Serious NHS safety incidents up by a quarter since 2010

The number of reported NHS accident and incidents resulting in death or severe harm to patients has risen by a quarter since the Coalition came to power and now tops 10,000 a year.Serious NHS safety incidents up by a quarter since 2010Campaigners claim that cuts to frontline staff have had an impact on patient safety, with doctors and nurses increasingly having to work in unsafe conditions.

However the Department of Health denied their assertions, saying the rise was the result of a culture of better reporting of incidents, which should be welcomed.

Statistics released by the NHS Commissioning Board show the number of patient safety incidents in England that resulted in death or severe harm, rose to 10,102 between April 2011 and March 2012.

By comparison, the number was 7,867 between October 2009 and September 2010, during which period the Coalition came to power.

John Lister, director of campaign group Health Emergency, claimed tighter budgets and reduced headcounts had contributed to the rise.

He said: “We’ve got a squeeze on staffing levels, meaning more reliance on agency staff and people working in less than ideal conditions. If you talk to anybody working in a hospital they will tell you that.”

He also said the “constant reorganisation” of the NHS meant the issue was not being tackled as it should be.

Peter Walsh, chief executive of the charity Action on Medical Accidents (AvMA), described the increase as “very worrying”.

He thought some of the rise was due to better reporting, but said that could not entirely explain it. In previous years most incidents of such seriousness would have been reported, he argued.

Examples of incidents resulting in severe harm or death could include overdoses, giving people the wrong medication, operating on the wrong site and giving a patient the wrong type of blood, he said.

A Department of Health spokesman emphasised that the most recent figure included – for the first time – suicides of people who had been in care. Without that, the number would have remained below 10,000, she said.

She said: “More reported deaths doesn’t mean more deaths or poorer care – it shows that the NHS is taking its responsibility to report incidents seriously.

“Evidence shows that trusts with higher reporting rates are likely to be safer for patients. We are determined to create a safer NHS and regular reporting is central to this. We expect all patients to receive high quality, safe and effective care.”


Third of health authorities still imposing postcode lottery treatment bans

A third of local health authorities are still imposing postcode lottery treatment on certain ailments including hernia operations, IVF, varicose vein removal and even hip and knee replacements, according to a survey of GPs.Third of health authorities still imposing postcode lottery treatment bansLast November Andrew Lansley- the then Health Secretary, banned primary care trusts (PCTs) and health commissioning groups from imposing across-the-board restrictions, describing them as “unacceptable”.

He said patients should always be able to be treated if their doctors said they needed it.

He reiterated his edict this June, after a study found nine in 10 local health authorities were imposing tight thresholds on at least one treatment deemed to be either ‘non-urgent’ or of ‘low clinical value’.

However, there are still widespread bans in place, according to a survey of 682 family doctors by GP magazine. It found 35 per cent said authorities or commissioners were restricting access on the base of cost alone.

GPs who responded to the survey said they were being forced to “fob off” patients until they could refer them on.

Some PCTs were not imposing blanket bans as such, but making it more and more difficult for patients to qualify for treatment, for example by raising the threshold of pain and immobility needed to qualify for a joint replacement.

One wrote the PCT was “not imposing a blanket ban, but it is made increasingly difficult in terms of the hoops you have to jump through to obtain funding, even to get a patient seen for an ever growing list of conditions.”

Some feel Mr Lansley had it both ways on the issue – on the one hand restricting funding and then blaming PCTs who had to reduce their spending.

One respondent said Mr Lansley had been “asking the impossible, with GP commissioners being the fall guys”.

Dr Richard Vautrey, deputy chairman of the British Medical Association’s GP committee, called on Jeremy Hunt, Andrew Lansley’s replacement to sort out the problem.

He told GP: “’The Department of Health has repeatedly said it would prevent PCTs and clinical commissioning groups (CCGs) from rationing treatments on cost alone.

“They are clearly not doing that and need to start putting words into action,” he said.  “This will be a big challenge for the new health secretary, and one he needs to address quickly.”

According to the poll, GPs seem to be strongly in favour of an England-wide list of services it will not fund, to eliminate the current postcode lottery.


Gonorrhoea cases jump 25pc in a year

Cases of gonorrhoea have jumped by 25 per cent in onee year, new official figures show- prompting criticism of the Government’s ‘safe sex’ message for teenagers.Gonorrhoea cases jump 25pc in a yearThe new statistics from the Health Protection Agency show there were almost 21,000 new diagnoses of the disease in England in 2011, up from just under 17,000 in 2010.

