1 in 3 diabetic inpatients suffer NHS error report finds

Almost one in three diabetic inpatients in Wales has experienced at least one NHS medication error-  a new report by Diabetes UK Cymru finds.1 in 3 diabetic inpatients suffer NHS error report findsThe charity is concerned because the number of people with diabetes in Wales rose more than a quarter in five years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Minimum pricing plans for alcohol will do nothing to curb binge drinking

The Home Office has announced plans to introduce a minimum price of 45p per alcohol unit and ban supermarkets from “irresponsible” alcohol offers- and recieved criticism as a result.Minimum pricing plans for alcohol will do nothing to curb binge drinkingMiles Beale, the chief executive of the Wines and Spirits Trade Association, said a multi-buy ban “feels like a particular attack on the middle classes”.

“You can’t assume people who are interested in three-for-twos are irresponsible drinkers,” he said. “I’m interested in three- for-twos but it doesn’t mean I’m going to drink the bottles all that night. Actually it completely penalises the normal consumer behaviour of the middle class.

MEP Paul Nuttall also said “Imposing a minimum 45 p per unit will be a blow for the majority of moderate drinkers in this country who just like a quiet drink at home. But it will not tackle the problem it is designed to solve.”

“And I find it bizarre that David Cameron, who generally falls over backwards to do as our masters in Brussels demand, is ploughing on with this scheme despite it being illegal under EU laws,” said Mr Nuttall, UKIP Deputy Leader.

“I am all in favour of ending loss-leader discounting in supermarkets and off licences which has played a significant role in the downfall of our pub industry and it would be nice to think it might mean more people going back to them.”

“But those who just like to have a glass of wine or two with their meal or a couple of cans of lager while putting their feet up this will hit hard. Everyone has to count their pennies these days,” he said.

A ten week public consultation is being launched today over the minimum pricing proposal but we all know that ‘public consultations’ are just politically correct box ticking exercises.

“Yes, we have a binge drinking problem, mainly involving young people, but minimum pricing will not solve it,” said Mr Nuttall.

The Government will consult on a minimum price of 45p per unit despite warnings that the measures could squeeze the weekly supermarket bills of moderate, middle-class drinkers.

The plans would effectively end buy-one-get-one free offers for supermarket drink and substantially raise the price of spirits.

The price of a bottle of gin could rise by a fifth under David Cameron’s scheme, the drinks industry has warned. Whisky may cost 10 per cent more.

The proposed price is higher than the 40p that the Prime Minister publicly backed earlier this year, and led to predictions that any floor price will soon rise again.

Ministers have insisted that setting a minimum unit price will primarily affect strong lagers and ciders and other low-cost, high-alcohol drinks.

But according to the Wines and Spirits Trade Association, a 45p rate would also mean significant increases in more popular products, including bottles of spirits.

The association has calculated that a 45p unit price would mean that 75 per cent of all gin sold in supermarkets and off-licences would become more expensive.

Tesco currently sells 75cl bottles of its Everyday Value gin for £9.85. The industry said that a 45p per unit floor price would increase the price of that bottle to £11.81, a rise of 20 per cent. If the minimum was 50p, as advocated by medical groups, that bottle could cost £13.13.

The association said that a 45p minimum price would increase the cost of 52 per cent of all alcoholic drinks bought in shops. It is also estimated that a bottle of wine now sold at £3.69 could rise to £4.39.

Consultants warn care hit by expensive deals on supplies

Many NHS hospitals in England are paying over the odds for expensive supplies- a snapshot investigation suggests.Consultants warn care hit by expensive deals on suppliesThe assessment by consultants Ernst & Young highlights big variations in the prices paid for a range of medical products.

The findings come despite long standing concerns from MPs and the National Audit Office over wasteful procurement.

The Department of Health says it is developing a barcoding system to help hospitals negotiate better prices.

The NHS is coming under enormous pressure to find savings. But nearly two years after the National Audit Office (NAO) highlighted waste in procurement, this assessment suggests some hospitals are still getting poor deals on supplies.

In February last year the NAO concluded better procurement could save the health service half a billion Pounds a year.

For this investigation, Ernst and Young looked at 10 NHS hospital trusts out of 166 – and found the prices paid for the same box of medical forceps ranged from £13 to £23. For an identical box of blankets the lowest price was £47, the highest more than £120.

The assessment revealed big variations across a range of other medical supplies including knee implants, syringe pumps and warming blankets.

