NHS is failing to support vulnerable young people says children’s minister

The children and families minister Sarah Teather has attacked the health service for failing some of the country’s most vulnerable young people.
NHS is failing to support vulnerable young people says children's ministerSarah Teather said the chance of a child receiving much needed speech and language therapy was a postcode lottery “between low and nil”, while the wait for a wheelchair could be “really long”.

Teather, who spent most of her own secondary school days in a wheelchair after suffering from a viral infection, said the health service “has not always been good at doing its fair share for children in this position”. Families were often left as the “piggy in the middle”, she said in an interview with the Guardian.

Health workers often agreed with parents that a child needed a wheelchair, incontinence pads or a form of therapy, but “nobody pays for it” and it fails to arrive, she said. This could severely impair a child’s chances in the future, she warned: “A six-month wait for speech and language therapy can be critical; an 18-month wait can be really critical.”

In some cases, by the time a wheelchair arrives, a child has grown too big for it, she said, adding that it was a “postcode lottery” to get basic equipment.

Government proposals, published in a green paper in March, would improve life for children with special needs and disabilities and their families, she said.

At the moment, children with severe or multiple health and learning disabilities receive a statement from their local authority. This covers only the services that schools are expected to give children, rather than those they need from the health service or social services.

The green paper proposes to replace the existing statement of special educational needs with a single care plan covering schooling, health and social services from birth to the age of 25. This would mean a child’s educational, social and health needs would be dealt with together. The plan would reflect a family’s needs and ambitions for the child’s future and would be continually reviewed.

The green paper also set out plans to give parents a personal budget to spend on services such as one-to-one tuition, laptops and wheelchairs.

“Rather than a family having to go to the council trying to bang down their door to get something, [the council] are coming to you saying, this is what we normally provide. The family then has a conversation about whether it is appropriate,” Teather said.

The government also plans to introduce into all schools a programme to help children with special needs improve at a faster rate.

Researchers found the Achievement for All programme helped nine- and 10-year-olds with special needs to learn reading, writing and maths three times faster than they were expected to under the national curriculum. Under the same programme, 14- and 15-year-olds with special needs made progress in maths and English that was equivalent to having an extra term of lessons in a year.

The programme, which has been piloted in 454 schools in 10 local authorities since 2009, works by setting pupils regular targets. Teachers and parents discuss progress three times a year for a minimum of 45 minutes. Children with special needs and disabilities are strongly encouraged to join school clubs and activities outside lessons.

Sonia Blandford, director of the programme, said it could reduce by 10% the proportion of children registered as having special needs.

From: http://www.guardian.co.uk/nhs-failing-vulnerable-young-people

Britain’s alcohol addiction crosses million hospital referrals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

GPs should offer £20 ovarian cancer blood test to women

Women over 50 who persistently feel bloated or have lower abdominal pain should be offered a £20 blood test to check for ovarian cancer, a panel of experts has recommended.
GPs should offer £20 ovarian cancer blood test to womenCampaigners say hundreds of lives could be saved a year if GPs were quicker to spot symptoms of the disease – dubbed a “silent killer” because it is hard to diagnose early enough.

Ovarian cancer kills almost 4,400 women in Britain every year – one every two hours – making it the fourth most common cancer in females.

While almost three times as many die from breast cancer, those diagnosed with ovarian cancer are far more likely to die earlier.

Figures published in The Lancet show that about 82 per cent of British women with breast cancer survive to at least five years after diagnosis. For ovarian cancer the figure is just 36 per cent. The key reason for the difference is late diagnosis.

Consequently, the National Institute for Curbing Expenditure (Nice) is publishing its first guidelines to help doctors identify and manage the disease.

These include checking the level of a blood protein called CA125, if a women tells her GP she has been persistently experiencing symptoms which could be ovarian cancer.

The test, which costs around £20, is already available on the NHS but offering it sooner could give women a greater chance of survival by speeding up diagnosis and treatment.

Dr Fergus Macbeth, director of Nice’s Centre for Clinical Practice, said older women were often misdiagnosed with irritable bowel syndrome (IBS) when they actually had early stage ovarian cancer. Other possible symptoms include feeling full quickly and the need to urinate urgently or quickly.

