The number of patients who contracted life threatening infections in NHS hospitals has almost doubled in two years to a record level, official figures have shown.Recorded cases of patients with a “nosocomial condition” – any infection acquired in hospital or a medical environment – also rose by more than a third last year compared with the year before.

A large proportion of the patients involved were aged over 75, the figures from the NHS Information Centre show. Illnesses related to such infections led to average stays in hospital last year of 31.1 days.

Experts blamed poor hygiene for the dramatic rise in infections, including superbugs MRSA and Clostridium difficile (C. diff) as well as norovirus and E.coli.

But the Department of Health dismissed the “misleading” figures, published online, saying that officials have “got better and better at tackling hospital infections”.

According to the new figures, supplied by NHS hospitals, the number of patients found by consultants to have hospital acquired infections rose last year reached a record 42,712.

That figure increased from the 31,447 recorded in the previous year and almost double the 22,448 documented in 2008/09.

Last year’s figures were the highest levels recorded in the 13 years in which the records have been publicly available. In 1998/99 there were just 335 such cases. The Centre did not provide a breakdown of illnesses.

It came as the Health Protection Agency said that there were 46 suspected outbreaks of norovirus in hospitals over the past two weeks, with more than half leading to ward closures or admissions restrictions.

The agency said the levels were within seasonal norms.

Commenting on the overall infection levels Joyce Robins, co-director of Patient Concern, said the figures were a “terrifying prospect for vulnerable elderly people who think they are going into hospital to get better”.

“It contrasts sharply with the happy propaganda that has been telling us that infection rates had dropped sharply,” she said.

A DoH spokesman said: “The NHS has got better and better at tackling hospital infections, demonstrated by the record lows we have seen this year.

“Because we are not complacent, we have introduced mandatory reporting of more hospital infections. That means that we have shone a light on the problems previously swept under the carpet.  But patients should be confident that the measures we have taken will continue the downward trend in hospital infections.”

The number of people being admitted to hospital after drinking too much alcohol has more than doubled in less than a decade, new research show.Some 1,173,386 people in England were admitted to casualty for injuries or illnesses caused by drinking in 2010/11, compared with just 510,780 in 2002/3, according to the research.

The figures for last year represent an 11 per cent increase on the previous 12 months, when alcohol-related admissions stood at 1,056,962.

Separate information published by Anne Milton, the public health minister, showed that since January an estimated 7,074 under-18s have been admitted to hospital due to alcohol abuse.

A recent report predicted that binge drinking will cost the NHS £3.8 billion by 2015, with 1.5 million A&E admissions a year.

Andrew Lansley, the Health Secretary, blamed Labour’s 24-hour drinking policy and accused the last government of “taking their eye of the ball” on the issue of binge drinking.

He said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge-drinking and long-term excessive alcohol abuse in a minority of people.

“Our alcohol strategy, which we will set out in the new year, will outline what further steps we are taking to tackle this growing problem.”

Recent Local Alcohol Profiles for England figures also show that the number of hospital admissions for conditions attributable to alcohol are rising at a similar rate.

The number of admissions has more than doubled since 2002/03 and increased by nine per cent last year.

In 2002/03 there were 926 admissions per 100,000 people for conditions caused by alcohol, rising to 1,743 per 100,000 in 2009/10 and 1,898 last year.

The biggest increase over the past 12 months was in London, with a jump in admissions of 14 per cent, followed by the East of England with 10 per cent.

Health officials have issued a warning about the serious threat posed by the norovirus bug after an outbreak has seen cases jump by 20 per cent on this time last year.The winter diarrhoea and vomiting bug has affected 35 hospitals, with hundreds of beds unavailable after 27 wards were shut in the past two weeks to isolate infected patients and deep cleaned.

Overall confirmed individual cases across the country from July to mid-December are 19 per cent higher than during the same period last year.

Norovirus is extremely contagious and can be lethal to the elderly, very young or very sick patients.

People who have been ill are being asked not to visit friends and relatives in hospital until they are well.

Medical bosses at hospitals across the country are working to prevent the condition spreading and to reopen wards that were closed yesterday.

