Health Direct NHS National Health Service

Subscribe Twitter
National Health Service Direct NHS

Health Secretary wants to cut nurses’ paperwork by third

February 14, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Conservatives, Health Professionals, NHS Targets, NHS Waste, Nurses, Preventable Crisis, Uncategorized

Jeremy Hunt the Health Secretary, wants to cut the amount of paperwork doctors and nurses have to do by a third so they can spend hours more every week with patients.Health Secretary wants to cut nurses' paperwork by third“Endless” box ticking and “burdensome regulation” mean nurses spend about a day a week on paperwork, Mr Hunt told a meeting organised by the think-tank Reform.

He has asked the NHS Confederation, which represents managers, to come up with a plan in the coming months to cut red tape.

His pledge has been welcomed by the Royal College of Nursing, which described the burden of paperwork as “excessive”.

Mr Hunt said that one of the primary lessons from the Francis report, into failings that led to hundreds of deaths at Stafford hospital, is that small things like ensuring a patient has enough water, matter more than targets.

As ministers make changes to ensure a repeat never happens, he claims “we must avoid thinking that care and compassion can be commanded from on high either by regulators or politicians”.

“Endless boxes to tick, cumbersome bureaucracy and burdensome regulations are the problem – they cannot be the solution,” he said.

Mr Hunt describes good healthcare as being “in the moment – the minute-by-minute interaction between a person in need and a person there to help”.

He continued “It is because people believe in the values of the NHS that they spend their working lives in it.

“So this is about unlocking those values that lie inside the outstanding doctors and nurses who deliver care week-in and week-out and stopping the dead hand of top-down targets crushing the goodness out of them.”

Among the cases that have come to Mt Hunt’s attention include a nurse who had to fill 10 forms – including one that was 22 pages long – to get a patient with a gunshot wound admitted to a trauma ward.

Dr Peter Carter, chief executive and general secretary of the RCN, welcomed the initiative.

He said: “Our members have been telling us for several years that they are forced to spend too much time filling in forms, ticking boxes and duplicating information.”

“While it is necessary to monitor care, record vital signs, and follow care plans, we are concerned that the burden is excessive and can be very poorly managed. In particular, the time spent filling in forms is time which could be spent with patients.”

“We urge all NHS organisations to focus on paperwork which serves the patient, and to ensure that there is enough support to allow nurses to focus on delivering care.”

From: http://www.telegraph.co.uk/Jeremy-Hunt-Lets-cut-nurses-paperwork-by-a-third

NHS Stafford Hospital- Francis Report blames no one and everyone

February 08, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Care Professionals, Doctors, Health Professionals, Labour Waste, National Health Service, NHS, NHS Cash Shortages, NHS Deaths, NHS Targets, Nurses, Patients, Preventable Crisis, red tape, Uncategorized

In the aftermath of NHS Stafford Hospital report by Robert Francis QC- there seems a huge contradiction- it blames everyone and yet at the same time no one is singled out for the hundreds of needless deaths.NHS Stafford Hospital- Francis Report blames no one and everyoneJeremy Hunt, the Health Secretary, said it felt “wrong” that no one had been brought to book, while David Cameron said doctors should have been struck off.

Julie Bailey, who set up the pressure group Cure the NHS after her mother died at Stafford and was instrumental in exposing the failures, said: “We want resignations. We have lost hundreds of lives within the NHS, we want accountability.”

She said Sir David Nicholson-  the chief executive of the NHS, who was in charge of a body that had oversight of Mid Staffs for part of the time when the deaths were occurring, was “a bully” who should not be in charge of the NHS.

She also called for the resignation of Peter Carter, the general secretary of the Royal College of Nursing, which had told a whistle-blower at the hospital to “keep her head down” rather than fight for change. She added: “We want everybody who knew about this disaster to be held to account, otherwise nothing will change in the NHS.”

James Duff, whose wife Doreen died after receiving sub-standard care at Stafford Hospital, said: “Not one person has lost their job over this – instead they have been promoted and some people have been moved sideways. This has been a disaster yet nobody is accountable.”

