NHS children’s services failing 1,500 lives a year

Up to 1,500 youngsters- half the number of people killed on the roads, are dying every year because of faults with children’s health services, which are approaching crisis point, the new president of the Royal College of Paediatrics and Child Health has said.NHS children's services failing 1,500 lives a yearChild death rates in Britain were higher than in Germany, France, Italy and Sweden.

Dr Hilary Cass, who took on the post last month, said the NHS did not compare well with other Western European countries when it came to children’s health.

She said: “If you look at the overall picture, we are performing very poorly when it comes to child mortality.”

Dr Cass, a paediatric disability consultant at Guy’s and St Thomas’s in London, continued: “We have about 1,500 excess deaths over and above what we would have if we matched the best performing country, Sweden.

“These are things that should be avertable with medical care – like meningitis, pneumonia and asthma,” she said.

While she admitted there was more investment in Sweden and more doctors per person, she argued: “We should aspire to be the best.”

However, Dr Cass warned there was a potential crisis looming because there were too few middle-grade paediatricians, which wasregularly forcing consultants to work night and weekend shift with little notice.

She said: “We can continue what we are doing for a year or two, but I think consultants will become very demoralised if they don’t see a solution to having to come in on unplanned nights and then having to work the next day.”

If the situation persisted, she predicted consultants woud retire early and the speciality would become less attractive for juniors.  “There’s a risk that morale will drop, and once that happens, we are on a slippery slope,” she said.

Paediatrics is currently a popular specialism, particularly among female medics, but she said that meant many work reduced hours in their 30s as they juggled their careers with young families. More were opting out of working a five-day week than before, she explained.

As a result, consultants were increasingly having to cover the role traditionally performed by middle-grade doctors, taking on some front-line out-of-hours shifts.

However, she said broader changes were needed to improve paediatrics. The number of hospital children’s departments should be cut by a quarter, she said, with the remainder rationalised into fewer, larger units.

The money saved could then be spent on deploying more senior paediatricians to work outside hospitals, where they could diagnose sick children quicker.

From: http://www.telegraph.co.uk/NHS-childrens-services-failing-1500-lives-a-year

Quarter of hospitals, clinics, care homes fail to meet basic standards of patient safety, quality of care

A quarter of hospitals, clinics and care homes in England are failing to meet basic standards for patient safety and quality of care, according to the most comprehensive study of its kind.Quarter of hospitals, clinics, care homes fail to meet basic standards of patient safety, quality of careThe Care Quality Commission’s state of the nation report based on 14,000 unannounced inspections of dentists and NHS, private, and social care run facilities reveal widespread problems with staffing levels, safe medication management and record keeping.

Nursing leaders last night said the report should act as a “wake-up” call to the government amid accusations that ministers had thus far ignored evidence of redundancies, unfilled vacancies and job cuts.

One in 10 services failed to meet legally binding standards for staffing levels which often led to compromises in the care and welfare of patients, as well as limiting training and supervision for staff, the CQC found.

Almost one in five services inspected were failing to safely administer medications with “worrying” examples of risks associated with age, side-effects and drug interactions being poorly managed.

Care homes for the elderly and adults with disabilities, which often have no trained nurses or doctors on a day to day basis, fared worst.

People with complex and multiple medical needs such as dementia or Parkinson’s disease sufferers often reside in these homes.

The deteriorating physical state and suitability of premises was also a particular concern in social care, the inspectors found.

In the private sector proper record keeping was the biggest concern.

The CQC inspectors found out of date and incomplete notes about patients, stored in insecure places which could jeopardize patients’ confidentiality.

The CQC says it has taken tough action against failing services, including some closure, and would continue to hold them to account.

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “It is shocking that more than one in four locations inspected in this report have failed to meet even essential standards of quality and safety… this presents a long overdue wake-up call for the Government. Those locations in question must be brought up to standard as a matter of urgency.”

The report also includes a special focus on maternity services, emerging as a problem area for a number of NHS Trusts due to midwife numbers not keeping pace with the birth rate and increase in complex births.