Nationally data from the Health Protection Agency released last week shows that norovirus rates remain below the level expected for this time of year, possibly reflecting the mild weather until now.

The HPA declares norovirus season has started when 4.8 per cent of calls to NHS Direct are about vomiting. Last week there were 4.2 per cent of calls about vomiting.

The first sign of Norovirus is usually a sudden sick feeling followed by forceful vomiting and watery diarrhoea. Other symptoms include a raised temperature, headaches, stomach cramps and aching limbs.

The data showed that last week the North East and South West were the worst affected.

Three hospitals reported that 124 beds are unavailable as a result of the ward closures. It is thought that the true number across all eight hospitals will be more than 200.

Wards were also closed to new patients at Montagu Hospital in South Yorkshire while 82 beds were closed on two wards at Northwick Park in Harrow, north London.

Croydon Health Services said it had one ward closed to new admissions.

Two wards were also closed at Warwick Hospital and the Richard Wells Ward was shut at Bedford hospital to contain a bout of gastroenteritis.

Director of nursing and patient services at Bedford hospital, Eiri Jones, warned visitors not to sit on hospital beds and not to visit at all if they had been ill in the preceding 72 hours.

Queens Hospital in Burton had one ward temporarily closed after a number of cases of diarrhoea and vomiting while the Countess of Chester Hospital had visiting restrictions in place at four wards to contain the outbreak.

A 14-bed ward at the University Hospital Southampton Trust was closed and County Durham and Darlington said it had seen isolated cases but had not had to close any wards.

Visitors to Northern Devon hospitals were warned only close relatives should visit patients and Mid Essex Hospital Trust said it had closed wards last weekend because of a similar outbreak.

The Royal College of GPs say the virus has not been a major problem so far this year – although outbreaks can occur very quickly, as the complaint is extremely infectious.

A statement from the Health Protection Agency said: “Norovirus is highly contagious and can be transmitted by contact with an infected person; by consuming contaminated food or water or by contact with contaminated surfaces or objects. The virus spreads rapidly in closed environments such as hospitals, schools, nursing and residential homes.

“Anyone who thinks they may have norovirus should not to go to their doctor’s surgery or A&E as this could spread the illness to vulnerable people and health care workers.”

Paramedics are to be told if a patient does not wish to be resuscitated or wants to die at home, under plans backed by ministers.Adults in Britain can legally refuse medical treatment, even if it leads to their death but doctors cannot undertake treatment to a patient if it clashes with any clinical judgment.

Patients should, however, be given an opportunity for a second opinion wherever possible.

While the General Medical Council (GMC), the doctor’s watchdog, said last year there was no absolute obligation to prolong life, the medical profession does have a final say about whether resuscitation is in the patient’s best interest.

This has led to accusations from some critics who believe doctors are “playing God” and ignoring vulnerable patients’ right to life.

It has also prompted fears that as hospitals face deeper budget cuts, not resuscitating patients will become a cost-cutting option. It is thought that four in five people who die in hospital are the subject of “do not resuscitate”(DNR) orders.

Cardiopulmonary resuscitation (CPR) attempts to restore breathing or blood flow to those whose heart has stopped beating or who have stopped breathing.

It can include using electric shocks to try to correct the rhythm of the heart, repeatedly pushing down firmly on the patient’s chest and inflating the lungs with a mask or tube inserted into the windpipe.

While television medical dramas suggest it is often successful less than a fifth of those who have had such treatment actually go home, according to the British Medical Association (BMA). Inevitably, the young and fit are more likely to survive than the frail and elderly.

In 2007 the BMA, together with the Resuscitation Council (UK) and the Royal College of Nursing, issued joint guidelines on the issue in a 25 page document titled “decision relating to cardiopulmonary resuscitation”.

Legal experts say the “do not resuscitate” advice is essential where a “patient or their family disagree with doctors about whether a particular treatment is futile, a burden rather than a benefit, or inappropriate”.

Roger Goss, the co-director of Patient Concern, has raised concerns previously that “do not attempt resuscitation” orders are being misused.

“We are concerned that patients are having “do not resuscitate” written on their notes without they or their relatives knowing,’ he said earlier this month.

