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 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.

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.”

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.

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

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

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.

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

“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

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

A misplaced “fever phobia” in society means parents too frequently use both medicines to bring down even quite slight temperatures, say the paediatricians, who warn that children often receive accidental overdoses as a result.

A high temperature is usually the body’s way of fighting an infection, according to advice issued today by the American Academy of Pediatrics, so to bring it down could actually lengthen the time a child suffers.

Doctors too readily advise parents to give the medicines, known collectively as “antipyretics”, according to the Academy.

The advice comes after a study indicated that children given paracetemol before 15 months were more than twice as likely to develop asthma by the age of six as those not given it.

Writing in a clinical report on fever and the use of paracetamol and ibuprofen in children, the authors warn: “Combination therapy with acetaminophen [paracetamol] and ibuprofen may place infants and children at increased risk because of dosing errors and adverse outcomes, and these potential risks must be carefully considered.”

Doctors, they write, should begin “by helping parents understand that fever, in and of itself, is not known to endanger a generally healthy child”.

They explain: “It should be emphasized that fever is not an illness but is, in fact, a physiologic mechanism that has beneficial effects in fighting infection.”

It slows the spread of bacteria and viruses, enhances white blood cell production, and “actually helps the body recover more quickly from viral infections”.

Despite this, they say: “Many parents administer antipyretics even though there is either minimal or no fever.”

Half consider it to be a fever even if their child’s temperature is not higher than 38C (101.4F), they report.

Many doctors are happy to advise parents to give paracetamol and ibuprofen alternately – known as combination therapy – believing side effects are very rare and minimal.

But the Academy warns: “Unfortunately as many as one half of parents administer incorrect doses.”

A frequent error is giving children adult-sized doses, while children who are small for their age can also receive doses that are too high even if their parents follow box instructions based on age alone.

In Britain, the National Institute for Health and Clinical Excellence (Nice) advises that the use of anti-pyretics “should be considered in children with fever who appear distressed or unwell”.

However, they “should not routinely to used with the sole aim of reducing body temperature in children with fever who are otherwise well”.

Similarly, “paracetamol and ibuprofen should not routinely be given alternately to children with a fever”, although it states this approach “may be considered if the child does not repsond to the first agent.”

The guidance also states: “The views and wishes of parents and carers should be taken into consideration.”.

Children’s paracetamol solutions like Calpol and ibuprofen solutions like Nurofen for Chilren are sold over the counter in chemists. Recommended dosage quantities vary by age.

There are different strength solutions for different ages, meaning it is possible for parents with different aged children to mix up which they are giving.

Rather than focusing on temperature alone, doctors should advise parents to look out for signs of serious illness, make sure their child is drinking enough, and “advocate a limited number” of doses of medication.

Dr Clare Gerada, chairman of the Royal College of GPs, said the two medications should be used “only to help a child be comfortable, and not to chase down a temperature.”

However, she said: “I don’t think we over-prescribe anti-pyretics and I don’t think parents give them too readily.”

She added: “I think they have their place. The younger the child the more cautious you have to be.”

She did not think that giving ibuprofen and paracetamol together was more likely to lead to increased dosing errors, saying: “In my experience of 20 years as a GP, parents are usually pretty careful.”

“I think the most important thing to be worried about is keeping medicines out of the reach of children, because some of them taste quite nice.”

They could also give “a false sense of security” in depressing a high temperature with a more serious underlying cause than a mild infection, she said.

From: http://www.telegraph.co.uk/Fever-medicines-given-to-children-too-readily

Department of Health data showed there were over 650 cases of NHS trusts not complying with alerts within deadline.

This is a 50% fall from last year, but Action against Medical Accidents said there was no excuse for non-compliance.

The charity first highlighted the issue last year when it obtained the figures under a freedom of information request.

But now the government has started publishing the figures itself.

The latest data, from January, showed that there were 654 instances of patient safety alerts not having been complied with – half the figure from August.

In total there were 203 trusts which had failed to comply with at least one alert, while five trusts had not complied with 10 or more alerts.

Peter Walsh, chief executive of Action against Medical Accidents, said: “There can be no excuse for not implementing these alerts. Each alert not complied with means patients are being put at unnecessary risk. Lives are being lost as a result.”

But he added: “We welcome the fact that as a result of the pressure we have brought to bear, there has been a significant improvement in compliance.”

A Department of Health spokesman said: “Although progress has been made, much more needs to be done across the system. We expect trusts to comply with safety alerts.”

From: http://www.bbc.co.uk/news/health-12527071

But after reviewing the costs, Tees, Esk and Wear Valleys Mental Health Foundation Trust decided to take advantage of a break clause in the deal.

It paid £18m upfront to get out of the PFI contract 23 years early, but it now owns the hospital outright and expects to save £14m over the course of the deal once maintenance and inflation is taken into account.

The move, disclosed in the Health Service Journal, comes after The Daily Telegraph uncovered evidence that hospitals are closing accident and emergency departments in order to pay the interest on PFI deals for new buildings.

Some PFI hospitals – built and run by private firms and effectively rented back to the state – will end up costing taxpayers more than 10 times their capital value.

“We concluded that the best option was to exercise what exists in the PFI projects, which is a clause called ‘voluntary termination’,” said Colin Martin, Director of Finance at the Tees, Esk and Wear Valleys trust.

“It effectively means we pay off the mortgage early.”

However he added that the trust – which runs mental health services in County Durham, the Tees Valley and along the North Yorkshire coast – did not regret the original deal and was committed to two other PFI deals.

“We wouldn’t have had the hospital if we’d waited for the traditional financing route,” Mr Martin said.

PFI deals became the preferred way of paying for public sector infrastructure projects under Labour, as they allowed new buildings to be constructed while avoiding large initial outlays of money.