Joe Stringer, from Ernst & Young, said the discrepancies were “staggering”, and he warned that the problem was getting worse. Trusts, he said, were reluctant to share information for fear of helping their competitors.

“With the NHS facing sustained pressure to contain rising costs and demand within a flat budget, transparency must be introduced across the board.  The consequences of inaction in the back office will only be felt more acutely in front line care.”

Earlier this year the government said better purchasing could save the health service in England at least £1.2 billion over the next four years, and announced plans for a “world class” procurement system. This included a cash fund to allow bulk-buying of equipment such as MRI scanners and ultrasound machines.

Responding to the new findings, the health minister Lord Howe said wasteful procurement was unacceptable.

“We are working on introducing a new barcoding system that will increase transparency, save money and make care safer.  The new system will take time, but ultimately it will result in the kind of price comparison website that already exists in other sectors, like supermarkets, and will revolutionise the tracking, safety and use of clinical products bought by the NHS.”

The chief executive of the Foundation Trust Network, Chris Hopson, said trusts understood the importance of good procurement.

“NHS Trusts know that they need to improve how they buy supplies to get best value and they are making good progress through a variety of different routes including commercial purchasing consortia and regional NHS procurement hubs.

“Price comparison websites and better public information on how Trusts are performing in this area will undoubtedly help drive further improvement.”

UK patients will access their NHS records online in three years

NHS patients will be able to access to their NHS records online in the next three years under plans to be announced by the Government.UK patients will access their NHS records online in three yearsDoctors’ surgeries will have to set up services to allow anyone to see their health files, book appointments and order repeat prescriptions on the internet.

People will also be given detailed information on the survival rates and success of treatments in their areas, so that they can choose to go to more “successful” hospitals or doctors if they wish.

A Government source said: “Many people are juggling longer working hours with caring for children and older relatives.  Looking after their own health, and the health of their families needs to be as straightforward as possible.”

“Looking after our health should be easy — in an age where people can do their banking or shopping online, it should be just as simple to view your health records, order a repeat prescription or book a GP appointment.”

The move for online health records comes despite the decision by Andrew Lansley, the previous health secretary, to cancel a massive NHS national database amid fears over its cost and security concerns.

However the new online plan will be operated at a local level. Patients will have to opt-in to the system to read their records over the internet. Paramedics and other medical experts will also be given access to the records of those making use of the system.

It will be introduced before the next election in 2015 in a move described as a “watershed” for the NHS.

The proposal is one of the key planks of the new NHS mandate being announced by the Government.

The mandate is a set of instructions given by ministers to improve the health service following the Coalition’s reforms. Under the plans, people will be able to enter their postcode into a new system to assess the effectiveness of health treatment in their local areas.

A scheme allowing people to compare the success of individual surgeons or other doctors will also be extended.

From: http://www.dyenamicsolutions.com/uk-patients-will-view-their-nhs-records-online-in-three-years

Cardiac arrest survival rates dire and not improving

Cardiac arrest survival rates across Britain are “dire” and show no sign of improving, campaigners warned.Cardiac arrest survival rates dire and not improvingOfficial figures show that fewer than one in five people who suffer a cardiac arrest receive adequate care from bystanders.

The NHS statistics also found that in some areas, just one in 14 people, who collapse with a cardiac arrest, survive such an incident.

Campaigners described the figures as “dire” and urged people to undertake vital CPR training.

Since April last year, when the Department of Health began collecting data on cardiac arrests, survival rates have shown no improvement.

Patient records kept by the country’s 12 regional ambulance services, show that fewer than 20 per cent of those who suffered a cardiac arrest – and were sent to hospital by paramedics – survived.

Survival rates peaked at 28 per cent in May last year but have since deteriorated and have failed to rise above 20 per cent, according to The British Heart Foundation (BHF) , which compiled the figures.

In the East Midlands, ambulance crews saved just three in 40 people – a 7.5 per cent survival rate. Survival chances are highest in Wiltshire and Gloucestershire, where one in three such patients survived and were later discharged from hospital.

In June only 58 of the 314 casualties attended by paramedics lived across England – just 18.5 per cent.

Separate figures show that medical professionals attend about 30,000 “out-of-hospital” cardiac arrests in Britain every year.

Prof Peter Weissberg, the BHF’s medical director, warned there had been “no sustained improvement in survival rates from witnessed out-of-hospital cardiac arrests, where CPR and a defibrillator could have helped”.

“Many people can survive an out-of-hospital cardiac arrest but only if they receive immediate CPR,” he said.

