despite backing from NHS rationing body the National Institute for Curbing Expenditure (NICE), blood flow monitors are used on less than 10 per cent of patients.

Dr Bruce Taylor, honorary secretary of The Intensive Care Society said more patients should be monitored by intensive care before they became seriously ill. But he said there was "no slack at all in the existing system" to take on more patients without a substantial rise in funds.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/26/nhs126.xml

On March 12, 2007 Health Direct posted: Medical errors- new campaign aims to reduce deaths and costs when a safety drive was launched by the labour government's health watchdog in the face of "alarming" figures on the harm patients suffer in hospital and elsewhere.

Various studies, some using US data, estimate that there is a one in 300 chance of a hospital patient dying as a result of medical error.

One in 10 is estimated to suffer harm, of whom a third suffer serious harm, while studies suggest that 600 errors are made a day in primary care with more than one in 10 prescriptions containing errors.

And again on 4 Nov 05 Health Direct posted: NHS accidents cost £2bn and up to 34,000 lives finds National Audit Office (NAO) when according to a report by the National Audit Office, around a half of incidents in which NHS hospital patients are unintentionally harmed could have been avoided, if lessons from previous incidents had been learned.

Whilst reporting has improved at the local level, at the national level progress on developing a national reporting and learning system has been slower than envisaged in the Department of Health’s 2001 strategy “Building a safer NHS for patients”.

UK stroke treatment is worst in Europe

The UK has the worst outcome for strokes in western Europe despite spending the same amount or more on care as other countries, a leading article in the British Medical Journal warned.

Hugh Markus, professor of neurology at St George’s university and medical school, said three different studies had put the UK at the bottom among several other western European countries.

The problem appears to lie in the way services are organised, with strokes seen as a “Cinderella” subject that falls between neurology and geriatric medicine, Prof Markus said.

Instead it needs to be treated as “a condition that requires emergency action”.

Clot-busting drugs can now be given to patients whose stroke is due to a blocked blood vessel rather than a broken one.

To do that, however, rapid 24-hour access to specialised expertise and imaging equipment is needed to determine the type of stroke. The drugs have to be given within three hours to have most effect and can harm a patient whose stroke is due to bleeding.

“It is unlikely that every acute hospital will be able to provide such a service,” Prof Markus said, and alternative strategies that include regional centres and the use of telemedicine are needed, as in Germany and America.

“In many European countries,” Prof Markus added, brain imaging “is performed on admission to the accident and emergency department, while in the UK many units struggle to provide it within 24 hours.”

A National Audit Office report in 2005 calculated that 550 deaths could be avoided a year, and 1,700 patients would recover fully rather than being disabled, if ­services were better organised.

A stroke strategy is apparently due to be published by the health department in the next few months.

The limited data available, Prof Markus said, “show that European countries with better outcomes focus resources more heavily on the acute aspects of care”.

“The vast majority of the cost of in-hospital stroke care in the UK is for nursing and hospital overheads, with the cost of investigations and medical care being very low.”

At present less than 1 per cent of patients eligible for clot-busting drugs get them in the UK, against 20 to 30 per cent in many European countries and North ­America and Australia.

From:
http://www.ft.com/cms/s/0/d7bdb1d6-518f-11dc-8779-0000779fd2ac.html

It is nearly two years since MPs in the National Audit Office pointed out that hundreds of UK citizens are dying needlessly and over a year since Health Direct posted on July 12, 2006- Stroke patients dying needlessly from Labour's health failures

Since then new Prime minster- same lack of compassion and urgency.

Stroke patients are needlessly dying or suffering more serious disablement because not enough priority is given to stroke services, according to a report by the Commons Public Accounts committee.

The report found that stroke is not treated as a medical emergency, brain scans for patients are often delayed and a significant proportion of stroke patients are not treated on specialist units.

