David Bowie thanked by end of life care doctor

A doctor specialising in end of life care has  thanked David Bowie helping people to talk about death.

A doctor specialising in end of life care has thanked David Bowie helping people to talk about deathDr Mark Taubert, palliative care consultant at Velindre NHS Trust in Cardiff, said it prompted a “weighty” discussion with a dying woman.

His letter, published on the blogs website page of the British Medical Journal (BMJ), has been retweeted by Bowie’s son, Duncan Jones.

The singer died from cancer aged 69.

Mr Jones had not tweeted since confirming his father’s death, which happened in New York on 10 January.

But he retweeted a link to the letter, where Dr Taubert described the conversation he had with the woman after she had been told her cancer had spread and that she would not live much longer than a year.

Starting the letter with “Dear David”, Dr Taubert wrote: “We discussed your death and your music, and it got us talking about numerous weighty subjects, that are not always straightforward to discuss with someone facing their own demise.

“In fact, your story became a way for us to communicate very openly about death, something many doctors and nurses struggle to introduce as a topic of conversation.”

He went on: “We talked about palliative care and how it can help.

“She told me about her mother’s and her father’s death, and that she wanted to be at home when things progressed, not in a hospital or emergency room, but that she’d happily transfer to the local hospice should her symptoms be too challenging to treat at home.

“We both wondered who may have been around you when you took your last breath and whether anyone was holding your hand.

“I believe this was an aspect of the vision she had of her own dying moments that was of utmost importance to her, and you gave her a way of expressing this most personal longing to me, a relative stranger.”

Dr Taubert also said dying at home and the last photos of Bowie carrying “off a sharp suit” would help people deal with any fears they had about the last weeks of life.

“You looked great, as always, and it seemed in direct defiance of all the scary monsters that the last weeks of life can be associated with,” he added.

Overseas nurses denied NHS jobs

Thousands of nurses were denied permission to work in England last year- despite hospitals facing staff shortages.

Thousands of nurses were denied permission to work in England last year- despite hospitals facing staff shortages
The Royal College of Nursing (RCN) has found that the refusals have hit high profile hospitals in Cambridge, Newcastle and Manchester.

A Freedom of Information request to the Migration Advisory Committee (MAC) found more than 2,341 refusals.

The RCN asked for the number of applications to allow overseas (non-European Union) nurses to work in England between April and November 2015 and the number refused.

It found that East Lancashire Hospitals NHS had the highest number of refusals with 300 out of 300 applications.

The research found that Brighton and Sussex University Hospitals and North Cumbria University Hospitals both had about 240 refusals.

Snapshot of FOI request results- total application for restricted certificates to allow overseas nurses
NHS Trust                     Total applications                            Total refused
Newcastle Hospitals                127                                                 85
The Queen Elizabeth Hospital King’s Lynn     157                    82
Central Manchester University Hospitals        195                    75
Cambridge University Hospitals (including Addenbrooke’s)     123     66
Bedford Hospital                     150                                                 45
Luton and Dunstable Hospital                             31                    15

Nursing was temporarily placed on the MAC shortage occupation list (allowing more overseas nurses) in December.

Janet Davies, chief executive of the RCN, said: “These figures show that when nursing is not on the list, many trusts are unable to recruit enough nurses, which could have an impact on patient care.”

Catherine Morgan, director of nursing at The Queen Elizabeth Hospital in King’s Lynn, she had been prevented from recruiting a number of overseas nurses.

“It is frustrating because we are running a hospital and do want it to be safe, and we had the opportunity to recruit from India and the Philippines and we had nurses keen to come over but haven’t been able to bring them over,” she said.

A Department of Health spokesman said: “The MAC is currently reviewing the shortage occupation list. Staffing is a priority and there are already more than 8,500 more nurses on our wards since 2010 and 50,000 more nurses in training.

“We want more home-grown staff in the NHS and our recent changes to student funding will create up to 10,000 more nursing, midwifery and allied health professional training places by 2020.”

Hospital staffing levels affect death rates

Fewer patients die after emergency surgery in hospitals that have more doctors and nurses.

Fewer patients die after emergency surgery in hospitals that have more doctors and nursesThe research, published in the British Journal of Anaesthesia, analysed data involving nearly 295,000 patients.

The findings stood despite patients at these hospitals being sicker and suffering more complications.

Researchers also found death was more likely following a weekend admission, which they said showed staffing was factor in the so called weekend effect.

That is the term given to the on going debate about Saturday and Sunday services.

Ministers in England are looking to improve staffing levels on the weekend, citing previous research as the basis for their policy.

Higher rates of death following weekend admissions and among babies born at weekends have been identified in two papers published by the British Medical Journal since the summer.

While this study confirms what would be expected – better resourced hospitals provide better care – it is this link with weekend care that has sparked interest.

The St George’s University of London team looked at what factors were behind variation in death rates following emergency abdominal surgery at 156 NHS trusts between 2005 and 2010.

This included surgery on ulcers, to remove appendixes and repair hernias.

While only a small number died within 30 days – just over 12,000 patients – there were small but significant variations in the death rates between those hospitals with the highest level of staffing and those with the lowest.

The third of hospitals with the lowest number of doctors per bed had death rates 7% higher than the third with the most. The difference was the same for nurse staffing levels.

Weekend admissions for emergency surgery led to an 11% increased risk in death compared with weekdays.

Lead researcher Dr Peter Holt said it was likely there would be a number of factors behind the higher death rates at weekends, but “clearly” staffing was one. “We need to ensure the whole system is safe seven days a week,” he said.

But he added the government needed to focus on getting emergency care right before even thinking about non-urgent services.

Royal College of Nursing general secretary Janet Davies said the study highlighted the importance of supporting “hard-working” staff.

“The NHS could reduce its staff turnover and save on the cost of temporary staff if it valued and invested in its permanent staff,” she said. “The benefits for all – staff, patients, and the NHS itself would be immeasurable.”

Health Direct praises hard working doctors and nurses in the NHS- but points out the current discussions on junior doctors is just one aspect of increased effectiveness- 7 day week diagnostics and consultants also needs to be addressed.