ESA benefit payments- retests axed for chronically ill claimants

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Work and Pensions Secretary Damian Green said it was pointless to re-test recipients of Employment and Support Allowance (ESA) with severe conditions and no prospect of getting better.

More than two million people receive ESA, which is worth up to £109 a week. The move has been welcomed by charities supporting those with severe illness.

Shadow work and pensions secretary Debbie Abrahams said it was “a welcome U-turn” by the government, but “the devil was in the detail”. What about mental health conditions, conditions that are fluctuating, conditions that may not necessarily have a physical manifestation?” she said.

Applicants for ESA have to undergo a work capability assessment to find out if they are eligible and they are re-tested to ensure their condition has not changed. Some are re-tested every three months and others up to two years later.

Under the government’s change, those who are deemed unfit for work and with conditions that will not improve will no longer face re-testing.

Illnesses such as severe Huntington’s, autism or a congenital heart condition are among those that are likely to qualify for continuous payments without reassessment. The criteria will be drawn up with health professionals.

Mr Green said a “key part” of making sure those who were unable to work received “full and proper support” included “sweeping away any unnecessary stress and bureaucracy”.

Currently, those in the “work-related activity group” – deemed unable to work at the moment but capable of making some effort to find employment – receive up to £102.15 a week in ESA payments.

Those in the “support group” – deemed unable to work and not obliged to do anything to improve their chances of finding work – receive up to £109.30 a week.

From April 2017, payments will fall to £73 for new claimants in the “work-related activity” category as ministers argue that too few people in the category are moving into work.

Former Work and Pensions Secretary Iain Duncan Smith, welcomed the “progressive” reform to the re-testing regime, which he had set up when in office.

“I hope that the government will… move on to the fuller reform… where we lock together with the health department much more to be able to get a better health assessment of people, rather than a just strictly work assessment.”

Tim Nicholls, policy manager at the National Autistic Society, said ESA was a vital benefit for those unable to work, covering basic daily living costs such as food, heating and clothes.

“The flawed assessment process can be highly stressful for autistic people who can experience high levels of anxiety meeting new people or when their routine is broken, particularly when the stakes are so high,” he said. “We will be looking out for more details from the government.”

Over 1000 NHS ‘never events’ a disgrace says Patients Association

Over 1,000 NHS patients have suffered from medical mistakes so serious they should never have happened.

Over 1,000 NHS patients have suffered from medical mistakes so serious they should never have happenedThe so called never events included the case of a man who had a whole testicle removed rather than just a cyst. In another, a woman’s fallopian tubes were taken out instead of her appendix.

Other “never events” included the wrong legs, eyes or knees being operated on and hundreds of cases of foreign objects such as scalpels being left inside bodies after operations.

Whilst NHS England insisted that such events were rare- the Patients Association said that they were a “disgrace”.

The research by the Press Association analysis also found that patients’ lives were put in danger when feeding tubes were put into their lungs instead of their stomachs.

Patients were given the wrong type of blood during transfusions and others were given the wrong drugs or doses of drugs.

The analysis showed there were:

  • 254 never events from April 2015 to the end of December 2015
  • 306 never events from April 2014 to March 2015
  • 338 never events from April 2013 to March 2014
  • 290 never events from April 2012 to March 2013

Katherine Murphy, chief executive of the Patients Association, said: “It is a disgrace that such supposed ‘never’ incidents are still so prevalent.

“How are such basic, avoidable mistakes still happening? There is clearly a lack of learning in the NHS. It is especially unforgivable to operate on the wrong organ, and many such mistakes can never be rectified.”

NHS England insisted never events were rare – affecting one in every 20,000 procedures – and that the majority of the 4.6 million hospital operations each year were safe.

A spokeswoman said: “One never event is too many and we mustn’t underestimate the effect on the patients concerned.

“To better understand the reasons why, in 2013 we commissioned a taskforce to investigate, leading to a new set of national standards being published last year specifically to support doctors, nurses and hospitals to prevent these mistakes.

More than 400 people have suffered due to “wrong site surgery”, while more than 420 have also had “foreign objects” left inside them after operations – including gauzes, swabs, drill guides, scalpel blades and needles.

