Half of NHS Trusts are still not complying with Patient Safety Alerts

AvMA, Action against Medical Accidents, reports that half of NHS Trusts are still not complying with Patient Safety Alerts. It should really beggar belief, but somehow the repeated cavalier attitude to patient care comes to be simply what we expect of the NHS, the Health Service that puts patients last.

"AvMA today published its latest report into implementation of patient safety alerts "Too little too late?" It shows that whilst there has been a significant improvement since our report six months ago, half of NHS trusts still have not complied with at least one alert which is past its deadline. 45 trusts had not complied with 5 or more alerts, some of which were years past the deadline. Full implementation of all alerts by the deadline given is supposed to be mandatory. Each alert not implemented leaves patients at unnecessary risk and it is inevitable that non-compliance with alerts has already resulted in patients being unnecessarily harmed or even killed."

Please read again the last sentence of that extract, and think about it.
The full report can be downloaded from the AvMA website.

NHS Trusts put patient safety at risk by failing to implement safety alerts in over 1000 instances

BBC News carries this report. As you will see, the regulatory bodies respond with their usual complacency, but "There can be no excuse for trusts continuing to put lives at unnecessary risk," said chief executive of the charity, Action Against Medical Accidents, Peter Walsh.

I suggest that the highest-paid member of the NHS Trust management team be made specifically responsible for the Patient Safety Alerts being implemented, and implemented on time, with a clause in his/her contract of employment that they will be sacked without pension/testimonial/reference/right of appeal the first time they fail to do this. This, I think, would ensure that an appropriate level of importance and urgency be accorded to this measure upon which, after all, patient lives depend.

Campaign group says least 100,000 non-medical staff in NHS trusts have access to confidential patient records

See BBC News report.

Sir Richard Branson criticised "horrific" hospital infection rates, accusing politicians and health bosses of "tinkering" with the problem.

Sir Richard Branson accuses politicians of failing over hospital superbugs
article in the Telegraph

Extract:

"The Virgin tycoon, who was recently appointed vice-president of the Patients Association, called for all hospital staff to be screened for the superbug MRSA and receive immediate treatment if infected.

He has also said managers at failing NHS trusts should be fired.

Infection rates for MRSA are falling across the UK with the most recent quarterly figures showing a 33 per cent drop year on year, but Sir Richard is calling for more to be done.

The entrepreneur - whose daughter Holly is a doctor - told the BBC: "There have been some improvements, but the facts speak for themselves - and the facts are still horrific.

"It feels like they have tinkered with the problem rather than really got to the heart of the problem. The hospitals are there to cure people. They are not there to kill people."

He said the NHS could learn from the airline industry about how to avoid mistakes and improve.

"In the airline industry if we had that kind of track record we would have been grounded years ago," he said.

"In the airline industry if there is an adverse event that information is sent out to every airline in the world.

"And every airline makes absolutely certain that that adverse event doesn't happen twice."

Sir Richard is helping to organise an international conference on infection control and patient safety early next year."

I'm pleased he is not afraid of speaking out about these important matters. He sounds as though he is an appropriate person to be vice-president of the Patients Association.

Thousands of patients are the victims of medical errors that could have been avoided if safety were given a higher priority in the NHS

Thousands of NHS patients suffer avoidable medical errors, says Healthcare Commission
article in the Telegraph

Extract 1:

"The report said only half of NHS trusts comply with all safety standards and there has been little improvement.

Errors that have led to patients being harmed include incorrect diagnosis, wrong doses of medication, surgeons operating on the wrong part of the body and paperwork going missing.

The wide ranging report covers all aspects of healthcare in England and highlights a number of areas of significant improvement in the NHS, particularly around deaths from cancer and heart disease and huge reductions in waiting times.

Demand for healthcare has increased dramatically, the NHS has higher levels of funding than ever before, and the health of the nation is improving, the report said.