The MPs found:
* Stroke is not treated as a medical emergency in the same way as a suspected heart attack, though the shorter the time between the stroke and the treatment, the greater the chance of reducing damage to brain tissue.
* Brain scans for many stroke patients are being delayed, though a scan is vital for determining appropriate treatment.
* A significant proportion of stroke patients are not being treated on a specialist stroke unit, despite evidence that this is the most clinically effective model for acute care.
* There is considerable variation between hospitals as to what a specialised stroke service entails.
* Public awareness of the symptoms and impact of stroke, and how strokes can be prevented, is very low.
* There are insufficient nursing, therapist and other specialist staff with expertise in stroke care across the primary and secondary healthcare sectors, and there is scope to improve training for the existing stroke workforce in the National Health Service (for example, by training stroke consultants to interpret brain scan results).
* The carers of stroke survivors, and stroke survivors living on their own, are often not accessing the social and care services they need.
* There is low awareness on the part of members of the public and general practitioners about the fact that a transient ischaemic attack ('mini stroke') is a strong indication of increased risk of major stroke, and requires immediate investigation and treatment.

Psychiatric wards at crisis point, says doctor

The crisis facing Britain's mental health wards is laid bare. Speaking exclusively, a senior consultant psychiatrist, who cannot be named, painted a picture of a service at breaking point. The wards are overcrowded, staff are overstretched and seriously ill psychotic patients are often forced to sleep on a sofa because beds have been cut to balance the books elsewhere in the NHS.

The doctor, who is also a representative of the Royal College of Psychiatrists, decided to speak out after a 58 year old female patient was strangled on a mental health ward in Rochdale. A 36 year old male patient has been charged with murder.

The doctor said it was often very difficult to maintain single-sex facilities because of the pressure on beds.

"The wards are packed to the gills with really psychotic patients," he said. "It is as bad as it ever has been."

He said most serious incidents on the wards, such as attacks on other patients or staff, absconding and murders, were a direct result of the pressures on beds.

The consultant said: "There are fewer beds, and staff are under immense pressure to get people out because of the number of people coming in.

"The inpatients are really ill, really psychotic and most are detained under the Mental Health Act.

"Most assaults are covered up. Nurses are off sick because they have been beaten up. There will definitely be more tragedies on the wards if the cuts continue," he said.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/16/npsychic116.xml

On Sept 29, 06 Health Direct posted: Mental health services are 'failing' as watchdog finds that the services are abysmal.

People suffering mental health problems are being failed by poor access to key community services, a watchdog says. Most people with mental health problems are treated out of hospitals.

The Healthcare Commission's review of 174 mental health teams in England found gaps in out-of-hours care, talking therapies and access to information. The watchdog rated only one in 10 as excellent, with nearly half just getting a fair grade.

The scandal of mental health provision- or lack of doesn't just effect the afflicted. On Nov 16 06 Health Direct posted: Scandal of Labour's blunders that led to murder by mental patient

The needs of dangerous psychiatric patients are being put before the safety of the general public, according to a report to be published today on the murder of a retired banker by a mental health patient. The highly critical report into how a psychiatric patient at a south London hospital escaped and attacked Denis Finnegan as he cycled through Richmond Park will reveal how a catalogue of systemic errors led to his death.

Chaired by Robert Robinson, a mental health lawyer, the report is said to be one of the most damning in the past decade. Over 400 pages it details a catalogue of preventable errors at Springfield Hospital which led to Mr Finnegan's murder. It concludes that a special medium secure facility in the hospital, the Shaftesbury Unit, must be closed pending an external audit.

"When people have been negligent it needs to be broadcast far and wide in the NHS. The lack of monitoring of patients like John Barrett is a major issue. I hope that this report will be used nationally to highlight what's gone wrong and to prevent it from happening again."

Whistleblower Surgeon breaks cover over NHS beds crisis

Specialist wards full to breaking point. Patients with serious injuries denied care. A health service paralysed by arguments about funding. Martin Bircher, one of Britain's most senior Accident and Emergency consultants, speaks out.

One of Britain's leading trauma surgeons has broken cover to expose the scandal of a national shortage of emergency trauma beds which is leading to thousands of serious injury victims suffering in agony.