He said: “While the symptoms are nonspecific, their persistence can be an important indicator of the disease.”

Women who experienced them 12 or more times a month should see a doctor, the guidelines say.

Although the CA125 test is a useful indicator, they cautioned that it only picked up around 50 per cent of early stage ovarian cancers. Sometimes women with tumours had no raised level of the protein, while others with raised levels sometimes did not have ovarian cancer.

Frances Reid, of the charity Target Ovarian Cancer, said: “This guidance tackles for the first time critical issues facing women who develop ovarian cancer, and could save hundreds of lives. British women must no longer die from delayed diagnosis”, she said.

From: http://www.telegraph.co.uk/GPs-should-offer-20-ovarian-cancer-blood-test

Scrapping NHS IT project could cost more MPs warned

Scrapping the controversial and delayed NHS electronic records project could cost more than seeing it through to completion, a parliamentary committee has heard.
Scrapping NHS IT project could cost more MPs warnedThe project to install electronic patient records systems at health trusts in the north and east of England and the Midlands is years behind schedule.

The programme has been described as not being “value for money” in a report from public spending watchdog the National Audit Office (NAO) and critics have called for the project to be abandoned.

But yesterday, Department of Health (DoH) CIO Christine Connelly told the parliamentary public accounts committee that cancelling the contract with supplier CSC could potentially leave the DoH “exposed to a higher cost than the cost to complete the contract as it stands today”.

She said if the contract were terminated, the resulting contractual costs could run up to “several hundred million pounds”, with the possibility that the supplier could seek damages.

Still further costs could be incurred during the process of moving health trusts over to new care records systems, she said.

But Connelly went on to say that the DoH is still considering all options for the contract with CSC, which the DoH has previously stated includes termination.

Sir David Nicholson, chief executive of the NHS, told the committee that the DoH is not currently minded to cancel its contract with CSC: “That’s not what we’re planning to do at the moment.”

Bizarrely he said the DoH could still get something “really good” out of its contract with CSC.

Care records systems are being installed across the whole of England, although progress has been slowest in the north, east and Midlands, the NAO report found.

CSC has repeatedly missed it’s required targets- known as milestones, for the rollout of the care records systems.

By March this year, CSC had missed 67 milestones set under its Local Service Provider (LSP) contract, and recently suffered a further setback when one of four trusts chosen to be early adopters of the care records system pulled out of the project.

The NAO report found that £2.7bn has been spent installing care records systems across the whole of England, and that there is a further £4.3bn still to be spent.

The care records system is being installed in the north, east and Midlands by CSC under the terms of its LSP contract, which is worth just over £3bn, but the DoH has said it expects negotiations will reduce the contract’s value by about £500m.

From: http://www.silicon.com/doh-cio-warns-on-cost-of-scrapping-e-records-project

Dentists overcharging NHS patients hundreds of pounds

Some dentists are overcharging NHS patients by hundreds of pounds a time, an undercover investigation has found.
Dentists overcharging NHS patients hundreds of poundsThey are quoting patients up to £725 for work which should cost just £198, under the current three tiered payment system for NHS work.

They are also commonly neglecting to offer patients a scale and polish alongside a check-up, which should both be covered under the lowest tier of work, and are instead trying to sell it as a private add-on.

Dentists should provide NHS patients with all the treatment that is “clinically necessary in order to keep your mouth, teeth and gums healthy”, according to a Department of Health leaflet.

Patients should pay a single charge depending on the complexity of the work, even if more than one procedure needs to be carried out.

The leaflet makes clear: “If your dentist says that you need a particular type of treatment, you should not be asked to pay for it privately.”

However, an undercover reporter for Channel 4’s Dispatches programme, who needed root canal work and a new crown, was mis-quoted by three dentists he went to see.

Under current NHS rules, they should have said both procedures were covered under Band 3 pricing, costing the patient a single charge of £198.

But one quoted him £725 for both pieces of work; the second said the crown was covered by the £198 NHS fee, but that the root canal work would cost him £480 as a private piece of work; while the third gave a similar quote, saying the root canal work would cost £400.