However, the last annual report before the Healthcare Commission is subsumed by the Care Quality Commission, the report focuses on patient safety and the lack of progress in the last five years.

The report said too few incidents are reported to the National Patient Safety Agency with particular problems in primary care where doctors and nurses report almost no errors although the majority of patient care is delivered by GPs."

"Dr Hamish Meldrum, Chairman of Council at the British Medical Association said: "The overall picture in this report is of major improvements to standards of care. We applaud the efforts of NHS staff in reducing the amount of time patients have to wait, and improving the quality of the care they receive.

Extract 2:

"Any errors are regrettable but there are millions of contacts between the NHS and patients every day. It is inevitable that, in a very small proportion of these, care falls below the highest standards. Doctors want to get rid of unacceptable variations in quality, but we need to be careful to analyse and learn from the causes of low performance rather than jumping to conclusions or simply adopting a blame culture."

Martin Fletcher, Chief Executive at the National Patient Safety Agency, said: “Good reporting is the cornerstone of patient safety. Safety cannot be improved without a range of valid reporting, analytical and investigative tools that identify the sources and causes of risk in a way that leads to preventative action. The National Reporting and Learning System has a vital role to play in supporting NHS organisations to identify risks to safe patient care. Patient safety needs to be everyone’s responsibility.”"

If you read the whole article you will see that the foolish Dr Meldrum's response is so glaringly at variance with the contents of the report as to be gross lies.

Couple the reluctance of doctors and hospital trusts to admit to errors and to report them, with the long-standing culture of cover-up by the medical profession as a whole, and add to that the widespread practice of further victimising the victims of medical negligence and you may begin to comprehend the vast scale of medical malpractice and avoidable suffering in this country. Then add further the difficulties of even getting a complaint acknowledged/received by the system: the Healthcare Commission has 'gatekeepers' who prevent Prof Sir Ian Kennedy and his fellow Commissioners from even seeing many of the complaints submitted by those who have suffered/are suffering from the mistakes/negligence of the system...

We are very badly served by the expensive, poorly performing NHS and our vastly overpaid doctors, and the NHS Complaints Procedures routinely add to the suffering of complainants/victims and are a national scandal.

Best and worst NHS trusts in 2007/08

Best and worst NHS trusts in 2007/08
List in the Telegraph

Free flights, meals and match tickets given to doctors by drug companies can damage patient care, say critics

Drug giants accused over doctors' perks
Article from the Guardian

Extracts:

"Drug companies are spending millions of pounds every year on all-expenses-paid trips to conferences around the world for doctors and other hospital staff, in what critics say is a massive marketing exercise dressed up as medical education.

The Guardian can reveal the scale of pharmaceutical company sponsorship following an examination of the registers of gifts and donations to doctors that all hospitals are required to keep. They show considerable largesse - from drug companies regularly picking up hefty bills for travel to international conferences in Europe, Asia and America, to specialist nurses' salaries, and weekly sandwich lunches for hospital staff training sessions.

All-expenses-paid trips to conferences in the US, Vietnam or Hungary are a regular feature of the registers, costing the companies up to £5,000 per doctor. Many of the declarations by doctors do not put a price on the trip. The total amounts received by staff at individual hospital trusts with complete registers are substantial - Sheffield's staff received funding of more than £105,000 from pharmaceutical and medical devices companies in the 12 months to last June.

Examples of the firms' hospitality include:

· Astra Zeneca paid £2,500 for a doctor at the Royal Bournemouth trust and £1,500 for a doctor at Sheffield teaching hospital to attend a cancer conference in Texas

· Sanofi-Aventis, the world's fourth biggest pharmaceutical company, paid for doctors at the Countess of Chester trust to go to conferences in Cape Town, New Orleans and Barcelona. At Gateshead trust, their reps gave a breakfast for 30 staff "to discuss drugs for the treatment of breast cancer". The trust's register records that "the donor was seeking to secure business".

· Roche spent £2,000 for an oncology consultant at Addenbrooke's hospital in Cambridge to go to a conference in May last year.

