A shortage of junior doctors to start work in hospitals this August is forcing the NHS to try to recruit from India.Tighter immigration rules introduced in recent years meant many overseas medics left Britain and returned home.

But the exodus, added to new European regulations limiting the hours of doctors, caused unfilled vacancies.

Attempts to recruit scores of Indian doctors foundered on a disagreement between government departments.

“We pulled the plug on overseas recruitment far too quickly,” said Professor Derek Gallen, who is postgraduate dean of medical training for Wales.

“We didn’t realise what the implications of that action would be two, three or four years down the line,” he added.

The Welsh Deanery is one of four medical training schools across the UK which has been recruiting in India over this year.

The other deaneries involved cover the Severn area, the West Midlands and Northern Ireland. In total, they plan to take more than 100 junior doctors over to the NHS.

The deaneries are looking to recruit in areas such as paediatrics, obstetrics, gynaecology, anaesthesia, as well as accident and emergency.

The need for junior doctors is most acute outside the big metropolitan areas.

The European Working Time Directive, which was fully introduced into the NHS last August, limits doctors to working no more than 48 hours per week and has left gaps on rotas.

Some district general hospitals have had trouble attracting enough staff to cope with the changes leading, in some cases, to services being cut.

In May, the Victoria Hospital in Kirkcaldy had to close its accident and emergency department overnight for a week due to a shortage of junior doctors.

At Erne hospital in Enniskillen, its obstetric and gynecology service had to be suspended for several weeks for the same reason.

The shortage of junior doctors means hospitals are struggling to fill vacancies, and having to devise their own initiatives to recruit doctors wherever they can find them.

From: http://news.bbc.co.uk/1/hi/health/10202803.stm

The NHS’s Connecting for Health CfH, NPfIT continues to push forward its plan to nationalise and centralise all medical records in England.

This despite a misleading announcement from the Department of Health that uploads to the Summary Care Record (SCR) aka Snoopers Charter are ‘on hold’.

In just the last few days, the medical press has reported that:

• NHS East Riding of Yorkshire began sending out notification letters to patients the day before election day;

• GP practices in Hastings, East Sussex have uploaded records over the past 2-3 weeks, despite patients complaining they hadn’t received a notification letter;

• At least 9 other Primary Care Trusts are working towards upload, and practice managers – not GPs – may already have given the go-ahead for upload at some practices in South West Essex.

Clearly, whatever deal was agreed between the British Medical Association and the NHS, there is no effective barrier to upload. And CfH is desperate to create a ‘critical mass’ of records, which it thinks will make the system impossible to scrap.

Health Direct warns that you need to act quickly.

30 million ‘Patient Information Packs’ were sent out in the run-up to the general election. No-one knows how many failed to reach their intended target. Both parties that now form the new government pledged to scrap the Care Records system but, every day that uploads continue, people’s medical confidentiality is being put at risk.

Please take a few minutes now or today to write to your new MP, urging him or her to call for an immediate halt to Summary Care Record uploads. POWER2010 has very kindly built an online letter-writing tool to help
you do this: http://www.power2010.org.uk/Halt

On the subject of the Nanny State’s Snoopers Charters- Home Information Packs (HIPs) were announced in the Queen’s Speech in November 2003, so were plans for a national ID scheme. The introduction of HIPs was subject to delays and plans were scaled back – just like the ID scheme.

In 2009 HIPS were finally issued and so were ID cards. The scrapping of HIPs was a manifesto pledge by the Conservatives and the Liberal Democrats, so was scrapping ID cards.

Yesterday Eric Pickles MP, the new Communities Secretary announced that “HIPs are history” and “laid an Order suspending HIPs with immediate effect” (pending primary legislation for a permanent abolition).

Meanwhile ID cards are still being issued and the UK Identity and Passport website states: “Until Parliament agrees otherwise, identity cards remain valid and as such can still be used as an identity document and for travel within Europe.” Alas we still await a Pickles style announcement from the Home Office.  See http://www.communities.gov.uk/news/corporate/1591777

The number of reported safety alerts involving NHS patients has risen sharply, with nearly 500,000 incidents in six months.