Others have been given the wrong type of implant or joint replacement, some patients have been mixed up with others, and some patients have been given the wrong type of blood during a transfusion.

Some patients have also been given far too high doses of drugs, including oral methotrexate, which is used for the treatment of severe arthritis, psoriasis and leukaemia.

Health Direct notes that the vast majority of the 4.6 million hospital operations each year are safe- but if a plane crashed after every 20,000 flights then people might stop flying.

Pharmacists could help ease GP pressures

An army of pharmacists could step in to help treat patients at GP practices across England leading health professionals plan.

Pharmacists could help ease GP pressuresThe proposals focus on pharmacists seeing patients with common ailments directly – not on setting up shops within surgeries.

Pharmacists would provide health advice and be able to prescribe medication once extra training had been completed.

Charities welcomed the move but say patient safety must be a priority.

NHS England officials said the idea complemented their plan to increase staffing in GP surgeries. But it is not yet clear whether they will push the proposals forward.

The plans, aimed at every practice in England, have been put forward by the Royal College of General Practice (RCGP) and Royal Pharmaceutical Society (RPS).

It could mean when patients call up their surgeries they are offered an appointment with a pharmacist, general practitioner or practice nurse.

Those who opt to see the pharmacist could get advice about their symptoms and discuss troubling side-effects of medication, as well as getting help with their repeat prescriptions.

People with long term conditions are likely to benefit the most under the plans – those on multiple medications could get help streamlining their daily drugs.

In a handful of practices pharmacists already help with the management of conditions such as diabetes and asthma, for example, helping patients get annual checks.

Under the proposals more practices could do this. And with additional training some pharmacists would prescribe commonly used medicines such as antibiotics.

Any patient who still needed advice from a doctor could still be seen by their GP.

GP and pharmacist leaders say the move is needed as practices face staff shortages and are struggling to meet the demands of an ageing population.

The RCGP predicts that on some 67 million occasions this year, patients will have to wait more than one week to get an appointment.

In contrast, there is currently an over-supply of skilled pharmacists who could ease this burden experts argue.

Initial pharmacist training lasts one year longer than basic nursing qualifications and one year less than medical school for doctors.

Dr Maureen Baker, chairwoman of the RCGP, said: “Even if we were to get an urgent influx of extra funding and more GPs, we could not turn around the situation overnight due to the length of time it takes to train a GP.

“Yet we already have a ‘hidden army’ of highly-trained pharmacists who could provide a solution.

“This isn’t about having a pharmacy premises within a surgery, but about making full use of the pharmacist’s clinical skills to help patients and the over-stretched GP workforce.”

David Branford, of the RPS, said: “Pharmacists can consult with and treat patients directly, relieving GPs of casework and enabling them to focus their skills where they are most needed, for example on diagnosing and treating patients with complex conditions.

“Pharmacists can advise other professionals about medicines, resolve problems with prescriptions and reduce prescribing errors.”

These types of partnership already exist in a handful of practices but experts hope the plan will eventually be rolled out across the UK.

Katherine Murphy, of the Patients Association said: “Any action that can, at the very least, ease the problem is to be welcomed and this plan for doctors and pharmacists to work together is an innovative step in the right direction.

“Of course, there must always be concerns that the pharmacists who undertake this work have the relevant skills and qualifications to treat patients, and with care.”

Patients visit A&E up to 50 times a year

Some patients are going to Accident and Emergency (A&E) units more than 50 times a year.
Patients visit A&E up to 50 times a yearData from 183 sites obtained under the Freedom of Information Act revealed nearly 12,000 people made more than 10 visits to the same unit in 2012-13.

And a small number of those – just over 150 – attended more than 50 times.

Doctors warned that the issue, while confined to a minority of patients, was adding to the mounting pressures on the system this winter.  Many hospitals are already struggling to hit their waiting time targets- without these extra issues.

In England, the four hour target was missed in the first two weeks of December, but the numbers attending A&Es eased over the Christmas period and the target has been met for the past fortnight.

However, that overall figure masks the struggle the biggest units are facing.

Of the 144 major centres, more than 60 failed to hit the target during the Christmas week despite the number of patients dropping by nearly 10%.

