Dignity and Compassion in the NHS: Can they be reduced to targets?
Towards a Two-Tier NHS
Latest Reports
Profits-before-patients
Is the NHS on Life-Support?
Concerns about 'dignity and compassion' within the NHS did not start with the advent of the coalition and it's cuts, but go back into the
New Labour years when the line of travel bore a remarkable resemblance to the coalition's, er, 'reforms'.
The King's Fund's 'Point of Care' programme raised issues which continue to this day. [*]
The goal of the programme is to enable health care staff in hospitals to deliver the quality of care they would want for themselves and their own families.
We are working with patients and their families, staff and hospital boards to research, test and share new approaches to improving patients’ experience.
Claire Raynor responds to the responses to the Patients Association report.
The King's Fund's programme has not had much success.
A window into the future of the "profits-before-patients" NHS
Lansley's talk about 'choice' is smoke-and-mirrors: there was no 'choice' for Joyce Farrow, just degredation.
Anyone who treated a pet in such a manner would be charged with cruelty.
The possibility that Karen Southern is a 'fall guy' for Bupa's senior managment remains a matter of speculation,
of course.
Given that EU competition law specifies that "the most economically advantageous" bid, wins the contract, it's quite clear that - contrary to Judge Mark Brown's
understanding - the 'culture' is profits first, patients second.
The rules of incorporation demand nothing less.
Devon NHS
Towards a two-tier health 'service'
Faced with the, er, 'need' to find £20bn in savings, and meet a predicted 4 per cent increase in demand, the coalition is betting it's bottom dollar on competition - the private sector - to square the circle and provide both outcomes.
In doing so the NHS will be transformed - degraded - in ways that are currently unpredictable.
One theory is that the NHS will become a sort of BT; a one-time monopoly surrounded by growing rivals eroding its market share by undercutting its costs.
This trend will driven by the ending of the NHS monopoly on treatment, and the introduction of competition law into the bidding process, which will favour the private sector.
(Recall how Stagecoach used predatory pricing to knock out the competition when buses were first deregulated.)
Patient 'choice' will - according to the theory - both drive up standards and drive down costs.
There are two points to be made here: first off, 'choice' in our local PCT (RIP) currently involves a choice of where to go to meet the same team travelling peripatetically around the local patch. Medically, it's no choice at all.
Second, and much more important, the sick are not comparing phone tariffs: the key factor in choice is the record - the expertise - of the nurses, doctors and consultants.
All the indications are that such information is not only unavailable to patients but, if your doctor is actually doing the choosing for you, s/he could well direct to you to the 'choice' favoured by his/her local consortia - the private replacement of the PCTs which will have its own agenda!
Finally, as the NHS Support Federation points out, it's probable that the private sector will cherry-pick the more straight forward cases, leaving the more complex - and more chronic - conditions to the NHS.
Meanwhile, the Lansley's of this world will make costs comparisons between sectors - tiers - with the aim of demonstrating the superiority of the private sctor.
But this will not be a like-with-like comparison!
Ali Parsa & 'the re-engineering of the NHS'Lords urged to back NHS private work plan
NHS private income cap to be lifted
Private firm to run NHS hospital
From Ward 25
Lancet foresees 'end of the NHS'
NHS Reform: Cameron & Lansley's PR Offensive
Paradoxes in the debate
Losing out to 'affluent medical tourists'
Lansley's reforms are a 'phony revolution'
Up to 1,600 West Midlands health trust jobs set to go
Watchdog raises alarm over health reforms
Will doctors' need MBAs?
A risky business: the White Paper and the NHS
Companies 'to control NHS funds'
Doctors to be paid bonuses under NHS reforms
Fragmenting The NHS
How patients could suffer
Lansley bankrolled by private healthcare provider
NHS reforms pilot scheme rolled out across country
The Government's reform juggernaut begins to move
The Practice plc
Tories rule out forced NHS closures
Q&A: The NHS shake-up
Is the NHS on Life-Support?
Thatcherism - political or social - is inimical to the founding philosophy of the NHS, which sprung from a society which cared about social justice; one in which it was believed that clinical need came before wealth and status.
This 'archaic' notion collided into Thatcher's 'no such thing as society' - aka 'autonomous individualism' - a social Darwinist proposition which now has widespread support among those in secure jobs who imagine they are never going to become sick or grow old.
The marginalised, however, experience the downside of the "fuck you buddy" dystopia. [FYBD]
Thatcherite individualism then - not 'more training', or another reorganization - is at the root of the NHS's problems.
Dementia 'patients' are both old and chronic sick - two 'unsustainable burdens'.
Without them there would be no need to spend billions on the NHS, the private sector could gake over. LOL.1. Dementia care: Hospitals 'must make improvements'
The Royal College of Psychiatrists' audit of 210 hospitals ... says while services are safe, they are lacking in other areas.
The report highlights issues such as poor communication with families and a lack of personal care for patients ...
Andrew Chidgey, head of policy at the Alzheimer's Society, told BBC Radio 4's Today programme:
"Unless we see a radical change in the way this is happening at the moment, we are going to see not just more people with dementia not getting the care they need, but a health service which is under incredible pressure because of the financial situation.
"What is important to note here is people are not going into hospital for treatment of dementia, they are going in for other things but when they get there they often stay far longer than other patients with the same condition, and many callers to our helpline are saying people are coming out of hospital worse than when they went in ...
BBC NEWS 16 Dec 20112. Doctor Eva Michalak wins £4.5m over discrimination
The tribunal earlier this year heard that senior staff members began a plan to get rid of Dr Michalak, who worked as an obstetrician, at a secret meeting in March 2003, when she was seven months pregnant.
She began to receive complaints and criticism against her, being accused of bullying junior doctors, until her suspension in January 2006.
She was then subjected to "a lengthy and wholly unauthorised period of suspension" before disciplinary proceedings began in May 2007, concluding in her dismissal in July 2008 ...
BBC NEWS 16 Dec 20113. Diabetes report reveals 24,000 a year die from condition avoidably early
The "incredibly alarming" figure is the first estimate of the number of patients who die early because a failure to have health checks, take drugs at the right time and maintain a healthy lifestyle increased their risk of dangerously high or low blood sugar, heart failure or kidney problems.
While three-quarters of the 24,000 deaths are among the over-65s, younger patients are most at risk.
Two young people aged 15 to 34 in England are believed to die every week as a result.
Dr Bob Young, a consultant diabetologist who led the audit, said the grim statistics gave the first "reliable measure of the huge impact of diabetes on early death. Many of these early deaths could be prevented".
Because the number of people with diabetes was increasing, the toll would increase ...
Gdn 14 Dec 20114. NHS whistleblowers must be protected
In Mid Staffs, the "silence from doctors and nurses", with few honourable exceptions, ensured that the desperate attempts to cut costs to become a foundation trust had fatal consequences.
The "shocking catalogue of appalling care" you report at Mid Staffs was a microcosm of what the NHS and social care could become ...
... the CQC has utterly failed to challenge the widespread absence of a learning culture.
Indeed, it failed to blow the whistle on its own underfunding, gagged its own whistleblowing inspectors, cut its inspections catastrophically by 70% between 2009 and 2011 and generally, as you state, had an "unhealthy organisational culture".
Its astonishing litany of shortcomings is rooted in previous government funding cuts and the desire for more "light touch" regulation ...
Gdn 13 Dec 2011
Thatcherite Britain
Stafford hospital investigator berates CQC regulator
The worst scandal to hit the NHS over recent years may never have been exposed if Heather Wood, the official investigator, had been less skilled and determined ...
The report of the public inquiry into Mid Staffs is due to be published later this year.
Robert Francis QC is expected to explain how systemic failures across the top tiers of NHS management allowed patients at Stafford to suffer from appallingly poor emergency care.
His findings will almost certainly trigger a further upheaval in the way the NHS is managed and regulated.
Wood told the inquiry: "I am not convinced that Mid Staffs would have been exposed by CQC."
She adds: "I worry that, unless the CQC makes more use of relevant experts in its inspections, we may become increasingly reliant on investigative journalists to expose problems in healthcare."
The disclosures by the BBC's Panorama about the mistreatment of people with learning disabilities at Winterbourne View private hospital near Bristol, and the assault of 80-year-old Maria Worroll at a care centre in London that the CQC had previously rated as excellent, are cases in point ...
Gdn 01 May 2012Inquiry told there could be 'another Stafford Hospital'
Doctor tells MPs of 'intimidation' at Stafford Hospital
Hospital trust branded the worst in Britain 'tried to gag whistleblowers'
Silencing the truth
Mid Staffordshire NHS Trust
Overnight discharges from NHS hospitals to be examined
It's all about cutting the number of beds ...
The Times newspaper discovered, via Freedom of Information requests, that 100 NHS trusts sent 239,233 patients home last year between 23:00 and 06:00BBC NEWS 12 Apr 2012Care Home Nurse's Story
"It was very common for residents to be returned after midnight.
On one occasion it was disgraceful as the weather was extremely cold and we did make a formal complaint but nothing came of it.
Sometimes because of the time the resident would become quite confused and unable to settle.
It has to be said the ambulance crews were often embarrassed.
Also, prior to discharge they would be kept waiting in a chair for hours for the ambulance to become available.
It was clear the health and well-being was low in their priorities."
How can a profession whose raison d'être is caring attract so much criticism for its perceived callousness?
Or is Britain suffering from a wider malaise?
British culture has changed. We value care much less than we used to.
Many of us, as the MP Margot James pointed out in the debate she tabled in October on care of the elderly, seem to be more interested in our rights than our responsibilities.
Nursing takes a bigger proportion of young people out of schools than any other profession, and these people, however well-intentioned, are going to reflect the attitudes of society at large.
"It is," said one lecturer in nursing who didn't want to be named, "not uncommon for a student nurse to have to be told that she should not text her friends while standing at a patient's bedside. Most of my colleagues," she said, "who teach pre-registration nursing find this is a huge problem." ...
Ind 12 April 2012What can and should be done about nursing
How did we come to this?
A crisis in nursing
Dementia patient Joyce Farrow, 90, was left covered in sores, rashes and dried faeces in a cold room at Stonedale Lodge, in Croxteth ...BUPA put profits before patients says Liverpool crown court trial judge
Mrs Farrow’s daughter, Pauline Slaughter, herself a qualified nurse, complained to staff and senior management and kept a diary which later proved crucial in prosecuting care home boss Karen Southern ...
While passing sentence Judge Mark Brown spoke of a culture of putting profits before patients.
He told Karen Southern:
"BUPA hold themselves up as being the leading UK providers of dementia care and as the home manager you were responsible for the care and well being of residents.
"It is clear from the evidence presented during the trial that the nursing home was run very badly and that there was a great deal of under-funding and cost cutting.
"This impacted significantly on the resources that were available which meant there were often inadequate staffing levels and the unit itself was filthy and the premises in a tired and dilapidated state." ...
Liverpool Echo 17 Mar 2012Bupa Care Homes admits failings after resident's death
BUPA Care Homes fined £90,000
Bupa don't care homes
Bupa care home staff tormented dementia victims
Home care for elderly branded 'shocking and disgraceful'
Care home residents 'denied basic GP medical services'
Elderly ignored and treated as 'objects' in care system
Pensioners 'passed like parcels' by care agencies
Devon NHS children's services set for privatisation
You don't have be the best, just the cheapest ... it's EU competition law
The Guardian has learned that NHS Devon and Devon county council have shortlisted bids led by two private, profit-making companies – Serco and Virgin Care – to provide frontline services for children across the county ...
The contract will be awarded to "the most economically advantageous" bid, according to criteria listed for it on the European commission website, where any European public tenders are required by competition law to be published ...
A spokesman for Lansley said the Devon bid was an example of how reforms were following the direction of travel for the NHS set long before the current government.
"We support patient choices and whoever is best getting the contracts ... " (!)
Neither of the two private companies in the Devon bids has experience of running specialist children's health services for the NHS ...
Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health ... also questioned whether private companies could run such important public services.
"It is hard to understand why a tender for something as important and complex as children's services has not been put into the public domain for scrutiny by professionals, since it makes it impossible to answer questions around why the service is being tendered, the criteria upon which successful bidders will be judged ... ", he said ...
Gdn 15 Mar 2012Tenders for NHS services
Care home residents 'denied basic GP medical services'
These are the people Mr Lansley believes should be running the NHS ...
Martin Green, from the English Community Care Association, a group representing the owners of care homes, believes up to one third of residents could be missing out on the full range of GP services they are entitled to ...
A report published by the Care Quality Commission (CQC) earlier this month found vulnerable people in care homes are struggling to get access to GPs and routine medicines.
The CQC looked at 81 care homes in England, chosen from areas previously flagged up as at risk of poor performance.
Only staff at 38% of homes reported they got regular visits from GPs, with one in 10 care homes saying they had to pay GPs to get them to visit residents ...
BBC NEWS 11 Mar 2012Meeting the health care needs of people in care homes
Hospital doctors told to rethink weekend working
What took you so long? Sickness is a 24/7 job!
There is a wealth of research into higher mortality rates at weekends.
There's also the 'small' matter of agency nurses on wards at night, btw.
When my partner had her blood pressure checked in the middle of the night, the 'nurse' didn't know how to fit the cuff properly!
At the end of last year, the research company Dr Foster found mortality rates rose by 10% at weekends. Other studies have shown similar correlations.
Staffing - and in particular the presence or absence of senior doctors - has been highlighted as a key factor.
... hospitals rely on consultants being on call, which means they give advice over the telephone and only come into hospital in emergencies ...