· GSK, the biggest British pharmaceutical company, paid £1,200 for a consultant at Sheffield teaching hospital to attend the 11th international congress of Parkinson's disease and movement disorders in Turkey last June."

"Joe Collier, the recently retired professor of medicines policy at St George's hospital, London, a former member of the Medicines Commission and an adviser to the select committee, said: "Through its orchestrated campaigns affecting all those involved in the use of medicines, the pharmaceutical industry enormously influences what patients are prescribed. On the whole these influences are detrimental to best practice."

Payments to doctors are far from transparent. The Department of Health requires NHS trusts to compile registers of their medical staff's and directors' possible conflicts of interest and to make them available to the public. Only a minority do so. The Guardian requested the registers for 90 hospital trusts under freedom of information legislation. Only around a quarter returned data that included the names of the doctors and the sponsoring companies and the amounts of money received. Some refused to give any information at all.

Collier said this was unacceptable. "Declarations of interest are a key way to help break the pharmaceutical industry's stranglehold. It is not a trivial issue. Public declarations by doctors are essential if prescribing is to be sensible and appropriate and according to patients' needs.""

"Labour MP Paul Flynn described as "codswallop" the companies' claim that their only intention was to help educate doctors. "It's not true. It's part of a huge marketing budget. It's all about maximising their profits, not helping people in life-threatening situations," he said. "The influence of these companies is enormous."

Doctors who receive funding believe they are not influenced by it. Robert Storey, a consultant cardiologist at Sheffield involved in drug trials, took four trips to conferences in the year to June 2007 courtesy of Astra Zeneca at a total cost of £12,000. However, he regards these as business trips because he is asked to disseminate research findings and are funded from the R&D budget. More junior doctors have their funding arranged through the drug rep and must fly economy class under Association of the British Pharmaceutical Industry (ABPI) rules.

"If it is done through the local rep, who may expect some sort of favour in exchange for that sponsorship, there is more stringent regulation," said Dr Storey. "[Those doctors] are seeing reps on a regular basis and although it is explicitly stated in the ABPI rules that there shouldn't be any conflict or conditions [on the funding], it probably does influence doctors' behaviour because they are unsure whether they will get further sponsorship for going to further meetings, so it is useful to them to engender good relationships with different reps."

I personally regard most of these expenses-paid junkets as bribery.

Data loss crisis spreads to the NHS

The Sunday Telegraph reports that "the data crisis has taken a new twist, as nine NHS trusts admitted losing personal information of patients."

Scores of premature babies may be dying unnecessarily across England because the NHS mismanaged a reform of neonatal units in 2003

Babies dying due to NHS confusion

Extract from the Guardian:

"Scores of premature babies may be dying unnecessarily across England because the NHS mismanaged a reform of neonatal units in 2003, parliament's spending watchdog reveals today.

Health ministers provided £73m over three years to link up hospital neonatal units in 23 regional networks that could provide specialist services to save premature and low birth weight babies.

But the National Audit Office finds that the Department of Health did not issue instructions for the units to be adequately staffed. As a result the service was overstretched. Its specialist nursing workforce was nearly 10% below strength. There were not enough cots to respond to every emergency and there was a lack of specialist 24-hour transport to move babies and mothers to other hospitals.

Jacqui Smith, when health minister in 2003, said she agreed with recommendations from the British Association for Perinatal Medicine for minimum staffing ratios. But the government did not order NHS trusts to implement them.

The NAO says there was "confusion" over whether staffing ratios were mandatory, making it difficult for unit managers to convince NHS trusts they needed more staff.

Half the 180 units providing neonatal services did not meet the approved ratio for high dependency care of one nurse to two babies. And only 24% met the intensive care ratio of one nurse to one baby."