The public sector union Unite said Sir David’s position was “untenable” as he was “not the person to lead the NHS into the world of patient-focused care as outlined by Robert Francis”.

Sir David was chief executive of Shropshire and Staffordshire Strategic Health Authority, with oversight of Mid Staffs, for a nine-month period in 2005-06 when the first instances of mistreatment and neglect are believed to have taken place.

Katherine Murphy, the chief executive of the Patients Association, said the report was a “watershed moment” for the health service.

She said: “It is clear that he [Mr Francis] has understood some of the very real failings that patients and their families face day in and day out.

“It is clear from the report that there is a lot of blame to go around for what happened in Stafford. Unfortunately too many people have escaped genuine accountability.”

Among the Francis Report’s 290 recommendations were the need for NHS hospitals to put “patients first, not numbers” and a “zero tolerance” approach to poor standards of care.

Health workers should have a “statutory duty of candour” and the obstruction of this duty should be a criminal offence, while gagging clauses preventing staff from raising concerns should be banned.

Ed Miliband, whose Labour party was in power as the Mid Staffs scandal unfolded, also apologised, but said the scandal was “not typical” of what happened in NHS hospitals up and down the country.

3,000 more patients have died needlessly in NHS hospitals

February 07, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Care Professionals, Doctors, Health Professionals, National Health Service, NHS, NHS Cash Shortages, NHS Deaths, NHS Targets, NHS Waste, Nurses, Preventable Crisis, red tape, Uncategorized

More than 3,000 people may have died unnecessarily at five NHS trusts in a crisis that could dwarf the horrors at Mid Staffordshire, which were detailed in a devastating report published yesterday.3,000 more patients have died needlessly in NHS hospitalsAn investigation began on Wednesday night into excessive mortality rates at the five trusts – the same warning sign that exposed the needless deaths of up to 1,200 patients at Mid Staffs.

The trusts in Lancashire, Essex and Greater Manchester have been “outliers” on an index of expected death rates for two successive years to 2012.

Within hours of the publication of a report which described the “disaster” at Mid Staffs as the worst scandal in the history of the NHS, the Department of Health released figures which raise the possibility that the “appalling” lack of care may still be going on at hospitals around the country.

Between July 2010 and June 2012, a total of 3,063 deaths were recorded at the five trusts, which comprise eight district general hospitals, over and above what would be expected. The worst figures were recorded at Blackpool Teaching Hospitals, where there were 879 excessive deaths. East Lancashire Hospitals NHS Trust, which has premises in Blackburn and Burnley, had 618; Colchester Hospital University Trust in Essex had 599; Basildon and Thurrock, also in Essex, had 508 and Tameside, near Manchester, 459.

Sir Bruce Keogh, the medical director of the NHS Commissioning Board, will be in charge of the investigation in the five areas, where patients and their families have been warning for years that care was inadequate.

The figures piled more pressure on Sir David Nicholson, the chief executive of the NHS, who was already facing demands to resign over his failure to root out the problems at Mid Staffs.

Professor Sir Brian Jarman, an international authority on hospital performance, said he warned the Government in early 2010 about high death rates at four of the hospitals now under investigation. Sir Brian, a former president of the British Medical Association, said problems in the NHS have been ignored for too long and called for Sir David to step down.

“I think he should go,” he said. “The Francis Report [into Mid Staffs] is very good but the difficulty is the same people are running the NHS and the mechanism of denial is continuing.” Earlier, Robert Francis QC published his findings following a 31-month public inquiry into deaths at Mid Staffordshire NHS Foundation Trust, in which he catalogued the “harrowing” experiences of patients at Stafford Hospital.

The report says there was “a failure of the NHS system at every level” to detect problems and take action. Despite between 400 and 1,200 people dying needlessly, and despite five investigations including Mr Francis’s £13  million public inquiry, not one person has been sacked or struck off.