In an unprecedented intervention by a senior practitioner in the NHS, Martin Bircher, a consultant at St George's hospital in London, one of Europe's leading centres in the treatment of major accident victims, has revealed a system paralysed by red tape and disputes over funding, which is putting thousands of patients waiting for treatment in specialist wards at risk.

His revelations have prompted calls for a review of funding for A&E services and a shake-up in the management of Britain's leading trauma centres.

Mr Bircher says the problem is worsened by the bureaucracy of the internal market. He has become so frustrated that he has broken free of NHS strictures against speaking to the press and agreed to talk to The Independent on Sunday about the suffering patients are put through.

Every one of Britain's specialist trauma beds is full, which means some patients can wait up to three weeks after their accident before badly broken bones can be repaired. The delay, says Mr Bircher, can jeopardise recovery.

With nothing but praise for frontline staff, he says patients who have been critically injured in road or other accidents have to wait an average of 12 days – often in agonising pain – before they can receive the vital specialist treatment.

This is because only a limited number of hospitals have the expertise to repair smashed bones, and those hospitals have a shortage of intensive care beds. With the average cost of keeping a trauma patient at around £500 a day and up to £2,000 a day in intensive care, this is also a false economy.

Reacting to the revelations Andrew Lansley, the shadow Health Secretary, said: "It is vital that clinicians are able to prioritise patients according to clinical criteria. It's only if we dispense with central targets and the bureaucratic burdens of the Department of Health that we can give GPs and local hospitals the opportunity to make services more efficient."

John Pugh, the Lib Dem health spokesman, added: "This shows how counterproductive the target culture is. Patients are being shunted in and out of A&E to satisfy the expectations of Whitehall. Medical staff should feel free to act in the best interests of patients."

Squabbles over funding

Mr Bircher, who risks censure from the NHS for speaking out, said primary care trust and bed managers are involved in making the final decision as to whether a patient can be moved. If they have to move them there is often a conflict or reluctance because the new area does not want an extra cost.

So after initial admission to a general hospital's emergency wards, where lives are saved, patients can find themselves waiting up to three weeks before their real recovery process can begin.

Mr Bircher, 52, cited one patient who had a motorcycle accident earlier this month and was referred to him to decide if she needed surgery to repair her badly broken pelvis. However, he did not receive the request for a week because an initial referral to another hospital was "intercepted by the primary care trust" and rerouted to a hospital that did not have a surgeon with the expertise to make the decision.

He called for emergency medicine to be funded centrally.

"These are basic core services that have to be provided," he said. "We shouldn't be sending each other little bills. Trauma and other emergency services like cardiac and stroke services should be top sliced. The money should come from central government funds."

Mr Bircher added that doctors and nurses on the frontline in hospitals should not be criticised. He said they do their best but are hampered by layers of managers whose major concern is the budget rather than patient care.

Delays in treatment

He said: "The delays are caused at various levels. If doctors, nurses, physiotherapists, the treating teams, were left to communicate between themselves without bureaucracy, things would happen much more quickly. In the good old days somebody would ring me up about a patient, I'd say send them across, make one call to sister on the ward and it would happen.

"Now I'm loath to accept a patient unless I'm sure their injury requires surgery. If I'm unsure I ask them to send X-rays. Even in this technological age this can take two or three days. It's not unusual for them to be delayed or get lost.

"It may be decided that the patient needs an operation and we decide to bring them in. There can still be a delay because bed managers are reluctant to accept a patient for three or four days before the operation is due because of the extra costs. So the patients often come in just hours before the operation. It is not unusual for a patient to arrive in the early hours of the morning, a very short time before their surgery.

"You suddenly find the patient may develop a problem and you can't operate. So you've accepted a patient for a slot and then you can't operate. A much better system would be to have a free flow of patients to the trauma centre where we can get to know them preoperatively. But because trusts all have separate budgets, though we're all playing for the same team, there seems to be a reluctance to accept patients at an appropriate time before the operation.

