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.Public 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

Beware going to your hospital this morning- Doctors and nurses say that Monday mornings are the busiest time of the week.The 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.”

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.The 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.

Shortages of doctors and nurses on hospital wards are likely to cause thousands of deaths a year, a new study has suggested.Researchers 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.

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.Research 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.”

With the festive break on us  here, in no particular order, is my personal selection of the 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.

A survey by the healthcare regulator found waiting times are getting worse in several key areas in England’s Accident and Emergency (A and E) departments.One third of patients said they were in A&E for longer than four hours in total, up from a less than a quarter in 2004, and a third of patients also said they had to wait more than half an hour to be seen by a doctor or nurse, also up from a quarter in 2004.

Patients arriving by ambulance also faced waits with nearly one in four having to stay with the ambulance crew for more than 15 minutes for A&E staff to become available to take over their care, and one in 20 had to wait more than an hour.

The survey of 46,000 patients who have been treated in A&Es in England was conducted by the Care Quality Commission.

The findings do not reflect official waiting time data from the Department of Health which suggests 95 per cent of patients are dealt with inside four hours, meeting the overall target.

Health Minister Lord Howe said: “Everyone should be seen quickly when they arrive at hospital, even more so when they arrive in an ambulance. It is unacceptable for patients to be left waiting in ambulances outside hospitals.

“The NHS needs to ensure it has proper plans in place to deal with high demand and we are doing everything we can to support the service in treating patients as swiftly as it can.”

The research, conducted across 147 NHS trusts with major accident and emergency departments, also found that 59 per cent of people were not told how long they would have to wait to be examined, compared with 56 per cent in 2004.

Almost half of patients who were prescribed medicines said they were not warned about possible side effects.

However, most people said they still had confidence and trust in the health professionals who treated them.

Perceptions of the cleanliness of A&E units have also substantially improved from previous surveys, the CQC said.

The national score for patient satisfaction with A&E services dropped slightly from 75.7 in 2008 to 75.4 in 2012.

The scores dropped in three of the five main areas measured, including access and waiting; safe high quality coordinated care and building relationships.

There was only an improvement in one area, cleanliness, which rose from 81.4 in 2008 to 82.2 in 2012.

David Behan, CQC chief executive, said: “The important issue is that people who need to be treated urgently do not have to wait. It is disappointing therefore that people have said they have to wait longer to be treated than four years ago.

“People should be seen, diagnosed, treated and admitted or discharged as quickly as possible and this is an issue that trusts need to urgently tackle.

“It is however encouraging to see people’s perceptions of trust in clinicians and cleanliness continuing to be high and more people than ever saying that they have enough privacy when discussing conditions with receptionists.”

British workers who overdo it at their Christmas party cost the economy tens of millions of pounds in lost man hours a survey has calculated.Researchers found that one in four workers will work fewer than four hours the day after being inflicted with “hangovers” following their end of year celebrations.

The research, concluded that the decline in productivity levels cost businesses almost £259 million throughout the annual party season.

It found that up to a third of workers arrived at work having drunken too much alcohol at their Christmas party- with nearly a fifth arriving late or calling in sick.

The survey, of 1500 people, found one in 10 workers admitted “doing something they regretted” at their staff party. Almost two in three employees also admitted they drank too much during festivities.

Among the top “faux pas” included “ranting” about colleagues, having sex with, or sharing a “cheeky kiss” with senior members of staff and “spreading gossip” about colleagues.

The survey, commissioned by lastminute.com, the online hotel and travel company, found employees in Glasgow, Cardiff and Leeds were the “most likely to be hungover at work”, the day after their Christmas Party.

Meanwhile researchers concluded that “workers in Liverpool, Belfast and Newcastle were most likely to kiss a senior colleague”.

Most parties are held at restaurants and bars.

Cancer patients are being let down by the NHS in England when they need emergency help, a report says.The royal colleges of physicians and radiologists looked at the care patients get in A&E units and from the likes of GPs and district nurses.