“Sadly, in the vast majority of cases in the UK this doesn’t happen.  We know Hands-only CPR works but more bystanders need to step in if we’re ever to see the majority become the minority.”

Last year the organisation launched its educational advertisement starring Vinnie Jones, the British actor. The organisation knows of 28 people who have survived a cardiac arrest because somebody they know had seen the campaign’s advertisement.

The video, which has been viewed online more than 2,4 million times, shows how hard and fast chest compressions need to be to the tune of the Bee Gees’ disco classic Stayin’ Alive. The charity is launching a new phase of the campaign.

Earlier this year Fabrice Muamba, a player renowned throughout the game for his fitness, suffered a massive cardiac arrest as Bolton played Tottenham in an FA Cup quarter final, in front of 35,000 spectators and millions watching on television.

A cardiac arrest is different from a heart attack. The heart suffers an electrical malfunction, which causes it to beat irregularly.  Casualties become unconscious and lose a pulse within seconds and can die within minutes unless they receive treatment.

A heart attack is triggered by a loss of blood flow through a blocked artery.

Health tourism clampdown to end NHS world health service

Foreigners could be forced to pay for GP appointments under proposals ministers are considering to make sure the NHS does not end up “serving the health needs of the world”.Health tourism clampdown to end NHS world health serviceAt the moment GPs must treat almost anybody who comes into their surgery.

This year new guidance was issued stipulating that “nationality is not relevant” when it comes to registration, and stating doctors had to register those from anywhere on the globe to “promote human rights and public health”.

Non-EU nationals are meant to pay for hospital care, but there is growing concern that the system of checking is lax and open to “abuse” by health tourists.

Those from EU countries are entitled to free NHS care under reciprocal arrangements.

Now Earl Howe, the health minister, has said he is considering extending charges for those not from the European Union, to cover GP appointments.

In a response to a parliamentary question, Lord Howe said: “Provision exists within primary legislation to allow the introduction of a system of NHS charges covering treatment for GP services.

‘As part of the department’s review of charging of overseas visitors for NHS care, consideration is being given to whether to extend charging for NHS treatment to primary care.’

He continued: “No decision has yet been taken on any option and this will also be subject to consultation across a number of related matters.”

According to figures obtained from NHS trusts, English hospital trusts last year wrote off £42 million that they had failed to claw back from foreign patients.

Lord Howe made clear the Government’s intention to clamp down on health tourism, which has reached such a level that some nickname the NHS the ‘World Health Service’.

He said: “The NHS is not there to serve the health needs of the world and we will not tolerate abuse of the system.  Last year we began a wholesale review of the current system to address concerns about access, cut down abuse and consider how best to ensure those who should pay do so.”

A Department of Health said hospitals had a “legal duty” to recover charges made to foreign patients, and noted that the Government had recently amended immigration rules so those with NHS debts exceeding £1,000 could be refused a new visa.

However, any move to charge foreigners for GP appointments will be resisted by the British Medical Association.

Dr Richard Vautrey, deputy chairman of its general practice committee, said: “We think the position should remain the same.  We don’t believe there is widespread abuse and GPs are not an arm of the Border Agency.”

He said introducing fee arrangements would be extremely complicated “and end up causing a whole range of unintended consequences”.

He explained: “There is the potential that some people who need urgent care will not get it, and that will lead to quite serious consequences.

“You only need to turn away one person who subsequently dies from meningitis, and you will regret it for the rest of your career.”

From: http://www.telegraph.co.uk/Health-tourism-clampdown-to-end-world-health-service

DNA code of MRSA superbug cracked by scientists

The DNA code of the superbug MRSA has been cracked by scientists so that their future spread can be halted more quickly.DNA code of MRSA superbug cracked by scientistsA new device can identify specific bacterial strains from their genetic codes so experts can target the transmission path of the infection and cut it off.

In an early test of the technology, researchers halted an outbreak of the MRSA superbug in a special care baby unit at the Rosie Hospital in Cambridge.

It is believed to be the first time DNA sequencing has been used to contain an infectious disease outbreak at a hospital.

The scientists are now developing the concept into a simple system that can be used routinely by hospital staff who are not genetics experts.

In future, it could be used to combat many kinds of infection outbreak, and also help doctors decide the best way of treating patients.

Professor Sharon Peacock, from Cambridge University, who led the research team, told a news briefing in London: ”What we’re working towards is effectively a ‘black box’. Information on the genome sequence goes into the system and is interpreted, and what comes out the other end is a report to the health care worker.