Patients Association chief executive Katherine Murphy said: “These figures are of great concern and provide yet more proof that our already overstretched A&E services are being put under increasingly severe strain.

“It needs to be recognised that every inappropriate attendance at the A&E would detract health professionals from attending to the genuine and often life-threatening emergencies,” she added.

She said improving access to GPs could make a big difference – before Christmas, official NHS data showed the number of people waiting longer than a week to be seen by a GP was growing.

A spokeswoman for NHS England said the figures should be seen in context – in England alone there were more than 21 million visits to A&E units last year.

“The figures presented here suggest that the number of people attending A&E frequently is relatively small when considered against the big picture.”

Meanwhile, a spokeswoman for the Department of Health said steps were being made to improve access to community care through the launch of a £3.8 billion joint pot in April 2015 to encourage the NHS and local government to work together.

Friday is worst day of the week for surviving surgery

Health Direct wishes you good luck if you are going under the knife today- you have a 44% gerater chance of dying than if you had your operation on a Monday.
Friday is worst day of the week for surviving surgeryPeople who have surgery towards the end of the week are more likely to die than those who have procedures earlier on, researchers say.

A British Medical Journal report into non-emergency operations in England, suggests the overall risk of death from such planned procedures remains low, but it shows “unacceptable” variation in survival rates through the week, a leading body of UK surgeons says.

Researchers from Imperial College London gathered data from all non-emergency surgery undertaken by the NHS in England in 2008-11.

Looking at some 4 million operations they found more than 27,000 deaths within a month of surgery, putting the average risk of death at 0.67%.

The researchers say they are concerned about the significant variation over the week, with the risk lowest for surgery carried out on Monday and then increasing with each subsequent day to peak at the weekend.

The paper shows people who have their operations on Friday are 44% more likely to die than those who have a procedure on Monday.

The researchers say the findings may be due to a poorer quality of aftercare at the weekend, when people who have their surgery later in the week need it most.

Dr Paul Aylin, lead author of the study said: “The first 48 hours following a procedure is most critical and when things can go wrong, such as bleeding and infections. If you don’t have the right staff, this is likely to contribute to things being missed.

“If I were a patient I would take comfort from the fact the overall death rate is low, but if I were to have an operation towards the end of the week I would be interested in whether the hospital had the appropriate services to look after me throughout my recovery, including at the weekend.”

He says the higher risk of death could be due to fewer doctors, nurses and many non-clinical staff being available on Saturdays and Sundays.

And the study suggests the risk of dying was higher still for surgery conducted over the weekend – 82% greater than on Monday – though the researchers caution only a minority of planned operations currently take place on Saturdays and Sundays.

Previous research looking at emergency procedures shows people are at greater risk of death if admitted during the weekend, but this is the first large study to look at planned operations, ranging from high-risk procedures such as heart bypass grafts to routine hernia repairs.

Katherine Murphy, chief executive of the Patients Association, said: “Whilst this research once again highlights the NHS’s weekend malaise and makes for concerning reading, it unfortunately doesn’t identify a new problem, but rather a failure to address an issue that has repeatedly been highlighted in the past…

“It is a shame that, despite the publication of hundreds of pages worth of reports and recommendations, so little action has been taken to actually address the problems identified.”

Organ donations rise in UK tripled in numbers

The number of living people giving one of their organs to a stranger almost tripled last year in the UK, according to new figures.Organ donations rise in UK tripled in numbersThe Human Tissue Authority (HTA) approved 104 so-called altruistic organ donations in 2012-13 compared with 38 the previous year.

The figures include the first case of someone giving part of their liver to someone they had never met.

Altruistic donations now make up about one in 12 of all living donations.

The total number of living donations, including those to family members or friends, rose from 1,217 to 1,243 over the same time period.

Diana Warwick, chair of the HTA, said donating an organ was a remarkable thing to do.

“Giving someone an organ is a brave and amazing gift. To do it for someone whom you don’t know is doubly so, and the huge increase in people willing to do so is incredible,” she said.

“The HTA works on more – and more complex – living donation cases every year and we expect this to continue. We remain committed to ensuring that people can donate organs with confidence.”