Dr Gwenda Hughes, head of surveillance of sexually transmitted infections (STIs) at the HPA, said the figures showed that “more must be done to encourage safer sexual behaviour through health promotion and ensuring easy access to sexual health services and screening.”

Most new cases are in gay men but, amongst heterosexuals, more than half of new cases of gonorrhoea (57 per cent) are in 15-to-24-year-olds, HPA figures show.

At the moment gonorrhoea – which can lead to infertility in women, and pregnancy complications in those who do get pregnant – is the second most common bacterial STI in Britain, after chlamydia, which is far more widespread.

In a statement the HPA also advised: “To combat the continuing high rates of STI transmission in England, and the growing risk of gonorrhoea treatment resistance it is essential to always use a condom when having sex with casual and new partners.”

But Professor David Paton, of Nottingham University, a long-standing critic of successive governments’ safe sex policies, said the HPA’s advice failed to mention that having lots of sexual partners was a risk in itself.

He said: “The advice says nothing about reducing the number of sexual partners or the dangers of having sex at too early an age.  It implies that, as long as you use a condom, it’s ok. But having lots of sexual partners is a high risk activity in itself.”

He argued this was flawed because condoms sometimes failed.

Peter Greenhouse, a consultant in sexual health and spokesman for the British Association for Sexual Health & HIV (BASHH), said gonorrhoea was “highly concentrated” in certain populations in Britain – particularly gay men.

He warned that resistance to a new antibiotic called ceftriaxone was growing so fast that “in five years we are going to be in real trouble”.


Benefits of statins for healthy hearts exceed diabetes risk

The benefits of taking statins for healthy hearts exceeds the increased risk of diabetes from the drugs new research has found.Benefits of statins for healthy hearts exceed diabetes riskAlthough the cholesterol busting drugs raise the risk of developing type 2 diabetes in those already prone to the disease, the cuts in heart attacks and strokes are worth it, an article- Cardiovascular benefits and diabetes risks of statin therapy in primary prevention published in The Lancet said.

Millions of people take statins to reduce the risk of suffering a heart attack or stroke and it has been argued that everyone over the age of 50 should take them.

However, in people who are already at risk of type 2 diabetes by being overweight for example, taking statins can increase the chances of developing the disease by 28 per cent.

For healthy people not at risk of diabetes, statins have no effect on the disease.

Conversely, statins can cause fatigue, muscle pains, headaches, nausea and memory problems.

Currently UK doctors consider statins for patients whose chances of having a heart attack over the next decade are calculated to be 20 per cent or greater.

A team of scientists led by Professor Paul Ridker, based at Brigham and Women’s Hospital, Boston, USA, analysed data gathered during the Jupiter trial, the first controlled study to report that taking statins results in an increased risk of developing diabetes.

They said for those taking statins during the five year trial the drugs clearly increased the likelihood of developing diabetes in patients already at risk of the disease, these patients were still 39 per cent less likely to develop cardiovascular illness while using statins, and 17 per cent less likely to die over the trial period.

Patients who were not already at risk of developing diabetes experienced a 52 per cent reduction in cardiovascular illness when taking statins, and had no increase in diabetes risk.

Professor Ridker said: “Our results show that in participants with and without diabetes risk, the absolute benefits of statin therapy are greater than the hazards of developing diabetes.

“We believe that most physicians and patients would regard heart attack, stroke and death to be more severe outcomes than the onset of diabetes, and so we hope that these results ease concern about the risks associated with statin therapy when these drugs are appropriately prescribed – in conjunction with improved diet, exercise and smoking cessation – to reduce patients’ risk of cardiovascular disease.”

In an accompanying commentary article Professor Gerald Watts of the University of Western Australia’s Cardiometabolic Research Centre, at the Royal Perth Hospital, said warnings over the use of statins and diabetes could be altered to apply only to people already at risk of diabetes.

He said: “A major take-home message for the clinician involved in either primary or secondary prevention of cardiovascular disease is that all individuals on a statin who have major risk factors for diabetes, particularly impaired fasting glucose, need to be informed about the risk, monitored regularly for hyperglycaemia, and advised to lose weight and take regular physical exercise to mitigate the emergence of diabetes.”


Superfoods- scientifically what are they?

Superfoods is yet another ambiguous food phrase to go along with “all-natural,” “no sugar added,” and “no artificial flavours or colours”.Superfoods- scientifically what are they? But scientifically speaking- what are they?

There really are foods that many nutritionists consider superfoods.

But these foods won’t come from your nearest take away or the processed, pre-packaged food from the grocery store or supermarket.

Why? Because they are all going to be a real (unprocessed) food.