”It could, for example, determine the species of the bacterium; it could determine antibiotic susceptibility, and it could provide information about what genes are present that are often associated with poor outcomes in patients.

”It will give information about how related that organism is to other organisms within the same setting, giving an indication of the capability of transmission from one patient to another.”

A report on how the baby unit outbreak was brought under control appears in the latest issue of the journal The Lancet Infectious Diseases.

The scientists used a technique called rapid whole genome sequencing, which maps an organism’s entire genetic code, to analyse MRSA bacteria taken from 12 babies.

MRSA (methicillin resistant Staphylococcus aureus) is an antibiotic resistant form of a common skin bug that can cause potentially deadly wound infections in hospitals.

Standard procedures had not been able to show whether a genuine outbreak had occurred, or whether the babies had all coincidentally been exposed to MRSA.

The team was quickly able to confirm that 10 babies were part of an MRSA outbreak involving a previously unknown strain of the bug.

Measures were introduced to clear MRSA from carriers and deep-clean wards, but two months later a new infection case was identified in the baby unit.

DNA sequencing showed it was caused by the same strain identified earlier, carried to the ward by one of 154 screened health care workers.

Co-author Dr Julian Parkhill, head of pathogen genomics at the Wellcome Trust Sanger Institute in Hinxton, Cambridgeshire, said: ”The staff member was decolonised and went back to work, and we believe this brought the outbreak to a close.”

He said he expected the cost of whole genome sequencing of bacteria to fall from around £100 per sample to £50, and ultimately just ”a few pounds” in the near future.

”People are talking about the thousand dollar human genome,” he added. ”If you can do the human genome for a thousand dollars you can do a bacterial genome for one dollar.”

The MRSA outbreak at the Rosie Hospital, part of Cambridge University Hospitals NHS Foundation Trust, was estimated to have cost the NHS around £10,000. This was double the cost of the DNA sequencing, said the researchers.

Free: http://www.telegraph.co.uk/Scientists-crack-DNA-code-of-MRSA-outbreak-to-halt-superbug

NHS wastes logo checking ‘head of brand’ on almost £100,000

The NHS has employed a ‘Head of Brand’ on a salary of almost £100,000 a year to ensure its logo is being used appropriately.NHS wastes logo checking 'head of brand' on almost £100,000Sir David Nicholson, chief executive of the NHS, on Tuesday denied it was “frivolous” waste of money but admitted the job title was “rather unfortunate”.

The Leeds based position at the NHS Commissioning Board, which has a salary range of £77,079 to £97,478, has already been filled from within the health service.

Nicola Plumb, formerly deputy director of communications at the NHS Commissioning Board, has taken on the post in the last few weeks. Before that Ms Plumb was Sir David’s communications advisor.

Labour MP Barbara Keeley told Sir David it was the sort of thing that made the public “see red” as he faced questions from the Commons health select committee on efforts to make massive savings.

Sir David said the position was needed to make sure private providers “understand what it means to be part of the NHS…the culture and the values and treat their patients accordingly”.

“It’s really important to us and for patients to know that these organisations are signed up to these values and principles”, when they used the NHS logo, he told MPs on the Health Select Committee.

Ms Plumb, has a degree in politics from Durham University, an MA in public policy from York University and a diploma in strategic marketing from the Chartered Institute of Marketing.

She has recently joined Twitter, the social networking site, on which she describes herself as “passionate about the NHS”. However, she has yet to ‘tweet’ a message.

Jamie Reed, the shadow health minister, said people would be “shocked” at news of the appointment, a day after the Royal College of Nursing announced 6,000 nursing jobs had been lost since the general election.

He said: “The Government has rashly forced parts of the NHS into the private sector and they’re now hiring staff to check who’s using the trusted NHS logo.  The NHS frontline is taking a battering as thousands of jobs are axed and ministers should get a grip on that instead.”

Speaking after the hearing, Worsley and Eccles South MP Ms Keeley said Sir David had “failed in his attempt to defend the development of a unit to promote the NHS ‘brand’ to the public.

“The NHS is a service not a brand,” she said.  “My constituents will be unhappy to see a salary of nearly £100,000 attached to this sort of unnecessary post.That money should be spent on patient services.”

Tim Kelsey, the NHS national director for patients and information, said Ms Plumb would lead a team of customer relations executives who would ensure the board “never loses sight of its responsibility to patients”.

He said: “Their job will be to make sure patients and the public fully understand what the NHS can offer to them, by making sure the NHS communicates with them in ways which make sense to them and which they can access easily.