"You can argue whether a patient needs a hip replacement at hospital x or y," he added. "As long as it's done in a reasonable time by a good team it doesn't matter. You can't have these petty squabbles. There just isn't time with trauma."

Patients in pain

His argument is illustrated by Lucy Lynn-Evans, a 21-year-old student from London who was severely injured in a road accident last month. She was riding her scooter to Brighton when she was run over by a 10-tonne lorry which came to rest on her hip. She is alive only because a laptop in her backpack took the full force when the lorry ran over her spine.

Her life was saved a second time by the staff at Redhill hospital, where she was initially taken with a smashed pelvis, smashed knee and leg broken in two places. They gave her a blood transfusion – she had lost five pints – and wrapped her hip, described by doctors as a "bag of crisps", in a sheet which was then pulled tight to keep the fragmented bones together.

This is the correct procedure. But Redhill hospital did not have the expertise to repair Ms Lynn-Evans's bones. That would require specialist surgeons and equipment that can be found only in certain hospitals around the country. All they could do in Redhill was put her on morphine and wait for a bed – which at one point she was told could take up to three weeks.

Her pain was so intense, however, that the morphine "only took the edge off it". "I was in a lot of pain, especially when they log-rolled me to change the sheet," Ms Lynn-Evans said from her hospital bed at St George's on Thursday. "It took four people to turn me. The nights were horrible. The mornings were really painful. The three weeks of waiting is an extra three weeks of pain. You just feel like you're going mad. You feel black and despairing. You want with all your heart for someone to make it better. I asked Dad to leave me outside the hospital because then it would be more likely I'd get a bed, rather than waiting by the phone. I felt despair, lying there feeling empty and feeling that I had to tackle this day by day for weeks."

Lack of beds

Ms Lynn-Evans's problem was that she was stable and not going to die; when a bed became available it would go to another more pressing case. At one point a bed became available at the John Radcliffe hospital in Oxford, but before she could be moved John Radcliffe's fund manager had to agree. The fund manager did not arrive at work until 9.30am. By the time Ms Lynn-Evans's case came to the top of the administrator's pile and permission was granted, the bed had gone.

Fortunately for Ms Lynn-Evans her mother, Julie, is a psychotherapist who works in child mental health. She is also a broadcaster with a string of top NHS officials in her contacts book. She was able to make a fuss where it counts, and her daughter was moved to St George's hospital in London after only five days.

"Because of the problems with the beds I didn't know where to go to after the accident," Julie Lynn-Evans said. "Lucy was taken to Redhill on the Friday and they saved her life. I cannot thank the doctors enough. But they knew they didn't have the expertise to fix her so I was told not to go to Redhill because they were going to move her. Then at 4am I was told to go to Redhill after all. I'd spent the whole time living through a mother's worst nightmare and yet unable to go to my child.

The same night as Lucy, a woman came in from a car crash. She was 63 and had a clot in her lung. Lucy was considered stable, so the woman got her bed. All the time Lucy's having no treatment. As a mother you'd do anything to help your child when you see them in so much pain. But I know that in securing a bed for Lucy, someone else had to wait longer."

Fortunately Lucy is going to make a full recovery, which she and her family put down to the excellent care they have received from surgeons, nurses and doctors at both St George's and Redhill hospitals. The delays, however, caused by bureaucracy and a shortage of beds, could have led to a very different outcome.

"The delays not only cause distress to families and patient, but other serious medical issues – thrombosis, bed sores, chest infections and urine and wound infections," said Mr Bircher. "The longer the bone fragments are left displaced, the more the clot begins to form new bone, thus the harder it is to replace the fragment to the correct position.

Patients suffer

"The first step to dealing with the problem is an acceptance and realisation that the system isn't working with trauma and other emergency services in medicine. Sending each other forms and bills is not a good way of doing it. I'm acutely aware that resources are an issue. But basic emergency services should be of the highest quality. If we consider ourselves a leading nation we should have a first-class emergency healthcare system. We do not, and the situation is worsening.