The study found there was confusion over how best to treat cancer patients seeking urgent help, causing delays and sometimes inappropriate care.

It said a rethink was needed as emergency admissions were on the rise.

Unplanned admissions for cancer patients have doubled since 2000-1 and now total over 300,000 a year.  Many of these – although by no means all – are related to the cancer or the treatment the patient is getting for it.

For example, some cancer drugs can leave patients susceptible to infection, while attendances for fevers and pain are common.

But the report found there was a lack of understanding about how to deal with cancer patients when they were admitted to hospital in an emergency.

They can find themselves passed between teams and experience delays in treatment.

However, the report also said those at the end of life could also find themselves undergoing unnecessary tests and treatments.

Surveys suggest one in four cancer patients who seek emergency help are not happy with the care they receive. The report said there needed to be better training for staff and co-ordination with cancer departments.

And it urged staff to be on the look out for undiagnosed cases of cancer – nearly a quarter of new cancers are diagnosed after a person seeks emergency help.

But it also said there was an onus on cancer specialists to ensure their patients were aware of the emergency problems they could encounter and what they needed to do.

Society of Acute Medicine president Dr Chris Roseveare welcomed the report, saying he acknowledged hospitals faced difficulties with the issue.

“This can be particularly problematic when a patient arrives on the acute medical unit outside regular working hours and when acute medical teams may struggle to obtain the necessary information about a patient’s treatment plan.”

National cancer director Prof Sir Mike Richards added: “I endorse all the recommendations and urge all of these groups to make the positive changes recommended here to improve the care of cancer patients in crisis.”

From: http://www.bbc.co.uk/news/health-20410373

Almost one in three diabetic inpatients in Wales has experienced at least one NHS medication error-  a new report by Diabetes UK Cymru finds.The charity is concerned because the number of people with diabetes in Wales rose more than a quarter in five years.

The Diabetes UK Cymru report reveals diabetes is growing rapidly with an increase of 35,000 people with the condition in Wales over the past five years to 160,000 – a rise of 28%.

By 2025, the number of people with diabetes is forecast to top 250,000 with 66,000 people currently undiagnosed.

Despite the concern, the charity says 70% of adults with type 1 diabetes and 43% with type 2 are not getting simple checks, such as blood glucose tests.

Diabetes UK Cymru director Dai Williams said “The cost of diabetes is massive – the bottom line is – it’s a ticking time bomb. We’ve got people wandering around with high blood sugars, not even realising it’s going to cause a problem.”

The report, called State of the Nation 2012, also claims that 29.8% of inpatients with diabetes experienced at least one medication error while on a ward.

Mr Tyndall raised concerns over clinical record keeping by the Hywel Dda health board and made recommendations.

Week In Week Out has also learned about three more complaints about the treatment of diabetic inpatients at Hywel Dda health board hospitals.

In a statement Hywel Dda health board said it takes any allegation of a breach of professional standards seriously and an investigation was ongoing.

Hywel Dda was the only health board in Wales which has increased the number of specialist diabetes nurses, from seven in 2008/9 to the equivalent of 12.34 full-time staff in 2012/13.

Cwm Taf in the south Wales valleys was the only board to cut staffing, from the equivalent of 13.89 full-time nurses in 2008/9 to 11 in 2012/13.

Cwm Taf Health Board is pioneering a new scheme to cut diabetes-related medication errors in their hospitals.

It is a highly visible branding campaign called Think Glucose and involves raising awareness of diabetes with all staff throughout every ward.

Hypo Boxes on every medication trolley means treatment can be given to patients suffering a hypoglycemic attack quickly; pre-printed medication charts cut the risk of mis-reading doseage; and colour-coded blood sugar monitoring charts mean that dangerously low blood sugar levels go into a red zone – alerting staff of the need to treat the patient quickly.

The campaign has seen medication errors at one hospital, the Royal Glamorgan, decrease from 50% to 6%.

At the moment, Cwm Taf is the only health board running Think Glucose, but other health boards are showing interest – and Hywel Dda says it will be rolling out the programme in the New Year.