Under the complex deals, private contractors carry out the building work then own the structure for up to 35 years, while the public sector body gives them annual interest and repays the capital sum as well as paying for maintenance.

However because of the length of the deals and the amount of interest involved, taxpayers end up paying several times the original value of the project.

In the first known example of an NHS hospital buying its way out of a PFI deal, the North-East mental health trust decided to purchase West Park Hospital outright.

It had agreed a 32-year deal with Norwich Union Public Private Partnership Fund to build the 116-bed facility, which opened its doors in 2004.

The hospital – which is also home to the trust’s headquarters – cost £16m to build but under the deal, the trust was paying the contractors £1.4m a year in interest payments and a further £600,000 in maintenance and paying back the principal.

In 2009, the trust reviewed its PFI deals and decided it had enough cash in the bank to pay the £18m break clause and so buy West Park outright. It gave the project company the required statutory notice and after the legal process was completed, the deal ended in December.

Treasury figures suggest it would have the remainder of the deal would have cost a further £32m, so it has saved £14m by getting out of it.

However it is unlikely the pioneering move will be copied by many other trusts, as most PFI deals are so large as to make early repayment impractical.

Aviva, the company that now runs the PFI firm that built West Park, was unavailable for comment.

From: http://www.telegraph.co.uk/Hospital-saves-14m-by-getting-out-of-PFI-deal

Her parents, a doctor and nurse, have described how they were “shocked” at losing their daughter and said it was wrong that not all children were given the swine flu jab this winter. During the 2009 swine flu outbreak, it was recommended that all under-fives be vaccinated.

In the past fortnight, the Government has come under fire for restricting use of the seasonal flu jab, which protects against swine flu and two other strains, to under-fives who suffer from health problems, such as neurological disorders or asthma.

Ministers insist they are legally bound to follow the recommendation of the Joint Committee on Vaccination and Immunisation, which last July decided against vaccinating all children against this winter’s flu strains, a position they reaffirmed over Christmas.

But Gemma and Zana Ameen from Quinton, Birmingham, said the “price was too high” not to vaccinate children against the potentially deadly swine flu (H1N1) virus.

Mrs Ameen, 28, who is 12 weeks pregnant, said: “I want to say to people, to parents, ‘If you can get the vaccine don’t hesitate’. The risk of not having it and the price you might pay is just too high.

“We have been so shocked by what has happened and we feel very strongly that everyone, particularly children, should have the vaccine. The Government has made the swine flu vaccine from last year available now — we should all be having it.

“Even financially, surely it makes sense. The swine flu vaccine is inexpensive and has already been bought — it cost £1,700 just to care for Lana in intensive care for one day.”

The Ameen family were visiting relatives in Stockport, Greater Manchester, when Lana became ill on Christmas Eve. At about 2am on Christmas Day, her parents took her to Stepping Hill Hospital, where they had formerly worked, where she was diagnosed with an infection and her temperature stabilised before being sent home.

When she woke she seemed slightly better, opening Christmas presents and eating a little lunch. But after falling asleep that afternoon, she started having fits and was taken in an ambulance back to the hospital. She was eventually transferred to Alder Hey Hospital in Liverpool and died the next day.

Since October, five of the 50 patients known to have died of flu have been under-fives.

From: http://www.telegraph.co.uk/Doctor-whose-three-year-old-daughter-died-of-swine-flu-calls-for-all-children-to-be-vaccinated

Fewer than a quarter of England’s 168 NHS hospital trusts have significant PFI hospitals in operation. But these trusts account for almost two-thirds of A&E closures or proposed closures.

Health campaigners said there was a “clear connection” between the “inflated” costs of the PFI and the cuts in A&E.

Most trusts insisted there was no connection — not all A&E closures are necessarily done on financial grounds and some are supported by local clinicians.

In recent days, The Daily Telegraph has disclosed how some PFI hospitals – built and operated by the private sector, and effectively rented back to the taxpayer – will end up costing the public purse more than 10 times their capital value.

The new Princess Royal University Hospital in Bromley, south London, cost £118million to build. It will end up costing taxpayers £1.2billion, including facilities management. South London Healthcare, the NHS trust responsible for the Princess Royal, has a second PFI hospital, the Queen Elizabeth in Woolwich.

The trust’s annual deficit was raised to £100million by the two deals. It has closed the A&E unit at one of its non-PFI hospitals, Queen Mary’s in Sidcup.

In internal documents seen by The Daily Telegraph, the trust stated that the “occupation costs” of the PFI hospitals were roughly double those of its non-PFI hospital.

A spokesman admitted that its PFI contracts placed “some undeniable restrictions on our flexibility”. But she insisted that the decision to close A&E at Sidcup was “entirely unrelated” to PFI.

Other trusts closing A&E units include Coventry and Warwickshire NHS Trust, which recently opened a new PFI hospital and plans to shut the full A&E unit at its non-PFI hospital in Rugby.

Barking, Havering and Redbridge Trust, which opened a new PFI hospital in Romford, wants to close the A&E unit King George’s Hospital in Ilford.

East Lancashire Trust has closed A&E at its Burnley hospital to help pay for a new PFI hospital at Blackburn. In Nottinghamshire, Sherwood Forest NHS Trust has downgraded A&E services at Newark after opening a new PFI hospital in Mansfield. At least four other trusts with PFI hospitals have similar plans.

Under its PFI contract, Queen Elizabeth Hospital, Woolwich, must have 64 visits a year from pest controllers, even when there are no pests to control. When there are pests, the hospital must pay for further visits, which it did 10 times last year.

Food served at the Queen Alexandra PFI hospital in Portsmouth is cooked in south Wales, then driven 100 miles to Hampshire.

Early PFI hospitals had on average 20 per cent fewer beds than the hospitals they replaced, according to research. Because of high service charges, several PFI hospitals cannot afford to keep even these reduced numbers of beds fully open.