BBC NEWS 09 Mar 2012
Elderly ignored and treated as 'objects' in care system
If you're one of the '99%' you're an object. And objects treat other people as objects. It's called 'autonomous individualism', and no 'Code' is going to change that fact!
The call for the new Dignity Code to prevent abuse is made in a letter to The Daily Telegraph signed by the care minister Paul Burstow and his Labour shadow, Liz Kendall, as well as charities, trades unions and academics.
It calls for hospitals, care homes and other institutions to agree a simple set of common standards of care for the first time to prevent cases of abuse and neglect. Care workers could eventually have this new code written into their contracts, supporters hope.
“For too long, too many of those people have been ignored, denied the basic right to speak for themselves or make up their own mind,” the letter warns. “In this era of human rights, too many older people have seen their basic human dignity undermined in situations where they are treated as objects rather than people.” ...
Tel 22 Feb 2012John Forbes Nash
Lords urged to back NHS private work plan
'Dignity and Compassion' - for private patients only
The letter from medical and clinical directors of 53 NHS foundation trusts and NHS trusts is published in the Times on Wednesday.
They defend the proposal to allow trusts to earn up to 49% of their income from non-NHS sources, saying "there are sound medical and clinical reasons for supporting this".
"It will enable us to bring much needed additional resources into our organisations to benefit NHS patients," the letter says.
"Examples of these benefits include developing treatment innovations and specialisms - such as complex paediatric treatment, robotic surgery, and employer-funded mental health treatment - and mean that trusts will be able to provide services on the NHS that can no longer be commissioned or are now rationed, including IVF."
BBC NEWS 08 Feb 2012Private firm to run NHS hospital
Losing out to 'affluent medical tourists'
Lansley bankrolled by private healthcare provider
Promises to simplify elderly care not kept
Ministers had claimed that they were putting an extra £2bn into local authorities' social care budgets.
The committee's report says that this is "not sufficient to maintain adequate levels of service quality", while an analysis for the King's Fund says a funding gap of £1.2bn could open up by 2014 unless councils can achieve unprecedented efficiency savings.
Many experts say that elderly patients are left confused by a system where they have to repeatedly give their details, undergo unnecessary repeat tests, and are left on their own to negotiate with councils, the NHS and welfare agencies.
In a damning assessment, the MPs say Lansley's reforms are built on the "hope" that GPs, hospitals and councils will respond to payments for working together.
Instead, the MPs argue that there should be a body set up just to commission services for elderly people, drawing on budgets from health, social care and welfare ...
Gdn 08 Feb 2012Pensioners 'passed like parcels' by care agencies
Up to 1.20 million frail and vulnerable patients are seeing their quality of life diminished because of a "salami slicing" of services and a failure to integrate health and social care, a report by the Commons health committee says ... the report warns that reforms will fail unless the system is radically overhauled to end an "artificial distinction" between health and social care dating back 80 years.
At present it is common for doctors and social services departments to duplicate each other’s work, carrying out multiple assessments on the same patients without pooling their efforts.
The lack of co-ordination means opportunities to help elderly patients are missed, with many ending up in hospital with acute conditions that could have been avoided ...
Tel 07 Feb 2012
NHS reforms one year on: patients and staff deal with 'cuts and chaos'
The fact that growing numbers of patients have been waiting longer than they should – for treatment, in A&E or for a diagnostic test – during the coalition's time in power is one of the many issues facing Andrew Lansley, the health secretary.
At the last count almost 250,000 patients in England had been waiting more than 18 weeks, including 100,000 who had to wait at least a year and 20,000 who had been waiting for more than a year ...
With the health and social care bill marooned in parliament for 12 months – it was a year ago on Thursday that it was tabled before MPs – there are signs of government panic over a health service too busy reorganising itself, while trying to save £20bn, to focus on patient care ...
Lansley's health service is a radical departure from the idea of a state-run, publicly-financed medical care system.
Instead the coalition's health service will allow hospitals to get 50% of their income from private patients.
It will allow patients a choice of provider, permitting private firms to offer services to NHS patients.
The news that the City's rating agencies are being considered to rate hospital finances is one example of how far the coalition is willing to see a market health economy evolve.
Ministers have refused to release their own assessment of the risks to the health service from the reforms, despite an order from the information commissioner to do so ...
Gdn 18 Jan 2012NHS heading for crisis point as job losses mount
Health secretary must reveal DOH assessment of restructuring risks
NHS plans for credit rating agencies to vet hospitals
£20bn NHS cuts are hitting patients
Application of competition law to NHS foundation trusts
Health and Social Care Bill
NHS waiting times
NHS
Healthcare assistants 'doing nurses' tasks'
A large survey of nurses found numerous examples where the junior staff, known as 'HCAs' on wards, were put in charge of jobs strictly speaking beyond their capabilities.
These included administering certain restricted drugs and caring for potentially vulnerable patients in intensive care.
The claims, highlighted in the survey by Nursing Standard magazine, yet again raise worries about the standard of care some patients are receiving.
The NHS Future Forum, an independent advisory panel, published a report on Tuesday warning that some nurses lacked the basic skills and attributes for the job ...
Tel 11 Jan 2012Hospitals feed patients on 90p a meal, official figures show
The NHS Future Forum
Nursing standards: PM aims to tackle 'care problem'
In November the Patients Association published a report containing 16 "shameful" stories about the care of elderly patients.
It included people being denied pain relief, left to sit in their own faeces and going without food and drink.
The dossier was published just a month after the Care Quality Commission attacked hospitals for what the regulator said were "alarming" levels of care ...
Central to his plan to tackle the problem is the Time to Care initiative, which is already being rolled out across hospital trusts.
The NHS-backed programme has been designed to give hospitals advice and support on how to redesign their systems so that staff are freed up to improve the care they provide to patients.
All trusts will be expected to be involved in this by 2013.
Mr Cameron also said he wanted nurses to carry out hourly ward rounds to check on patients at their bedside.
Bonus payments will also be available to those places that do well on four key measures - pressure ulcers, falls, blood clots and hospital infections ...AnalysisBBC NEWS 06 Jan 2012
The standards of care on hospital wards have dogged the government in the past year. Stories of vulnerable patients being left without food and water and in terrible pain understandably stir public anger.
And so this announcement is an attempt by the prime minister to wrestle back the initiative.
Much of what is being unveiled is simply building on what already happens.
For example, nearly two-thirds of hospitals are involved in the Time to Care initiative, while nurse rounds are commonplace on some wards.
But while you will not find many in the NHS disagreeing with what the prime minister is saying, the big question is whether this can be done when the health service is under tremendous pressure.
The level of savings the NHS has to make - £20bn by 2015 - is unprecedented.
Unions say it means jobs are being lost and resources stretched, raising questions about how achievable the aims are.'NHS nurses need time and resources to care'
The Productive Ward
'Appalling neglect': how NHS let down the most vulnerable
It's not just the NHS, it's 'no such thing as society' - Margaret Thatcher is an accessory to this woman's death, and the suffering of millions of others.
Mary's numerous complaints about her daughter's care make hard reading.
Staff did not notice that anti-epileptic drugs in Lisa's bloodstream were at dangerously high levels.
Lisa received too little attention from staff, with a drip in her arm being allowed to run dry.
Despite doctors' reassurances she would feel little pain and only had two hours to live, in fact she suffered for days and was never given any pain relief.
In her report the ombudsman criticised the hospital's taking of blood samples, and cited its failure to perform a blood test for a week, despite Lisa's vomiting, as "highly undesirable".
The ombudsman also castigated the staff's failure to manage Lisa's epilepsy, provide her with basic nursing care or meet their obligations under disability discrimination law.
"I trusted the hospital with my much-loved daughter but they left her fighting for breath and in terrible pain," Mary said.
"It was like watching someone drown before your eyes. It's awful to say but my dog had a better death than my daughter."
Lisa Sharpe's death is one of 74 deaths of patients with learning disabilities over the past decade that the charity Mencap claims were caused or contributed to by "institutional discrimination in the NHS" ...
Gdn 02 Jan 2012'She went weeks without pain relief'
Learning Disability
Is the NHS Fit for purpose?
Failures in care; failures of personnel management; failures in regulation; and, overshadowing them all, the dictates of the Washington Consensus, especially Clause 7. But the deeper causation stems from the theory - nostrum - on which the Washington Consensus is based: extreme individualism, merging into social Darwinism.
Margaret Thatcher summed it up: "There's no such thing a society".
And no British institution is more grounded in the idea of society than the NHS.
Thatcherism - aka the Washington Consensus - affects funding, training, and above all perceptions of the sick.
Like the Victorian poor - deserving and undeserving - there are the deserving sick - breast cancer patients - and the undeserving sick - like diabetics.
The fact that lifestyles' impact on health has come to play a major part in the 'blame' game within media reporting ingores the fact that some conditions are down to genetic luck - like some cancers, and some heart diseases. These four recent reports highlight the problems. The old are now an unsustainable burden, and those suffering dementia are at the far end of unsustainability. The call for better training ignores this deeper perception.Dementia care: Hospitals 'must make improvements'
The Royal College of Psychiatrists' audit of 210 hospitals ... says while services are safe, they are lacking in other areas.
The report highlights issues such as poor communication with families and a lack of personal care for patients ...
Andrew Chidgey, head of policy at the Alzheimer's Society, told BBC Radio 4's Today programme:
"Unless we see a radical change in the way this is happening at the moment, we are going to see not just more people with dementia not getting the care they need, but a health service which is under incredible pressure because of the financial situation.
"What is important to note here is people are not going into hospital for treatment of dementia, they are going in for other things but when they get there they often stay far longer than other patients with the same condition, and many callers to our helpline are saying people are coming out of hospital worse than when they went in ...
BBC NEWS 16 Dec 2011Doctor Eva Michalak wins £4.5m over discrimination
The tribunal earlier this year heard that senior staff members began a plan to get rid of Dr Michalak, who worked as an obstetrician, at a secret meeting in March 2003, when she was seven months pregnant.
She began to receive complaints and criticism against her, being accused of bullying junior doctors, until her suspension in January 2006.
She was then subjected to "a lengthy and wholly unauthorised period of suspension" before disciplinary proceedings began in May 2007, concluding in her dismissal in July 2008 ...
BBC NEWS 16 Dec 2011Diabetes report reveals 24,000 a year die from condition avoidably early
The "incredibly alarming" figure is the first estimate of the number of patients who die early because a failure to have health checks, take drugs at the right time and maintain a healthy lifestyle increased their risk of dangerously high or low blood sugar, heart failure or kidney problems.
While three-quarters of the 24,000 deaths are among the over-65s, younger patients are most at risk.
Two young people aged 15 to 34 in England are believed to die every week as a result.
Dr Bob Young, a consultant diabetologist who led the audit, said the grim statistics gave the first "reliable measure of the huge impact of diabetes on early death. Many of these early deaths could be prevented".
Because the number of people with diabetes was increasing, the toll would increase ...
Gdn 14 Dec 2011NHS whistleblowers must be protected
In Mid Staffs, the "silence from doctors and nurses", with few honourable exceptions, ensured that the desperate attempts to cut costs to become a foundation trust had fatal consequences.
The "shocking catalogue of appalling care" you report at Mid Staffs was a microcosm of what the NHS and social care could become ...
... the CQC has utterly failed to challenge the widespread absence of a learning culture.
Indeed, it failed to blow the whistle on its own underfunding, gagged its own whistleblowing inspectors, cut its inspections catastrophically by 70% between 2009 and 2011 and generally, as you state, had an "unhealthy organisational culture".
Its astonishing litany of shortcomings is rooted in previous government funding cuts and the desire for more "light touch" regulation ...
Gdn 13 Dec 2011
Hospitals lambasted for 'alarming' treatment of older people
Dame Jo Williams, the commission's chair, said:
"Too often our inspectors saw the delivery of care treated as a task that needed to be completed. Those responsible for the training and development of staff, particularly in nursing, need to look long and hard at why the focus has become the unit of work rather than the person who needs to be looked after – and how this can be changed.
Task-focused care is not person-centred care. Often what is needed is kindness and compassion, which cost nothing."
The entire NHS needed to ensure that it made big improvements to end the scandal of poor care, she added.
Poor leadership in NHS organisations had let "unacceptable care ... become the norm", while the attitude of some staff resulted in "too many cases where patients were treated by staff in a way that stripped them of their dignity and respect", said the report.
Inspectors also found unacceptable care on well-staffed wards and, equally, excellent care on understaffed ones ...
Gdn 13 Oct 2011
'Age discrimination within NHS' leaves elderly neglected
Reading Andy Burnham's hypocritical comments you might think that an absence of compassion started with the coalition.
The Patients Association highlights harrowing cases of pensioners being left starving or suffering in agony, and relations being ignored as they watch their loved ones die because nurses claim to be “too busy” to help.
A raft of previous reports proves otherwise. Neoliberalism's 'fuck you buddy' culture is systemic in all three main parties.
The head of the charity said the report, which “shames everyone involved”, showed that despite government promises of action following a series of other damning reports, standards of care continue to get worse ...
Cases highlighted in the Patient Stories report include:
• Nurses taking 15 minutes to respond to a patient who pressed his emergency button as he was left “gasping for life”.
• A pensioner who was told to soil his clothes by a nurse who did not have time to take him to the lavatory.
• A patient who spilt boiling soup over her legs, scalding herself, after a nurse insisted that she was too busy to help.
• A man who had forcibly to refuse an injection to relieve “internal bleeding”, with which he was not suffering, because of a mix-up over his medical notes.