From: http://www.independent.co.uk/quarter-hospitals-clinics-care-homes-fail-to-meet-basic-standards-for-patient-safety-and-quality-of-care

NHS is paying for Labour’s dodgy deals

The NHS faces huge costs because of flaws in Private Finance Initiative (PFI) contracts agreed by the previous administration.NHS is paying for Labour’s dodgy dealsYesterday afternoon, the Queen opened the South West Acute Hospital in Enniskillen. She will doubtless have been impressed: the facility, the first to be built in Northern Ireland for more than a decade, is a gleaming shrine to 21st century healthcare.

What may not have been mentioned, however, was that the £276 million hospital was constructed not with public funds, but by a consortium under the Private Finance Initiative – and that the deal to build it included a 30 year “facilities management” contract for one of the firms involved.

The Enniskillen deal may be a shining example of value for money.

But many PFI contracts are not.

Ministers are on the verge of taking over the South London Healthcare Trust, after it proved unable to cope with a bill of more than £60 million a year in interest alone.

One of the trust’s three hospitals, the Princess Royal in Bromley, took £118 million to build, yet will cost roughly £1.2 billion. All told, Labour signed 103 PFI deals for the NHS, at a value of £11.4 billion and an eventual price of more than £65 billion.

The diversion of that money away from patient care will put inexorable pressure on budgets, to the point where some hospitals will crack under the strain.

PFI, in short, is not merely about £22 light bulbs and £875 Christmas trees – it is about budgetary incompetence on a monumental scale.

And it comes as little surprise that it can be traced back to Gordon Brown, who turbo-charged the Tories’ fledgling public-private partnerships in order to buy schools, hospitals and more on the never never.

This allowed him first to evade spending restrictions, and later to splurge on public-sector salaries; in the mean time, the credit card bills got higher and higher.

Many PFI deals delivered what was promised – but where things have gone wrong, as in Bromley, the contracts were often drawn up so poorly that there is little the Coalition can do. Ministers have renegotiated some deals to claw back costs, and should make every effort, and twist every arm, to do more.

They should also remind voters of the ignominious parts played in this debacle by Ed Miliband, Andy Burnham and Ed Balls.

But, above all, they need urgently to produce a way of funding infrastructure that draws on the private sector’s strengths rather than exploiting the public sector’s weaknesses.

Jesse Norman, the Tory MP who has led the way in exposing PFI’s flaws, points out that the state must spend more than £200 billion on new infrastructure over the coming decade, and cannot do so without private help.

The Treasury is beavering away on a new model of funding. If it repeats the errors made by Labour, the cost to the nation will be heavy indeed.

From: http://www.telegraph.co.uk/The-NHS-is-paying-for-Labours-dodgy-deals

Your iCoach guide to becoming an ex-smoker

The iCoach gives you information and tips for the particular phase that you are in and it gives you access to various tests and a diary. The aim of the iCoach is to enable you to move to a next phase to come closer to a final smoke stop.

The iCoach is a unique online method that helps you stop smoking for good. The iCoach consists of 5 phases in the process to stop smoking:
Phase 1: I do not plan on stopping
Phase 2: I should stop, but I am still in doubt
Phase 3: I will stop smoking shortly
Phase 4: I have just stopped
Phase 5: I have stopped for some time now

The Benefits to you

  • Free – you can’t argue with that!
  • It works – more than 30% who start the programme quit smoking
  • For everyone – even for smokers that are not quite ready to quit
  • For you – adapts to your needs, your time, and your goals
  • Friends – speak to people like you and get support from a dedicated community

What is iCoach?
The iCoach gives you information and tips for the particular phase that you are in and it gives you access to various tests and a diary. The aim of the iCoach is to enable you to move to a next phase to come closer to a final smoke stop.

Duration of one phase ?
A process to stop smoking can normally last years but with the advice and tips of the iCoach you can move on to the next stage more quickly. You will receive about 50 tips via e-mail during every phase, which means a new tip every day for 50 days. They have been drawn up to gradually prepare you for the next phase. Some stay in one phase a few days or weeks, others a little longer. Take your time to finish one phase, but avoid getting stuck in one phase.