In an effort to disguise their private ownership, a number of PFI hospitals have changed their names to include a royal connection. Greenwich District Hospital became Queen Elizabeth Hospital. Salford Hope Hospital is now Salford Royal. Oldchurch Hospital, Romford, became Queen’s Hospital. Farnborough Hospital, in Bromley, was renamed after Princess Anne.

From: http://www.telegraph.co.uk/Casualty-units-shut-to-pay-for-private-finance-hospital-contracts

He said desperately sick people had been left for hours waiting on trolleys, with even those requiring intensive care enduring long delays.

Dozens of NHS units have cancelled surgery and clinics for outpatients.

At least 10 major centres issued “black alerts” — the highest emergency warning — meaning they were at breaking point, forcing patients to be sent elsewhere.

Scores of hospital wards closed due to norovirus, the winter vomiting bug, which put more than 1,200 beds out of use in one week as nurses attempted to isolate the disease.

Hospitals in Cambridge and Norfolk were on “black alert” for more than two weeks. In the past 10 days, major hospitals in London, Liverpool, Surrey, Southampton, Peterborough, Derby, King’s Lynn and Great Yarmouth issued the same warning.

While many hospitals did not schedule non-emergency surgery during the Christmas and New Year period, in the past week dozens cancelled thousands of planned operations.

Routine surgery was stopped at hospitals in Leicester, Sheffield, Macclesfield, Middlesbrough, Northallerton, Durham, Darlington, Bassetlaw, Belfast, Portsmouth, south Wales and many parts of London.

Last night it was disclosed that two boys, aged two and 10 months, had died from swine flu in Northern Ireland.

John Heyworth, the president of the College of Emergency Medicine, said: “We have seen A&Es absolutely overwhelmed, with people queuing on trolleys and long delays even for those being admitted to intensive care. The hospitals are gridlocked.”

He expressed anger about the failure of Government and the NHS to develop sufficient contingency plans, given that a flu outbreak was widely anticipated following the swine flu pandemic in 2009. “My frustration is that so much of this is predictable. This did not come out of the blue and yet the planning is inadequate — as though there is a sense of denial about it. The planning this winter has been far less effective than last year.”

Mr Heyworth claimed that casualty units had been hit by a “dramatic surge” in demand not just because of an increase in the number of very sick patients suffering flu complications, but also because less serious cases went to A&E because they could not see a GP at evenings or weekends.

“In many parts of the country out-of-hours services are absolutely inadequate, so what we get is people turning up at A&E simply because they do not know where else to go, or else they delay and only seek help when their condition is serious,” said Mr Heyworth. It is not good enough. We are failing the public.”

Across the country, hospitals were struggling to cope. Southampton General Hospital spent more than three weeks on “black alert”, closing 10 wards as norovirus swept through the centre. It was forced to stop all non-emergency surgery and cancel most appointments for outpatients during the period. The crisis warning was finally lifted on Thursday.

Because of the same bug, four wards were closed at Royal Cornwall Hospital last week and cancer and surgery wards in Poole, Dorset, were closed to new admissions. Three wards were closed at West Suffolk hospital.

On Thursday, it was disclosed that the number of deaths from flu had almost doubled, with 110 deaths this winter.

Hospitals were already struggling to cope with an increased number of elderly patients needing surgery following falls during the big freeze when they were hit by rising influenza admissions and cases of norovirus.

The latest figures for England showed that in the week ending last Sunday, 23 casualty units were filled to capacity, forcing ambulances carrying emergency patients to take desperately sick people miles further for treatment.

The Government was criticised by influenza experts for failing to introduce a national public advertising campaign about the perils of swine flu until Jan 1, by which time the outbreak was on course to hit epidemic levels.

Katherine Murphy, of the Patients Association, said: “It is really worrying that the NHS is not prepared to deal with these sorts of pressures. The system is on a knife-edge, and it does not have enough slack in it to cope once we have an outbreak of flu and cases of norovirus.”

She said the charity was “inundated” with calls from elderly people who had their operations cancelled and had not been given a date for the surgery to go ahead.

“What concerns me even more is that this is happening at a time when the health service is gearing up to make major savings, and massive reforms,” said Ms Murphy.

A spokesman for the Department of Health said there was always more pressure on the NHS at this time of year and insisted that the service had been prepared and was coping well.

“This year’s flu has resulted in greater than usual numbers of patients requiring critical care,” he said.

“Where necessary, local NHS organisations have increased their critical care capacity, in part by delaying routine operations requiring critical care back-up. This is a normal operational process which is initiated by NHS organisations at the local level.”

From: http://www.telegraph.co.uk/Swine-flu-hospitals-gridlocked

Macmillan Cancer Support said that showed too many patients were not being cared for properly after being given treatment like chemotherapy and radiotherapy.

According to the NAO’s report, which examines how well the NHS has managed to deliver the last government’s five year Cancer Reform Strategy so far, waiting times have fallen and the number of days cancer patients spend in hospital has dropped.

The strategy, launched in 2007, was meant to make NHS cancer services “among the best in the world” by 2012.

But the NAO report said there was “limited assurance” as to whether the £6.3 billion spent on cancer care annually was money well spent, because such poor information linking spend and outcomes was available.

In particular it illuminated problems caring for cancer outpatients.

Ciaran Devane, chief executive of Macmillan Cancer Support, said: “English cancer services have improved but there is still an incredibly long way to go for the UK to be a world leader.”

She warned: “The NHS won’t be able to support the growing number of cancer patients unless it seriously ups its game.

“The whole NHS needs to realise that cancer is a long term condition for many. If the NHS does not provide appropriate services after patients leave hospital, they can expect to see a massive increase in costs as cancer patients are forced to use emergency services.

“Abandoning cancer patients after treatment is no longer acceptable, nor does it make any financial sense.”