The NHS is “sleepwalking” into a nursing crisis with thousands of frontline posts lost and training positions axed

The Royal College of Nursing (RCN) said that despite the Coalition’s promise to protect frontline staff from cuts the NHS workforce has fallen by almost 21,000 since the Coalition Government came to power.The NHS is "sleepwalking" into a nursing crisis with thousands of frontline posts lost and training positions axedThis includes a loss of more than 6,000 qualified nursing posts – from a total of 312,000 nursing posts in the NHS.

The RCN’s report also warns that parts of the health service face the prospect of nursing shortages within three years as thousands of training posts are slashed, meaning trusts will have to recruit from overseas.

Patient safety will be seriously undermined by falling numbers of nurses, with the RCN’s chief executive warning that standards of care “are going to get a lot worse”.

The nursing union has been tracking job cuts since the Coalition came to power in May 2010. It has found that about 1,000 posts are being earmarked as “at risk” by NHS trusts every month as they try to find savings of £20 billion during this parliament.

As well as job losses, the number of new nurses being trained has fallen sharply, by 14 per cent in just two years.

In London, training places for adult nurses have fallen by 21 per cent, which will lead to substantial shortages by 2015 – highlighting failures in long-term workforce planning, warns the RCN. District nursing is heading towards crisis, as numbers of nurses have plummeted by a third since 2001 to 8,000.

The RCN questions how the NHS can re-focus care from hospitals to the community – essential for improving patient outcomes and saving money – if the cull of district nurses continues.

Nurse leaders warn that the Government will soon be stranded in a “perfect storm” of an ageing population with increasing numbers of long-term conditions without enough nurses safely to care for patients.

Peter Carter, the RCN’s chief executive, said: “London is facing a workforce crisis within three years. The remedy will be to go overseas to countries like the Philippines to raid their workforce again, and an over-reliance on agency and temporary staff – in order to bail out the Government’s poor workforce planning.” He added: “The standards of care are under huge strain across England and if this trajectory continues unchecked then things are going to get a lot worse. There is no rogue information in our data. This is not the worst-case scenario: it is the declared scenario from trusts.”

The pledge to protect frontline staff was a key Coalition promise even as it announced the need to save £20bn to cope with increasing healthcare demands as budgets flatline after years of record investment.

But official figures reveal that there were almost 6,150 fewer full-time equivalent qualified nurses in July this year compared with May 2010 despite Coalition promises to protect frontline staff. In total, there are 20,790 fewer NHS staff, but the number of doctors has increased by 7,000, according to the NHS Information Centre.

The long-awaited report into the Mid Staffordshire hospital scandal is expected to recommend minimum nursing levels to improve patient safety in hospitals. On average there is one qualified nurse to every four paediatric patients, but only one for every nine elderly patients.

Yet there is compelling evidence from King’s College London that patient outcomes improve when science is applied to nurse-patient ratios – in short, making sure there are enough nurses safely to care for patients in different settings.

From: http://www.independent.co.uk/fears-for-patient-safety-as-60000-nhs-jobs-face-the-axe

Cancer overtakes heart disease as number one UK killer

Cancer has overtaken heart disease as the UKs number one killer, new figures released by the Office for National Statistics (ONS) show.Cancer overtakes heart disease as number one UK killerAlmost a third of people now die of one kind of cancer or another, according to mortality statistics for 2011.

The figures show that cancer was recorded as the underlying cause of death in 143,181 people in 2011, or 29.6 per cent of total deaths in England and Wales.

Cardiovascular disease was recorded as the underlying cause in 139,706 people, or 28.8 per cent of deaths.

This is a turnaround in position from 2010, when 32.0 per cent died of cardiovascular diseases and 28.7 per cent died of cancer.

These figures llustrate that switch is due principally to the drop in deaths from heart disease and stroke, rather than the rise in cancer.

In particular people are now far less likely to die of heart attacks than they were 10 years ago, thanks primarily to better emergency care but also to healthier lifestyles.

Death rates from heart attacks have halved in a decade, an Oxford University study published in January showed.

The decline has been steepest among those suffering heart attacks in middle age- with more people surviving to old age, more are living to develop various types of cancer.

Although cancer has become the number one cause of death, survival rates for almost all cancers are improving and have been improving for years, due to better diagnosis and treatment.

However, ministers admit British survival rates are not as good as the best-performing European countries.

They estimate another 5,000 lives a year could be saved if rates were brought into line with the likes of Sweden and Germany.