Mr Francis said conditions of “appalling care” flourished because managers “put corporate self-interest and cost control ahead of patients and their safety”. He said patients were “let down” by a “lack of care, compassion, humanity and leadership”, with patients having to relieve themselves in their beds because no one would take them to the lavatory, others drinking water from vases because they were not given drinks and “callous indifference” to their suffering by ward staff. Staff who tried to raise concerns were ignored, bullied or intimidated, and watchdog bodies failed to react to repeated warnings.

Stafford Hospital- hiding mistakes should be criminal offence- Francis inquiry

February 06, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Care Professionals, Doctors, Health Professionals, Labour Waste, National Health Service, NHS, NHS Cash Shortages, NHS Deaths, NHS Targets, Nurses, Preventable Crisis, red tape, Uncategorized

NHS staff should face prosecution if they are not open and honest about mistakes, according to a public inquiry into failings at Stafford Hospital.Stafford Hospital- hiding mistakes should be criminal offence- Francis inquiry Years of abuse and neglect at the hospital led to the unnecessary deaths of hundreds of patients.

The “appalling” levels of care that led to needless deaths have already been well documented by a 2009 report by the Healthcare Commission and an independent inquiry in 2010, which was also chaired by Mr Francis.

They both criticised the cost-cutting and target-chasing culture that had developed at the Mid Staffordshire Trust, which ran the hospital.

But inquiry chairman, Robert Francis QC, said the failings went right to the top of the health service.

He made 290 recommendations, saying “fundamental change” was needed to prevent the public losing confidence.

His report comes after the families of victims have voiced anger that no-one has been sufficiently punished for their roles.

Senior managers were able to leave the trust with little sanction, while most doctors and nurses involved have escaped censure from their professional regulators.

Responding in the House of Commons, Prime Minister David Cameron apologised to the families of patients.

He said he was “truly sorry” for what happened at Stafford Hospital, which was “not just wrong, it was truly dreadful” and the government needed to “purge” a culture of complacency.

Mr Cameron said a full response to the inquiry would follow next month, but he did immediately announce that a new post of chief inspector of hospitals would be created in the autumn.

The final report contains 290 recommendations over nearly 1,800 pages. In particular, it recommended:

  •     The merger of the regulation of care into one body – two are currently involved
  •     Senior managers to be given a code of conduct and the ability to disqualify them if they are not fit to hold such positions
  •     Hiding information about poor care to become a criminal offence as would failing to adhere to basic standards that lead to death or serious harm
  •     A statutory obligation on doctors and nurses for a duty of candour so they are open with patients about mistakes
  •     An increased focus on compassion in the recruitment, training and education of nurses, including an aptitude test for new recruits and regular checks of competence as is being rolled out for doctors

While it is well-known the trust management ignored patients’ complaints, local GPs and MPs also failed to speak up for them, the inquiry said.

The local primary care trust and regional health authority were too quick to trust the hospital’s management and national regulators were not challenging enough.

Meanwhile, the Royal College of Nursing was highlighted for not doing enough to support its members who were trying to raise concerns.

The Department of Health was also criticised for being too “remote” and embarking on “counterproductive” reorganisations.

Instead, it urged everyone from “porters and cleaners to the secretary of state” to work together to shift the culture and adopt a “zero tolerance” approach to poor care.

Mr Francis said: “This is a story of appalling and unnecessary suffering of hundreds of people.  They were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety.”

He said the public’s trust in the NHS had been “betrayed” and a change of culture was needed to “make sure that patients come first”.

Patients admitted to hospitals on bank holidays almost 50 per cent more likely to die

January 30, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Doctors, Health, Health Direct, Healthcare, NHS Deaths, Out of hours, Uncategorized

Patients are much more likely to die if they are admitted to hospital on a bank holiday because there are fewer doctors on duty according to new research.Patients admitted to hospitals on bank holidays almost 50 per cent more likely to diePublic holidays are usually tagged on to a weekend, providing a three or four day holiday, resulting in what the authors refer to as a “cumulative effect”.