The previous government had pledged to cut the total number of emergency cancer admissions – not just via A&E but also for example by doctors making emergency referrals – but instead the number has been rising steadily.

It has risen from 231,000 in 2000/01 to 300,000 in 2008/09. However, the rate of annual increase has almost halved. Four in five have an existing diagnosis.

Karen Taylor, from the NAO, said there was “poor understanding” of the issue while primary care trusts “don’t appear to be aware of it’s extent”.

Mike Hobday, head of policy at Macmillan, said the reason was clear.

“The traditional NHS approach at the end of cancer treatment has been to say, ‘Go away, you are cured.’ ”

But he explained: “While treatment is in most cases extremely good, people with cancer have ongoing problems. Chemotherapy is toxic – you can’t do it without impacting people’s health.

“Patients aren’t being given the support to manage themselves, so they turn up at A&E.”

A “small investment” in things like better information and dedicated helplines for cancer patients would reap large savings by lowering emergency admissions, he predicted.

With growing numbers of cancer survivors and stretched budgets “the NHS has to do this smarter”, he said.

Dr Jodie Moffatt of Cancer Research UK said the increase could partly be explained by the tripling of cancer patients receiving chemotherapy since 2000. The government was trying to tackle the problem, she argued.

Paul Burstow, the Health Minister responsible for care services, said: “This report is a damning indictment of Labour’s failure to deliver on their promises to improve the quality of cancer care.

“The shocking levels of emergency admissions are the legacy of Labour’s obsession with hitting targets instead of helping patients.

“Under Labour, NHS spending rose to European levels of funding, but they have failed to deliver European levels of quality cancer care. If the NHS was performing at the level of the best in Europe, an extra 10,000 lives could be saved each year.”

Jo Webber, deputy director of policy at the NHS Confederation, which represents health trusts, said: “It is difficult to attribute a rise in emergency re-admissions to any one factor.

“Commissioning appropriate after-care services and providing patients with access to specialist services and home support services all play their part in bringing numbers of re-admissions down.

“Providing patients with access to quality treatment in or close to home, as well as information on local support services, is just as important as the early detection and treatment of the disease when planning an effective cancer strategy.”

From: http://www.telegraph.co.uk/Cancer-patients-abandoned-after-treatment

Emergency patients are being let down by the health service because managers are more concerned with meeting targets by treating those with appointments, the heads of Royal Colleges warn.

In a letter to The Daily Telegraph, some of the country’s most senior doctors say they are “deeply frustrated” at the low priority given to Accident and Emergency.

Targets concerning waiting times and cancelled operations, introduced under Labour, result in managers pushing doctors to operate on patients whose care has been pre-planned, in order to avoid financial penalties. But they can also mean that those who come in as emergency cases are stabilised and admitted but then left to wait for surgery.

Studies have shown that elderly people with fractured hips who do not undergo surgery within 48 hours are less likely to regain full mobility. Younger patients with shattered pelvises, from motorcycle or horse-riding accidents, are less likely to walk again if their operations are delayed.

A report published on Thursday criticised care for the elderly, finding that two thirds of those who died within a month of surgery had not received proper care and that they had often been left in pain.

Most of those patients were being treated for bowel conditions or broken hips, which are usually admitted as emergency cases.

John Black, president of the Royal College of Surgeons, said the report echoed concerns that surgeons had been raising for some time.

In the letter, Mr Black said: “It is a source of deep frustration to our members that hospitals have become organised to deal quickly with elective operations at the cost of properly managing emergency care.”

The Coalition’s reforms of the NHS could help by making hospitals more accountable to GPs for the care they provide, he said.

The letter was signed by Peter Nightingale, president of the Royal College of Anaesthetists; Peter Kay, president of the British Orthopaedic Association; Finbarr Martin, president of the British Geriatric Society; Mike Horrocks, president of the Association of Surgeons; and Clare Marx, the Royal College of Surgeons’ lead representative in matters of patient safety.

Mr Horrocks said: “In recent years, the NHS has been set targets for elective operations to bring down waiting lists.

“This has been fantastic for patients with non-emergency conditions, but came at the detriment of those who require urgent treatment as hospitals focused on hitting those targets.

“The new government has committed to moving away from targets and towards measuring and rewarding hospitals who deliver good outcomes and this report should provide further evidence that this approach is correct.”

Under Labour, patients had to be treated within 18 weeks of a referral by their family doctor.

Surgeons have told the Telegraph that this resulted in extreme pressure to operate on any patients in danger of failing to meet that target, ahead of cases that came in as emergencies.

Any pre-planned operation that was cancelled was recorded and the data published. The patient then had to be rescheduled within 28 days, adding to the pressure to give elective operations priority, doctors have said.

Mr Black added: “Surgeons have been saying for some time that emergency surgery is a Cinderella service in the modern NHS.

“We will only solve these problems if focusing on emergency care becomes a priority in the boardroom as well as the ward.”

Katherine Murphy, director of the Patients Association, said: “It can be so debilitating for someone who has a fracture to be left for a couple of days or longer, waiting for an operation when the trust is focused yet again on meeting these pernicious targets. It is an appalling way to determine who gets care. An emergency should be an emergency.

“The financial rewards for elective surgery are more lucrative for the trust than for emergencies and that is why trusts continue to focus on elective treatment. We cannot make savings by putting patients through unnecessary pain and suffering.”

From: http://www.telegraph.co.uk/Emergency-patients-let-down-by-targets-say-surgeons

Pensioners and the poor were most at risk of being diagnosed late. The detection rate is even worse among sufferers of brain tumours or acute leukaemia, with more than half of these cancers diagnosed only in an emergency.

The figures were described as “shocking” by leading cancer charities. Spokesmen said a lack of awareness of symptoms among the general population and a failure by doctors to identify the early warning signs were largely to blame.