"It's pot luck where you go. There's not a defined system. We have to fight every day to get patients in. We have to break through the bureaucracy and develop a new system. There is a lack of intensive care beds in London and around the country which further magnifies the problem.

"Direct funding from the centre, perhaps cutting out the trusts, is perhaps a good idea. One must involve clinicians at the sharp end in the decision-making. Like the Bank of England the politicians should let it go. Doctors, honestly, know best."

Dermot O'Riordan, a member of the council of the Royal College of Surgeons, agreed that a number of services – not just trauma – needed commissioning at a higher level and in some cases co-ordinating nationally, although not necessarily centrally funding.

Mr O'Riordan, the RCS council member responsible for the Delivery of Surgical Services Committee, said: "Commissioning of very specialist services, whether elective or emergency, needs to be done at a higher level than a primary care trust. Some need to be co-ordinated by the strategic health authority and some even at national level."

From:
http://news.independent.co.uk/health/article2814751.ece

C Difficile and hospital bugs remain a problem

The number of cases of the potentially dangerous Clostridium difficile (C Difficile) is thriving, figures show. A review by the Health Protection Agency showed hospital MRSA cases had fallen by 10% in the first three months of 2007 compared with a year ago. But rates for C. difficile, which mainly strikes the elderly, rose by 22% this quarter.

Some NHS trusts complained that targets - both clinical and financial - were hindering the fight against infection.

In a separate survey carried out by the Healthcare Commission - an NHS watchdog - some 45% of the 155 trusts said time targets for treating patients in A&E were getting in the way of infection control measures.

These figures represent a very small proportion of the 10 million inpatients that the NHS treats in hospitals every year.

Pressure to move patients to any available bed rather than the most appropriate bed or an isolation ward was one reason cited for the difficulties.

A further 36% of trusts said they were having problems combining investment in cleaning with financial targets, while 88% said their limited IT infrastructure "was restricting their ability to draw important lessons from incidents of infection".

The survey was carried out in May 2006, and the watchdog noted that a number of practices - particularly regarding individual staff objectives for bringing down infection - had changed.

But Healthcare Commission chief executive Anna Walker added: "We cannot afford to lose momentum. Trusts should be asking themselves what more they can do to protect patients and the public from healthcare associated infection."

The National Audit Office has estimated that these infections cost the NHS as much as £1bn each year.

Between April 2006 and March 2007, there were 6,378 cases of MRSA infections reported, compared with 7,096 for the previous year, the Health Protection Agency (HPA) said.

Meanwhile, there were 15,592 reported cases of C. difficile in patients aged 65 and over in England in the first quarter of 2007. This represents a 2% rise when compared with the same period last year, but is 22% higher than the previous quarter.

The HPA says this rise can be explained by the fact that higher numbers of vulnerable people are admitted to hospital at this time of year.

Liberal Democrat health spokesman Norman Lamb said the government had "spectacularly failed" to halt C. difficile.

Shadow health secretary Andrew Lansley called the figures "the tip of the iceberg, because they do not include the number of infections in people aged under 65".

From:
http://news.bbc.co.uk/1/hi/health/6913873.stm

On 2 May 07 Health Direct posted that Deadly NHS superbugs continue rising with C difficile again up when more hospital patients in England are getting the deadly Clostridium difficile bug, figures show.

Health Protection Agency (HPA) data showed 55,681 cases were reported among over 65s in 2006 - up 8% in a year. MRSA cases continued their downward trend, but they are not falling quickly enough to meet Labour's target next year.

Patients Association spokeswoman Katherine Murphy said: "Too many people are dying from these infections. We must learn from other countries such as Holland which have got infection rates close to zero.

GPs out of hours cover- death row shows systemic failure

The partner of a woman who died from septicaemia following flaws in out-of-hours GP care has said he is convinced it could happen again. Penny Campbell, 41, from Islington, north London, died in 2005 after consulting eight doctors in four days. A report said a major system failure in the service was a direct factor leading to Miss Campbell's death.