‘Bearing in mind NHS budget cuts over the next few years, it is not far-fetched to foresee that “do not resuscitate” orders will proliferate to the point where everyone over a certain age — perhaps 65 or 70 — gets one stuck on them.”

In England, Andrew Lansley, the Health Secretary, has stopped short of a national policy.

From: http://www.telegraph.co.uk/Paramedic-patients-resuscitation-advice-focus-on-current-rules

NHS Hospitals are breaking the law by failing to report incidents that result in severe harm to patients a charity has warned.Peter Walsh, chief executive of the charity Action Against Medical Accidents (AvMA), said many were failing to own up to such incidents despite a law that had been in force since April 2010, requiring them to do so.

He was commenting on National Patient Safety Agency (NPSA) figures, showing an 8.5 per cent increase in the total number of reported incidents in the NHS in England, between April to September 2010 and October to March 2011.

The vast majority of such incidents result in “no harm” (69 per cent), “low harm” (24), or “moderate harm” (six).

However, one per cent result in “death or severe harm”. Since April 2010, health trusts have had to report these incidents.

Between the two most recent six-monthly periods for which data are available, the number of such reported incidents rose by 13 per cent – from 4,358 to 5,012.

While significant, Mr Walsh believed if all trusts were reporting as they should, the rise would be larger still.

He said: “Given that there was a new set of rules that came in, in April 2010, that made it a statutory requirement for trusts to report incidents that cause severe harm or death, we would have expected a bigger increase.

“So we think some trusts might be holding back on reporting incidents that caused severe harm.”

He added: “We think work is needed looking at why trusts do not seem to be reporting at a rate we would expect.”

Individual cases that were known through clinical negligence claims should be checked back, to see if trusts had reported them to the NPSA, he recommended.

A spokesman for the NPSA said that overall new figures reflected an improving culture of reporting incidents in NHS trusts.

Sarndrah Horsfall, chief executive of the NPSA, said: “Identifying patient safety incidents and ensuring they are reported and analysed is at the heart of reducing risk in healthcare.

“NHS organisations should use the data and review the tools, guidance and support available to them. This will ensure patient safety incidents continue to be reported and learned from, strengthening the patient safety culture across all levels of the NHS.”

From:  http://www.telegraph.co.uk/Hospitals-failing-to-report-serious-safety-incidents

St John Ambulance, the charity, has been accused of abandoning its volunteers as it attempts a widespread restructuring project.The first aid organisation has announced plans to streamline its management amid financial woes.

It is set to embark on a major restructuring exercise to rebalance its books, which includes setting up eight regional boards and merging offices in 41 regions.

But the charity, which has recorded operating losses seven years in a row, is accused of “kicking volunteers in the teeth” by those who regularly help out.

They claim that disillusioned volunteers will no longer want to raise money if the cash goes in a central pot rather than helping local projects.

“All counties work in their own particular way according to their local people and in a way that can only be done by them,” one senior volunteer said.

“If the structure is changed … what incentive is there for local people to volunteer and raise money?”

A former chairman of a county division claimed the changes would lead to “financial ruin”.

“We are absolutely horrified because we feel that this restructure is doing away with the strong volunteer ethos of St John’s. It’s like kicking volunteers in the teeth” she said.

Under the plans eight regional directors will be created on salaries of £80,000 a year plus benefits to represent London, the south east, south west, East Midlands, West Midlands, East of England, North-West and North East.

Officials admitted that “financial” pressures were partly behind the new structure as well as “increasing regulation”. It denied it was in “imminent financial crisis”.

While the service claimed there would be no redundancies the charity admitted “some roles have been placed at risk and are therefore undergoing consultation”. It would not provide further details.

The charity, founded in 1877, currently employs about 1600 staff across the country and has more than 40,000 volunteers on its books.

It trains more than half a million people a year and has more than 1000 ambulances that provide support to NHS trusts. The Duke of Gloucester is the service’s Grand Prior of the Order.

In a letter sent to volunteers around the country, Rodney Green, the charity’s Prior and chairman of board of trustees, admitted the organisation faced a “number of difficult challenges in the years ahead”.

A briefing note sent to volunteers explaining the changes, said the organisation needed to increase its “charitable and community impact”.