But fewer patients are dying or coming to seriuos harm as a result of medical errors in England, the National Patient Safety Agency (NPSA) said.
The figures show that 473,162 incidents were reported between April and September last year, compared with 379,345 in the same period in 2008.

The agency said that the year-on-year rise of nearly 25 per cent was positive because increased reporting meant that lessons could be learnt and patterns identified.

The number of incidents which resulted in death across England has decreased from 1,856 to 1,160. Cases that resulted in severe harm to the patient also fell from 3,643 to 2,412.

However, campaigners say that the level of avoidable mistakes is still unacceptably high.

The most commonly reported incidents were accidents involving patients, such as slips, trips and falls, which accounted for nearly 155,000 reports, a third of the total.

But there were nearly 51,000 cases of medication errors— such as administering the wrong type or dose of drug— and a similar number of delayed or wrong site procedures.

Under a new system of NHS regulation that began last month, hospitals and health authorities could face fines or possible closure if they fail to report anonymised details of “serious incidents” to the NPSA.

However, they are not obliged by law to provide details of such events to injured patients or their next of kin.

The campaign group Action Against Medical Accidents (AvMA) has renewed calls for a legal duty of candour to apply to all trusts, to ensure patients and relatives are given full details if they are harmed.

Peter Walsh, chief executive of AvMA, said: “How can people have faith in a system that puts collecting data before being open with patients?

“We are not saying that the labour Government intended to legitimise cover-ups of medical accidents, but that is the effect.

“One would have thought that recent scandals such as Mid Staffordshire Hospital would have underlined the need to tackle the culture of cover-up and denial.”

Six unidentified trusts in England — two hospital trusts, three primary care organisations and an ambulance trust — did not submit enough data on incidents to be counted in the latest reporting period, the NPSA said.

But Suzette Woodward, the NPSA’s director of patient safety, said that overall the latest figures were “extremely positive”.

“[They] provide real evidence of an improved patient safety culture in the NHS with a decrease in the severity of incidents reported and a corresponding, real increase in the number of patient safety incidents reported to the NPSA.

“This trend is extremely positive and goes to show just how seriously frontline services view reporting and, more importantly, learning from incidents.”

Katherine Murphy, director of the Patients Association, said: “We welcome the increased reporting, but it is appalling that after constant pressure and now even plans to make reporting mandatory, that some organisations are still not reporting incidents sufficiently.

“Patient safety is supposed to be a priority and yet some trusts don’t even seem able to comply with basic recommendations about reporting.

“It raises the question of whether the managers at those organisations really are committed to patient safety.”

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7073966.ece

The NHS is facing upheaval and cutbacks as a decade of budget increases comes to an end and £20 billion of savings must be found over the next five years.

Despite pledges from Labour and the Conservatives to protect front line services, there is evidence that their promises may have come too late.

A list of cuts has already been identified – including job losses, banning certain operations, closing casualty departments, downgrading maternity services and reducing the number of junior doctors. But these have been mostly quietly ignored by the three main parties.

The Conservatives pledged to stop all closures until they could be reviewed but, with billions of pounds of savings needed to cope with growing demand, cuts and closures are almost inevitable.

David Cameron emphasised that he was personally in favour of the NHS, after his experiences with his disabled son Ivan, who died last year, to combat arguments that the health service was not safe in Tory hands. The party manifesto contained promises about dentistry and round-the-clock GP services which appear too expensive in the current climate.

Both the major parties were accused of chasing the “fear of cancer” vote. The Tories said they would fund cancer drugs turned down by Nice, the health rationing watchdog, but did not mention drugs for other illnesses such as arthritis or dementia.

Labour said cancer patients would see a specialist and have test results back within a week. The party was criticised for unveiling its manifesto at a new hospital in Birmingham. It is against the rules to use NHS premises for election events.