Her partner Angus MacKinnon has called for doctors found to have provided sub-standard care to be struck off.

Mr MacKinnon, 40, plans to write to the General Medical Council (GMC) about the conduct of four of the doctors. He is also pursuing civil action over the case.

He said he believed the same tragedy could happen again elsewhere in England.

"I've had dozens of people contact me, cases where people had really narrow escapes," he said.

The report identified weaknesses in the arrangements for out-of-hours care nationally.

The report said six GPs provided Miss Campbell with a "reasonable standard" of care but one did not adequately explore her symptoms to see if she had an acute illness.

Mr MacKinnon added: "If Tesco can open till midnight every night, why can't our GPs open till midnight every night?

"I don't want to spend the rest of my life feeling bitter about what happened to Penny. I'd like something positive to come out of it."

Both the Department of Health and Camidoc, the local GP out-of-hours service Miss Campbell contacted, have accepted the finding of the report and said they have accepted, and implemented already, many of the recommendations.

A spokesman for Camidoc said: "The death of Penny Campbell was a terrible tragedy and we at Camidoc continue to extend our sympathies to Miss Campbell's family and friends."

Rachel Tyndall, chief executive of Islington PCT, the lead commissioner for Camidoc, said the NHS trust would learn the lessons.

"There were failings in her care and the systems to guarantee quality," he said.

From:
http://news.bbc.co.uk/1/hi/england/london/6691365.stm

This of course is the same Out of Hours GPs service contract that Labour negotiated only last year which recieved the accolade of: BMA team 'stunned by GP contract' as a bit of a laugh
in Health Direct's post on 31 Jan 07.

GPs were so stunned by the terms offered to them when negotiating their new contract in 2004 that they thought it was a "bit of a laugh", a doctor has said. Dr Simon Fradd, who was one of British Medical Association's GP negotiators, said they were shocked by the approach taken by the labour government. They could not believe that the labour govt was stupid enough to offer GPs the chance not to do evening and weekend work for only a 6% pay cut, he said.

Doctor's MTAS online system may be ditched- cost unknown

Channel 4 interviewed the Secretary of State for Health, Patricia Hewitt over the crisis surrounding the appointment of thousands of junior doctors. The new Medical Training Application Service (MTAS) was heralded by the government as an 'agent of change', designed to establish a fairer, more transparent system for recruiting the next generation of specialist medics. But for months now it's been ridiculed within medical circles for effectively deselecting some of the brightest junior doctors.

And for being so transparent that - at one point - it actually left all the personal details of thousands of medics - including their sexual orientation - sitting on a website for all to see.

A gross security breach exposed by this programme - and now - as the Secretary of State revealed today - subject to a possible police investigation.

In a written ministerial statement she said "Action has been taken by the contractor... to address the weaknesses identified. Because the investigation has made it clear that criminal offences may have been committed the... analysis and report have been given to the police."

Even more embarrassing for the health secretary this morning was the admission that her department's new £6.3 million medical recruitment system was effectively being shelved.

"Given the continuing concerns of junior doctors about MTAS, the sytem will not be used for matching candidates to training posts, but will continue to be used for national monitoring.

A bit of a coup, you'd think, for the group of junior doctors who mobilised 15 months ago specifically with a remit to discredit MTAS. Not so, they said. the damage has already been done. The new recruitment strategy came in for criticism earlier this year when it emerged that there simply weren't enough training posts available.

A leaked document from NHS Employers revealed that the charity VSO had been approached by the government - the problem they said was an excess of applicants for training posts over places, by about 10,000. One junior doctor told channel 4 news he was off to Ireland to finish his training.

By March it became clear that very good candidates like Salima Dhalla - an experienced doctor with two degrees - weren't being short listed for interview.

The BMA declared the system unfair. Thousands protested in London and Glasgow and Patricia Hewitt - who'd already announced a review of MTAS - began saying sorry.

Her final apology followed Channel 4 News's revelation on 25 April of a major breach of security on the MTAS website.