• A patient who was left without blankets or a pillow and told to eat ice cream with his fingers because there were no spoons.
The Patients Association, which normally receives 5,000 calls per year from patients and relations asking for help and reporting concerns, said that since January it had received 961 calls reporting neglect, a 37 per cent increase on the same period in 2010 ...
Tel 09 Nov 2011Hospitals lambasted for 'alarming' treatment of older people
Half of hospitals 'failing to feed elderly patients properly'
Elderly care in the NHS: 'There is nowhere for people to go'
Elderly people hurt in falls being failed by the NHS
Inquiry told there could be 'another Stafford Hospital'
Hungry, thirsty, unwashed
Bupa care home staff tormented dementia victims
Inadequate NHS hospital care for elderly 'condemns many to death'
Elderly 'going hungry on NHS wards'
Doctor tells MPs of 'intimidation' at Stafford Hospital
Trust left patients humiliated and in pain
Sentenced to death on the NHS
The economics of turning people into things
Hospital trust branded the worst in Britain 'tried to gag whistleblowers'
Nearly 250 NHS patients dying of malnutrition every year
Nurses should blow the whistle on poor quality care, says Andrew Lansley
Mr Lansley said: "It is unacceptable for some of these essential standards of dignity and support for people's food and drink not to be met."
He added: "Staff across the NHS, if they see examples of poor care [it is important] that they blow the whistle ...mr-edTel 13 Oct 2011
The whistle-blowing rules that were put in place last year are a farce. They weren't back dated for a start - not good for the NHS to show willing on the issue. They don't prevent managers getting back at an employee via other routes either. Which they do. Everyone who works in the NHS knows that if you blow the whistle in the NHS your career is toast - regardless of the whistle-blowing rules
Try telling Barbara Allatt, the trainee nurse who raised the issue at South Staffordshire Trust, that whistle-blowing is an option. She lost here place on the Nursing training course in 2009 and was REFUSED a tribunal over the issue this January.
People will only speak up if whistle-blowers are seen to be treated correctly even if such an action is retrospective. As such FULL reinstatement of people like Barbara Allatt with double back pay (assuming qualification in her case) is the bare minimum for Andrew Lansly's words to be anything other than hot air.
Elderly care in the NHS: 'There is nowhere for people to go'
The NHS is desperate to cut beds and the time people stay in them.
But many frail old patients must remain on the wards because there is no suitable care for them at home ...
If the hospital can swiftly usher patients out of the building, it can shut down wards, a process that the hospital chief executive, Mark Newbold, sees as a sign of success.
"The real breakthrough in terms of reducing staff is when you reduce capacity.
"So if we can close a ward, then we don't need those staff, and no one will notice that those staff aren't there because that facility is not open," Newbold says.
However, reality throws up obstacles to this plan.
Because social services budgets are being cut at the same time, delays beyond the control of hospital staff slow the flow of patients back into the community ...
Gdn 12 July 2011
Diabetics are put at risk as NHS cuts hit specialist nursing posts
A survey of 385 hospital trusts and primary care trusts (PCTs) by Diabetes UK found that 218 jobs were vacant last year, even though the number of people with diabetes is rising by 150,000 a year ...
The research also reveals that the proportion of DSN posts lying unfilled because of cost-saving programmes had risen to 43% – up from 34% in 2009.
PCTs and hospitals in England have increasingly been reducing their staff and cutting back on the services they provide as they struggle with the demands of a £20bn NHS efficiency drive, flat budgets and rising costs.
The new findings confirm a growing tendency among bosses of cash-strapped NHS organisations not to replace specialist nurses – who also help patients with cancer, multiple sclerosis, Parkinson's disease and other conditions ...
Obs 22 May 2011
Coalition cuts to the national health service have started to bite hard, and these key areas are the first to suffer ...NHS cuts: the first casualties
Gdn 11 Apr 2011Mental Health
Eighty people in Kent with schizophrenia, depression, bipolar disorder and anxiety have lost a service that helped them continue living at home.
The "floating support" service run by the charity Rethink closed on 31 March.
Rethink's Gabriella Albert said:
"We helped people with severe and enduring mental health needs live in their own houses rather than being hospitalised.
"Without the service they could get trapped in a vicious cycle of mental illness, end up very, very unwell and be admitted to hospital."
Cuts to child and adolescent mental health services in Islington, north London, have already deprived some people of access to family therapy sessions.
Birmingham's three PCTs have reduced access to the improving access to psychological therapies scheme, despite such "talking therapies" for the anxious and depressed being a key priority of both the coalition and Labour.London Ambulance Service to cut 890 jobs
Three patients die on psychiatric ward
What the cutbacks will mean on the NHS frontline
A public inquiry called after a higher than expected number of deaths at Stafford Hospital, has been told a similar situation could reoccur ...Inquiry told there could be 'another Stafford Hospital'
You cannot regulate for the absence of a moral compass.
The chief executive of the trust that runs Stafford Hospital said he had no confidence regulators would be able to prevent a similar situation arising.
Antony Sumara said he thought the regulation system needed overhauling ...
BBC NEWS 16 Mar 2011Stafford Hospital inquiry told of trust's finance issue
Patients' families 'felt let down'
The cases in the Ombudsman's report include:Hungry, thirsty, unwashed
* A man with advanced stomach cancer who was discharged on the eve of a bank holiday from the Bolton NHS Trust with too little morphine to control his pain, leaving his family to drive around most of the weekend, frantically trying to obtain more supplies.
* A woman admitted to Ealing Hospital NHS Trust with breathing difficulties whose husband was left, forgotten, in a waiting room for three hours, denying him the chance to be with his wife when she died.
* A woman discharged from Heart of England NHS Trust to a care home who arrived bruised, soaked in urine, dishevelled and wearing someone else's clothes.
Shortage of money and resources was not the problem, Ms Abraham said ...
"The findings of my investigations reveal an attitude – both personal and institutional – which fails to recognise the humanity and individuality of the people concerned and to respond to them with sensitivity, compassion and professionalism...
"The difficulties encountered by the service users and their relatives were not solely a result of illness, but arose from the dismissive attitude of staff, a disregard for process and procedure and an apparent indifference of NHS staff to deplorable standards of care."
... Of nearly 9,000 complaints to the Ombudsman last year, 18 per cent were about the care of elderly people and twice as many were accepted for investigation as for all other age groups put together ...
Independent 15 Feb 2011A service that can't care has sown the seeds of its own destruction
Poor treatment of older people in the NHS is an attitude problem
Ten Cases that Shocked the Watchdog
Inadequate NHS hospital care for elderly 'condemns many to death'
Senior doctors investigated all the deaths of patients over 80 that took place in hospitals within 30 days of surgery over a three-month period of 2008, questioning medical staff and examining case notes.
They were concerned by what they found.
"Most patients were admitted as emergencies by very junior doctors without timely input of senior care-of-the-elderly clinicians.
"There is a long way to go to ensure good practice and appropriate care," said Ian Martin, one of the report's authors and clinical co-ordinator in surgery, who lamented that previous advice from NCEPOD in 1999 and 2001 has not been taken.
The experts found that 71 hospitals appeared to have no acute pain service.
"Pain is not being treated as a fifth vital sign or being monitored, let alone addressed and controlled," said Dr Kathy Wilkinson, another author and NCEPOD clinical co-ordinator in anaesthesia.
"It is shocking that the survey has revealed organisational failures to respond to the suffering of elderly patients. I hope our report is a wake-up call." ...
Guardian 11 Nov 2010Care of Older People
Baby Peter 'was failed by all agencies'
Baby Peter's "horrifying death" was down to the incompetence of almost every member of staff who came into contact with him, official reports say ...
Publishing the serious case review into Peter's death in full for the first time, Children's Minister Tim Loughton said he hoped it would bring "closure" to the case.
The report said: "In this case, the practice of the majority, both individually and collectively... was incompetent."
"Their approach was completely inadequate and did not meet the challenge of the case," it continued.
The report said that his "horrifying death could and should have been prevented" ...
Parts of [the first review ] ... revealed there were six opportunities to save the toddler's life.
BBC NEWS 26 Oct 2010
Elderly 'going hungry on NHS wards'
Elderly people are being left to go hungry on NHS wards, a report said.
Those who enter hospital malnourished can get worse during their stay or become malnourished under the care of NHS staff.
The report from the charity Age UK found almost one in three nurses believe their own relative could enter hospital with nobody noticing they were malnourished.
The study - Still Hungry To Be Heard - builds on previous research which showed some elderly people receive no assistance with meals despite struggling to eat.
Those who have difficulty swallowing are sometimes put at risk of choking by not being given pureed food, while others have their food trays placed out of reach at the end of beds or on tray tables that are too high.
The charity has also heard of elderly people receiving no help with cutting food into smaller pieces or opening lids on containers.
Food trays are also sometimes taken away untouched without any questions, according to the charity.
The study found fewer than half of hospitals screen older patients for malnutrition on admission to hospital and only a third screen patients during their stay.
Just 5 per cent screen on discharge, despite evidence showing good nutrition both in and out of hospital helps people get better.
The report found many hospitals are largely ignoring guidelines which say people should be screened.
Independent 30 Aug 2010
Anna Walker, who was chief executive of the Healthcare Commission until it was disbanded last year, earned the largest combined amount in the past three years – £68,150 on top of her six-figure salary.NHS boss earned £68,000 in bonuses - on top of six-figure salary
"Dr Patrick Geoghegan ... who earns £170,000-180,000 received
£20,573 in the same year for helping it do well against NHS targets."
Notice Dr Geoghegan received bonuses for hitting targets, not for patient care.
She received £22,375 in 2006-07, £23,000 in 2007-08 and £22,775 in 2008-09 for running the then NHS watchdog in England ...
This is the first time both the number of bonuses and their size has been disclosed. The Lib Dems sought information from every hospital trust, primary care trust (PCT), mental health trust and ambulance service in England, as well as other NHS bodies such as strategic health authorities. While some pay no bonuses, many do.
However, the figures do not reveal the full picture because some refused to disclose theirs and a few simply gave their chief executive's salary band.
The £32,000 one-off bonus and the £68,150 over three years are large but not atypical.
Laura Roberts, chief executive of the Manchester PCT, received £25,732 extra in 2008-09, while Dr Patrick Geoghegan, her counterpart at South Essex Partnership mental health trust – who earns £170,000-180,000 – received £20,573 in the same year for helping it do well against NHS targets ...
Observer 25 Apr 2010
Major jobs cuts on way in NHS
Major cuts in NHS staffing levels which could have "disastrous" consequences are likely after the election, the leader of the nurses' union has warned.
Sir David Nicholson, the chief executive of the health service, has already warned that up to £20bn of savings will have to be found by 2014.
This works out as a saving of about 5% a year. The three main parties have all said savings can be made by improving productivity, by tackling management waste and redesigning services.
But (Royal College of Nursing leader Peter ) Carter said he felt politicians from all sides were being overly optimistic ...
Reports of recruitment freezes have already started to emerge in places such as Essex, Lancashire and Dorset, but Mr Carter believes this is just the start ...
BBC NEWS 24 Apr 2010
NHS whistle-blower tries to oust health minister
Gary Walker was dismissed as the head of one of Britain's largest hospital trusts over accusations that he had used bad language during meetings.
But he told The Sunday Telegraph that senior NHS figures wanted him out because he had refused to put waiting time targets above all other considerations ...
... early 2009, as Britain experienced the coldest winter for a decade, the trust experienced a massive rise in the number of patients arriving at A&E departments.
By April, emergency attendances had risen by 30 per cent in just 10 weeks. As the hospitals prioritised emergency patients, waiting times for operations on non-urgent patients grew.
When Mr Walker discussed the situation with SHA bosses, he was told to leave quietly, and fabricate a story about why he was going, or his "career would be in tatters," he alleged ...
Telegraph 18 Apr 2010
Tories rule out forced NHS closures
While Dave is reported by the BBC to oppose closures, Andrew Lansley is telling Guardian readers that if sub-standard hospitals don't improve, patients will go elsewhere. The word 'closure' is not used, but is heavily implied.
Conservative leader David Cameron has ruled out the forced closure of A&E and maternity wards in the party's manifesto for England ...
The new chief executive of the King's Fund, Professor Chris Ham said: "It's pretty clear to most people you can't freeze existing services in their current pattern. This is not primarily financial, but about patient safety and to ensure they get a good experience, and that the NHS delivers the best possible results." ...
Commenting on the manifesto, Dr Hamish Meldrum, Chairman of BMA Council said:
"The idea of being able to see a GP from 8am to 8pm, seven days a week is bound to be popular, and patients deserve good access to GP services, but this shouldn't come at the expense of the quality of a patient's overall care, which is at risk if services become fragmented ... " ...
He said all the political parties needed to move away from a market model for the NHS in England, which wasted NHS money.
BBC NEWS 13 Apr 2010He wants to end what he calls the NHS's secrecy towards data about standards and outcomes of treatment in order to empower patients to choose where to have their cancer care or hip replacement, and thus force sub-standard hospitals to improve.How would the NHS look under a Conservative government?
Patients would get details, for example, of how successful different types of surgery had been at every hospital, judged on criteria such as how soon patients were able to return to work, whether or not they were left pain-free, and how many had to undergo further treatment.
Hospitals would have to make available information about patient readmissions, standardised mortality rates, complaints, availability of single-sex accommodation, and their rates of all hospital-acquired infections.