How do I know if I am ready for the next phase ?
You get a certain amount of advice in every phase. The last piece of advice is a quick test to check if you are ready for the next phase. Depending on your answers, you will be encouraged to move on to the next phase or you will receive specific tips to make the step to the next phase easier.

How can I go to the next phase ?
You can move to the next phase by doing the Quit Smoking Phase Test. This quick test only takes a couple of seconds. You can do the phase test whenever you want.

Coalition ministers take over bankrupt PFI hospitals

One of Britain’s biggest hospital trusts is “on the brink of bankruptcy” and will be taken over by ministers in the coming weeks after being saddled with large debts from PFI deals.Coalition ministers take over bankrupt PFI hospitalsSouth London Healthcare Trust, which runs three hospitals in the capital, is losing more than £1 million a week and will be run by a troubleshooter and a new management team.

It was formally warned last night that it would be the first NHS body to be taken over by Whitehall-appointed administrators under the “unsustainable providers’ regime”.

More than 20 other hospitals in financial difficulty also face being taken over unless they take urgent steps to turn around their fortunes.

A government source said: “This hospital trust was brought to the brink of bankruptcy by Labour. It is losing £1 million a week, money which could be spent on 1,200 extra nurses for local people.

“The standard of care that patients receive at the hospital trust is not good enough, although there have been some improvements in recent months. It is crucial that those improvements are not put at risk by the challenge of finding the huge savings that the trust needs to make.

“We don’t want a repeat of Stafford, where crude attempts to balance the books had tragic consequences.”

“This will clearly be a difficult and controversial process, but we are determined to turn this trust around so patients in south-east London get the care they deserve.”

The trust runs three hospitals – Queen Mary’s in Sidcup, Queen Elizabeth in Greenwich and Bromley – serving more than a million people and employing more than 6,000 staff.

However, it is thought to have been crippled by the costs of two Private Finance Initiatives used to rebuild two of its hospitals. The schemes, which totalled more than £1 billion, cost more than £60 million annually in interest payments alone.

Draft financial plans submitted by the hospitals to the Department of Health show that it faces a shortfall in its accounts of between £30 million and £75 million annually over the next five years.

Stephen Dorrell, chairman of the health select committee, said in theory under PFI the public and private sectors were meant to share the financial risk of ventures, but this did not happen.

“I regret the fact that contracts were signed that paid private sector costs when the public took the risk. That is indefensible,” he said.

A senior Whitehall official visited the hospital to deliver a letter from Andrew Lansley, the Health Secretary, warning bosses that the legal process to effectively take over the trust had begun. New management is expected to be installed next month.

Mr Lansley’s letter said: “A central objective for all providers is to ensure they deliver high quality services to patients that are clinically and financially sustainable for the long term.

“I recognise that South London Healthcare NHS Trust faces deep and long-standing challenges, some of which are not of its own making. Nonetheless, there must be a point when these problems, however they have arisen, are tackled. I believe we are almost at this point.

“I appreciate that any decision to use these [special] powers will be unsettling for staff, but I want to stress that the powers are being considered now so that patients in south-east London have hospital services that have a sustainable future.

“I am determined to improve health care services for patients in south-east London and will take whatever difficult steps are necessary to achieve this.”

Lives at risk due to arbitrary postcode lottery health rationing warn surgeons

NHS rationing of common operations is putting patients’ lives at risk by subjecting them to “unproven and arbitrary” decicions about their healthcare, the heads of Britain’s top surgical organisations warn.Lives at risk due to arbitrary postcode lottery health rationing warn surgeonsWriting in The Daily Telegraph, the five say decisions over whether patients get operations like hernia repairs, hip and knee replacements, and weight loss procedures are being “compromised by financial pressure”.

Their letter comes after an in-depth study found nine in 10 primary care trusts (PCTs) in England are rationing access to common operations.

Almost two thirds are restricting joint replacements after referral by a specialist, while a similar proportion are doing so for cataracts removals.

Professor Norman Williams, president of the Royal College of Surgeons, and the letter’s lead signatory, said restricting access was nothing but “a quick fix” for financially-strapped health authorities, that would cost more in the long term.