Intimate confidential details of medical students openly available to the public. The next day Channel 4 news exposed another MTAS security breach.

This time over students able to read each other's confidential files. The government suspended the website.

The question is why did it take them over 24 hours to do so on a matter of such sensitivity?

In the face of an increasingly indignant junior doctor lobby, Patricia Hewitt announced that thousands more interviews would be made available for those seeking training posts this August.

But in Scotland chaos ensued - as Channel 4 News revealed how employers were desperately emailing candidates to ask them if they were supposed to be being interviewed.

The programme's revealed how further data problems have stalled a number of candidates applications on the erroneous grounds that they were immigrant workers and last night, on Channel 4 News, consultants finally went public about the pressure this was having on patient care.

Finally, the latest error brought to our attention: An email sent out by Wessex deanery congratulating the candidates on their application. Half an hour later 31 of those contacted were told it had been only a draft email sent in error. They hadn't in fact got the job.

From:
http://www.channel4.com/news/articles/society/health/doctors+online+system+to+be+ditched/511747

Hewitt's pathetic record on IT development was highlighted by Health Direct on 30 Apr 07 in our post- Contender for greatest of all Labour's NHS failures- MTAS Junior Doctor application system- The crisis that is leading highly qualified junior doctors to head abroad is the result of one of the National Health Service's all-time great administrative cock-ups.

It is has left 30,000 junior doctors bitterly disillusioned and angry. But it also has big potential implications for patient care.

Highly-qualified junior hospital doctors are now quitting the National Health Service for jobs in Australia, New Zealand and elsewhere following the fiasco over a new application system for training jobs that has left many without an interview.

Almost 5 per cent had already had overseas offers. This raised the possibility that many would take four- or five-year training posts that would deprive the NHS of their services for at least that long and perhaps their whole careers, the BMA said.

This disaster waiting to happen recieved a warning form Health Direct over a year ago- 6 Mar 06 in Junior Doctors' new IT MMC recruitment system is a disaster - It is an irony that many of the questions junior doctors must answer when they fill in the new form to apply for hospital jobs relate to their leadership skills and ability to work as part of a team.

The form is part of a new applications procedure, called Modernising Medical Careers (MMC), which involves no human interaction whatsoever. Hospitals are banned from holding interviews, having to rely instead upon a computer "dating" system that supposedly matches the applicant to the job.

As 80 eminent doctors have been moved to protest to the Department of Health, the results have been disastrous. Sixty junior doctors recruited in this way have failed to demonstrate a basic level of medical competence, while many others have had to be retrained at huge expense.

No checks have been made, so it seems, on the information that applicants put on the forms. Moreover, in the absence of an interview, there is no way hospitals can be sure whether the applicant is a genuine, qualified medical student or whether they are an impostor who paid someone to fill in their form for them.

And what has Patricia Hewitt and her cohort of expensive paper pushers at the Dept of Health done about these warnings for over a year? F All. Talking of Football, DoH and Ostriches- they are all about as impressive as the Football League at ignoring disasters.

NHS critic's father dies from MRSA after awful care

A former nurse who tackled Tony Blair over NHS failures in her daughter's treatment has lost her father to the MRSA superbug. During the 2001 election campaign Carol Maddocks confronted the Prime Minister during an appearance on the BBC's Question Time programme and told him that the health service was letting down her daughter Alice, who had a rare blood condition.

She was later invited to Downing Street where he pledged funding to improve registries of bone marrow donors to help save Alice's life.

Now Mrs Maddocks has described how her father Harry Lister, 74, died an agonising death after contracting MRSA following "awful" care in their local hospital.

"My father was let down by the NHS and we, as a family, are really angry about it. Society now accepts that when we go into hospital we could contract MRSA, but this should not be a risk we run," she told The Sunday Times.

Mr Lister died of MRSA at Dewsbury and District hospital last June after going in for examination of a bowel problem.