The authors of the study Emergency medical admissions, deaths at weekends and the public holiday effect, published in Emergency Medicine Journal, wrote: “If we assume that patients with severe illnesses are no more likely to be admitted on any one day of the week than any other, then it becomes difficult to escape the view that a cumulative effect of lack of services and/or lack of doctors on public holidays must have a part to play in the higher public holiday mortality demonstrated in this study.”

According to the study, carried out at Dumfries Infirmary in south-west Scotland, patients admitted at weekends were slightly older, less likely to have cancer and more likely to have a respiratory problem. Those admitted on public holidays were also more likely to have a respiratory problem. But otherwise there were no distinctive differences in the caseload.

In all, 3.8 per cent died within seven days of admission, while 8.9 per cent died within 30 days. After taking account of factors likely to influence the results, death rates were only slightly higher at weekends.

But they were significantly higher for public holiday admissions – on weekdays and weekends – than for other days.

Some 5.8 per cent of patients died within seven days compared with 3.7 per cent of those admitted on other days of the week, while 11.3 per cent died within 30 days compared with 8.7 per cent of those admitted at other times.

This means that patients admitted as medical emergencies on public holidays were 48 per cent more likely to die within seven days and 27 per cent more likely to do so within 30 days.

There were no differences in senior doctor staffing between normal weekends and weekdays at the hospital – a factor frequently cited to explain the differences in death rates between weekends and weekdays.

Dr Sian Finlay, one of the researchers at Dumfries Infirmary: “Consultant physicians in Dumfries spend as much time on the acute medical unit during public holidays as they do on normal days and weekends.

“But it is also true that fewer consultants and junior doctors cover the other medical wards in holiday periods. It’s difficult to escape the view that higher mortality rates among patients admitted on public holidays reflects a cumulative lack of services and/or doctors during these three and four-day periods.”

From:  telegraph.co.uk/Patients-admitted-to-hospital-on-bank-holidays-almost-50-per-cent-more-likely-to-die

Monday mornings are the A&E rush hour

January 28, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Doctors, Health Direct, health insurance, Health Professionals, Health Websites, NHS Cash Shortages, Nurses, Private Healthcare, Uncategorized, Waiting Times

Beware going to your hospital this morning- Doctors and nurses say that Monday mornings are the busiest time of the week.Monday mornings are the A&E rush hourThe busiest time in accident and emergency departments in England is Monday morning, hospital data shows.

There are 4,000 cases every hour between 10am and noon on Monday – twice the average.

Late morning was the busiest time of day throughout the week but Monday came out on top, figures from the Health and Social Care Information Centre show.

There were 17.6 million A&E visits in 2011-12, up from 16.2 million in the previous year.

The chief executive of the Health and Social Care Information Centre, Tim Straughan, said: “It is well-known of course that accident and emergency departments are very busy places.

“The fact that A&E services in England on average see twice the average number of new cases coming through the door collectively on a typical Monday morning indicates just how much society relies on these front line services.”

Dr Clifford Mann from the College of Emergency Medicine said: “As it is implausible that there is an acute deterioration in population health on each and every Monday morning the message inherent in these figures is a lack of primary care capacity.

“This in turn reflects the fact that there is a significant spill over effect from the weekend – again because of a lack of primary care provision.”

New Meningitis B vaccine for killer strain of meningitis is licensed

January 23, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Health Direct, Health Websites, Mental Health, NHS Deaths, Quangoes, red tape, Uncategorized

A meningitis B vaccine that could save thousands of lives has been licensed for the first time, in a move hailed as the most important breakthrough in 30 years.New Meningitis B vaccine for killer strain of meningitis is licensedThe vaccine could soon be available privately and Government advisers are deciding if it should be introduced into the free NHS childhood vaccination programme.

The jab, called Bexsero, has been licensed for use in babies from the age of two months and offers protection against the majority of meningitis B strains that occur in the UK.