They called for new screening programmes as quickly as possible and for public awareness campaigns to highlight the symptoms of cancer.

Patients whose cancers are diagnosed only when they reach A&E departments are more likely to have advanced forms of the disease, making it often impossible to treat.

Experts say England’s poor detection rates could explain why the country has much lower survival rates than other countries in Europe. They believe that many hundreds of lives could be saved each year if more early diagnoses were made.

The study comes after the Office for National Statistics disclosed that the cancer death rate among British women was higher than in countries such as France, Italy and Portugal.

Britain has national screening programmes for only three types of cancer: cervical, bowel and breast cancer.

Harpal Kumar, the chief executive of Cancer Research UK, said: “The figure for diagnoses via emergency presentations is way too high.

“This statistic helps explain why we have lower survival rates than we would hope to have, lower than the best countries in Europe.

“We need screening programmes to be rolled out as early as possible and GPs given rapid access to the tests that will enable patients to be moved quickly through the system.” Mr Kumar said people should be better educated about the possible signs and symptoms of different types of cancer.

Prof Sir Mike Richards, the National Cancer Director, who acted as clinical director to the project, said the overall figure of 23 per cent had been “quite a surprise”.

“We need to look at this group of patients and see what we can do to reduce the proportion coming in as emergencies,” he said.

The NCIN, part of the NHS-run National Cancer Programme which coordinates national information on cancer, looked at all English patients diagnosed in 2007 and worked through their files to find when their disease was diagnosed.

The proportion of cancers identified during an emergency varied widely between different types, depending on how easy they are to identify and on general awareness.

Only a small number of skin and breast cancers – 3 and 4 per cent respectively — were diagnosed at emergency, with most identified by doctors or screening programmes.

Overall, 23 per cent of cancer cases were diagnosed during an “emergency presentation” by the patient, most often to A&E departments. Of those with brain or central nervous system cancer, 58 per cent were not picked up until they were seen in hospital, along with 57 per cent with acute leukaemia and 47 per cent with pancreatic cancer.

Patients under 25 and over 75 were the most likely to present as emergencies, as well as poorer ones. These patients were less likely to survive for a year than those whose illness was detected in the doctor’s surgery.

The authors of the study said: “One-year relative survival rates were lower for patients presenting as emergencies than for those presenting via other routes.”

From: http://www.telegraph.co.uk/Cancer-detected-late-in-quarter-of-cases

These levels of mental health are the same as soldiers, sailors and airmen in training and less than those in other high-stress occupations, such as police officers, doctors in emergency departments and disaster workers.

Focusing on the mental health of UK armed forces while on deployment, the study by researchers at the Institute of Psychiatry, King’s College London, included servicemen and women at eight locations across Iraq in January and February 2009.

Of the 611 surveyed, 20.5 per cent demonstrated symptoms of psychological distress, while 3.4% showed signs of PTSD.

Respondents were more likely to report good health if they were of officer rank, if they felt their unit was very cohesive and had supportive leadership, and if they had taken a period of rest and recuperation in an area outside an operational theatre.

Those who reported psychological distress were most likely to be young, female, in the Army, and of junior rank.

Personnel belonging to junior ranks were also more likely to show symptoms of PTSD, along with those who felt they were in danger of being killed.

The report showed that sickness levels were very low with only 1.6 per cent of personnel taking more than three days off during their six month deployment.

While a lot of research on the mental health of UK armed forces personnel has been conducted either before or after deployment, very little is known about their mental health during employment, Professor Neil Greenberg from the Academic Centre for Defence Mental Health said.

“Interestingly, those who told us they remembered having a pre-deployment stress briefing reported significantly better mental health than those who did not,” he said.

Although most units had medical support, Prof Neil said training for medical staff had only recently begun to be standardised to ensure it covered mental health disorders.

“Improving training, as well as raising awareness among staff of the link between these personnel reporting sick and having poorer mental health, may help identify those in most need of psychological help,” he said.

Those who took part in the survey, published in the British Journal of Psychiatry, represented about 15 per cent of personnel deployed in Iraq at the time.

From: http://www.telegraph.co.uk/Servicemen-in-Iraq-less-stressed-than-emergency-services-in-Britain

Lawyers for the victims said the failings of Stafford Hospital left patients degraded and humiliated, and amounted to human rights’ abuses.

The trust has offered a total compensation settlements of £1.1 million, which the families are expected to accept, and apologies in each case. It did not accept the failings were breaches of human rights.

A public inquiry into the worst hospital scandal in more than a decade opens next week.

Last year, inspectors found that hundreds more patients died than would have been expected at the hospital between 2005 and 2008, amid “appalling” conditions.

Dehydrated patients were forced to drink out of flower vases, while decisions about treatment for Accident and Emergency patients were left to receptionists.

Up to 1,200 patients may have died needlessly over the period, as managers attempted to cut costs and hit targets.

The settlements for the group of 97 cases, including 84 deaths, covers failings as recent as this year, and dating back to 2002.

Among those to receive a payment is Heather Wilhelms, 55, who lost her mother, father, and husband at the hospital in the space of 18 months.

Her mother’s ovarian cancer was missed, while her father was sent home without treatment days before he died, after blood poisoning went undetected.

Nine months later, her husband died from lung disease in wards which his widow described as “filthy”. She told how her loved ones went to hospital for treatment and one by one, came out in their coffins.

The compensation payouts range from £1,000 to £27,500, with an average payment of just over £11,000 for bereaved relatives and those who survived failings in care.

Emma Jones, from lawyers Leigh Day & Co, which represented the families, said the action was believed to be unprecedented, with the 97 cases representing the largest group to be offered payouts by one hospital.

She said lawyers argued that the hospital’s failings were so basic and substantial, that they amounted to breaches of patients’ fundamental human rights.