The HTA believes the number of living organ donations is rising, as public awareness spreads.

Lisa Burnapp, lead nurse for living donation at NHS Blood and Transplant, said donors were motivated by a decision to do something genuinely good for someone in need.

“The increase in non-directed altruistic living donors has exceeded all expectations and means that more patients can benefit from a successful transplant and enjoy life with their families and loved ones,” she said.

“This is an incredibly important gift and we are indebted to people who choose to donate in this way.”

There are currently about 10,000 people in need of a transplant in the UK, with three people a day dying due to the lack of suitable available organs, according to NHS figures.

Potential living donors undergo extensive medical and psychological screening.

This includes an independent check, which ensures that the donor understands the risks involved, is not under any pressure, and that no reward has been offered.

Hospitals reveal 750 blunders that should never have happened

More than 750 patients have suffered after preventable mistakes in England’s hospitals over the past four years.Hospitals reveal 750 blunders that should never have happenedThe incidents, such as operating on the wrong body part or leaving instruments inside patients, are categorised by the Department of Health as “never events”.

This means they are incidents that are so serious they should never happen.

NHS England admitted the figures were too high and said it had introduced new measures to ensure patient safety.

The department has categorised 25 incidents that should never happen if national safety recommendations are followed by medical staff. The BBC discovered through Freedom of Information requests to NHS trusts that the majority of mistakes fell into four categories.

There were 322 cases of foreign objects left inside patients during operations; 214 cases of surgery on the wrong body part; 73 cases of tubes, which are used for feeding patients or for medication, being inserted into patients’ lungs; and 58 cases of wrong implants or prostheses being fitted.

He argued that hospitals have no incentive to report “never events” because they may have to reimburse the cost of the procedure to the NHS as well as paying for the patients’ long-term care.

Horrific as these incidents are, it is important to put them in context. On average each year there are 4.6 million hospital admissions to the NHS in England that require surgery. The NHS says the risk of a “never event” happening to you is one in 20,000.

Dr Mike Durkin, director of patient safety for NHS England, said the 700 “never events” were “too many”. He said: “One is too many in any week, in any day, in any hospital.”

He added that NHS England had started collating the data to help educate staff on better practice.

The World Health Organisation’s patient safety checklist has also been adapted for use in England and Wales.

A&E- accident and emergency facing serious problems

Accident and Emergency (A&E) departments are facing a “serious problem” a health minister has said, after NHS chiefs ordered urgent action to tackle growing pressures.A&E- accident and emergency facing serious problemsRising attendances have meant A&E units in England have started struggling to hit the four hour waiting time target.

The problem has got so bad that NHS England has pledged extra money to help hospitals that are struggling.

But Health Minister Anna Soubry warned there would be “no quick and easy solution”.

She said: “We have a serious problem, we’ve had a problem for a while. If you look at the number of people presenting to A&E it’s grown by a million in just the last year.”

“And unfortunately unless we take urgent action, which we’ve been doing, it’s a problem which will grow. It’s very complicated. There is no quick and easy solution.”

It has been clear for some time that pressures have been growing in A&E.  For the past decade the numbers attending the units have been rising year by year. There are now more than 21 million visits annually – up 50% in a decade.

There is a combination of reasons why they have grown, including a rise in number of people with chronic conditions, such as heart disease, that end up having emergencies; the ageing population; and problems accessing out-of-hours GP care. A&E units have also had problems recruiting middle-grade doctors, which creates staffing problems.

But until recently, hospitals had just about been coping. The harsh winter seems to have tipped A&E units over the edge.

In the past few months, the waits that patients face have reached their worst levels for a long time.

The four-hour target – 95% of patients have to be seen to in this time – started to be breached in many places. Since the start of last month, the NHS overall has missed it.

There are signs that, with the weather improving so have the waiting times, but not as much as many would have liked.

The problem is that A&E is the safety net of the NHS: the place people go when there is no other option. If it breaks there is a real problem.

The situation prompted the Care Quality Commission to issue a stark warning about the future of A&E.

CQC chairman David Prior said: “Emergency admissions through accident and emergency are out of control in large parts of the country. That is totally unsustainable.”