But, for the first time, they would have to break it down by department and, ideally, by individual ward – not just for the trust overall, which, as Lansley remarks, is of little use to patients.
While good hospitals should not worry, chief executives and medical directors of some hospitals "should be quite afraid of this", says Lansley.
"Underperforming hospitals or units should accept that they have to improve the service they offer or that patients, quite properly, will go elsewhere.
Some hospitals and some departments will lose out as a consequence [of publication]. We don't know to what extent a lot of hospitals are just complacently accepting that standards aren't as good as they ought to be. This kind of information drives out that sense of complacency." ...
Guardian 13 Apr 2010
Ramon Niekrash, in his first interview since winning a landmark case to salvage his reputation, said health professionals needed to think "very hard" before standing up against poor patient care, because it is "potential professional suicide".NHS targets and secrecy are hurting patients, doctor warns
"Your employer won't thank you; the law won't protect you. You're on your own," he says.
His story, which saw him suspended and his reputation in tatters after repeatedly raising concerns about the treatment and safety of patients following cuts at a London hospital, has raised disturbing questions about the legal protection of whistleblowers, 10 years after legislation was brought in by the Labour government ...
Mr Niekrash started raising concerns about patient care that same year. The urology ward was closed to save £1m, so patients were spread across the whole hospital. With too few specialist nurses and doctors spending so much time going from ward to ward, post-operative complications were sometimes being missed.
Outpatient clinics were bursting at the seams. New patients were prioritised which meant existing cancer patients sometimes had appointments cancelled several times, according to Dr Niekrash, something the trust has always denied ...
A fellow surgeon, Roy Isworth, recalls: "Patients would come in and ask me how I was feeling, or how my holiday had been, because that's what they'd been told when their appointment was postponed." ...
Independent 11 Apr 2010
Hospital checklists for common conditions 'cut deaths'
My nearest and dearist trained and worked as a nurse for more than three years at the end of the fifties. She could not believe what she was reading.
Checklists that spell out exactly how to care for patients with common conditions have dramatically reduced hospital deaths, say doctors ...
It was, she claims, axiomatic that you carried round in your head a 'checklist', and matron was there to act as, er, 'backup'.
It's called personal resonsibility/having one's own moral compass ...
The British Medical Journal reported a 15% fall in the number of people who had died at one north London hospital trust using so-called care bundles.
These are checklists covering dozens of conditions including strokes, heart failure and MRSA infections.
The researchers said death rates could be "halved" using the system.
The lists were introduced at North West London Hospitals NHS Trust by its former director of nursing, Liz Robb, who travelled to the US to learn the methods ...
Under the system, when a patient is first diagnosed with one of these conditions, a coloured checklist is placed into their medical notes and a sticker on the front tells doctors and nurses to follow it.
Recommended treatments and care are based on the best available medical evidence and even include simple but vital elements such as hand-washing.
For example, any patient with diarrhoea and vomiting would be put in a side room with a closed door and have their antibiotic or laxative prescription reviewed.
Staff would also have to confirm with a signature that they had worn gloves and aprons, used soap and water to clean their hands before and after contact and notify the Infection Control Team ...
BBC NEWS 01 April 2010Warning on death rates at 25 NHS trusts
A dozen of the country's supposed flagship NHS trusts were today told to improve or face action from health care regulators ...12 NHS foundation trusts ordered to improve
Under the new registration scheme, the CQC can impose fines, launch prosecutions or suspend services at failing trusts ...
Foundation trusts were created in 2004, and gave more control to local management teams.
Held up by the Government as being at the "cutting edge" of health care, they have to show they are financially viable and provide better services in return for the extra freedom.
Around 130 NHS trusts have been given foundation trust status since the scheme was launched.
Patients' groups said the number told to improve raises questions about their flagship status.
Katherine Murphy, director of the Patients Association, told the BBC: "Foundation trusts are meant to be the premier league of the NHS. But these results call into question the assessment process and actual status.
"We believe there is too much emphasis placed on financial performance rather than quality of care. The foundation trust regime needs looking into." ...
Independent 01 April 2010
Thousands of hospital beds in England should be axed to save money and improve care, a think tank says.Hospitals 'should axe thousands more beds'
Centre right group Reform said in some areas up to a quarter of beds could go.
It said advances in technology and rising rates of conditions like diabetes meant the focus should shift towards more community services.
The government said local health chiefs could decide, while the British Medical Association said cuts made for purely financial reasons would be "immoral".
The hospital bed count has been falling for decades, but Reforms's call represents a more rapid programme than has been seen in recent years.
There were just under 300,000 beds in 1987, but by last year that had fallen to 160,000 as advances in treatment have meant patients do not need to spend as long in hospital ...
The think tank suggested that more than 30,000 beds could close in the coming years if all areas matched the bed to population ratio achieved in the south central region.
This would mean London, the north east and north west removing about a quarter of their beds ...
BBC NEWS 17 Mar 2010Politicians' cosy consensus on NHS 'must be broken'
Fewer hospitals, more competition
Far too few hospitals provide parents with accommodation so they can stay beside their ill son or daughter, Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, told the Observer.NHS 'neglects' parents of sick children
He said it was "not good enough" that some parents have to sleep on a pulldown bed or an unused patient's bed, sometimes for weeks or even months, in order to keep a vigil by their child. Some end up exhausted and reduced to tears by sleep deprivation and the lack of privacy ...
He accused the NHS of neglecting the needs of people who deserved a better deal for playing a key role in their child's recovery.
"Every week, hundreds of pre-term babies are born and thousands of children end up in hospital with a broken limb, cancer or cystic fibrosis. But there aren't enough family accommodation facilities across the NHS and the situation is not good enough. In my experience, the majority of parents who are in hospital overnight are on a Zedbed beside their sick baby or child," he said.
"They will be woken frequently throughout the night when other children are admitted, or the ward buzzer sounds, or the lights go on and off. They will often become exhausted. Parents can't be expected to sleep on a put-you-up bed for weeks on end," he added ...
Observer 14 Mar 2010Action for Sick Children
Closing some NHS wards and hospitals and allowing patients to email their consultants could help save money and improve patient care, according to those making the day-to-day decisions about the running of the health service ...Close hospitals and wards to improve patient care, say NHS managers
Telegraph 11 Mar 2010Co-operative PCTs - the future of the NHS?
'GP federations' are the future of the NHS
The pros and cons of PFI hospitals
The NHS: how the health service can get back on its feet
More than half of hospital trusts inspected last year reported wrongly on their standards of care ...NHS trusts give 'wrong' hospital performance data to public
The Care Quality Commission, which is in charge of inspecting hospital trusts, found that 17 of the 28 it inspected last year had assessed themselves wrongly.
The figures come as mounting evidence suggests some hospitals are drawing up plans to cut more than 10 per cent from their budget in an effort to save the NHS as much as £20 billion over the next three years ...
The Daily Telegraph reported last week how 13 of the 36 hospitals in London were planning to cut casualty and maternity units, with fears that if these savings were replicated across the country hundreds of wards are at risk ...
Professor Brian Jarman, who developed a system of measuring hospital mortality rates used in the annual Dr Foster hospital guide to patient safety, told the Panorama programme the system is open to manipulation.
The professor of epidemiology and public health at Imperial College said: "My view is that patients do not realise that hospitals are self assessing. I could hardly believe it until I read it ... " ...
Telegraph 08 March 2010Spot-checks reveal mistakes ...
DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected.Labour hid ugly truth about National Health Service
They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.
The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed.
One report, based on the advice of almost 200 top managers and doctors, says hospitals ignored basic hygiene to cram in patients to meet waiting-time targets ...
Lord Darzi ... commissioned the three reports from international consultancies to assess the progress of the NHS as it approached its 60th anniversary in 2008. They have come to light after a freedom of information request.
The first report ... identified the neglect of patients as a serious obstacle to improving the NHS. “The lack of a prominent focus on patients’ interests and needs ... represents a significant barrier to shifting the trajectory of quality improvement in the NHS.” ...
The stark assessments, collected from leading NHS clinicians and managers, include:
A damaging rift between doctors and managers ...
Pointless new structures ...
A culture of fear and slavish compliance ...
Brian Jarman, emeritus professor at Imperial College London and an expert in hospital standards, said the findings should have been made available to Robert Francis QC, who led the inquiry into the Mid Staffordshire NHS Foundation Trust.
He said: “These reports have never seen the light of day. We desperately need a better monitoring system for the NHS which actually works.”
Times 07 Mar 2010
Policymakers believe that too many patients attend A&E "inapropriately," putting pressure on already stretched staff and budgets, and have encouraged hospitals to "educate" those people to see their GP or attend minor injuries units instead.Patients should feel welcome at A&E
But the report questions assumptions within the NHS that up to 60% of patients who attend casualty departments could be diverted to GPs or primary care nurses.
It says there is a risk "some of the most vulnerable patients (who) for cultural, personal and socio-economic reasons, will almost always turn to the emergency department for their care will effectively be denied access to the health service ...
"These are the very people that it is vital the NHS delivers care to. Trying to redirect them elsewhere may well mean they do not receive it at all." ...
Guardian 05 Mar 2010
More than a third of NHS primary healthcare trusts, which fund hospitals in England, are running deficits that have led to a cutback in surgical operations and seen calls to close casualty departments, according to a joint study by the Guardian and the thinktank Civitas ...Patients hit as NHS cash crisis forces big cutbacks
James Gubb, head of health policy at Civitas, said the tide of red ink was "of huge concern" given the tight budgets the NHS will be facing very soon.
"If financial control cannot be exercised in times of plenty, it does not bode well for times of famine," he added. "With billions to effectively be cut from the NHS we are looking at huge productivity improvements to maintain today's standards. Prudent organisations would be looking to set money aside to invest for such times."
Liam Byrne, chief secretary to the Treasury, has had meetings with big-spending departments in advance of the pre-election budget, expected later this month.
Byrne told Andrew Burnham, the health secretary, that some hospital buildings would need to shut as he seeks to find £11bn in Whitehall savings ...
Guardian 02 Mar 2010Former minister points to 'incompetence' in NHS
Patients denied surgery
Not a single official has been disciplined over the worst-ever NHS hospital scandal, it emerged last night.'No one's to blame'
Up to 1,200 people lost their lives needlessly because Mid-Staffordshire NHS Trust put government targets and cost-cutting ahead of patient care.
But none of the doctors, nurses and managers who failed them has suffered any formal sanction.
Indeed, some have either retired on lucrative pensions or have swiftly found new jobs.
Former chief executive Martin Yeates, who has since left with a £1million pension pot, six months' salary and a reported £400,000 payoff, did not even give evidence to the inquiry which detailed the scale of the scandal yesterday.
He was said to be medically unfit to do so, though he sent some information to chairman Robert Francis through his solicitor ...
Health Secretary Andy Burnham accepted 18 recommendations from Mr Francis and immediately announced plans for a new inquiry, to be held in public, into how Department of Health and NHS regulators failed to spot the disaster ...
Daily Mail 25 Feb 2010Doctor tells MPs of 'intimidation' at Stafford Hospital
The independent inquiry said the Mid Staffordshire NHS Trust had become driven by targets and cost-cutting.Hospital left patients 'sobbing and humiliated'
The report - the latest in a long line of critical reviews into the trust - said the poor care caused "unimaginable distress and suffering".
The government-commissioned inquiry has already been dubbed a whitewash by campaigners who want a public inquiry.
In particular, they want a probe into how the scandal could have happened, including the role of the wider NHS in the case.
Regulators said last year at least 400 more people had died between 2005 and 2008 than would be expected, due to "appalling" care - although this report said the figure could not be verified.
The trust had been climbing the NHS ratings ladder during the period in question and was even given elite foundation trust statusSTAFFORD HOSPITAL TIMELINE November 2007 - Campaign group, Cure the NHS, set up amid concerns about careThe latest report ... documents cases where patients were left in soiled sheets which relatives were forced to wash.
March 2009 - Healthcare Commission report published, revealing "appalling" standards of care and at least 400 excess deaths
April 2009 - Two Department of Health reviews published, showing standards improving
May 2009 - The hospital says a report into the role of the chief executive, Martin Yeates, in the scandal will not be published
July 2009 - Ministers announce an independent inquiry into case, but stop short of a full public inquiry as demanded by campaigners
July 2009 - Inspectors say hospital care is safe, but they still have concerns about staffing. Warning repeated in subsequent checks
October 2009 - The trust is given the worst grade, weak, in the annual NHS ratings system
February 2010 - Independent inquiry published, describing patients left "sobbing and humiliated"
Patients were left alone, leading to falls - some fatal, which were sometimes not reported.
And one woman, who gave evidence to the inquiry, said: "My Mum was in absolute agony, I can hear her screams now, as I walked into the ward."
Half of the patients and relatives who gave evidence also cited problems getting enough food and drink.
The report criticised the "ineffective" management which were too often concerned with hitting targets, particularly in A&E, as well as the "lack of compassion" and "uncaring attitude" which was too often demonstrated by staff.
But staffing levels were also said to be too low because the trust was trying to slash costs by £10m.
BBC News 24 Feb 2010Trust left patients humiliated and in pain
Health service unions have called on the government to suspend the tendering process that will lead to the virtual privatisation of an entire NHS trust and its £40m debt.Government must halt tendering process that will lead to NHS privatisation, say unions
Hinchingbrooke hospital in Huntingdon is set to become the first NHS general hospital to be operated by a private company after the only wholly NHS bidder for the contract dropped out this week.