Miss Jones said: “This was about basic neglect; food and drink placed out of reach, buzzers unanswered, people left after soiling themselves.

“In some cases we argued that the poor treatment caused the deaths – in many, the argument was that basic fundamental human rights were being denied – that people were being degraded, neglected and humiliated.”

Often, when elderly people die following failings in hospital, compensation is low, especially if no spouse is bereaved.

The lawyers said the case was significant because the arguments had centred on how badly patients had been treated, rather than proving their deaths had been hastened.

“For the relatives it was never about the money but more a recognition that their mum, or dad should never have been left to suffer in that way,” said Miss Jones.

She added: “We don’t know of any bigger group claim against any one hospital, we think this is unprecedented.”

The Labour Government refused to hold a public inquiry to find out what went wrong, and to prevent a repeat of the scandal.

Since taking power, the Coalition Government has ordered such an investigation – one of the key demands of The Sunday Telegraph’s Heal Our Hospitals campaign – which is due to start taking evidence next week.

On Saturday an inspection report revealed that the hospital is still failing to meet most basic standards of patient care.

The Care Quality Commission said it had concerns about the care and welfare of patients, and respect shown to them, its safeguarding of patients from abuse, the management of medicines, the safety of premises and equipment, staffing and complaints.

Inspectors said the trust had made progress, and that some of the concerns involved changes which would take time to “bed in”.

Last week it emerged that the trust had paid a locum Accident & Emergency doctor more than £5,000 to work a single 24-hour shift, in response to a sudden staffing crisis.

Julie Bailey, who founded local campaign group Cure the NHS as a response to the standard of care given by the hospital to her own mother, who died in 2007, said: “The size of the group exposes the scale of this crisis; it is an absolute disgrace that in the 21st century, the most vulnerable people were treated so appallingly.”

She added: “For relatives who have gone through this, no amount of money can ever compensate for what happened to their loved ones.”

Mrs Bailey said there were many more relatives and victims who had never received a penny. “Every day, someone comes to me who has never even spoken before about what they went through.

“There are so many people suffering as a result of this scandal, and no one has been held to account for what we are going through.”

Antony Sumara, Chief Executive of Mid Staffordshire NHS Foundation Trust, said: “As always, I offer our sincerest apologies to the families concerned, for the distress caused by the poor care their relatives received at our Trust in the past.

“We have made a lot of progress over the last year in improving the care for our patients and will continue to focus our efforts on building on these improvements and making sure that they are sustained.”

From: http://www.telegraph.co.uk/Almost-100-victims-of-Staffordshire-scandal-receive-payouts-after-unprecedented-group-claim

Patients will be left untreated as the NHS struggles to mop up the consequences of severe cuts in local authority funding, said Nigel Edwards, the head of the NHS Confederation.

The Coalition has promised to increase the NHS budget over the next four years, even as it cuts more than £40 billion from other public services. Local councils will bear some of the heaviest cuts.

In a letter to The Daily Telegraph, Mr Edwards — whose organisation represents NHS trusts running hospitals and ambulance services — says the cuts in local authority budgets will force them to reduce care services for the elderly and vulnerable.

“Less support from council services will quickly lead to increased pressure on emergency services and hospitals,” he writes. “Hospital beds will be blocked for those who badly need care because the support services the elderly require after discharge will not be available.”

Calling for a greater co-ordination of council care services and NHS facilities, he says: “When it comes to the care of the most vulnerable in our society, it really is essential that the NHS and local authorities are in it together.”

His warning coincides with the most explicit admission yet from a Cabinet minister that the Coalition’s cuts in public spending will cause genuine distress.

Danny Alexander, the Chief Secretary to the Treasury, says in an interview with The Daily Telegraph that the cuts will mean real hardship for many. “For a lot of people it’s going to be very difficult indeed,” he says.

Mr Edwards’s warning comes in response to this week’s spending review, which set out Coalition plans to address the deficit in public finances. Central government support for councils in England will be reduced by 27 per cent over the next four years, leaving them seeking deep cuts in the services they offer.

Councils last year spent £14 billion on adult social care services. Care funding is the largest part of council budgets not legally ring-fenced, leaving it vulnerable to cuts.

To reduce the scale of any cuts in care, the Treasury this week earmarked £2 billion over the next four years for councils to spend on adult care services. However, local government leaders and charities said it was not enough to compensate for larger cuts in council budgets.

The Local Government Association, which represents councils in England and Wales, said even with the extra cash councils would still face a £4 billion shortfall in budgets for adult social care by 2014. A spokesman for the LGA said the spending review would have a significant impact on care services.

Some councils have already begun raising the entry criteria for care to those judged to be in the most severe need.

Government sources said ministers were aware of the likely pressure on the health service and had set aside funds in the NHS budget for care services.

A spokesman for the Department of Health said it was understood that social care could have an impact on NHS demands and that is why they were strengthening programmes that would integrate hospital care with care in the community, as well as providing the extra funding.

He added that “we expect local health and social care professionals will work together” to “improve outcomes for everyone”.

Kieran Mullan, from the Patients Association, said: “Social care and the NHS do not exist in silos. One impacts directly on the other. Poor services in the community lead to admissions to hospital and lack of services prevent discharge when it might be best for the patient.”

From: http://www.telegraph.co.uk/Spending-Review-2010-NHS-faces-bed-blocking-crisis

Over the last five years, London Ambulance Service responded to 11,780 alcohol-related call-outs involving under-18s at a cost of more than £2.5m, the research showed.

In 2009/10, West Midlands Ambulance Service responded to 1,296 alcohol-related call-outs involving under-18s at a cost of almost £250,000, while the North East Ambulance Trust responded to just under 1,000 at a cost of £175,000.

In all cases, more young girls were seen by ambulance crews than young boys, the charity said.