National Patient Safety Agency calls for standardised wristbands

Patient safety watchdog calls for standardised wristbands - Guardian

Extract:

"Nearly 3,000 hospital patients were given the wrong treatment last year because of inaccurate or confusing information on their identification wristband, according to the National Patient Safety Agency. The results, the agency said, could be potentially devastating, especially in surgery. In one mix-up a diabetic patient was given an almost fatal dose of insulin.

The agency, a special health authority established to coordinate the reporting of patient safety incidents, has told NHS trusts to standardise both the colour and data on the bands by July next year. Its survey of 62 trusts found eight different coloured bands in use and some departments within trusts using bands of different colours to signify the same condition.

Illegible writing on bands is one cause of confusion for doctors and nurses. The agency also notes that eight of the trusts could not be identified on the returned questionnaires because of "missing or illegible information". In the questionnaires, staff from nine trusts gave inconsistent replies to whether colour coding was used: seven responded "yes" and "no." One said "yes" and "don't know" and one gave all three responses. There were a small number of "don't knows" to nearly every question. The range of colour codes was illustrated by the use of four colours in different hospitals for "risk of falls": green, blue, yellow and orange. In others green and yellow are used to signify a confused person, and Jehovah's Witnesses not wanting blood products can be either red or blue.

The NPSA said the bands in future should be white with black text, carrying the last name, first name, date of birth and NHS number. Trusts will have the discretion to use red bands to denote a specific risk such as an allergy or a patient who does not want to receive blood products."

Sounds an excellent idea, though long overdue!


Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
How to Lose weight!

See my website http://www.wildeaboutsteroids.co.uk/.html
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Read my Mensa article on Obesity and the Salt Connection

See Sodium in foods
and Associated health conditions

I can be contacted via my website if you need my further help. My help is free...(o:

Hospitals fail to meet waiting times in over half of cases

NHS trusts fail on waiting times - Guardian

Extract:

"Less than half of NHS patients are receiving hospital treatment within the government's flagship waiting-time target of 18 weeks, new figures revealed today.

Only 48% of patients in England are treated within 18 weeks and 12.4% have to wait more than a year for treatment, according to figures published by the Department of Health today.

The results cast doubt on whether the government can meet its promise that all patients would be treated within this time by the end of 2008.

Patients in south-east England suffered the longest waits for hospital treatment with only a third seen within the target time."


Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
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NHS Trust Hospitals employing less-qualified Maternity Support Workers instead of midwives may be risking patient safety.

Maternity care flaws may put patients at risk, says report - Guardian

Extract:

"NHS trusts could be risking the safety of mothers and babies by using maternity support workers to do the work of trained midwives, a report says today.

The independent study for the Department of Health found a number of trusts across England were converting midwife positions into posts for lesser-qualified maternity support workers (MSWs).

The health secretary, Patricia Hewitt, has always insisted MSWs would not be used as substitutes for professionally qualified midwives. But the report found they were doing tasks deemed within the role of midwives and requiring specialist midwifery knowledge and training.

The report said a lack of consistency in the training and role of MSWs had the potential to leave midwives and hospital managers uncertain about their competence, and placed patients at risk from a low standard of care."

Cutting down on salt and salty food is good for the health of pregnant mothers and their unborn babies. - See pregnant mothers

Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
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Some NHS trusts refusing some treatments to heavy smokers or patients who are obese

Hewitt: NHS ban on fat people legitimate - Telegraph

Extract:

"Patricia Hewitt, the Health Secretary, said yesterday that it was "perfectly legitimate" for NHS trusts to refuse some treatments to heavy smokers or patients who are obese.

A survey found at least four trusts have stopped providing orthopaedic surgery for smokers
Miss Hewitt defended the right of doctors and managers to draw up local guidelines on treatment after a survey revealed that some trusts are already banning operations."