Seven more undercover patients went for check ups at different dentists. None of them was offered a scale and polish as part of NHS treatment, although they all needed one, even though this should be included under Band 1 treatment, which at the time carried a £16.50 charge.

Three of them were told they could opt to see a hygienist privately, a service typically costing £25 to £40.

Dentists say the way the banding system works pushes them towards wrongly charging extra for treatment – known as ‘gaming’.

Danny Pretorius, who stopped doing NHS work last year, told the programme: “If you had to do everything by the book like you should do, it would be virtually impossible to earn a reasonable living.”

The current “payment by procedure” system, which was introduced by Labour in 2006, has been very unpopular with dentists.

Last December the Coalition announced it was to be abolished and replaced with a “payment by patient” system, to encourage more preventive work.

Pilots of three variants of the new scheme are due to start around the country this summer.

A Department of Health spokesman said: “We are committed to improving dental access, and we will achieve this sustainably by replacing the existing dental contract with one that pays dentists for the number of patients registered and the quality of the care they provide, rather than the number of treatments carried out.”

*Dispatches: The Truth About Your Dentist was broadcast on Channel 4 at 8pm last night (Monday).

OECD- UK’s huge elderly care bill threatens family ties

Britain faces one of the largest bills for elderly care of any leading industrialised nation, with rising costs threatening to undermine the bonds between parents and their children, a major international study has found.
OECD- UK's huge elderly care bill threatens family tiesResearch to be presented this week suggests that a combination of low birth rates and rising life expectancy will force the UK to spend an extra £80 billion each year on pensions, long-term care and the health service by 2050.

The mounting costs will leave working adults facing a triple blow of higher taxes, longer working lives and less inherited wealth as their parents are forced to sell property to pay for care, the study said.

The Organisation for Economic Cooperation and Development (OECD), which conducted the research, warned that workers may be unable or unwilling to take time off to look after elderly relatives or pay more tax to support rising numbers of older people in future.

In order to preserve goodwill, the elderly will have to stay in work for longer and save more towards their own private pensions so that they are seen to be fending for themselves, the study said.

In an interview with The Daily Telegraph, the OECD’s leading pensions analyst warned that Britain’s ageing population, combined with already high rates of family breakdown, meant relations between the old and the young are under threat.

Edward Whitehouse, the organisation’s head of pensions policy analysis, said the UK was projected to have “among the highest long-term care expenditures by 2050” of any of the 28 countries examined.

“I don’t think that future governments will be able to afford that, which brings us on to how we are going to pay for that system,” he said. “The money has got to be found from somewhere. It is going to have to be higher taxes or cuts in public spending on other programmes.”

The research suggested that by 2050, the UK will be forced to spend 21.6% of GDP on long-term care, pensions and health services to cope with the rise in elderly people requiring state assistance.

This is an increase from 16.5% of GDP spent in 2010, and equates to a rise of about £80 billion in today’s terms.

According to government projections, 11 million Britons will live to the age of 100. Economists have estimated that the international cost of ageing populations will be 10 times that resulting from the financial crisis.

Last week, the pensions minister, Steve Webb, warned that the UK must radically re-think the idea of retirement as life expectancy continues to lengthen.

Plans are in place to raise the state pension age to 66 and the default retirement age of 65 has already been abolished.

Last night, David Willetts, the universities minister, backed the OECD for setting out the “inevitable” burden Britain faces “as the baby boomers age”.

The OECD analysis, which will be presented in Paris this week, suggested that to pay for the care and pensions that an ageing population will need, adults will be forced to spend much longer working and taxes may have to rise.

According to the OECD’s figures, Britain’s projected bill for long-term care and support services – such as home help, adaptations to property, and residential accommodation – will almost double from 2.2% of GDP to 4.3% by 2050.

Of the 28 OECD countries included in the research, only Malta and Spain will be spending a higher proportion of national income on long-term care.

But the research on “intergenerational solidarity” warned that the rising bill for elderly care could “undermine the nexus of family relations between generations”.

The OECD report said: “Future generations may be less willing and able to pay continually rising taxes to support a growing share of economically inactive people.”