What makes them so super? There isn’t a universally or nutritionally tested way of defining what foods are actually “super.”

But many health experts consider any whole food that is low in calories and has a high nutrient density or above average nutritional benefits is a superfood.

These nutritional benefits vary greatly depending upon the particular superfood, but according to the American Cancer Society (ACS), many of these antioxidant-rich foods may help reduce your risk for fatal diseases like cancer.

In fact, according to the 2011 ACS Guidelines for Nutrition and Physical Activity for Cancer Prevention report- Reducing the Risk of Cancer With Healthy Food
a third of the annual cancer deaths in the United States are caused by poor diet and lack of adequate physical activity.

Here are three nutritious, real, and tasty foods that could easily be considered superfoods because of their numerous health benefits:

Blueberries — These sweet and naturally blue berries are crammed with disease-fighting antioxidants, known to help alleviate the damage done by inflammation. Other benefits come in the form of ellagitannin and anthocyanin, both of which are believed to be effective against certain types of cancers, including breast and esophageal cancers. They are great in smoothies or as a sweet pairing with some grilled pork chops fresh off the barbecue (when we get the weather).

Red bell peppers — While all peppers are low in calories and are a healthy option for any meal, red peppers — which taste sweeter and aren’t as spicy as other varieties — pack a special nutritional punch. They contain 11 times more beta-carotene than green bell peppers and also give you 240 percent of your recommended daily value of vitamin C. Fajitas, anyone?

Watermelon — Yes, it’s hard to believe, but this tasty treat provides some awesome nutritional support for your body. Aside from refreshing you, this fruit also delivers significant amounts of lycopene, a carotenoid present in many superfoods. A recent study led by food scientists at Florida State University even suggests that watermelon can be an effective weapon against prehypertension, a precursor to cardiovascular disease.

So now you have a little background into what makes a food “super.”

Hopefully this has got you thinking about the foods you’re putting in your body and how they might be affecting your long term health.


Litigation culture draining billions from NHS hospitals

The growth of the “litigation culture” is draining NHS hospitals of money, a report warns.Litigation culture draining billions from NHS hospitalsPayouts made by the NHS have trebled over the past decade to more than £1.3 billion a year, of which more than £200 million goes in fees to lawyers.

At the same time, fear of being sued has fuelled the growth of “tick box bureaucracy” and has eroded trust between professionals and the public, according to the report published by the Centre for Policy Studies.

The authors say that the rise in legal claims is “bleeding public services dry” and has created the fantasy that there is “no such thing as an accident”.

The readiness of patients to bring claims has been portrayed by some as a means of holding public services to account.

However, the consequence has been that doctors increasingly follow procedures designed to “cover their backs” rather than to do the best for patients, says the report.

As a result, it says, nurses fill in paperwork rather than tend to the sick, doctors over-order precautionary scans, and surgeons avoiding using new techniques which might be in their patients’ best interests.

As of March, the NHS Litigation Authority estimated its potential liabilities for outstanding clinical negligence claims at £18.6 billion. The amount is the equivalent to one-sixth of the annual health service budget.

NHS authorities choose to settle most claims out of court, in an attempt to limit the amount they have to pay.

Only in around one in 30 cases are damages set by court. The £1.33 billion bill faced by the NHS in 2011/12 included £230 million in legal costs.

The report accuses trade unions of facing both ways on the issue of litigation.

Frank Furedi, Professor of Sociology at the University of Kent and joint author of the report, said that the litigation culture was “bleeding public services dry”.  Every time we bring a claim against our health or education services, we are in effect suing ourselves,” he said.

“And every time we are encouraged to ‘name, blame and claim’ as an act of responsible citizenship, to stop other people sharing our bad experiences, we end up contributing to the worsening of these very services.”

The academic said that in recent years there had been official recognition of the “villains” of the piece; the lawyers who earn fees from representing accident victims and the claim management companies that encourage individuals to lodge claims.

However, to stem the tide, a cultural shift was necessary, he said.

“If we want to put a brake on the culture of litigation and litigation avoidance in Britain, we need to look beyond ambulance-chasers and greedy lawyers to the cultural conditions that have allowed litigious sentiments to flourish as common sense,” said Professor Furedi.

“In particular we need to challenge the expectation that professional ‘best practice’ in the public sector should be measured by the absence of complaints or litigation.”


Abortions raise risk of premature births next time

Women who abort their first pregnancy are at significantly greater risk of having subsequent premature births a study has found.Abortions raise risk of premature births next timePrevious studies suggested that multiple abortions could result in complications in future pregnancies, but a new paper suggests that the risk after one termination is just as great.