The authors of the letter, who also include the presidents of the British Orthopaedic Association (BOA) and the Association of Surgeons of Great Britain and Ireland, write that access to treatment “should be driven by need based on clinical assessment, and must not be compromised by financial pressure”.

They go on: “Most methods to restrict access to surgery use unproven and arbitrary thresholds which unfairly deny patients some of the most successful operations which vastly improve quality of life.”

Patients are being left immobile when hip and knee replacements are delayed, they say, while hernias are being left dangerously untreated.

“Any hernia left untreated puts the patient at serious risk should the hernia strangulate, meaning that they would require emergency surgery to address the potentially life-threatening problem,” they warn.

Last night (Wednesday), Prof Williams, a colorectal surgeon, said: “Trusts might say, ‘These are the hernia patients we will admit straight away’. But you don’t know which patients are going to strangulate and obstruct the bowel.”

He said he knew of a patient who had been left in severe pain with gallstones, only to be told after being approved for an operation that she had to endure another such painful episode before qualifying.

Different PCTs were setting different criteria for access to operations: “There’s so much variation, which is of considerable concern – we are after all the National Health Service.”

He continued: “We have been worried about restricted access for some time, but it seems to be getting worse.”

He believed health managers were trying to save money, both due to the tighter budget settlement and the demand by Sir David Nicholson, chief executive of the NHS, to make “efficiency savings” of up to £20 billion over four years.

But he said: “Surgery is an easy target, but I don’t think it’s going to save the money they think it will. It is a quick-fix, short term-ism.”

Joe Dias, president of the BOA, said patients needing hip and knee replacements gained less benefit from surgery if made to wait, as the delay resulted in further joint deterioration.

He said patients were regularly being denied surgery, even if they had serious trouble climbing stairs and often woke at night in pain, by trusts relying on a questionnaire called the Oxford hip and knee score.

“We should not make a judgement based on a score,” he said. “We should talk to the patient and see what they can and can’t do.  If the decision to operate is just based on a score, why have doctors?”

Other procedures, including operations to relieve carpal tunnel syndrome, shoulder and ankle problems, and back pain were also being rationed, he said.

From: http://www.telegraph.co.uk/Lives-at-risk-due-to-arbitrary-health-rationing-say-surgeons

False dental claim fines hit thousands

More than 8,000 NHS dental patients have been fined in the past year for claiming free treatment when they were not eligible in the last year.False dental claim fines hit thousandsThe fines totalled more than one million Pounds.

Some of those affected say the rules about who does and does not qualify were not made clear to them.

But the Department for Work and Pensions says that all claimants receive adequate information.

In total, 8,329 people were fined in the past year.

Vaneeta Sharma was fined £100 for claiming free dental treatment. Despite being in receipt of Jobseekers Allowance (JSA), she was not on the type that allows you to claim free treatment.

She told Radio 4’s Money Box programme: “When I went to the job centre the first time, they did not make it clear that there were two types of Jobseekers Allowance.”
Benefit confusion

Ms Sharma was on contribution-based JSA. This is a short-term benefit based on a person’s past National Insurance contributions.

This is distinct from income-based JSA which is what a claimant receives if they still need help after six months.

While income-based JSA does entitle you to free dental care, contribution-based JSA does not.

Confusing the two benefits has left Ms Sharma facing a charge she says she can not afford.

“This £100 is a lot of money to me. I don’t mind paying my dental charges but I am not happy paying this penalty charge.”

The letter Ms Sharma received from the Department of Work and Pensions did not distinguish between the two types of benefit. Nor did it state that this had implications for what other benefits she could access.

Marie Clair at the Campaign for Plain English told Money Box that she would expect this information to be much more prominent: “As far as I am concerned this letter says ‘I’m pleased to tell you that we can pay you Jobseekers Allowance.’ It is not until almost the last line that you understand that it is contribution-based in this instance.”

It is not just JSA where confusion can arise. Pension Credit and Employment and Support Allowance also come in two forms and only one type is a passport to free dental care.

The Department for Work and Pensions said: “We make it clear at the point of claim what type of Jobseeker’s Allowance you are claiming.

Enclosed with every award letter is a INF1 leaflet that further explains the differences between the benefits and also a signpost to tell you where you can find out about other benefits you may be eligible for.”