Under the formula set out by the health secretary, Andy Burnham, last autumn, internal NHS organisations should be the "preferred provider" of services within the NHS. But as Hinchingbrooke is deemed to be a failing trust due to its massive accumulated debt, the regional health authority was able to put the management contract out to tender.
Five private health companies - Care UK, Circle Health, Interhealth Canada (UK), Ramsay Health Care UK and Serco Health - are now competing to run the 27-year-old, 369-bed hospital.
Both the trust's assets and staff at Hinchibrooke will remain within the NHS. The move has, nonetheless, been condemned by both the public service union Unison and the British Medical Association (BMA), which represents doctors. The contract, due to start in April 2011, marks a significant opening up of the NHS's internal market ...
Guardian 19 Feb 2010
Three-quarters of NHS trusts are endangering patients by not complying with safety alerts meant to stop fatal errors recurring, a charity says.NHS trusts 'not complying with safety alerts'
Freedom of information requests from Action Against Medical Accidents found 80 trusts in England had not complied with 10 or more patient safety alerts ...
... figures obtained by the charity revealed that in addition to the 80 trusts, 300 trusts had yet to comply with at least one patient safety alert and 200 had not complied with an alert dating back five years.
In one case, the BBC's File on 4 has discovered evidence that Hinchingbrooke Healthcare NHS Trust, based in Huntingdon, Cambridgeshire, failed to update fully its own policy in the light of advice from the National Patient Safety Agency about the right way to test the position of feeding tubes.
A year later, patient Peter Cameron died a "tortured" death when a nasal-gastric feeding tube was inserted into his lung instead of his stomach, the programme found ...
BBC NEWS 16 Feb 2010Nasty Health Service
The report by academics at the London School of Economics (LSE) shows that there is a far higher concentration of hospitals in politically sensitive areas “where no one wants to be blamed for hospital closure” than in areas where the Government enjoys a comfortable majority ...Hospitals more likely to close in safe seats
The study, which looked at 100 hospitals, disclosed that patients taken to well managed hospitals after a heart attack were significantly more likely to survive.
It found that management scores in NHS hospitals were generally lower than in the private sector, including in the manufacturing and retail industries as well as in private hospitals.
Hospitals managed by executives with no clinical experience perform worse than those where doctors and nurses are promoted to senior management positions, according to the report, which will be published this week in the journal Centrepiece.
“People management” was particularly bad in the NHS, the report said.
In one institution, an NHS manager who was asked whether staff often ended up doing the wrong sort of work for their skill level said: “You mean like doctors doing nurses’ jobs and nurses doing porter jobs? Yeah, all the time. Last week, we had to get the healthier patients to push around the beds for the sicker patients.” ...
Telegraph 15 Feb 2010 Election 2010 Electoral Reform
The leader of the Roman Catholic Church in England and Wales is to use a homily to criticise what he sees as a lack of compassion in some parts of the NHS.Archbishop Vincent Nichols attacks NHS over compassion
Archbishop Vincent Nichols will say that some hospitals see patients as no more than a set of medical problems ...
He will say the constitution of the NHS promises to respond with humanity to a patient's distress and anxiety as well as their pain.
But the archbishop will claim some hospitals fail to meet that commitment because of a prevailing culture which sees patients as no more than medical cases to be resolved.
He will say systems of care have been created which by treating patients in this way inflicts what amounts to hidden violence on them ...
BBC NEWS 13 Feb 2010 'Mechanistic Modelling' of Human BehaviourSentenced to death on the NHS
The economics of turning people into things
A total of 104 out of 148 NHS Trusts that provide maternity services responded to the request from the Conservatives - a response rate of 70.Almost half of maternity wards 'turn away woman in labour'
An analysis of the data, obtained by the Conservatives, showed that almost half of the trusts that responded had closed their maternity unit or had been forced to divert women to another site ...
In total, there were 553 closures in England, or an average of five per trust, compared with four in 2007 when there were 402 closures - a 38 per cent rise.
Of the 83 units where there was data for both 2007 and 2008, 31 hospitals (37 per cent) experienced more closures in 2008, 40 (almost half) experienced the same amount and 12 (14 per cent) experienced fewer closures ...
Telegraph 08 Feb 2010
Hundreds of people who suffer serious injuries are dying due to poor care, according to the National Audit Office ...NHS trauma services in England 'not good enough'
A report found the death rate in England for major trauma patients is 20% higher than in the United States.
The NAO also concluded that services had barely improved over the past two decades, despite there being repeated calls for reform.
There are 20,000 major trauma cases in England every year - patients with serious injuries, often from road accidents, falls or burns.
Trauma is the biggest cause of death in people under 40 and the numbers are growing.
The NAO said as far back as 1988 studies identified deficiencies in care.
But its report concludes there is little sign of progress, citing recent evidence that a majority of cases are not handled well.
The analysis found survival rates vary significantly from hospital to hospital, and that between 450 and 600 lives could be saved each year in England if major trauma care was managed more effectively.
Too often patients with severe injuries are taken by ambulance to the nearest casualty department, rather than the hospital with the equipment and expertise to cope with these complex cases ...
BBC NEWS 05 February 2010Targets 'damage NHS trauma care'
Half of trauma care 'not good'
Fears over trauma patient care
National Audit Office
More than 500,000 patients are readmitted to hospital every year soon after being allowed home, figures obtained by the Conservatives revealed.Rise in hospital readmissions revealed
The number of patients readmitted as emergencies within 28 days of being discharged rose from 359,719 in 1998-1999 to 546,354 in 2007-08, the data showed.
Elderly patients made up a large proportion of those affected - with 159,134 over the age of 75 readmitted in 2007-8, compared to 94,283 in 1998-99 ...
A Department of Health spokesman said ... "Rates of readmission can ... be a sign of better care ... "
Independent 01 Feb 2010
A hospital trust branded the worst in Britain by the NHS regulator actively discouraged staff from expressing fears about the safety of patients, an independent inquiry is expected to conclude.Hospital trust branded the worst in Britain 'tried to gag whistleblowers'
Senior managers at Mid Staffordshire NHS Foundation Trust, where poor working conditions may have contributed to more than 1,000 deaths, will be accused of promoting a culture of secrecy, according to sources close to the inquiry.
The disclosure of a key finding of the report, expected to be released this week, comes as campaigners for patients who suffered neglect in Stafford and Cannock Chase hospitals call for a judicial review into the trust.
An official close to the inquiry told the Observer that it will conclude that staff were discouraged from bringing problems to the attention of managers and NHS authorities.
"Staff have known about the problems on the wards for many years, but there has been no means by which they can bring them up. Those who have tried to do so have been shot down. Some have been ordered to withdraw or hide their allegations," the official said ...
Observer 31 Jan 2010
A hospital which was criticised after the deaths of two newborn babies must employ more permanent midwives and open more maternity beds, a watchdog says.Calls to improve Milton Keynes maternity services
A Care Quality Commission (CQC) report ... said temporary measures put in place by the hospital trust were "not sustainable" and added that the trust should concentrate on plans to recruit more permanent midwives and open more beds permanently ...
The commission had investigated the unit after the death of Romy Feast in 2007.
She died less than an hour after being delivered by Caesarean section.
Milton Keynes coroner Thomas Osborne found that the surgery was needed straight away but was delayed by three hours because of "system and communication failures".
The hospital was also criticised over the death of Ebony McCall in May 2009.
"Systems failures" and an overstretched staff contributed to her death, Mr Osborne ruled in December ...
BBC NEWS 19 Jan 2010Stillbirth rate 'still too high'
Stillbirth rate not coming down
Crisis in neonatal care 'deepens'
Sands
Bliss
Care homes forcing elderly to have feeding tubes fitted
Thousands of elderly people are being forced to have tubes fitted so they can be artificially fed if they want to be admitted to a care home, a major report warns today.
There is no evidence that tube feeding prolongs life, and it deprives patients of the pleasure and social contact involved in normal eating and drinking, says a Royal College of Physicians working group which recommends that artificial nutrition should only be used as a last resort.
The report found that many care homes across the country are making it a condition of residence that people, often in the advanced stages of dementia, have a tube fitted into their abdomen.moluki
6 Jan 2010, 2:39PM
... I fear very much getting ill at all. I have recently seen horrors in our local hospital (Worthing) that I have repetitive nightmares about.
The neglect was widespread, this affected the younger patients badly, but the old man with dementia in the ward my husband was on suffered terribly, the staff did not have the time or skills to care for him. Horrendous and terrifying. He was left in his own mess for hours, not once but most nights, and there is a long list of things that happened that were utterly disgusting while my husband was in there.
The place was a vision of hell at night. Frankly some of the staff did not give a damn, they actually seemed to have contempt for sick vulnerable people. My husband was left to beg and cry for help for 7 hours in agony after surgery when things got complicated, he was simply ignored and is still suffering from the consequences. The staff were aware and did absolutely nothing, despite other patients trying to get them to help. I still cannot get my head around what happened. Just so degrading and humiliating. The staff I mention who were seemingly neglecting patients were mostly from agencies.
We are paying a massive price not to fund and support our healthcare properly. We will all suffer way more than we should at some point I fear unless we wake up and sort this out. It is a disgrace and must be very sad for the dedicated kind staff who do care.
I hope there is an affordable local version of that clinic in Switzerland in time for me when my time comes! Sadly this all stinks to me of another example of how we have lost touch with what I believe really matters in life. Love respect and dignity for all, always.
Guardian 06 Jan 2009
Tories accuse hospitals of 'fiddling' A&E waiting times
Hospitals are fiddling a four-hour A&E wait target by using other wards as dumping grounds, the Conservatives say.
Data from 114 NHS trusts in England found many patients faced long waits in assessment units which did not count towards the waiting time.
Over a fifth of units reported keeping patients longer than the recommended 24 hours with the average wait being 17 ...
BBC NEWS 23 Dec 2009What goes down, may also be up
A&E wait figures 'being fiddled'
Minister blasted over A&E target
Target 'putting A&E care at risk'
Woman's death was 'gross failure'
Gross failures and neglect contributed to the death of a grandmother-of-five after a routine procedure went wrong at a Birmingham hospital, a coroner ruled.
Rosemary McFarlane, 64, died after being given a chemical that was 10 times the recommended concentration, which burned her lungs and killed her.
She was the only patient to be given a phosphate-buffered saline solution at Heartlands Hospital last year.
The coroner recorded a narrative verdict at Birmingham Coroner's Court ...ANALYSIS:BBC NEWS 22 Dec 2009
Michele Paduano, West Midlands' health correspondent
This is not the first time the Heart of England Trust has failed to carry out proper drugs checks.
Baljit Singh Sunner and Paul Richards died in 2007 after being given five times the correct dose of a fungicide amphotericin.
The coroner ruled neglect had contributed to their deaths too.
A year earlier another patient died after being given a muscle-relaxing drug called suxamethonium instead of lignocaine.
An external consultant who reviewed the trust's safety in 2007 said the hospital was no more or less safe than others.
The hospital's chief executive Mark Goldman said a Care Quality Commission review this year had not raised any safety concerns.
There have long been concerns about an NHS no-blame culture making staff complacent.
Mr Goldman agreed today that until staff took individual responsibility for their actions, avoidable deaths would happen.
NHS trust 'improving too slowly'
A hospital trust which was criticised for its high death rates is not improving quickly enough, a health watchdog has said.
Mid Staffordshire NHS Foundation Trust had not recruited enough permanent nurses in the past six months, the Care Quality Commission (CQC) said ...
BBC NEWS 17 December 2009Failing hospital 'caused deaths'
Relatives' reactions to report
Mid Staffs NHS Trust
Call for 999 ambulance response targets rethink
... Janette Turner, from the Sheffield University's Medical Care Research Unit ... told the BBC:
"The only proven clinical value of an eight-minute response is for patients with cardiac arrest, where a really fast response really can make the difference between whether they survive or whether they die, but for the other patients there's no proven relationship between how quickly the ambulance gets there and whether they survive.
"The problem that creates for ambulance services is if they get there in seven minutes and the patient dies, they have succeeded because they have met a target and if they get there in nine minutes and the patient lives, they have failed because they haven't reached the target."
She is now working with the Department of Health on developing additional performance measures.
Health Minister Mike O'Brien said: "Targets help to drive improvement and we have seen ambulance trusts making progress following the changes to performance requirements from 1 April 2008.
"Investment and improvements is the subject for the Department of Health and the results indicated that in the majority of cases there's no real reason why a patient, even one with a life threatening condition, needs to be seen within eight minutes."
BBC NEWS 17 December 2009'Why I will never dial 999 again'
Apology over ambulance wait death of boy aged 10
Woman's six-hour ambulance wait
Injured woman told 'no ambulance'
Baby ward shortages 'scandalous'
A coroner has branded midwife shortages at a hospital where a newborn baby girl died as "nothing short of scandalous".
Deputy coroner for Milton Keynes Thomas Osborne said "systems failures" and overstretched staff led to the death of Ebony McCall in May this year.
An inquest heard her mother, Amanda, who arrived at Milton Keynes General Hospital in pain, requested a Caesarian section but was told it was too risky.
Ebony was later born with only a faint heartbeat and she died soon after.
Miss McCall's consultant Anthony Stock had earlier told the inquest: "The care in this case should have been consultant-led.
"The care did not come up to a standard that I would have expected normally for a patient booked in my name."
He said Miss McCall, who has only one kidney, was considered "low risk" in cardiac terms but when she came into hospital with stomach pain, would have been "high risk" ...
The Care Quality Commission (CQC) health regulator said the coroner's findings would be used in a follow-up to the 2008 report on the maternity unit.