Researchers from Aberdeen University studied the health data of more than 600,000 Scottish women whose second pregnancy came after either an induced abortion, a live birth or a miscarriage.

Speaking at the British Science Festival in Aberdeen, Prof Siladitya Bhattacharya said: “We found that women who had had a previous induced abortion had a higher risk of a spontaneous pre–term birth in their next ongoing pregnancy, compared with women who had never been pregnant before.”

“Abortion is common; most people know somebody who has undergone an abortion. The statistics for Scotland are compelling. In the last five years, 12 to 13,000 women have had abortions every year, and 40% of those are women under the age of 25.

Women who aborted their first pregnancy were 37 per cent more likely to have a subsequent premature birth than those in their first pregnancy, the study found.

However, they were 15 per cent less likely to have a subsequent pre–term birth than women who had previously suffered a miscarriage, according to the paper, which was published in the BMJ Open journal last month.


Creating better health sector websites

Like any online experience NHS health websites must be built around it’s users’ needs- in this case patients.

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The Health Direct listing on MedHunt, Health On the Net’s medical search engine:

Historically the NHS and the web have not mixed well. From the diaster surrounding Bliar’s initial attempts to introduce e-patient records, to problems with setting up a national application system for junior doctors online, attempts to enhance online offerings have often backfired.

Understanding users’ needs, and how they are being met- or not must be at the heart of online transformation.

Research has shown that “patients care about their experience of care as much as clinical effectiveness and safety”.

Simply bolting an online booking system onto a website that doesn’t deliver against user needs will not deliver any benefit to the sector or patients. Indeed it is just another waste of tax payers’ funds.

Most NHS trust sites tend to focus on how the site will look and how much information can be fitted into the visual design already in place, rather than the experience.

This approach may offer all the right information, but it is often less accessible for patients and users. – the beta site intended to replace – is a fantastic example of how user experience will always win over appearance. It doesn’t contain lots of imagery or shiny, new features, but is completely task focused- making it really easy to navigate.

From showing popular topics, by time, to encouraging users to provide feedback at every point of interaction with the site, delivers a high quality user experience that will keep visitors coming back to find the information they need.

As shows, the best sites are those built around the needs and goals of all stakeholders. They are useful, accessible, desirable and easy to use.

Most importantly, they continually evolve according to user feedback and visitors’ changing needs. Unlike a printed brochure a website is never finished.

Starting with user needs and planning your site around them will ensure you end up with a product (not just a website) that is appealing to users on more than just a visual level.

It will also ensure your website continues to work in an increasingly multi screen world- where people will contact you by smartphone as well as tablet format.

It was once more of an aesthetic task- but not any more. Build a site to be beautiful and you might as well throw your money away.

Equally build a website that makes a snail look fast- like the HMRC website, and you turn a bad experience into a disaster- and you will lose lots of money. Oh the Governement is anyway- there’s a surprise.

Build a site to meet and exceed your users’ needs and your investment will deliver significant returns for you- whether it’s for profit or public service.


NHS rationing is putting health at risk says doctors’ leader

Dr Mark Porter, the new head of the BMA, says NHS cuts are ‘morally wrong’ and present a serious risk to patients. NHS rationing is putting health at risk says doctors' leaderThe NHS is putting patients’ health at risk by denying them drugs and operations because of growing rationing being imposed to save money, the new leader of Britain’s doctors has warned.

The drive to meet demanding efficiency targets is so serious that the NHS is offering some GPs surgeries extra money if they send fewer patients for tests and treatment in hospital — a move condemned as “morally wrong” by Dr Mark Porter, the British Medical Association’s recently elected chair of council.

In his first interview since taking up the post Porter said the NHS was offering fewer and fewer services to patients and that many had been “cut out”, often against doctors’ wishes.

The shrinking of the NHS’s “offer” to the public was being hastened by the coalition’s health reforms, creeping privatisation of services and the system’s need to save £20 billion by 2015, Porter claimed.

Those pressures mean the fear that a patient may be harmed because they are denied a test or treatment “is a realistic concern”, said Porter. The same changes, especially the growing number of  private firms providing NHS services, also threaten to fragment the health service by making it less of an integrated system and have a severe impact on recent improvements in the quality of care, he added.

The NHS has come under growing criticism for making it harder for patients to have operations for routine conditions such as hernia, cataracts, grommets, wisdom teeth, or hip or knee replacement, and denying infertile couples IVF.