From: http://www.bbc.co.uk/news/business-18308437

Doctors strike- only just 8 per cent take action claim govt

Just eight per cent of doctors working in the NHS were on strike- Government figures suggest.Doctors strike- only just 8 per cent take action claim govtA quarter of GP surgeries are operating a reduced service due to BMA members participating in the day of action, the Department of Health said.

It said some 11,500 doctors up and down the country took part in their first day of action in 37 years in protest over the Government’s controversial pension reforms.

Around 2,700 elective operations were cancelled and rescheduled – approximately 9 per cent of normal daily number of elective operations.

Another 18,750 outpatient appointments have been cancelled and rescheduled – approximately 9.4 per cent of normal daily outpatient activity.

Approximately 6,000, or 75 per cent, of GP surgeries provided routine appointments today, with approximately 2,000, 25 per cent, providing urgent only appointments.

It follows a survey by The Daily Telegraph, published in today’s paper, which predicted two in three GP surgeries would be operating as normal despite the action.

In May, the BMA insisted it had a “strong” mandate for industrial action – its first strike in nearly 40 years – when half its members responded to a ballot with 79 per cent of votes in favour.

The Daily Telegraph’s research found that two thirds of GP surgeries expected to have all their doctors working today and would be open for business as usual. The vast majority of hospitals said few or no operations would be cancelled.

The slump in support for industrial action over pensions follows fierce public criticism and claims that doctors are being “greedy and immoral”. One poll on Wednesday found that only a third of Britons backed the action.

David Cameron said doctors should not strike as most already had gold-plated pensions which people working in the private sector “can only dream of”.

The BMA, representing two thirds of doctors, is fighting cuts to their £1million pension pots. Under government proposals, new doctors will have to work until 68 and make bigger contributions to earn a pension worth £68,000 a year.

According to the Department of Health, the taxpayer currently funds 80 per cent of doctors’ pensions, making the scheme “unsustainable”.

Under the terms of the BMA ballot, GPs were expected to refuse to see patients unless they were in urgent need, while hospitals were supposed to cancel all non-urgent surgery such as hip replacements and cataracts.

But a survey of 50 NHS organisations showed that many have had second thoughts.

Of 30 hospital trusts, more than two thirds said the strike would have “minimal” impact on operations and outpatient appointments, with six saying there would be no cancellations. They included the Papworth Hospital NHS Foundation Trust in Cambridgeshire, the Royal Marsden Hospital in London and Nottingham University Hospitals NHS Trust.

A survey of 20 primary care trusts found that two thirds of GP surgeries had no doctors taking part in the strike. Of those who were affected, the majority said that surgeries would remain open as normal and patients with pre-booked appointments would be seen. In South Yorkshire, Wiltshire and Oxfordshire more than two thirds of family doctors were not supporting the action and would be open for “business as usual”, while in Sussex and Wakefield just a quarter of GP surgeries were taking part.

Katherine Murphy, chief executive of the Patients Association said: “Doctors are just being greedy. It is immoral. The only losers in this are the patients who have been waiting for operations and are in pain.”

“It is reassuring that some doctors are having second thoughts, I hope a lot more will have second thoughts because the public has little sympathy with them in this financial climate.”

From: http://www.telegraph.co.uk/Doctors-strike-just-8-per-cent-take-action

NHS compensation to misdiagnosed patients rises to £98 million

NHS payouts to patients whose conditions were misdiagnosed by medical professionals increased by three quarters in the last year to nearly £100 million.NHS compensation to misdiagnosed patients rises to £98 millionCompensation paid to people whose illnesses were not spotted or were detected too late soared from £56 million in 2009-10 to more than £98 million in 2010-11.

Nearly one in ten of the 1,204 successful cases brought against NHS trusts last year related to health staff failing to diagnose cancer, figures released by the NHS Litigation Authority (NHSLA) in response to a Freedom of Information request show.

The number of successful misdiagnosis claims increased by nearly 80% in the five years from 2006-07, when there were 681 claims resulting in compensation totalling just under £50 million.