Up to 2,000 people are infected with meningitis B each year in the UK and one in ten will die despite receiving prompt medical treatment.

A further one in four will suffer lifelong disability as a result of the brain disease.

Meningitis is commonly cited as the most feared disease by parents because it strikes otherwise healthy children who can deteriorate and die within hours.

Campaigners urged the Government to introduce the vaccine routinely as soon as possible after previous jabs against the disease took five years from licensing to reach the general population.

Steve Dayman, founder of the charity Meningitis UK, who lost his 14 month old son Spencer to meningitis and septicaemia, said: “This ground-breaking vaccine is the most important development since I lost my son to meningitis 30 years ago.

“The news is the most significant step forward in the fight I have ever heard.

“The Government must introduce the Meningitis B vaccine into the immunisation schedule as soon as possible – it will save thousands of lives and spare families so much suffering.

“Any delay means lives will be lost.  The last major meningitis vaccine took five years to be introduced – we cannot wait that long again.  Cost shouldn’t be a barrier for this vaccine either – you cannot put a price on life.”

“Please support our Beat it Now campaign. Together we can end the heartache caused by Meningitis B.”

There are already vaccines against the other major causes of meningitis, Hib and meningitis C, which saw substantial reductions in deaths and disability from the disease.

The Health Protection Agency estimates that since 2000, the MenC vaccination programme has prevented over 9000 cases of serious disease and more than 1000 deaths. Uptake rates of the vaccines, given to babies, has remained consistently high.

Doctor and nurse shortages on wards cause thousands of NHS deaths a year

January 22, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Care Professionals, Doctors, Health Direct, Health Professionals, NHS Cash Shortages, NHS Deaths, Nurses, Uncategorized

Shortages of doctors and nurses on hospital wards are likely to cause thousands of deaths a year, a new study has suggested.Doctor and nurse shortages on wards cause thousands of NHS deaths a yearResearchers found that patients were almost 10% more likely to die when there were fewer medically-trained staff available.

It is thought that those being treated in overstretched hospitals are more prone to developing fatal complications and infections because they are not properly monitored.

The study from the University of Southampton and Imperial College London looked at almost 70 million records of patients who had surgery between 1997 and 2009.

Researchers calculated how many had later died of complications including pneumonia, bladder infections or blood clots – conditions which could normally be treated if detected early but if not properly monitored could be fatal.

They found that across the NHS every year around 28,000 patients died as a result of complications which might potentially have been cured.

The study, published in the International Journal of Nursing Research, also considered data on the numbers of doctors and nurses on all wards.

It found that patients were 9% more likely to die if there were fewer doctors than average, and 8% more likely to die if there were fewer nurses.

It also showed that patients on wards where there were more untrained workers such as healthcare assistants were 10% more likely to die.

Professor Peter Griffiths, who led the research, said that while some very frail patients would have died regardless of the standard of treatment, a high proportion were probably due to poor care.

He said: “The suspicion is that poor care is a very plausible explanation in a lot of these cases. If a hospital responds with the best possible care, the consequences of that complication should be less. If you do not have enough staff, they cannot provide good care.”

The results will cause concern because many debt laden hospital trusts have been axing nursing posts or imposing recruitment freezes, with thousands cut in the last two years.

Number of children with asthma admitted to hosptal falls since smoking ban

January 21, 2013 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Doctors, Health Direct, Preventable Crisis, smokers, Uncategorized

The number of children with symptoms of asthma who have been admitted to hospital  has fallen since the ban on smoking in public places came into effect.Number of children with asthma admitted to hosptal falls since smoking banResearch shows there was a 12.3% fall in admissions in the first year after the law came into place in July 2007, and these have continued to drop in subsequent years, suggesting that the benefits of the legislation were sustained over time.

NHS statistics analysed by researchers at Imperial College London showed the fall was equivalent to 6,802 fewer hospital admissions in the first three years of the law coming into effect.

The findings Hospital Admissions for Childhood Asthma After Smoke-Free Legislation in England have been published in the journal Pediatrics.