But Labour pointed out that the hospital was still in the hands of the private finance initiative organisation – a policy which means the NHS will be repaying billions of pounds for new hospitals for decades.

Nick Clegg refused to ring-fence NHS spending given the size of the national debt.

The Liberal Democrat campaign focused on cutting waste on managers, scrapping regional strategic health authorities and pledging more power to communities to direct the health service locally.

From: http://www.telegraph.co.uk/General-Election-2010-cuts-inevitable-as-NHS-must-make-savings

The NHS is sending millions of patient records and confidential medical notes to India for processing — despite a pledge by Labour that personal information would not be sent overseas.
It is the first time that databases of names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments.

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

The rising rate of blunders in IVF treatment ‘may be systemic’, says leading patient safety expert

The number of reported mistakes a t the 138 fertility clinics in England and Wales nearly doubled in the year to April 2009, rising to 334 from 182 the previous year. One leading patient safety expert has now warned that blunders which have occurred as record numbers of women seek treatment, may be “systemic”.

The increase comes as one clinic, IVF Wales, is at the centre of a fresh scandal after losing the last two remaining embryos it had frozen for one of its patients. It is the second time in less than 12 months that a mix up at the centre, based at University Hospital of Wales in Cardiff, has left patients devastated.

The Cardiff-based couple has had their eight-year quest to have a baby put on hold as a result of the blunder, which followed an initial, unsuccessful course of IVF. The pair, identified only as Clare and Gareth, are suing Cardiff and Vale University Health Board, which last year paid out a five-figure sum in compensation for negligence after another mix up.

Guy Forster, a solicitor at the law firm Irwin Mitchell who is representing the couple, said the incident raised questions about the Government’s IVF watchdog, the Human Fertilisation and Embryology Authority.

“This raises concerns about the HFEA’s ability to regulate the IVF industry properly. I think it should be doing a lot more to follow up when an incident occurs, especially at a clinic with a poor track record,” he said, adding: “These problems appear to be on the rise.”

An official review last year found that the HFEA was failing to punish badly run fertility clinics by not using the “full range of sanctions” at its disposal. Professor Brian Toft, a patient safety expert at Coventry University, said: “If the HFEA fails to clamp down when something has gone wrong then things will continue to go wrong.”

He said the rise in reported incidents, uncovered by BBC Radio 5 Live, implied clinics were not learning from their mistakes, adding: “I have been told there are not enough qualified staff doing the work. HFEA do not make any recommendations for staffing levels per number of patients. If you have a lot of patients and not enough staff, this could account for an increase in errors. This problem may well be systemic.”

Professor Sammy Lee, an IVF expert, said the watchdog must ensure clinics comply with regulations. “They need to obtain staff that have experience of enforcement and are able to make sure that regulations are put into place,” he said.

An HFEA spokesman played down the increase in blunders, which he said was partly due to new rules requiring clinics to include incidents when patients suffered from ovarian hyperstimulation syndrome (OHSS). “The number of reported incidents has increased as the sector has responded positively to the opportunity to share lessons learned from incidents which have been reviewed and investigated,” the HFEA added in a statement.

From: http://www.independent.co.uk/errors-at-ivf-fertility-clinics-double-in-just-one-year

The NHS reported the highest number of serious data breaches of any UK organisation since the end of 2007, the Information Commissioner’s Office says.

David Smith, deputy commissioner at the ICO told the Infosec security conference the NHS had highlighted 287 breaches to it in the period.

That accounts for more than 30% of the total number reported.

The NHS – the UK’s largest employer with 1.7m staff – has only started the process of rolling out digital patient records.

Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.

Mr Smith said the problems were not confined to the public sector and that results could be skewed because the public sector has a culture of reporting all breaches whereas not all private sector firms did.

Richard Vautrey, the deputy chair of the British Medical Association’s GPs committee thinks the number of breaches reflect the size and complexity of the NHS as well as its culture of openness.