“We need a greater consistency in our quality – so that we can meet more stringent regulatory requirements and also better support the front line,” stated the document, titled “Becoming ‘The Difference’: transforming St John Ambulance”.

“More urgently, we need to balance the books and achieve secure finances.  For seven years running, we have spent more than we earned and are set to make further losses this year. The charity cannot sustain this.”

Mr Green insisted the changes, signed off by the trustees last month following “rigorous analysis of the current structure”, would transform the organisation “so that we can save yet more lives”.

From: http://www.telegraph.co.uk/St-John-Ambulance-abandoning-volunteers-over-restructure-project

Health Direct warns that as the bank holiday weekend approaches that the number of alcohol related hospital admissions in England has topped one million for the first time.
An NHS Information Centre report said admissions had increased by 12% between 2008-09 and 2009-10.

That includes liver disease and mental disorders due to alcohol abuse as well as some cancers, accidents and injuries.

The Department of Health will publish a new alcohol strategy later this year.

The number of admissions reached 1,057,000 in 2009-10 compared with 945,500 in 2008-09 and 510,800 in 2002-03.

Earlier this year the charity Alcohol Concern predicted the number of admissions would reach 1.5m a year by 2015. It estimated that would cost the NHS £3.7bn a year.

Tim Straughan, chief executive of the NHS Information Centre, said: “Today’s report shows the number of people admitted to hospital each year for alcohol related problems has topped 1m for the first time.

“The report also highlights the increasing cost of alcohol dependency to the NHS as the number of prescription items dispensed continues to rise.

“This report provides health professionals and policy makers with a useful picture of the health issues relating to alcohol use and misuse. It also highlights the importance of policy makers and health professionals in recognising and tackling alcohol misuse which in turn could lead to savings for the NHS.”

Professor Sir Ian Gilmore, the chair of the UK Alcohol Health Alliance, said: “This confirms doctors’ impressions that the health harm from alcohol continues to rise.”

“While total alcohol consumption has fallen in recent years it is likely that the number of abstainers in England is increasing, but those who do drink continue to do so in a harmful and destructive way.”

The body which represents drinks manufacturers in the UK, the Portman Group, expressed surprise that admissions had increased at the same time as alcohol consumption had decreased.

David Poley, chief executive of the Portman Group, said: “If the hospital admissions data are robust, they clearly put paid to the argument that measures to reduce overall alcohol consumption are effective in reducing harm.

“The report shows that the proportion of people misusing alcohol is falling. We just need to find a way of persuading and educating this hard core of misusers who account for these admissions to drink responsibly.”

Alcohol Concern said the latest set of figures were alarming but that early detection of alcoholism contributed to the increase.

Its director of policy and communications, Nicolay Sorensen, said: “More people than ever before are drinking in a way that is harming their health and it’s a serious public health problem. It’s one of the biggest public health problems facing the country.

“In addition, the NHS has been doing some great work to identify people that have alcohol problems and so some of the increase is due to better identification and better referral.”

Public Health Minister Anne Milton said: “These statistics show that the old ways of tackling public health problems have not always yielded the necessary improvements.

“We are already taking action to tackle problem drinking, including plans to stop supermarkets selling below cost alcohol and working to introduce a tougher licensing regime.

“We will also be publishing a new alcohol strategy later this year.”

Rates of alcohol-related hospital admissions came down in the past two years in Scotland, after increasing for a decade. In Wales, figures for up to 2006 showed increasing admission rates and in Northern Ireland the total number of admissions increased year on year since 2006/07.

From: http://www.bbc.co.uk/news/health-13559455

Hospitals in England have been fined for keeping patients in mixed sex accommodation under a new push to eradicate the problem.There were 2,660 breaches in April – half the number from the previous month, the Department of Health said.

Hospitals are fined £250 for each day a patient is kept in mixed sex wards.

It means at least £665,000 of fines have been levied, although the sum could be higher as the data does not detail how long a breach has been for.

The Coalition government’s drive on mixed sex accommodation follows failed attempts by the Labour administration to tackle the issue.

Labour ministers struggled, partly because large chunks of the NHS estate date back decades and proved hard to convert.

Extra money has now been ploughed in to the system to help build more single rooms to rectify this.