Asthma affects one in every 11 children in the UK.

Before the ban was implemented, hospital admissions for children suffering a severe asthma attack were increasing by 2.2% per year, peaking at 26,969 admissions in 2006/07.

The findings show the trend reversed immediately after the law came into effect, with lower admission rates among boys and girls of all ages, in both wealthy and poor neighbourhoods and in cities and rural areas.

Previous studies have shown that hospital admissions for childhood asthma fell after smoke-free legislation was introduced in Scotland and North America.

The smoking ban in England has also been found to have reduced the rate of heart attacks.

Dr Christopher Millett, from Imperial College London’s School of Public Health, led the study.

He said: “There is already evidence that eliminating smoking from public places has resulted in substantial population health benefits in England, and this study shows that those benefits extend to reducing hospital admissions for childhood asthma.

“Previous studies have also suggested that the smoke-free law changed people’s attitudes about exposing others to second-hand smoke and led more people to abstain from smoking voluntarily at home and in cars.

“We think that exposing children to less second-hand smoke in these settings probably played an important role in reducing asthma attacks.

“The findings are good news for England, and they should encourage countries where public smoking is permitted to consider introducing similar legislation.”

Top Christmas health risks

December 27, 2012 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Health, Health Direct, Preventable Crisis, Uncategorized

With the festive break on us  here, in no particular order, is my personal selection of the top Christmas health risks.Top Christmas health risks High lights- low lights

It may look festive but dragging a tree – plastic or wooden – into your living room and covering it with electric lights and tiny glass baubles is asking for trouble!

According to the Royal Society for the Prevention of Accidents (RoSPA) around 1,000 people visit A&E after calamities with their tree and 350 following problems with Christmas lights. How many years have you been using those lights? Consider a new set, and remember to turn them off at night.

 Up in smoke

Candles cause more than 1,000 house fires and several deaths every year. Fairy lights, decorations and even Christmas cards are also a fire hazard. You are more 50% more likely to die in a house fire at Christmas than any other time. Make sure you don’t take the battery out of your smoke alarm to supply a new toy.

But remember the majority of house fires start in the kitchen.

Tread with care

There are more accidental falls and traffic accidents in December with bad weather and short daylight hours both playing a part.

Snow and ice can be a lethal opponent to even the fittest individual and the best drivers. Last winter there were 76 deaths due to exposure to the cold, 25 fatalities caused by falling on ice or snow and one involving ice skates.

Over eating

Let’s face it most of us will eat too much over Christmas. That’s not a problem if it’s a one-off, but two out of three adults are overweight or obese.

The British Heart Foundation says Christmas lunch can provide more calories than are needed in an entire day and has advice on how to reduce fat and calorie consumption, such as removing skin from turkey and eating slowly.

Alcohol

Whereas eating too much will simply harm your own waistline, excess alcohol can ruin the lives of others too.

Assaults – many fuelled by alcohol – and drink driving both rise over Christmas and New Year. There is also a rise in alcohol poisoning.

Seasonal ailments

There are always more deaths in winter than other times of year, with causes such as respiratory and circulatory diseases, and infections like flu.

There are five times as many emergency admissions for pneumonia in December compared to August and cold weather also triggers a rise in asthma problems .

Colds, sore throats and painful joints are all more prevalent in winter. There are things you can do to minimise some risks such as have a flu jab, stay warm and wash your hands regularly.

Lonely this Christmas

There’s only one thing worse than being surrounded by your relatives at Christmas and that’s not being surrounded by them.

Someone calls Samaritans every six seconds but the charity says the idea that Christmas is the busiest time of year is something of a myth.

Research suggests there is a fall in suicides during the Christmas period followed by an increase just after the New Year.

Of course loneliness is just one of many problems people face in the coming weeks.

Some will be confronted by a growing mountain of debt early in the New Year as Christmas bills start to pour in. Then there is marital breakdown – more people consider ending their relationship in January than at any other time.