This said a lack of resources, mainly in the number of midwives and bed capacity, was putting maternity services at risk ...
BBC NEWS 11 December 2009Baby death ward 'standards lapse'
Baby's hospital death 'avoidable'
Maternity units closed to mothers
4,000 new midwives to be employed
NHS maternity units falling short
Midwives: end the crisis
Baby P clinic 'was understaffed'
Doctors at a clinic that failed to spot a broken back in Baby Peter two days before he died were under an "excessive workload", a report has said ...
Dr Kim Holt, who warned about the way the clinic was run in 2006, said the 17-month-old baby could have been saved if managers had listened to her ... (she) ... had warned the clinic's appointment system was "chaotic".
She was one of four who wrote a letter detailing problems at the hospital's clinic a year before the failed diagnosis.
They warned the clinic - run by Haringey Primary Care Trust and manned by Great Ormond Street Hospital doctors - was understaffed ...
The report's authors described the workload of consultants at the clinic between 2006 and May 2008 as "excessive" and said the consequences of cutting a consultant post "were not adequately considered" by management ...
The British Medical Association is supporting Dr Holt's claim to be reinstated to her original post ...
BBC NEWS 08 Dec 2009Communication problems cited in Baby P report
Nearly 250 NHS patients dying of malnutrition every year
Health charity BAPEN which campaigns on hospital malnutrition claims there has been a 16 per cent rise in deaths since Labour came to power in 1997.
The problem is costing the NHS a £14 billion a year as failing to make sure patients are fed properly means they take longer to get better and in the most extreme cases die.
This week Chief Nurse Dame Christine Beasley claims that £7 billion of the £15 billion a year the health service needs to save could be clawed back by attacking malnutrition.
Patient groups welcomed the promise that the Government was finally getting serious on poor nutrition in hospitals.
But they warned that the Department of Health had not kept previous promises and they pointed more than 2,000 deaths since 1997.
It is estimated that around 30 per cent of all hospital patients are malnourished leading to patients staying in hospital longer and getting sicker when they should be getting better ...
Telegraph 07 December 2009
The mysterious Dr Foster
Dr Foster is not, of course, a doctor at all, but a witty name chosen by two journalists when they set up a healthcare analysis company eight years ago, planning to exploit the mass of data churned out by the NHS (..."Dr Foster went to Gloucester, in a shower of rain")
Tim Kelsey from The Sunday Times and Roger Taylor from the Financial Times saw an unexploited commercial opportunity in the work of Professor Sir Brian Jarman of Imperial College. Professor Jarman had devised a way of measuring how well hospitals perform by using the Hospital Episode Statistics (HES) produced by the NHS.
Kelsey and Taylor's timing was good. The Department of Health under Alan Milburn needed evidence to support and monitor progress in implementing the NHS Plan and, after some initial hesitation, embraced Dr Foster warmly. The first Good Hospital Guide under the Dr Foster imprint appeared in 2001. Hospitals were under notice to collaborate with Dr Foster, however little they liked doing it.
So keen was Milburn's successor, Patricia Hewitt, on the product that she bought the company. Under a deal negotiated in 2006, £12m of public money was invested in a joint venture between Dr Foster and the NHS body, the Information Centre for Health and Social Care, to create the Dr Foster Intelligence consultancy.
The fact that this deal went through without a competitive tender raised some eyebrows, and was heavily criticised by the National Audit Office (NAO). The department had paid too much, and had failed to give others a chance to bid, the NAO ruled.
Professor Denise Lievesley, a statistician who had become chief executive of the Information Centre, protested to her bosses in the NHS, and again in 2007 when a contract to provide material to the NHS Choices online information service was awarded to Dr Foster without (in her view) proper procurement procedures.
She was eased out of her job, with a gagging clause preventing her from telling her side of the story ...
Independent 01 December 2009NHS watchdog chief Barbara Young quits after Essex hospital furore
Eight NHS foundation hospitals under investigation
Another eight NHS foundation hospitals are being investigated for possible poor performance, the BBC has learned.
The regulator, Monitor, has already taken action against two foundation trusts in Essex and has now widened its probe after more concerns were raised.
Health Secretary Andy Burnham has also asked the Care Quality Commission (CQC) to find out whether any other trusts in England need immediate investigation.
The eight foundation hospitals being examined have not been identified ...
The Patients Association, meanwhile, said patients had been "appallingly" let down.
Director Katherine Murphy said: "How many times do the public need to keep hearing about this before the government is embarrassed enough to do something about it?
"The system of regulation and supervision needs to be urgently reformed." ...
BBC NEWS 28 November 2009
Taskforce sent in to raise standards at Essex NHS trust
An expert taskforce is being sent into a hospital in Essex amid concerns about standards of care.
The independent regulator highlighted higher-than-expected death rates among patients, and poor standards of hygiene, including blood-spattered kit ...
The inspectors saw:
• Floors and curtains stained with blood
• Blood-splattered on trays used to carry equipment
• Badly soiled mattresses in the A&E department with stains soaked through to the foam filling
• Items that should only be used once still in use
• Equipment in the resuscitation room that was past the use-by date
• A children's blood pressure cuff heavily stained with blood
• Suction machines contaminated with fluid inside and out with what looked like mould growing on the equipment
The inspectors criticised a poor care environment in A&E, in particular a lack of privacy for patients.
They also highlighted inadequate arrangements to treat children, with few specialist paediatric staff ...
The independent hospital analysis website Dr Foster has found the Essex trust to have a hospital standardised mortality ratio of 136.
This means the rate of death among patients at the trust is a third higher than would be expected by looking at national figures, after adjusting for patients' age and the severity of their illness.
This is likely to prompt comparisons with Stafford Hospital where similar concerns were raised about a higher than expected mortality rate.
After internal investigations at Stafford failed to find a problem, an independent inspection found serious failings in emergency care ...
BBC NEWS 26 November 2009Hundreds of patients may have died needlessly
Katherine Murphy, director of the Patients Association said: “Yet again patients are being neglected. Lack of monitoring, lack of help with feeding, lack of dignity, avoidable pressure sores. How many times do the public need to keep hearing about this before the Government is embarrassed enough to do something about it?
"We’re sick and tired of NHS managers and senior staff walking away unscathed when families are left with a life sentence of grief.”
Basildon was one of the country's first foundation trusts, meaning it was given special status in 2004 to have more freedom over its spending and did not have to answer to ministers. Mid-Staffordshire was also a foundation trust, raising questions that the system is allowing failures to slip through.
It has also emerged that Basildon became the first foundation trust to be issued with a warning notice over poor infection control earlier this month over hygiene in the A&E department and contamination of medical equipment.
The trust, which has a budget of £250 million and more than 700 beds at its main hospital in Basildon, has repeatedly pledged to improve but failed to do so, the CQC's report said ...
TelegraphFailings found at second hospital, chairman sacked
Investigation of the Basildon hospital scandal must ask if warnings were ignored
Chief Executive of 'appalling care' hospital has affair with safety manager
Colchester hospital boss sacked
Dirty Essex hospitals prompt call for system reform
Can we trust the data on hospitals?
NHS mistakes 'harming thousands'
More than 5,700 patients in England died or suffered serious harm due to errors latest figures for a six-month period show.
The National Patient Safety Agency said there were 459,500 safety incidents from October 2008 to March 2009 - the highest rate since records began ...
A breakdown of the latest figures show that in two thirds of cases - 303,016 - there was no harm to the patient, while a quarter - 122,246 result in low harm, which included minor injuries from things such as falls resulting from poor safety practices.
Another 28,521 - or 6% - resulted in moderate harm and 5,717 - 1% - in death or severe harm, which is classed as permanent injury or disability ...
Peter Walsh, of Action Against Medical Accidents, said the reporting of safety incidents should be made mandatory, adding: "Not to do so would be a travesty." ...
BBC NEWS 07 October 2009
Whistleblower nurse 'faced witch hunt'
A nurse choked back tears today as she told an employment tribunal she faced a "witch hunt" and was threatened with having her house burned down if she did not drop a complaint.
Senior nurse Jenny Fecitt said her daughter took the anonymous call warning their house would burned, while she was in dispute with her employer after raising concerns over a work colleague ...
Ms Fecitt ... is taking NHS Manchester to tribunal, along with fellow nurses Annie Woodcock and Felicity Hughes, claiming they were victimised after voicing their concerns - ignored by health bosses - about Mr Swift.
They have listed 46 examples of what they say is victimisation and bullying after the complaint was not treated seriously ...
Independent 22 September 2009Whistleblower Nurses Take NHS To Tribunal
Whistle-blowing nurses take NHS to tribunal
NHS nurses attacked for 'cruel' treatment of elderly patients
Many elderly patients are being treated in a demeaning manner by a small number of "bad, cruel nurses" according to a report published today by the Patients Association.
The charity's investigation presents 16 stories in detail from a database of hundreds of stories from patients and their relatives who claim to have been badly treated by the NHS.
It reveals stories of people allegedly left lying in their own faeces and urine, having call bells taken away from them and being left without food or drink.
LordBrett
27 Aug 09, 9:10am
... The training game now is `bums on seats`- universities are under pressure (from themselves mainly) to fill courses.
When I interview for student nurses, I am told we are short of (number) of places.
I know that out of 40 students, perhaps 5 will be very good, 20 ok - mediocre and the rest awful.
When they inevitably start to fail written work and/or placements, we are practically told to move heaven and earth to keep them, because each student is worth thousands.
We are even told teaching jobs are on the line if we lose students.
That`s why I`m leaving - its all become like an episode of The Wire.
Guardian 27 August 2009
Patients Not Numbers, People Not statistics
The Patients Association has campaigned for many years to improve the quality of care provided by the NHS and throughout that time our efforts have been fuelled by the accounts we receive from patients and their relatives through our HelpLine on a daily basis.
As a consistent pattern of shocking standards of care has emerged we have decided to publish a number of these accounts to highlight the unacceptable experiences facing patients up and down the country on a regular basis.
The Patients Association calls on Government and the Care Quality Commission to conduct an urgent review of the standards of basic care being received by patients in hospital and demands stricter supervision and regulation of hospital care ...
Extracts from the accounts:
Account 1: Leslie Kirk"Toilets were not cleaned properly with faeces clearly left from several previous uses. My sister often had to clean them herself before she'd let my father use them."Account 2: Pamela Goddard
"At no time during my father's stay on the ward did we feel there was anyone who cared for patients enough and who took responsibility for ensuring they got the attention they needed.""Upsettingly for my brother who visited her frequently, she was often found in her own faeces and urine when he arrived. He would need to prompt staff to come and wash and change her."Account 3: Florence Weston"She was also told that, because of being unable to use the toilet facilities through being immobile, she should wet the bed. This was highly embarrassing for her. Even worse, on one occasion, a night nurse told her off for doing this severely enough to reduce her to tears and cause her to ask me if she could go home."Account 4: Oenone Hewlett"When she arrived at Wexham Accident and Emergency following her stay at St Marks, the doctor thought she must have been at home alone and neglecting herself. We had to explain she had been in hospital. He couldn't understand how she could've become so dehydrated."Account 5: Bella Bailey"Confused patients often wandered around semi naked and some staff passed them by in the corridor without a care. Night time and weekends were the worst. Night time was often the most busiest and noisiest. Staff squealed and giggled whilst patients tried to grab a bit of sleep in between their discomforts."Account 6: Thomas Milner"The nurse also failed to provide incontinence pads as had been done during the evening and night before. He was bleeding rectally and he ended up laying in urine and blood. He also wet the floor and my elderly mother wiped this up while the nurse and assistant nurse watched on and did nothing to help. They did not even bring a mop and bucket afterwards to disinfect the floor."Account 7: Anne McNeill"I remember on one occasion I visited her and found her sitting in a chair with her own vomit all over her clothes. It was dried so it seemed as if it must have been left there for some time. There was also dried vomit in bowl next to her. I looked up and down the ward and couldn't find a nurse anywhere."Account 8: Thomas George Dalziel"When we were taken to his bed we were not prepared for the horrific sight of seeing him, eyes wide open with a resuscitation tube down his throat. This image has traumatised not only us but also my sister and brother in law for the rest of our lives!"Account 9: Jayne Knowles Smith"I used to pride myself on being a nurse and hopefully I was caring and thoughtful. I have had the misfortune of seeing nursing from another angle as a patient. It's a scary world out in the wards. I'm not sure if it's the training that's lacking, the basic skills or just understaffing."Account 10: Colin Richard Purkiss Smith"That evening my husband wanted to go to the toilet. I needed help from staff to take him and so I asked staff for help. Over an hour later still no one had come and my husband had an accident in the bed. I went outside of the room to the nursing station to get one of the staff to get clean sheets for the bed and when I looked, I noticed that one of the staff on duty was surfing the internet."Account 11: John David Drake"I then went to the Hospital and when we arrived at the Ward, we were both shocked to see the state that my Husband was in. My Husband appeared very de-hydrated and even more confused. My Husband had not been washed and neither was there water on my Husband's locker. I washed my Husband myself and gave him a lot of water to drink. It took some time as it was hard for him to swallow but with some patience and care he was able to drink plenty of water to quench his thirst."Account 12: Professor Leslie C Vaughan" I find it unacceptable that a man at this point so obviously close to the end of his life should be left alone behind a curtain on a busy ward. The staff had phoned us and knew we were coming so that they surely could have spared a sympathetic nurse to sit with him until we arrived.Account 13: Margaret Bristo"Often you would stand right in front of them (the nurses station) but staff would keep their heads down and avoid eye contact with you. All my brothers and sisters felt the same. One even said asked "am I invisible" after being ignored time and time again."Account 14: Alice Fowler"I witnessed patients struggling to open plastic packages of sandwiches and/or fruit juice. Sometimes if patients weren't awake during meal times their food was left uncovered without any attempt to wake them or encourage them to eat. The food would then be taken away untouched."Account 15: Barbara McVernon"A few mornings after Mum's admission, I arrived to discover a patient with dementia in her room, going through her belongings. When the old lady refused to leave and became aggressive, I rang the nurses' bell but no one responded. I was reduced to shouting down the corridor. Eventually a non-uniformed woman came and led her away."Account 16: Patient A"The toilet was disgusting. It was soiled and had a soiled toilet brush. The public toilets downstairs were bad enough, often dirty and blocked. It's horrifying to see this in a hospital let alone on a ward. There are countries poorer than us yet their hospitals are clean and immaculate."The Patients Association'Cruel and neglectful' care
Alzheimer's is not a 'health condition'
NHS Worcestershire ruled that Judith Roe, 74, did not qualify for NHS funding because her condition was a "social" rather than "health" problem, even though she was so ill she could not make a cup of tea and regularly left the stove on.