“So many people have access to data and often human error is to blame. There is an increased attempt to be open and honest about what happens to data,” he said.

He added that he was not aware of a specific case where a data breach had affected patient privacy or care.

“We need to keep their breaches in perspective,” he said.

As part of its plans to digitise patient records, the NHS is asking patients if they want their data stored on national databases. It is important that people are given the chance to opt out, said Mr Vautrey.

Currently the reporting procedure for data breaches in the UK is voluntary although the ICO is “moving towards” a compulsory system.

In April the ICO introduced fines of up to £500,000 for serious data breaches.

The European Union’s Telecoms Package requires telecom firms to report data breaches and Mr Smith said he expected this requirement to expand beyond telcos.

Data encryption firm PGP welcomed the tough new approach to data security.

“Finally the ICO, which has long demanded greater powers, will be able to severely punish those in serious breach of the Data Protection Act. For too long, organisations have continued to ignore the warning signs – risking both the privacy of their customers and the reputations of their brands,” said Jamie Cowper, European marketing director at PGP.

He anticipates “severe fines” for the next private sector company to be involved in a serious data breach although he does not imagine the ICO will pursue the NHS.

PGP calculated that data breaches cost companies, on average, £67 per piece of data lost.

From:

http://news.bbc.co.uk/1/hi/technology/10089066.stm

Health Direct asks- given that the NHS has the worst record of data security and that labour politicans have already sent 250,000 political letters to cancer sufferers- are you CERTAIN that your medical records will be safe on the Snoopers Charter database? If not OPT OUT NOW- whilst you still can!

The biggest single supplier to the £12bn NHS NPfIT white elephant programme is on the brink of being fired from a key part of its contract after failing to meet a deadline to install systems at hospitals in the north west.

CSC, which holds the contract for two-thirds of England, missed the deadline to get the Lorenzo electronic medical record product up and running at the Morecambe Bay NHS Trust’s hospitals.

CSC originally said the system would go live almost two years ago, in June 2008.

The failure is the latest crisis for the much-troubled programme which is running at least four or five years late.

CSC and BT, which covers London, had each been given a deadline to get new systems running smoothly in a big, acute, hospital, with the Department of Health warning last year that it would “look at alternative approaches” if that failed to happen.

BT has since installed a system at Kingston Hospital to the health department’s satisfaction. Christine Connelly, the department’s chief information officer, said it now needs to go through a due process under its contract with CSC which could yet see a new deadline set and met.

But if progress is not made, she told the Financial Times, the department has the option of cancelling CSC’s contract to install the systems in acute hospitals and letting hospitals choose from other suppliers.

Morecambe Bay, she said, remained keen to continue and under the contract CSC has to be given time to propose a fresh deadline for deployment, with the programme then assessing the credibility of that and whether to agree it.

“We have to walk through this step by step,” Ms Connelly said. “In a contract as large and complex as this we cannot just set a deadline and say that’s it. We have to act responsibly and not expose the department and the taxpayer to risk.”

But, she warned bluntly, “we cannot wait for ever”.

CSC has contracts worth about £3.3bn to install hospital, community, mental health and GP systems, with the latter elements progressing much better.

But Ms Connelly said if CSC’s plan was not credible the NHS had the option of cancelling the acute hospital part of the deal, thought to be worth around £1bn. CSC did not respond to attempts to contact it last night.

BT, having hit its deadline, has agreed a contract variation, signed yesterday, which the department said would save the NHS £112m, or about 12 per cent of the contract value, as part of the £600m savings the health service is seeking on the programme as a whole.

As part of the deal, BT is now signed up to install much fewer full systems in London, with about half the hospitals likely to add clinical systems to their existing IT arrangements, rather than replacing everything, Ms Connelly said.

Allowing hospitals to choose other suppliers is already starting to happen in the south of England, although the first contracts for that have yet to be signed. That should start to take place from May this year, she said.

From: http://www.ft.com/cms/s/0/6a9f7ee2-3d26-11df-b81b-00144feabdc0.html