Countries where large numbers of older people rely on state pensions and care are more likely to regard the elderly as “a burden” on society, the research suggested.

In addition, the UK is particularly at risk as a result of high rates of family breakdown, with more than 12% of British children living in step families, compared with an OECD average of 8%, and more single parents.

Mr Whitehouse said smaller and more complex families meant there would be fewer people to provide “informal care” to frail relatives in future.

One key solution would be for older people to remain in work for longer and build up their own private pensions, he said.

“When people see that older people are doing things to help themselves they have a more positive attitude towards them than in countries where they are very reliant on the state and where people are retiring early,” he said.

The research also suggested, however, that many older people provide childcare for their grandchildren and give more of their time and money to younger people than they receive directly in return.

Those most likely to regard older people as “a burden” were the elderly themselves.

Mr Willetts, whose has written a book on the subject, The Pinch, will detail the government’s plans to ensure fairness between generations in a speech at the Social Market Foundation think tank.

He told The Telegraph that the OECD had set out some of the increased burdens are “inevitable” as the post-war “baby boom” generation ages.

“Any healthy society has an obligation to its older members as well as its younger members but we have got to be more flexible,” he said. “That’s why we are moving to raise the pension age.

“The contract between generations is in everyone’s interest. We have got an obligation to our kids to give them a good education and help them get a start on the housing ladder and build up pension savings. That increases the chance that they will then sustain us when baby boomers need domiciliary care and nursing care.

“There is an American bumper sticker which says, ‘Be nice to your kids, they choose your nursing home.’”

Stephen Burke, director of United for All Ages, a social enterprise working with councils and charities, said the growing bill for elderly care was “already causing tensions between generations”.

“The cuts in public spending are pitting the needs of older and disabled people against children, young people and families,” he said. “Using older people’s wealth, for example through a care duty on estates, would be a fairer way of paying for better care for our ageing population.”

From: http://www.telegraph.co.uk/OECD-huge-elderly-care-bill-threatens-family-ties

Mixed sex wards lead to hospital fines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

NHS £12 billion IT system is waste of money NAO still finds

NHS patients are getting “precious little” from the NHS electronic care records system in England, the National Audit Office (NAO) has found.
NHS £12 billion IT system is waste of money NAO still findsThe £7bn system to replace paper files is falling further behind schedule and in places where it has been introduced it is not working as it should.

The National Audit Office also said some patients would not even get one as large chunks of the NHS had pulled out.

In conclusion, the NAO said the system was not providing value for money – something the government rejected.

The Electronic care records are the key part of the overall £12.4bn NHS IT project.

The scheme was launched in 2002 by Tony Bliar with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections.

It is the third time the NAO has looked at electronic records – and each time the findings have been more damning.

The report from the NAO presents a depressing account of delays, contractual wrangling and technical glitches.

The original vision for the scheme was compelling – a national network connecting hospitals, GP practices, ambulance services and mental health trusts, and an end to the tortuous paper trails that have caused frustration and misery for doctors and patients alike.

But the complexity and cost of the scheme meant it was always seen by many as a high risk strategy. And when it ran into trouble the plans were scaled back, and the original vision set aside.

Many GPs and hospitals are now working with different systems, prompting the NAO to question whether further investment in the national programme would be pouring good money after bad.

The latest report details a range of problems that the programme is struggling with.

In London, all GP practices and more than half of hospital trusts have pulled out, while in the south three-quarters have. However, this has not been accompanied by a proportionate drop in cost.

Meanwhile, the contract covering the rest of country is currently being renegotiated. Even after such a scaling back, roll out in places that remain part of the system is still proving difficult.

The NAO said it doubted the final deadline of 2016 – which is already six years later than originally envisaged – would be met.

And even in those trusts that have electronic records, there are problems. For example, some hospitals have struggled to introduce electronic prescriptions.

The NAO said the difficulties were caused by a range of factors, including the government being too ambitious, difficulties with technology and the complexity of the NHS.

The problems have prompted some critics to call for the entire scheme to be scrapped – although this is something the NAO stopped short of suggesting.

The government has already announced there will be a review of the project. This is due to start next week.