She was forced to sell her £200,000 home to pay her £600-a-week nursing home fees, which would have been funded if she had been categorised correctly ...
Telegraph 18 August 2009Alzheimer's carers awarded £300,000
Patient safety 'still threatened'
Basic changes recommended after a cancer drug slip-up that killed a teenage boy have yet to be implemented, eight years after he died, MPs say.
The House of Commons Health Committee warns targets "too often" come before patient safety and highlights inaction on measures which could save lives.
Wayne Jowett died in 2001 after drugs were injected in his spine not a vein.
Changes to spinal needles to stop the same mistake happening again were drawn up, but have yet to be introduced.
"It is totally unacceptable that an identified and simple solution to a catastrophic problem should take so long to be put into practical use," the health committee wrote in their 100-page report on patient safety failings.
The MPs also suggested that a fear of litigation and a "blame culture" was preventing healthcare workers from being open when mistakes occurred ...
The committee said it was appalled at the failure to introduce the NHS Redress Scheme, designed to encourage openness by removing the threat of lengthy and costly litigation, three years after parliament passed the necessary legislation ...
BBC NEWS 02 July 2009
Patients with suspected cancer forced to wait so NHS targets can be hit
People arriving at Accident and Emergency departments with symptoms which could indicate the aggressive spread of the disease are waiting weeks for diagnosis and treatment while “routine” cases are prioritised.
Hospital managers told researchers that treating desperately sick patients more quickly would “reflect badly” on their performance against Government cancer targets which only cover those referred to specialists by GPs ...
Telegraph 07 June 2009
Firm that hired death case doctor loses NHS contract
The company that employed a foreign doctor who accidentally killed a patient on his first UK shift providing out-of-hours cover is losing its contract with the local NHS, it was revealed tonight.
The health authority has promised that "tough questions" will be asked of all companies that want to bid to run the services, including close examination of their induction procedures for staff and policies on the safe use of controlled drugs ...
The Guardian has also learned that two more incidents have emerged of patients who needed hospital treatment after being seen by doctors working for the same company and using the same painkilling drug used in the accidental killing.
The cases, which happened before last year's fatal mistake in Cambridgeshire, also involved Take Care Now, the company that hired the doctor Daniel Ubani when, on his first UK shift, he administered a dose of diamorphine 10 times the normal recommended maximum level to 70-year-old David Gray.
Guardian 21 May 2009Exhausted relief doctor gave patient fatal dose
Care of terminally ill attacked
The standard of care of the terminally ill in the NHS in England has been criticised by MPs.
Palliative care has been given a low priority, said members of the Committee of Public Accounts.
They said lack of services and poor co-ordination of health and social care meant many people were denied their wish to die at home.
NHS end of life care was also criticised in a National Audit Office report published last November.
Approximately 500,000 people die in England each year, and around 75% of these deaths follow a period of chronic illness.
Although most people would rather die at home, the majority (60%) end their days in hospital - even though there is no clinical need for them to be there.
The MPs said front line health workers often lacked training in basic end of life care.
They said people who died in hospital did not always receive first rate care, such as the most effective pain management, and were not always treated with dignity and respect.
The MPs also highlighted problems of poor co-ordination between different branches of the caring professions which meant that the wishes of terminally ill patients were often not known.
And even when a patient had made it clear they wanted to die at home, that wish was often not satisfied because of a lack of services to care for them outside hospital ...
BBC NEWS 13 May 2009Care 'failing the terminally ill'
Promise to improve care for dying
Calls for better care for dying
Elderly 'denied dignified death'
NHS criticised for Baby P errors
A catalogue of failings by the NHS meant a series of opportunities that could have saved Baby P's life were missed, the health regulator says.
The toddler - now named as Peter - from Haringey, London, had been seen by health services 35 times by the time he died after horrific abuse in 2007.
Two doctors involved in his care have already been suspended.
But the Care Quality Commission said Haringey's services were poor, leading to an apology from NHS trusts involved.
Baby Peter had suffered more than 50 injuries by the time of his death in August 2007, aged 17 months.
The catalogue of abuse he suffered emerged during a court hearing at the end of last year that led to the conviction of his mother, her boyfriend and their lodger for causing his death ...
The 35 contacts with the NHS covered visits to a GP, health visitors, consultant paediatricians, hospitals and walk-in centres.
The regulator criticised three trusts in particular - Haringey, which was responsible for the community services, North Middlesex Hospital and the specialist children's hospital Great Ormond Street, which provided the paediatric staff for both the local trusts.
It said system failure meant medical records were not shared between different health services and NHS workers did not properly alert social services and police to their concerns ...
Staff shortages and delays in assessments were also noted ...
... the CQC pointed out that staff did not follow protocols when they were in place.
Bone and skeleton scans were not always carried out to give a clear picture of Peter's injuries.
The report said the consultant who saw Peter two days before his death and noted bruises and marks over his body did not alert a social worker ...BBC NEWS 13 May 2009THE MISSED OPPORTUNITIES
- Six recorded visits to hospital, two of which were to an A&E unit
- GP saw Peter 14 times, the last of which was a week before his death. The doctor is under investigation
- One visit to a specialist health service. Paediatrician now suspended
- Five visits made to Peter at home by health visitors
- Two recorded visits to walk-in centres
- Other contacts include mental health workers and parenting counselling service
Hospitals 'ignoring whistleblowing staff afraid for patient safety'
Just weeks after a damning report condemned failures which led to the deaths of up to 1,2000 patients at Stafford Hospital, a survey for the Royal College of Nursing (RCN) suggests that other hospitals could be turning their backs on problems putting patients at risk.
Nurses also fear that they will be victimised if they speak out about the problems, the poll reveals ...
Speaking on the eve of the RCN's annual conference in Harrogate, Dr Peter Carter, chief executive of the College, said: "Sadly, the recent example of Mid-Staffordshire shows us what can happen if genuine concerns are dismissed or not investigated properly. We know that incident reports filled in by nurses were not acted upon with disastrous consequences. We also know that nurses have genuine concerns that they will be victimised if they speak up. And too often they're right."
One nurse told the RCN that she had been told that she would "never get on" in the local healthcare trust where she worked because she had spoken out.
Dr Carter said: "We've had laws protecting whistleblowers for ten years now however they're not worth the paper they're written on if they sit in a drawer and gather dust. If Trusts want to avoid another Mid-Staffs, they need to make every nurse aware of the protection that the law gives them when they raise concerns about patient safety." ...
Telegraph 11 May 200940,000 names on petition for sacked NHS whistleblower
Nurse who secretly filmed for Panorama is struck off register
The chair of the tribunal panel, Linda Read, said Haywood's secret filming for Panorama was a "major breach" of the nursing code of conduct.
"The panel is of the view that the misconduct found is fundamentally incompatible with being a nurse," Read added. "The registrant embarked upon filming many vulnerable, elderly patients in the last stages of their lives, knowing that it was unlikely that they would be able to given any meaningful consent to the process, in circumstances where their dignity was most compromised."
She added: "Although the conditions on the ward were dreadful, it was not necessary to breach confidentiality to seek to improve them by the method chosen."
Guardian 16 April 2009Silencing the truth
'Looking after Mum and Dad'
Four psychiatric patients dying each day in NHS care
The NHS is today castigated for providing "inadequate" psychiatric help to vulnerable mental health patients, as new figures reveal an average of four deaths a day among those in its care.
Data collected by the National Patient Safety Agency (NPSA) shows that 1,282 people in England died in what it calls "patient safety incidents in mental health settings" in the period 2007-08.
Another 913 patients - more than two a day - suffered what is termed severe harm, or permanent injuries, in such incidents.
The figures include patients who died as a result of self-harming behaviour, including suicide, disruptive or aggressive behaviour, medication safety errors and accidents, although it is not specified how many deaths fell into each category ...
Paul Corry of the mental health charity Rethink was equally critical:"These figures are very disturbing and unacceptably high. Almost 1,300 deaths in a year is far too many. The NPSA data tell us that too often NHS care for mental health patients is poor."The NHS has reduced the number of suicides in psychiatric hospitals in recent years, said Corry, but guidelines intended to help another vulnerable group - mentally ill people who have recently returned home from care, among whom suicides are common - are widely ignored."Every mental patient who returns home is supposed to be visited within seven days to check on their mental state and see if they are feeling suicidal," he said. "In places where it's done it helps to stop people taking their own lives. But very often it doesn't happen." ...
Observer 12 April 2009'If only the nurse had said there was a problem'
Mental Health
Rethink
National Patient Safety Agency
Starved by the NHS: 242 patients die from malnutrition in a single year
Malnutrition killed more than 240 patients on NHS wards in 2007, the highest toll in a decade, figures show.
The appalling statistics reveal that the number of men and women starving to death in hospitals has risen by 16 per cent since Labour came to power.
Since 1997, 2,311 hospital patients have died from malnutrition and the effects of hunger.
There were 209 cases in 1997, when Tony Blair was elected under a pledge to save the NHS. Ten years later the toll was 242.
In one area the number of deaths from malnutrition rose by more than 50 per cent.
The figures also show that over the past decade 55 patients have starved to death in council-run care homes ...
Daily Mail 08 April 2009Patient 'died of starvation in NHS hospital' Telegraph
Number of elderly patients starving in NHS wards doubles to 30,000 in two years This is London
Patients left to starve on NHS wards Telegraph
Patients leave hospital half-starved and the NHS is chucking food in the bin Guardian
NHS discriminates against over-65s
NHS mental health services often discriminate against people over 65 by withholding treatment that is freely available to younger adults, the Healthcare Commission said today.
It found older people in many parts of England do not have access to out-of-hours services, crisis support, psychological therapies, and programmes to tackle alcohol or drug abuse.
They are often excluded on grounds of age without any attempt to discover whether they would qualify on the basis of need ...
About 40% of older people who visit their GP are thought to have a mental health problem, but GPs rarely refer them for specialist help. The commission said the problem will increase as the population ages. The number with dementia is expected to rise from 700,000 to more than 1 million by 2025 ...
A second study from the commission found gaps in community mental health services for all adults. Almost half of the people needing specialist mental healthcare do not have an out-of-hours number to call if they are in a crisis.
And 55% of people with schizophrenia have not been offered recommended psychological therapies.
Guardian 31 March 2009
Investigation reveals appalling neglect
by NHS of people with learning disabilitiesNHS and social care staff have been responsible for an appalling catalogue of neglect of people with learning disabilities, the health and local government ombudsmen say today after an investigation into six "distressing" deaths.
They included the case of a 43-year-old man with Down's syndrome and epilepsy who starved for 26 days in Kingston hospital, Surrey, because he was unable to speak.
The ombudsmen found patients with learning difficulties were treated less favourably than others, resulting in "prolonged suffering and inappropriate care". When relatives complained, they were left "drained and demoralised and with a feeling of hopelessness".
The investigation upheld complaints of maladministration against seven NHS trusts and two local authorities involved in the six unrelated deaths between 2003 and 2005. It also criticised the watchdog, the Healthcare Commission, for failing to deal properly with complaints.
Ann Abraham, the health service ombudsman for England, said: "The recurrence of complaints across different agencies leads us to believe the quality of care in the NHS and social services for people with learning disabilities is at best patchy, and at worst an indictment of our society." ...
Guardian 24 March 2009Disabled people 'failed by NHS'
Anger over care for son who died
Will 'shocking' care be addressed?
Call for damning death verdicts
Disabled 'face suffering in NHS'
'The NHS failed my daughter'
NHS starts inquiry into deaths of patients with learning difficulties
A Mencap spokesman, David Congdon, said: "We hope that the ombudsman will find that these people all got a pretty poor deal from the health service. There were three recurring failings: a failure to diagnose what was wrong with someone, especially when they couldn't communicate; lack of treatment of pain; and a failure to listen to parents or carers. If you ignore people, or think they are fussing too much, you aren't going to properly diagnose what's wrong with someone, which can lead to people dying unnecessarily."
Guardian 19 January 2009
Patient with Down's syndrome starves in hospital
Birmingham Children’s Hospital is failing to cope with high numbers of patients, turning away desperately ill children in a bed and management crisis, an investigation has revealed.Birmingham Children's Hospital can't cope with demand - report
The Foundation Hospital Trust can’t cope with a surge in demand with too few beds, cancelled operations, poor working procedures for staff and poor planning of services, an independent Healthcare Commission report found.