Alcohol Concern also found that between 2004 and 2009 28% more girls were admitted to hospital via accident and emergency departments for alcohol than boys – 23,347 girls compared to 18,159 boys.

The report ‘Right time, right place: Alcohol-harm reduction strategies with children and young people’ calls for earlier identification of young people engaged in ‘risky’ drinking such as young people attending A&E or getting into trouble with the police for alcohol, so they can access information, advice and support.

The charity’s chief executive, Don Shenker, said: “As long as alcohol remains as heavily promoted as it currently is, young drinkers will continue to consume far more than they might otherwise, leading to inevitable health harms, wasting ambulance and police time.

“As well as tackling the ludicrously cheap price of alcohol in some settings, we want all under-18-year-olds who turn up at A&E to be advised and supported to address their drinking.”

A spokesman for the Department of Health said: “This report shows the devastating impact that alcohol has on the lives of young people who drink too much. We must educate them so they understand how bad it is for their health now and in the long term. And we must do more to stop shops selling alcohol to under 18s.

“Everyone has a part to play in this. Parents, police, education and social services need to work together. The new Public Health Service will give communities the power and budget to tackle alcohol problems in their areas.”

From: http://www.independent.co.uk/figures-show-rise-in-drinkrelated-hospital-admissions-for-children

The Department of Health has published the results of two simultaneous reviews of the SCR, covering the content of the record and the information patients receive before their record is uploaded.

The reviews were set up by the coalition government this summer, following concerns about patients’ awareness of the SCR and the kind of information added to it. This had led to the suspension of further patient information programmes.

The review of the content of the record, led by NHS medical director Sir Bruce Keogh, concluded that the core record should only contain a patient’s demographic details, medications, allergies and adverse reactions, and that these should continue to be copied from the GP’s medical record.

The review group said the DH should only consider expanding the content of the record “when we have built trust in the system and when patients request that we should do so.”

Sir Bruce said: “In an advanced national health system, it is reasonable for citizens to expect that when they arrive in accident and emergency or require treatment out of hours, the clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions.”

The separate Patient Information and Preference Review group, led by national director of patient and public affairs Joan Saddler, concluded that an opt-out form should be included in the patient information packs, and that these should also be simplified.

It said services such as HealthSpace should also continue to provide access to SCRs.

Almost 30m patients have already received information about the SCR but the review concluded that there should be no requirement to send another letter to those patients.

However, it said but there should be awareness raising campaigns at local, regional and national levels to ensure patients realise that an SCR is being created for them unless they choose to opt out.

Health minister Simon Burns said he was pleased that a consensus had emerged about the importance of the SCR in supporting safe patient care, so long as the content of the record was limited to core information.

He added: “Coupled with improvements to communication with patients which reinforce their right to opt out, we believe this draws a line under the controversies that the SCR has generated up to now.

“We see this review as having taking a significant step towards the goal of patients owning their records and using them to share decision-making with healthcare professionals.”

A BMA spokesperson said: “We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.

“Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation. It is essential that patients have genuine control over who has access to their records, and when changes are made to them.”

The review groups concluded that patients should play a key role in deciding the evolution of the record and that new arrangements should be introduced to define responsibility for decisions about the introduction of any new content to the record.

They said the principle should be that any change to the scope of the record should be driven by citizens and patients with appropriate advice from professional bodies and in line with the IT capability.

Saddler said the availability of core information when patients need care was essential if patients were to be at the heart of care but it should also be easy for patients to opt-out.

She added:”Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use.”

The SCR Content Review group said standards should be defined to support a patient’s wish to add information to their SCR such as end of life preferences, a care plan for patients with long term conditions or the inclusion of a patient’s significant medical history.

The review groups, which between them took evidence from almost 50 bodies, said it had heard strong opinions that the use of smartcards was not universal within GP practices which had implications for accurate updating of the SCR.

The reviews said use of smartcards was outside their remit but recommended that further options were investigated to mitigate the risk of practices not using smartcards.

The review group on Patient information and Preferences also recommended that the outer envelope that patients receive should have clear emphasis that the information contained in the envelope is about “Your health records, you need to make a choice.”

John Heyworth, president of the College of Emergency Medicine, said the college welcomed the decision to proceed with the SCR.

He added: “Clinicians working in emergency departments are currently often deprived of key background and patient information, particularly during the initial phase of time critical treatment and this may significantly compromise the quality and safety of care provided.

“Immediate access to such records will lead to better and safer care for our emergency patients.”

The review’s conclusions were backed by a range of bodies including the Patients’ Assocation, The Royal College of Nursing, Asthma UK and Sue Ryder Care.

From: http://www.e-health-insider.com/summary_care_record_given_go-ahead

Critical care experts say there may be as few as 3.5 intensive care beds per 100,000 people in the UK, compared with more than 24 per 100,000 in Germany.

Dr Gordon Rubenfeld, from Sunnybrook Health Sciences Centre in Toronto, said that huge investment would be needed to keep pace with the growing demand for intensive care services.

One figure suggests that by 2030, the incidence of acute lung injury will have risen 50%, driven by pneumonia cases in older people.

Dr Rubenfeld analysed the availability of critical care beds in various countries, and while conceding that the figure of 3.5 per 100,000 might under-represent the true position, he concluded that, at present levels, the UK would not be in a good position to deal with the extra demands of a disaster.

If we have a pandemic of normal winter flu we would be stretched to the limit”

Currently, an intensive care bed costs the NHS about £1,500 a day, and Professor Mervyn Singer, from University College London, said it was unrealistic to expect a significant expansion of intensive care at a time when health budgets were shrinking in real terms.

He said: “We are clearly in a worse position than some other countries because there is no spare capacity in the system, with many units running at 100% capacity, or close to it.

“While it would be nice to have extra wards and staff ready in the event of a disaster, it is not a particularly pragmatic expectation.