April marked the first month the new fining system was applied. Previously, the levels of fines varied considerably depending on the treatment and were inconsistently levied.

Over the past few months, the government has been publishing breach figures ahead of the start of the new fining system. These show the problem has been improving.

In December there were more than 11,000 breaches. By March that had fallen to under 5,500. However that has to be seen in the context of the one million plus patients seen each month.

Single sex accommodation means patients sharing sleeping, bathroom and toilet facilities only with people of the same sex.

The rules do allow wards to be segregated into distinct bays as long as they have separate facilities.

They apply to all trusts from acute hospitals to mental health units. Only intensive care and A&E are excused.

Health Secretary Andrew Lansley said the downward trend was pleasing, but there were “still too many breaches”.

He added all the fines would be reinvested back into patient care.

From: http://www.bbc.co.uk/mixed sex wards lead to hospital fines

Hospital casualty departments are struggling to cope with growing demand for emergency care because they have too few staff and not enough beds, Britain’s top accident and emergency doctor has warned.
As new figures pointed to a steep rise in A&E waiting times and 890 ambulance jobs were lost, John Heyworth, president of the College of Emergency Medicine, joined a growing chorus of doctors warning that the NHS funding pressures are already hitting frontline services.

“The emergency care system is struggling to cope at the moment,” he said. “Many departments spend their time firefighting because of the number of patients coming in, the limited number of emergency department staff and limited availability of beds.”

David Cameron and the health secretary, Andrew Lansley, have insisted that the NHS will not be affected by the deep cuts to public spending elsewhere and that frontline services will be protected during their shakeup of the health service.

But medical organisations, health charities and patients’ groups are increasingly sceptical that the pledge can be kept as health spending fails to keep pace with the rising cost of treating Britain’s ageing population.

“The line that the NHS is being protected from cuts – even to frontline services – is looking increasingly absurd”, Dr Hamish Meldrum, chairman of the British Medical Association’s ruling council, told the Guardian on Tuesday. “The financial pressures are really starting to bite and these are yet more examples of vital services that are showing signs of the strain and that will be stretched to the limit.”

Heyworth pointed to NHS figures showing a steep rise in patients waiting more than four hours for A&E treatment, saying they showed “an increasing mismatch between ever rising demand, ever limited emergency medicine consultant numbers, which are woefully inadequate, and limited hospital bed capacity for emergency patients.”

The hospital statistics reveal that 292,052 people in England were not treated within the four-hour target between July and December last year, soon after Lansley announced in June that he intended to scrap the rule. That was up from 176,522 patients in the same period in 2009 – a 65% leap inside one year.

The A&E statistics coincided with the axing of 890 jobs by the London Ambulance Service (LAS) and the disclosure that services in which specialist nurses help people with diseases such as cancer and diabetes are also facing cuts.

The ambulance service cuts in London will see 560 frontline posts disappear, including paramedics. The capital may also see some of its ambulance stations close, while, according to LAS chief executive Peter Bradley, solo paramedics rather than two-person crews will start responding to more callouts from September as part of a drive to save £53m over the next five years.

“Unfortunately we are not immune to the financial pressures facing the NHS,” he said. “With nearly 80% of our budget spent on staff costs it would be impossible to make the savings required without removing posts.” The health union Unison’s regional organiser, Phil Thompson, warned the cuts could endanger patient safety. “These cuts are so deep they may not heal. With demand escalating and nearly 1,000 fewer staff no one can now be sure of a safe service.”

The ambulance cuts prompted the NHS chief executive, Sir David Nicholson, to issue his second reminder in 72 hours to health service managers that there should be no cuts to patient services as part of the drive to make £15bn to £25bn in “efficiency savings” by 2015.

From:  http://www.guardian.co.uk/nhs-funding-pressures-hitting-frontline

Leading health organisations have slammed the Government’s “responsibility deal” on alcohol and refused to sign up as partners.
The six organisations, including Alcohol Concern, the British Medical Association and the Royal College of Physicians, accused the Department of Health of allowing the drinks industry to dictate health policy.

Under the deal, the drinks industry would be asked to sign up to a number of alcohol pledges.