Theatre staff were also unable to identify surgical equipment and care was ruled as being below standard, particularly in speciality areas such as renal and liver transplants, neurosurgery and cardiac services.
Concerns were still being raised last month including fears for patient safety after a brain surgeon was handed incorrect instruments and his hand was jolted by an untrained theatre nurse during a lifesaving procedure ...
Surgeons from Queen Elizabeth Hospital, in Edgbaston, first raised concerns in January last year, but serious issues were not rapidly addressed and a report by Birmingham primary care trusts was not passed on to board members of Monitor, the overseeing body of foundation trusts and the Children’s Hospital.
Children’s Hospital bosses told investigators at least 70 children a month had to be redirected to other hospitals, travelling further away from home for treatment, with numbers of cancelled admissions due to lack of beds rising in the past year ...
Parents Ayaz and Sophie Ahmed, whose daughter Alesha died at Birmingham Children’s Hospital, said they were not surprised by the findings as they saw the hospital managed “appallingly” with staff unaware of procedures and a two week delay in getting their baby into intensive care ...
Birmingham health scrutiny chairman, Coun Deirdre Alden, was critical of the trust blaming patient choice for the rise in demand ...
Birmingham Post 20 March 2009Hospital 'put children at risk'
Children's hospital boss resigns
Complaints spark hospital inquiry
Scandal hospital chief's £45,000 rise
[Move over Fred, you've got company]
The chief executive of Stafford Hospital, which was condemned yesterday for "appalling" emergency care that may have cost hundreds of lives, took a pay rise of up to £45,000 while the hospital was being investigated.
Martin Yeates, who was suspended on full pay by the Mid-Staffordshire NHS Trust on Monday, was told in a letter on 23 May 2008 of the initial findings of the Healthcare Commission's investigation, detailing the chaotic conditions in the A&E department, with unqualified receptionists assessing patients, a shortage of nurses and doctors and a "complete lack of effective governance".
The letter was copied to the Department of Health but Mr Yeates remained in his post for nine more months, until he resigned two weeks ago, before being formally suspended by the trust ...
Annual reports for the trust show Mr Yeates' pay increased from between £135,000 and £140,000 in 2006-07 to between £150,000 and £156,000 in 2007-08. He had a further rise when the trust achieved coveted foundation status in February 2008, taking his pay to £180,000, an overall increase of between 7 per cent and 33 per cent.
The chairman of the trust, Toni Brisby, who resigned this month, had her pay doubled from £20,144 to £40,000 for three and a half days a week when the trust achieved foundation status.
Although the rises were agreed in February 2008, they were not confirmed until a meeting of the trust's governors' nominations and remunerations committee in August 2008, three months after the Healthcare Commission had alerted the Department of Health ...
The Independent 19 March 2009
A&E patients 'left in agony'
Patients were allegedly left screaming in pain and drinking from flower vases on a nightmare A&E ward.
Between 400 and 1,200 more people died than would have been expected at Mid Staffordshire NHS Foundation Trust over three years, a damning Healthcare Commission report said.
The watchdog's investigation found inadequately trained staff who were too few in number, junior doctors left alone in charge at night and patients left without food, drink or medication as their operations were repeatedly cancelled.
Patients were left in pain or forced to sit in soiled bedding for hours at a time and were not given their regular medication, the Commission heard.
Receptionists with no medical training were expected to assess patients coming in to A&E, some of whom needed urgent care.
Sir Bruce Keogh, medical director of the NHS, said there had been a 'gross and terrible breach' of patients' trust and a 'complete failure of leadership'.
The Healthcare Commission's chairman Sir Ian Kennedy said the investigation followed concerns about a higher than normal death rate at the Trust, which senior managers could not explain.
He said: 'The resulting report is a shocking story. Our report tells a story of appalling standards of care and chaotic systems for looking after patients. These are words I have not previously used in any report.
'There were inadequacies in almost every stage of caring for patients. There was no doubt that patients will have suffered and some of them will have died as a result.'
Julie Bailey, 47, was so concerned about the care being given to her 86-year-old mother Bella that she and her relatives slept in a chair at her hospital bedside for eight weeks.
She said: 'We saw patients drinking out of flower vases, they were so thirsty. Patients were screaming out in pain because you just could not get pain relief.
'It was like a Third World country hospital. It was an absolute disgrace.'
The Trust's chief executive, Martin Yeates, and chairman, Toni Brisby, resigned earlier this month.
Orange Tuesday 17 March 2009, 14:10pmA&E patients 'left in agony'
Failing hospital 'caused deaths'
John Forbes Nash and targets in A & E
A hospital's "appalling" emergency care resulted in patients dying needlessly, the NHS watchdog has said.
About 400 more people died at Staffordshire General Hospital between 2005 and 2008 than would be expected, the Healthcare Commission said.
It said there were deficiencies at "virtually every stage" of emergency care and said managers pursued targets at the detriment of patient care ...
The commission said that, while it was impossible to blame all of the the 400 extra deaths on the hospital's care, some patients would have died as a result.
Chairman Sir Ian Kennedy said: "This is a story of appalling standards of care and chaotic systems for looking after patients.
"There were inadequacies at almost every stage in the care of emergency patients.
"There is no doubt that patients will have suffered and some of them will have died as a result.
"Trusts must always put the safety of patients first. Targets or an application for foundation trust status do not lessen a board's responsibility to its patients' safety." ...
BBC NEWS 17 March 2009Alan Johnson moves to 'close this regrettable chapter in hospital's past'
Hospital condemned
Relatives' reactions to report
What are the lessons for the NHS?
Why are so many hospital doctors sending their patients home too early?
Two weeks after undergoing a triple heart bypass, hospital staff said Brian was ready to go home.
Though the 70-year-old was suffering bouts of severe breathlessness, he was told he’d be able to manage on his own.
Yet once he was at home, Brian found breathing so difficult he wasn’t able to lie down in bed, and two days after being discharged from hospital, he had to be readmitted. He was put on oxygen immediately and spent a week in hospital.
Brian was one of thousands of NHS patients each year who are discharged from hospital too early because of bed shortages or the need to meet government targets. These patients then have to be readmitted for emergency medical care.
There’s been a steep rise in emergency readmissions - a patient readmitted within 28 days of being discharged.
In 1998, 7 per cent of patients needed readmitting, according to the National Centre for Health Outcome Development. By 2006, it had risen to 9 per cent, which means an extra 100,000 patients a year had to go back into hospital. ...
Five years ago, the Government introduced delayed discharge fines, which means local authorities are penalised if a patient has to stay in hospital longer than necessary because community care is not in place. ...
However, medical and nursing support in the community is not always in place.
There are variations in the quality of community health and social care, and the co-ordination between hospital and community care, and this can affect hospital readmissions. If the quality of community care is poor, the patient is more likely to be readmitted to hospital.
The problem has been compounded by the fact hospitals are cutting follow-up appointments. This means increasing numbers of patients are having their post-op checks done by GPs and practice nurses rather than specialists.
This has prompted concerns over whether GPs have the expertise to deal with complex cases. Indeed, the latest figures show more GPs are referring patients to outpatient departments.
‘It is imperative that the pressure to speed up an older person’s discharge from hospital is not at the expense of their treatment and care, and is backed up by services in their community,’ says Gordon Lishman, director general of Age Concern. ...
Daily Mail 30 December 2008
East Lancashire hospital chief blasts critical GPs
This squabble between a GP and the chief executive of East Lancashire Hospitals NHS underlines the issues raised by Rachel Ellis in the Daily Mail:
EAST Lancashire’s hospital boss has told the GP who criticised her under fire A&E department: You’re bang out of order.
And Marie Burnham said GPs had put extra pressure on services by sending too many patients their way — and called on community health trusts to stump up more cash to ease bed shortages.
The chief executive ... hit back after Barrowford GP Dr Iain Ashworth told the Lancashire Telegraph that patients were being discharged “dangerously early” to free up beds.
It followed a row over the unprecedented number of patients turning up at A&E.
Earlier this month the volume of patients forced the emergency department at the Royal Blackburn Hospital to be closed for three hours.
Patients were sent up to 28 miles away for treatment.Community Care
Dr Ashworth's statement confirmed the causes of the problem: Margaret Thatcher's ignorant decision to insist on a bed occupancy rate of 105 per cent, and the lack of community alternatives to care in hospital:
Dr Ashworth said: “There is not enough infrastructure in the community to look after these people.
“We would all like people to be able to recover at home, but the hospitals shake-up was pushed through on political imperative, with no real planning for what would happen to the patients.
"We try not to send people to hospital if we can help it, because we know there are no beds."Lancashire Telegraph 27 November 2008
NHS cutbacks see thousands more patients admitted as emergency cases
Cutbacks in routine hospital care are leading to thousands more patients being admitted as emergency cases, new figures have revealed.
Consultants say lives are being put at risk because doctors are under pressure to see existing patients less often in order to meet NHS targets and boost hospital income.
Health service data shows that a fall in the number of follow-up appointments per patient has been accompanied by a sharp rise in the number of patients readmitted as an emergency.
Consultants say patients' infections and complications are going undetected until they have reached an advanced stage, while chronic conditions continue uncontrolled, creating a danger of permanent damage or death.
The new NHS figures show that the number of follow-up appointments per new patient fell by 14 per cent last year, while the number of emergency readmissions within two weeks of hospital discharge rose by 12 per cent ...
Telegraph 05 October 2008
NHS 'fast losing its compassion'
In an interview on Radio 5 - 30.12.2008 - it became clear that 'compassion' is causing concern inside the Westminster_Whitehall Bubble, where - you could not make this up - they are searching for a way of measuring it, so that it can be turned into a target!
There has been a deterioration in the level of compassion in the NHS in recent years, the head of a leading health think-tank has told the BBC.
The King's Fund is running a special project to try to get nurses and other staff to focus on being compassionate.
Its chief executive, Niall Dickson, said this was a fundamental issue that should be a top priority for every hospital board.
He blames work pressures for staff being less feeling ..."It's to do with staff facing very difficult situations - because patients are sicker and hospital stays are shorter - rather than them all turning into nasty people.
"If we can't get compassion into our healthcare, the system is failing. It's as fundamental as that.
"The board of every hospital should be looking at this as one of their top priorities - what is it like for someone who's coming in to be treated, and how can we improve that experience?"
BBC NEWS 30 December 2008The, er, 'deterioration' is well illustrated by this concurrent report:
Compassion 'key to good health care'
Amanda Platt still burns with indignation when she recalls her late father-in-law's dying days in the care of the NHS.
Aged 101, he was sent home from hospital on an hour-long journey in a taxi, wearing ill-fitting pyjamas.
After a five-day stay on a mixed ward, his clothes that were soiled with excrement were put in the same bag as his clean ones.
Salisbury Hospital in Wiltshire says it has apologised to the Platt family.
But Mrs Platt wept as she said: "You just don't do that to people. All he had left was his dignity.
"His hearing aid was squashed and his false teeth were lost. The teeth were brand new - he had insisted on having new ones and they had cost him a lot of money, but he didn't want to ever be seen without his teeth in.
"I was so furious. I think respect in that situation is the same as compassion." ...
BBC NEWS 30 December 2008Dying with Dignity?
It would be good to think that the above report is a one-off, but the appalling case of the Maidstone and Tunbridge Wells NHS Trust suggests otherwise:
Rape victim 'too grubby' for NHS
The National Health Service has been criticised in court after a doctor told the male victim of a double rape that he was "too grubby" to be treated. The 50-year-old victim was attacked by Levi Lavers, 19, from Newlyn, Cornwall, after Lavers broke into his home. He was given six years in youth custody. Prosecutors said that after the attacks the victim "was then treated abominably by the NHS". ...
BBC NEWS 22 April 2008
Hospital bug deaths 'scandalous'
With typical New Labour hypocrisy, Alan Johnson shifted the blame onto the hospital management when all they were doing was trying to meet Whitehall's grotesque targets:
The deaths of 90 hospital patients from clostridium difficile are "scandalous", Health Secretary Alan Johnson has said.
Kent police have launched an investigation into whether the Maidstone and Tunbridge Wells NHS Trust should be prosecuted for the deaths.
The Healthcare Commission said a "litany" of errors in infection control had caused the "avoidable tragedy".
The trust said it had not been prepared for "an outbreak of that size and complexity" but had learned lessons.
The commission's report said nurses at the trust were too rushed to wash hands and left patients to lie in their own excrement. ...
BBC NEWS 11 October 2007
Man dies after street gang attack
A 23-year-old man with learning difficulties has died in hospital after being "savagely attacked" by a gang of up to five youths.
Brent Martin was found with multiple injuries on Sunderland's Town End Farm estate on Thursday night after reports of a man being beaten up.
He was taken to the city's Royal Hospital, where he died on Saturday.
A 21-year-old man and three youths, one aged 16 and two aged 17, are being questioned by police.
Mr Martin, described as vulnerable by police, had been the victim of a "sustained and brutal" beating. ...
BBC NEWS 25 August 2007IT TOOK 30 MINUTES FOR THE AMBULANCE TO COME, AND WHEN HE WAS TAKEN TO THE A+E THEY LEFT HIM FOR 2 HOURS IN THE CORRIDOR AS IF HE WAS ANOTHER DRUNK THAT HAD BEEN BASHED UP. it was only 2 hours later that the NHS staff realised he was not another drunk, but that he had taken a beating to his head and needed to be moved to ICCU.
Anonymous Blog 25 August 2007 21:52