He added: “The patient or resident is the weakest voice in the system. It is a classic market failure. The user doesn’t know nearly as much as the professionals, even with the internet.”

Soon after the CQC warning was made, NHS England announced it was asking regional health bosses to work together to ensure plans are in place for each A&E in their patch by the end of the month.

Health Minister Anna Soubry says lack of access to GP surgeries is “one of many factors” putting pressure on A&E services.

NHS satisfaction ratings stabilising after record fall

Public satisfaction ratings with the NHS appears to have stabilised following a record fall- according to the British Social Attitudes Survey.NHS satisfaction ratings stabilising after record fallThe poll of more than 1,100 people in England, Wales and Scotland last year found satisfaction with the way the NHS was run stood at 61%.

This followed a record fall from 70%, in 2010, to 58% in 2011.

The drop coincided with the first year of the spending squeeze and controversy over reforms in England.

The 2012 survey, conducted by NatCen Social Research, found that 74% were satisfied with GPs while just 30% were satisfied with social care.  A total of 59% said they were satisfied with A&E units and 56% were satisfied with dentists, it found.

Prof John Appleby, of the King’s Fund think tank, said the poll was an “important barometer”.

“With no real change in satisfaction with the NHS in 2012, this suggests the fall in 2011 was not a blip and that the ground lost may take some time to recover,” he said.

Patients Association chief executive Katherine Murphy said it was important to “look beyond statistics and properly assess patient experience”.

“People are still contacting our helpline every day to tell us that they or a loved one is receiving the most appalling care in hospital.

“These serious issues need to be tackled and the government needs to monitor closely the impact of its reforms.”

A spokesman for NHS England, the new national board which oversees the health service, said: “The changes which have been implemented put patients at the centre of everything the NHS does.

“We are committed to providing the best services possible for patients in England.”

Stafford Hospital aftermath- five more hospital trusts to be investigated

Five other hospitals trusts are to be investigated in the wake of the public inquiry into failings at Stafford Hospital.Stafford Hospital aftermath- five more hospital trusts to be investigatedNeglect and abuse at the hospital led to hundreds of unnecessary deaths between 2005 and 2008.

In response to the inquiry, Prime Minister David Cameron announced that five other hospitals with persistently high death rates would be investigated.

All the trusts named have had high rates for two years.

They are Colchester Hospital University NHS Foundation Trust, Tameside Hospital NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Basildon and Thurrock University Hospitals NHS Foundation Trust and East Lancashire Hospitals NHS Trust.

Death rates are calculated by looking at the number of people that would be expected to die when taking into account the age and disease profile of the local population.

High death rates were one of the factors that triggered the original investigation into Stafford Hospital. While not necessarily proof there is a problem, they are a “smoke alarm” suggesting there could be.

The figures for the five hospitals were already known about within the NHS and were being monitored- however, the intervention has only now been ordered amid mounting concern about levels of care.

Speaking in the Commons, Mr Cameron said: “I have asked the NHS medical director, Prof Bruce Keogh, to conduct an immediate investigation into the hospitals with the highest mortality rates and to check that urgent remedial action is being taken.”

The government’s full response to the public inquiry will come next month, however, it has already been announced that a new post of chief inspector of hospitals will be created in the autumn.

Speaking in the House of Commons, David Cameron said he was “truly sorry” for what happened at Stafford Hospital, which was “not just wrong, it was truly dreadful” and the government needed to “purge” a culture of complacency.

There has been anger from some quarters after nobody has so far lost their jobs as a result of the public inquiry.

Sir David Nicholson has been the focus of anger from families affected by the scandal. He is currently chief executive of the NHS and was in charge of the Regional Health Authority while death rates were high at Stafford Hospital.

Responding to calls for him to go, he said: “I think it’s perfectly understandable, I understand the anger that they feel, the upset that they feel about the treatment of their loved ones in Mid-Staffordshire hospital.

“I absolutely understand all of that. At the time I apologised and in a sense I apologise again to the people of Stafford for what happened, but apologies are not enough.”

You are correct Sir David Nicholson- apologies are not enough, Health Direct asks you to resign now.