These reportedly include ensuring 80% of products on the shelf are labelled for unit content, raising awareness of the unit content of drinks in pubs and clubs and taking action to reduce under-age drinking.

There would also be a pledge to commit to action on advertising and marketing by promoting responsible drinking and keeping alcohol adverts away from schools.

But the six organisations which had been involved in the Government’s Responsibility Deal Alcohol Network (RDAN), which also include the British Association for the Study of the Liver, the British Liver Trust, and the Institute of Alcohol Studies, refused to support the deal.

They said the pledges were neither specific nor measurable, that they lacked scope and that there was no evidence such voluntary interventions would be effective.

The statement read: “We have not yet seen evidence that Government is working towards a comprehensive, cross-departmental strategy to reduce alcohol harm, based on evidence of what works, with rigorous evaluation metrics.”

The organisations called on the Government to provide:

• A clear and firm commitment on how it intends – via evidence based policy – to tackle affordability, availability and promotion of alcohol as part of a cross-government strategy;

• A clear presentation of the steps that will be taken if the current RDA objectives are not met in 12 months’ time;

• A firm commitment to consider change – including through regulation – if voluntary commitments from business are not met after an agreed time period.

Don Shenker, chief executive of Alcohol Concern, said: “This is the worst possible deal for everyone who wants to see alcohol harm reduced.

“There are no firm targets or any sanctions if the drinks industry fails to fulfil its pledges.  It’s all carrot and no stick for the drinks industry and supermarkets.”

“By allowing the drinks industry to propose such half-hearted pledges on alcohol with no teeth, this Government has clearly shown that when it comes to public health its first priority is to side with big business and protect private profit.”

Dr Vivienne Nathanson, director of professional activities at the BMA, said: “The Government has talked the talk in respect of wanting to tackle alcohol misuse but when it comes to taking tough action that will achieve results, it falls short.

“Instead it has chosen to rely on the alcohol industry to develop policies – given the inherent conflict of interest these will do nothing to reduce the harm caused by alcohol misuse.”

Katherine Brown, Head of Research and Communications at the Institute of Alcohol Studies, said: “The most effective means of reducing alcohol-related harm is through adjustments in affordability, availability and promotion.

“These policies are supported by a broad evidence base and have been recommended to Government by a recent cross party House of Commons Health Committee report.

“The Responsibility Deal fails to address any of these policy areas and we are yet to see any real proof that Government is looking into developing a cross-departmental comprehensive alcohol strategy, based on evidence of what works.”

Alison Rogers, chief executive of the British Liver Trust, said: “For more than 10 years we have been persuaded to play the long game, sitting and watching the alcohol industry cultivate their relationship with the Government.

“Now it must stop for the sake of the 100 families losing loved ones each week from alcohol-related liver disease.”

And Sir Ian Gilmore, the Royal College of Physicians’ special adviser on alcohol, said: “The industry pledges published in various newspapers do not give practising doctors, who see the rising tide of health harm from drink in their daily practice, any confidence that they will get to the core of how we reverse this entirely preventable cause of illness and death.”

Sir Ian was among a trio of experts who recently warned the Government that up to 250,000 extra lives could be lost in the next 20 years in England and Wales unless tough restrictions on alcohol are introduced.

The liver death rate in the UK is 11.4 per 100,000 people, more than double that of other countries with similar drinking cultures, including Australia and Holland.

Health Secretary Andrew Lansley said: “We have made clear from the start that the responsibility deal is just one strand of the Government’s wide public health policy. It explicitly excludes cost and price competition to avoid conflicts of interest.

“The Treasury have already announced an introduction of a new tax on super-strength beers; the Home Office have made their announcement on a ban in sales of alcohol below cost and plans to tighten licensing laws; and, our public health strategy sets out how local areas will be given a ring-fenced public health budget to ensure alcohol misuse gets the priority it deserves.

“In tandem to this action, the responsibility deal is working with the industry on voluntary agreements to get speedier results. For example, to improve unit labelling. The Responsibility Deal has achieved more in the last six months than the previous Government’s Coalition for Better Health did in a year and a half. What is more, this is only the first step.”

From: http://www.independent.co.uk/health-bodies-attack-government-alcohol-plans