I have no strong views on whether smokers should have limited access to health care, but I have very, very strong views about obese people and health care. - Since doctors, nutritionists and successive governments/Departments of Health, et al, are those actually responsible/to blame for the huge and growing incidence of obesity, particularly by their negligent prescribing of steroids and other dangerous drugs which cause salt sensitivity and massive fluid retention, followed by almost non-existent monitoring of their patients/victims (see http://www.wildeaboutsteroids.co.uk/story.html), no obese person should be being denied treatment if there is any useful treatment that would help that person.
Obesity is NOT a self-inflicted disease. - It is an iatrogenic disease.

Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
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Research carried out for The Daily Telegraph reveals large disparity in mortality rates in NHS hospitals.

Revealed: Lottery of death rates in hospitals - Telegrpah

Extracts:

"Patients are twice as likely to die in hospitals with the highest mortality rates than in those with the lowest, according to a report from Dr Foster Research, the independent health information company.

It found that despite the Government pouring billions of pounds into the NHS, a postcode lottery exists with standards of care varying widely across the country."

"Patients at the Royal Free Hospital NHS Trust in north London were identified as the most likely to survive, with a mortality rate 26 per cent below the expected rate.

By contrast, George Eliot Hospital NHS Trust in Nuneaton, Warks, had the highest mortality rate - 43 per cent above the expected rate.

The research did not investigate cause of death at individual hospitals but Dr Foster Research said typical factors would be medical error, infection and failure to deliver "quality of care"."

"Dr Foster Research's mortality rates, the most comprehensive ever compiled, are standardised to take into account a range of risk factors, such as the age of patients, sex, social demographics, the level of deprivation in the area and whether a patient has any other illnesses."

The Department of Health is, predictably, untroubled by these figures: "A Department of Health spokesman said: "We would strongly advise against patients using these figures to make decisions about the relative safety of hospitals. It is impossible to condense into one number the entire performance of a hospital in a way comparable with every other hospital in the country.""


Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)

British women may no longer be entitled to one-to-one care from a midwife during labour.

Women to give birth without care of a midwife - Telegraph

Extract:

"Women may no longer be entitled to one-to-one care from a midwife during labour, after a shift in Government policy set to be announced this week.

The Royal College of Midwives says any plans to go back on earlier pledges by allowing hospitals to use cheaper and less-skilled maternity support workers will increase the risks for women and babies.

Several recent reports have suggested that standards of maternity provision are falling as NHS trusts battle huge deficits, and more women are encouraged to have their babies at home. One report by the Conservatives suggested that around one in six of England's 282 maternity units could be shut down.

In its 2005 manifesto Labour promised that by 2009 all women would be cared for by a midwife throughout the pregnancy, and receive continuous care during the delivery. But "Maternity Matters", the strategy to be announced by Patricia Hewitt, the Health Secretary, this week, is ex-pected to suggest that some women could give birth without the care of a midwife."

A "disastrous failure" in the government's strategic planning allowed NHS trusts to indulge in reckless recruitment of extra staff.

MPs criticise 'boom and bust' NHS planning - Guardian article

Extract:

"A "disastrous failure" in the government's strategic planning allowed NHS trusts to indulge in reckless recruitment of extra staff causing unsustainable pressure on the pay bill, a Labour-controlled Commons select committee said yesterday.

Between 1999 and 2004 the number of nurses employed by the NHS in England increased by more than 67,000 - about 340% more than the Department of Health intended. Over the same period the number of GPs grew by 4,098 - or 105% more than the official plan.

The health select committee said: "It was too easy to throw new staff into the task of meeting targets rather than consider the most cost-effective way of doing the job. Large pay increases were granted without adequate steps being taken to ensure increases in productivity in return." Increases in the NHS budget were seen as "a blank cheque for recruiting new staff". This caused the NHS to lurch "from boom to bust"."

Healthcare Commission found 55% of mental care inpatients have to share sleeping accommodation or bathrooms with members of the opposite sex.

Census reveals wide extent of mixed sex psychiatric wards

Extract:

"Health inspectors will today publish conclusive evidence that the government's claim to have ended the scandal of mixed-sex psychiatric wards in the NHS was false, or at best misleading. In a census of all mental health establishments in England and Wales, the Healthcare Commission found 55% of inpatients have to share sleeping accommodation or bathrooms with members of the opposite sex.