Tory MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee and long-standing critic of the plans, said: “It is perfectly clear that throwing more money at the problem will not work.

“This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

But the Department of Health said while the original vision “was flawed”, the project still had the potential to deliver value for money.

Dr Chaand Nagpaul, of the British Medical Association, said: “We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.”

From: http://www.bbc.co.uk/news/health-13430375

Drinking coffee cuts prostate cancer by 20 per cent

Drinking six or more cups of coffee a day could cut the risk of prostate cancer by 20 per cent new US research has found.Drinking coffee cuts prostate cancer by 20 per centCoffee has been linked to a reduced risk of dying from prostate cancer in a study of nearly 50,000 US men.

Those who drank six or more cups a day were found to be 20% less likely to develop any form of the disease – which is the most common cancer in men.

They were also 60% less likely to develop an aggressive form which can spread to other parts of the body.

But charities say the evidence, reported in the Journal of the National Cancer Institute, is still unclear. They do not recommend that men take up coffee drinking in the hope of preventing prostate cancer.

The study looked at about 48,000 men in the US who work as health professionals. Every four years between 1986 and 2006, they were asked to report their average daily intake of coffee.

During this 20-year period, 5,035 of the men were diagnosed with prostate cancer, including 642 fatal cases.

Each year about 37,000 men are diagnosed with prostate cancer in the UK. Some 10,000 die from the disease.

No difference was seen between caffeinated and decaffeinated coffee, suggesting caffeine itself was not the cause.

But even relatively small amounts of coffee – one to three cups per day – were found to lower the risk of lethal prostate cancer by 30%.

The researchers think there may be unknown compounds in coffee that protect against the disease.

Lead researcher Dr Kathryn Wilson, from the Harvard School of Public Health in Boston, said: “At present we lack an understanding of risk factors that can be changed or controlled to lower the risk of lethal prostate cancer.

“If our findings are validated, coffee could represent one modifiable factor that may lower the risk of developing the most harmful form of prostate cancer.”

Commenting on the study, Dr Helen Rippon of The Prostate Cancer Charity, said other studies had not shown the link and the research evidence was still unclear.

She added: “Although this study is a welcome addition to our knowledge, it is far from definitive and we would not recommend men who are not already habitual coffee drinkers to become so in the hope of preventing prostate cancer.

From: http://www.bbc.co.uk/news/health-13430219

Killer quango NICE unveils new money saving tool

Killer quango NICE- The National Institute for Curbing Expenditure has launched a new online money saving tool – NICE Pathways – that pulls together connected National Health Service guidance into one easy-to-use resource.
Killer quango NICE unveils new money saving toolFor the first time, doctors and commissioners will be able to view and navigate all of NICE’s separate sets of recommendations that relate to a single care pathway in a user-friendly electronic flow chart, as part of a bid to improve the use of its evidence across the nation.

The postnatal care pathway, for example, covers everything from the baby’s first 24 hours up until the first two – eight weeks after birth, providing an immediately accessible overview of all recommended care, as well as links to other products such as the Institute’s Quality Standards and implementation tools.

Launching the new tool at NICE’s 11th annual conference in Birmingham, Gillian Leng, the Institute’s deputy chief executive, said that 18 care pathways have already been completed and that the target is to have 60 on the site by the end of the year.

“NICE Pathways will provide a useful starting point for users new to a topic, while giving specialists confidence that they are up to date with everything NICE has recommended,” she said.

The move comes under a wider plan to improve the digital format of its guidance, which, in future, is likely to remain a crucial element of the new system of value-based pricing for new medicines planned by the government for 2014.

While NICE’s exact role going forward is yet to be defined, in his address to the conference health minister Earl Howe stressed that the Institute – which is to be re-established under primary legislation – will continue to provide independent advice to clinicians, and be a source of advice on cost effectiveness.

From: http://www.pharmatimes.com/NICE_unveils_new_digital_guidance_tool_at_annual_conference

Health Direct notes the use of the phrase “a source of advice on cost effectiveness” as it evokes the memory of labour’s spin- the type of phraseology that labour used to use for cost cutting.