Rationing of access to certain procedures deemed not worthwhile by the NHS- postcode lottery- which is still piecemeal and localised, will soon become much more widespread as the spending squeeze in the service tightens, said Porter. “You see it happening in examples now, but it’s when it becomes service-wide in a few years’ time, if the current policies continue, that the population will notice in the wider sense.”

NHS organisations’ lists of treatments they will no longer pay for mean that “bits of the NHS are being parcelled off and taken out of the NHS offer year by year”. Although the NHS constitution guarantees universal and comprehensive healthcare “there’s lots of areas where bits of the NHS have been taken out of the offer”, Porter said. “It’s no longer a comprehensive service. We can see the effect of people to whom we have to say: I’m sorry, this treatment is no longer available.”

The use of referral management centres, in which family doctors’ decisions to refer a patient to hospital are analysed by a third party before any treatment can be given, “are particularly distressing for GPs who know how they would like to deal with patients but find their ability to do so is more constrained than ever before”. The situation was in stark contrast to “rhetoric” from ministers about how patients and GPs are being given more power than ever before as a result of their changes to the NHS in England, Porter added.

Both existing NHS primary care trusts (PCTs) and the clinical commissioning groups (CCGs) led by local GPs that will replace them next April are offering GP practices money in return for sending fewer patients to hospital to receive what can be expensive care there, despite NHS leaders and ministers having told them to restrict access only on clinical, and not financial, grounds.

Porter said that while the BMA supported schemes to improve the quality of referrals, such offers potentially gave GPs a conflict between their clinical judgment and personal self-interest, as GPs who run a practice can decide either to spend income on improving services or use it to boost their salaries. “It’s morally wrong and professionally wrong. Paying a direct financial incentive like that can be a direct financial incentive to the person themselves and that incentive shouldn’t be there. Doctors’ minds should be on what’s best for the patient, not on whether the PCT will sub them for certain types of financial behaviour,” he said.


Statins fear is putting patients health at risk researchers warn

Everyone over 50 should consider taking statins to reduce the risk of a heart attack because the possible side effects have been exaggerated, a leading expert has said.Statins fear is putting patients health at risk researchers warnSir Rory Collins, of Oxford University, said taking cholesterol-lowering statins before warning signs start to appear could provide much more protection from heart attacks or stroke.

He accused medical regulators of overstating the possible side effects of statins, the majority of which have not been borne out in clinical trials, because it could encourage them to stop taking the medication and put their health at risk.

He disputed claims that statins can cause sleep disturbances, memory loss, sexual dysfunction, depression, lung disease, cataracts, diabetes, memory loss and confusion.

The only side effect proven by experiments is a very low risk of myopathy – a condition which causes muscles to weaken – which is easily outweiged by the benefit to the heart of taking the drugs, Sir Rory said.

Sir Rory said current guidelines on statin use should be scrapped and patients encouraged to begin using the medication earlier. He was speaking after his keynote lecture at the European Society of  Cardiology’s annual congress in Munich.

Today doctors are advised to prescribe statins if a patient has more than a 20 per cent chance of a heart attack or stroke in the next five years, but Sir Rory said taking the drugs earlier could provide patients with “more bang for your buck”, adding: “At 50 you should be considering it.”

His research group recently published a study showing statins can cut the risk of a heart attack or stroke by a fifth in people with no immediate risk of heart disease.

Sir Rory said: “There is an argument being made that if we start treatment earlier and continue for a longer time then the benefits will be much greater. You are not trying to un-fur arteries, you are preventing them from furring in the first place.

“If you start at a younger age, then if you keep on with the treatment you may get more benefit than if you wait. I think the age of about 50 is the age to start thinking about it.  The question of whether to look at starting even earlier to get more benefit when you are older is an open question.”

In his lecture, Sir Rory claimed that regulators should reconsider the way statins are labelled and remove warnings of possible sideeffects which have not been proven to be caused by the drugs.

Official guidance on the drugs from the Medicines and Healthcare products Regulatory Agency warns of symptoms including sleep disturbances, memory loss, sexual dysfunction, depression and lung disease.

The medication has also been linked to the risk of cataracts and diabetes, and this year the American FDA changed its list of sideeffects to include memory loss and confusion.

He added that research has shown an increase in diagnoses of diabetes among statin users, but said the drug may have merely accelerated the diagnosis and not the disease itself.

He said: “I think we need to look properly at the safety and the reliability of statins.  The reality is that these drugs are remarkably safe and the problem is that high-risk patients are getting the message that these drugs have side effects. We have evidence now of worthwhile absolute benefits in low-risk individuals, and against that we have very small examples of myopathy.”