Ministers have blamed “no-win, no-fee” conditional fee agreements for a sharp rise in the cost to the NHS of defending and settling legal proceedings brought for negligence.

In January Ken Clarke, the Justice Secretary, hit out at the “extraordinary” increase in payments to lawyers acting for medical negligence victims.

The biggest single misdiagnosis payout since 2006 was £4.1 million, although there were another eight cases where the damages were more than £2 million, the NHSLA figures show.

These are typically cases where the patient was permanently disabled and will need costly care for the rest of their life.

The largest compensation sum paid for a cancer diagnosis mistake was £959,000, with a further 12 payments of £300,000 or more.

A Department of Health spokesman said: “Unsafe care will not be tolerated in a modern NHS. The vast majority of the millions of people seen by the NHS every year do get good quality, safe and effective care. However, if patients do not receive the treatment they should and mistakes are made, it is right that they are entitled to seek compensation.

“It is truly regrettable that an extremely small minority of cases lead to patients being negligently harmed and any compensation paid is based upon the individual circumstances of each case.”

Dentists’ warning on acidic soft drinks including smoothies and juices

Children’s teeth are rotting by health conscious parents misguidedly giving them too many acidic fruit smoothies and juice drinks- senior dentists have warned.Dentists’ warning on acidic soft drinks including smoothies and juicesThe concerns were raised as official figures disclosed that dental problems have become the third most common reason for children to be admitted to hospital.

The investigation reveals that the acid levels of popular juice drinks consumed by millions of households – including one found to be more acidic than vinegar.

Dr Kathy Harley, dean of the dental faculty at the Royal College of Surgeons, said many parents encouraged their children to drink smoothies and juices every day, unaware that the combination of high acid levels and sugar content can destroy young teeth.

Instead of giving children the apparently healthy snack of fruit juice and a box of raisins, it would be better for their teeth if they were given a glass of water and a handful of chocolate buttons, she said.

Manufacturers are required to publish information about the nutritional content of drinks on the label – but not their levels of acid, which can erode the surface of teeth, making decay more likely.

Dr Harley said 50 per cent of five year olds now have signs of damage to their tooth enamel caused by excess acid in their diet.

She said that while health conscious parents had the best of intentions in trying to follow the Government’s “five a day” advice for feeding their children fruit and vegetables, in fact the combination of acid and sugar in juice drinks meant they should be restricted to a “once a week treat”.

Tooth enamel begins to be destroyed when acid levels in the mouth drop below 5.5 on the pH scale, which has 7 as neutral and 1 as strong acid.

While water has a pH of 7, and milk is just below at 6.8, our investigation found that a soft drink called This Water with lemons and limes, which describes itself as a “juice drink blended with pure squeezed juices and pure spring water”, had a level of 2.7 – making it more acidic than cider vinegar, which had a level of 2.9.

This Water also contains 9.5 teaspoons of sugar in a 420ml (14.7 fl oz) bottle. In 2008, the company, which is part of Innocent Drinks founder Richard Reed’s empire, had an advertisement campaign banned by the Advertising Standards Authority for failing to inform consumers about the sugar content of its juice drinks.

The products were advertised with the strapline: “Simple, natural, refreshment” in posters which stated that the drink was made from water and fruit but made no mention of added sugar.

The other fruit drinks tested, including Tropicana orange juice, Copella apple juice, Innocent smoothies, Capri Sun orange drink and Robinsons Fruit Shoot apple and blackcurrant low sugar drink all had acid levels ranging between 3.3 and 3.8.

The most acidic beverage tested was Coca Cola, with a pH level of 2.5 and 12.5 teaspoons of sugar in a 500ml (17.5 fluid ounces) bottle.

Dentists said that rather than consuming fruit or fruit juices as a snack, they were better consumed at meal times or accompanied with something containing calcium, such as cheese, which neutralises acid.

Children should be encouraged to drink water afterwards to wash away some of the acid, but not to brush their teeth until at least an hour afterwards, as teeth are weakened by exposure to acid, they said. Saliva also helps to restore the balance.

From: http://multi-vitamins.eu/dentists-warning-on-smoothies-and-juices-popular-drinks-are-more-acidic-than-vinegar