“There are things you can do in the event of a disaster, such as cancelling surgery, which frees up beds, but it is very much a ‘make do and mend’ approach in these circumstances.”
Local demands

Dr Kevin Gunning, a consultant in intensive care at Addenbrooke’s Hospital, Cambridge, and a spokesman for the Intensive Care Society, said that in the event of a major pandemic or other disaster, the true determinant of intensive care capacity would be staff such as trained nurses rather than beds or equipment.

While there had been significant improvements since the year 2000, when a severe outbreak of winter flu caused problems across the NHS, he said the UK was still relatively poorly resourced compared with much of western Europe.

He said: “It’s fair to say that we would have struggled with a flu pandemic of the scale some were predicting last year.

“If we have a pandemic of normal winter flu we would be stretched to the limit.”

A Department of Health spokesman said: “The number of beds has increased and continues to increase but more does need to be done in some areas.

From: http://www.bbc.co.uk/news/health-11503873

It said a rise in patients who spent a day or less in hospital suggested many admissions could be avoided. NHS managers agreed action was needed to tackle the problem.

Emergency admissions include patients admitted through A&E units as well as direct into other parts of hospitals.
Ageing population

The think tank, which analysed a range of official NHS data during its research, found emergency admissions now accounted for more than a third of the total.

The rise seen since 2004-05 is costing the NHS an extra £330m a year alone and the think tank said the issue had to be a priority if the NHS was to prosper in the current economic climate.

Researchers found there was a range of factors behind the trend.

They pointed to the ageing population – the elderly were more likely to be admitted as an emergency – as well as financial incentives in the NHS which were motivating hospitals to admit more.

The report also noted there had been a significant jump in patients being admitted for one day or less.

It said this was partly related to advances in medicine which meant patients did not need to spend as long in hospital, but argued many could have been avoided with better community services.

While the report only looked in detail at the situation in England, it also noted rises had been seen elsewhere in the UK.

And it said the recent announcement by ministers that hospitals would be fined for readmissions would only have a limited impact as many of the cases did not fall into that category.

Nuffield Trust director Dr Jennifer Dixon said: “Reversing this unsustainable rise in emergency admissions must be the number one priority for the NHS – any reform to the health service that does not tackle this will fail. Our hospitals are overheating and are treating patients at great cost to the NHS.”

Nigel Edwards, acting chief executive of the NHS Confederation, which represents managers, said: “This report furthers the case for fundamentally reviewing the urgent and emergency care system.

“Hospital is often the right place for sick patients to be but we know that for many there are better, more convenient and more cost-effective alternatives to hospital admission.

Dr John Heyworth, president of the College of Emergency Medicine agreed there were pressures in the system, but questioned some aspects of the research.

“It is fundamentally incorrect to assume that admissions for less than 24 hours are unnecessary or financially inefficient. In fact, the opposite applies.”

From: http://news.bbc.co.uk/1/hi/health/10490508.stm

Nursing and doctors’ leaders welcomed the greater flexibility they have been given to treat patients according to clinical need rather than being forced to stick to strict central guidelines.

But patients’ groups expressed concern that the reforms could result in a “free-for-all,” and that without targets long waiting times could return to the NHS.

GPs will no longer be forced to see patients within 48 hours of them seeking an appointment.

The requirement for 98 per cent of patients attending Accident and Emergency wards to be seen within four hours has been relaxed to 95 per cent.

And the target for patients to be given a hospital appointment within 18 weeks of being referred by their GP has been abandoned altogether.

Andrew Lansley, the Health Secretary, insisted that people would still have the right to demand high levels of service from the NHS, but that this would be done locally rather than dictated from the centre.

“I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes,” he added.

“Doctors will be free to focus on the outcomes that matter – providing quality patient care.”

Katherine Murphy, director of the Patients Association, said: “The targets focused minds in the NHS, made people start realising services had to get better.”

But Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, welcomed the relaxation in targets.

He said: “Patients should have good access to GPs. However, while this target may have been intended to improve access it has in fact had adverse consequences.

“At the moment practices need to have enough appointments available on the day or the following day to meet the target, so those who want to book in advance find there are fewer appointments available.”

Under the changes to the NHS Operating Framework, Mr Lansley has also ordered health bodies to reduce management costs from £1.85 billion to £1 billion by 2013.

While spending on the health service will continue at current levels, he said it was crucial to make “immediate” savings which could be reinvested in patient care.

From: http://www.telegraph.co.uk/NHS-waiting-times-are-relaxed-and-abandoned

There will be a full public inquiry into the scandal hit Stafford Hospital in Mid Staffordshire NHS Trust, the government has announced.

Campaigners consistently said it was the only way to uncover the failings, but previous labour ministers had resisted.

As they emerged into the rain from the House of Commons to pose for photographers, Stafford Hospital campaigners hugged each other and laughed. “It’s the first time we’ve smiled since this whole thing began,” Julie Bailey told me. She’s the woman who founded Cure the NHS after her mother died at the hospital having experienced what Julie says was eight weeks of dreadful care.

The group has been pressing for a Public Inquiry since the Healthcare Commission first uncovered the extent of the problems at Stafford Hospital last year. They argued that anything less wouldn’t have the powers to answer all their questions. Julie Bailey looked tearful as I asked her about her mother’s experience.

“I’ve done this for her,” she said. “She’d have done all this and more if she’d had the chance.” She believes the public inquiry will mean people who’ve been able to duck questions until now will be forced to account for themselves. “It’s not about revenge,” she said, “it’s about accountability and openness. Tomorrow we’ve got to start a new beginning for the NHS because we don’t need any more unnecessary deaths.”

The problems at Stafford – run by the Mid Staffordshire NHS Trust – were laid bare by the NHS regulator in March 2009.

The Healthcare