In a statement Julia Squire, the chief executive of The Mid-Yorkshire Hospitals NHS Trust, said: "We are very sorry to hear that Mrs Maddocks is unhappy with the care that her father received. We would be grateful if Mrs Maddocks could get in contact with our complaints department so that we can fully investigate."

The trust said Mr Lister's notes were in transit and it would not comment further until it received them.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/05/14/nmrsa14.xml

Health Direct posts that the scandal of thousands of preventable deaths every year in NHS hospitals through patients contracting MRSA, C Difficile and other superbugs is not going to improve until the labour govt is prepared to finally address the issue.

It means more money to reduce bed occupancy rates, thorough cleaning of the beds between use and constant hygiene on wards including the automatic washing of hands by staff between contact with every patient.

On 15 Feb 07 in Clash of NHS targets- MRSA and cash underfunding or clean hospitals Health Direct posted that the labour government's NHS waiting targets and wish to tackle the spread of hospital acquired infections like MRSA are in direct conflict, according to a leading expert. Professor Hajo Grundmann, currently based at Groningham University Medical Centre in Holland, maps the incidence of MRSA across the European Union.

And a week later- Feb 23, 2007 in MRSA and Clostridium difficile deaths up by half in year the Health Direct blog we calculated back in 2004 that fewer people being killed on UK roads than by superbugs.

Since then Health Direct calculates that with these new figures for 2005, there were nearly 70% more deaths linked to MRSA and Clostridium difficile than were killed in traffic accidents on all of the UK’s roads.

Deadly NHS superbugs continue rising with C difficile again up

More hospital patients in England are getting the deadly Clostridium difficile bug, figures show. Health Protection Agency (HPA) data showed 55,681 cases were reported among over 65s in 2006 - up 8% in a year. MRSA cases continued their downward trend, but they are not falling quickly enough to meet Labour's target next year.

The HPA said C. difficile rates were "very high" and the Patients Association called for more to be done to protect patients from bugs.

Patients Association spokeswoman Katherine Murphy said: "Too many people are dying from these infections. We must learn from other countries such as Holland which have got infection rates close to zero.

"That is what we should be aiming for. We need to make NHS chief executives more accountable and ring-fence infection control budgets as it is to easy to raid them when there are cuts."

She also said all patients should be screened - at the moment only those at highest risk are routinely tested as they enter hospital.

In November 2004, then health secretary John Reid pledged MRSA rates would be halved by April 2008.

But government memo, sent to ministers by a Department of Health official last year, predicted it would only be cut by a third by then.

The same memo said C. difficile, a stomach bug which can cause potentially life-threatening bowel inflammation problems, was now "endemic throughout the health service, with virtually all trusts reporting cases".

Ministers have asked NHS trusts to set their own targets to reduce C. difficile rates. The latest figures confirm the problems - although the rate of increase in C. difficile is slowing.

From 2004 to 2005, there was a 17% rise compared to the 8% being reported last year.

There were 1,542 MRSA bloodstream infections from October to December 2006 - 7% down on the previous quarter.

The HPA does not look at deaths although figures from 2004 show that MRSA was mentioned on over 1,000 death certificates in England and Wales, while C difficile was listed on over 2,000.

Dr Mark Enright, an expert on infections from Imperial College London, said: "C. difficile has hit the NHS out of nowhere and we are still getting our head around dealing with it."

Shadow Health Secretary Andrew Lansley said: "The government has badly let down NHS staff and the patients they care for."

And Lib Dem health spokesman Norman Lamb said "tougher action was needed".

From:
http://news.bbc.co.uk/1/hi/health/6593225.stm

Health Direct is not surprised by teh latest shocking figures on superbugs. On 23 Feb 07-
MRSA and Clostridium difficile deaths up by half in year as the Health Direct blog was partly set up in response to the preventable crisis that is killing thousands of patients in the UK.

We calculated back in 2004 that fewer people being killed on UK roads than by superbugs. Since then Health Direct calculates that in 2005, there were nearly 70 per cent more deaths linked to MRSA and Clostridium difficile than were people killed in traffic accidents on all of the UK’s roads.