Last year ministers rejected a report from the National Patient Safety Agency that recorded at least 19 rapes of mental health patients in England, and more than 100 other improper sexual incidents in psychiatric units in the previous two years.

Lord Warner, then health minister, said the allegations of rape were unsubstantiated. He told peers in July that 99% of NHS trusts providing mental health services met "single-sex objectives" that were set out in 2000, requiring all mental health units to provide totally separate sleeping, toilet and bathing accommodation for men and women. Lord Warner said mixed sex wards were an exception that might apply to "a very small number of patients, when admitted as an emergency".

But the census - conducted by the commission and government-funded mental health agencies - found only 45% of the 32,000 inpatients in NHS or private sector psychiatric wards on March 31 last year had the benefit of single-sex accommodation."

The cost of parking at your NHS hospital: £95m

The cost of parking at your hospital: £95m

Extracts:

"NHS hospitals were yesterday accused of exploiting the "most vulnerable" after they were found to have made more than £95 million in parking charges last year.

Patients attending for treatment and relatives or friends visiting people in hospital were charged up to £3.50 an hour despite paying to build car parks through their taxes.

Last night, the cancer charity Macmillan, which obtained details through Freedom of Information, called for an end to the "shameful" charges. Two trusts each raised more than £2 million and a further 30 raised more than £1 million each from "outrageous charges on the weak and vulnerable''.

Southampton University Hospitals NHS Trust took £2,414,672 and Cambridge University Hospitals NHS Foundation Trust took £2,263,297.

Patients and visitors often have no choice but to use hospital parking, which used to be free. Some out-patients are too weak to walk further from their car and many of those who visit in-patients are themselves elderly or infirm.

The charity Macmillan Cancer Support Research raised the parking issue yesterday on behalf of cancer patients who have to make regular hospital visits. It said the £95 million total was shocking.

Judy Beard, Macmillan's acting chief executive, said: "Cancer patients spend hundreds of pounds each year on hospital parking. Macmillan wants to see all cancer patients travelling regularly for treatment to be able to park free."

"Hospitals have also started to charge for bedside telephones and television sets and many have replaced charity-run cafes with more expensive cafeterias."

Complaining about NHS treatment adds further difficulties for complainants. - Susan Hodges and Richard Murphy lost their baby at birth.

'Why could no one tell us why our son died at birth?'

Extract:

"Nearly two years after their baby son Oliver died soon after he was born, Susan Hodges and Richard Murphy are still waiting to have questions answered. They have found their dealings with one of London's flagship NHS trusts perplexing and frustrating. Straightforward questions about what went so terribly wrong in the crucial minutes leading up to his birth have gone unanswered.

However, their experience of hitting a 'complaints brick wall' is not uncommon. More than 100,000 complaints were received by the NHS last year, with an increasing proportion going to independent panels because of dissatisfaction with the responses from hospital trusts or primary care trusts.

Despite government promises to overhaul the complaints system, the issue has now fallen even further down the list of priorities. The plan is to create a single system for dealing with complaints about both healthcare and social care, but instead of introducing reforms quickly, the government has embarked on a new consultation, which will begin in April. Officials have said there is no plan to introduce new reforms until 2009. By then, another 200,000 people will have been caught up in the complaints system."

"The campaign group Action Against Medical Accidents (AvMA) has been calling for years for reform of NHS complaints procedures to be speeded up. Peter Walsh, its chief executive, said: 'Far too many people are trapped in a system which is unwieldy and slow, and very often insensitive to their needs. Our view is that however complicated the complaint, no trust should take more than six months to fully investigate and respond to the individuals.'"

The Healthcare Commission should be remedying this situation, which has been going on for as long as there have been complaints about NHS care, i.e. for decades. It is a national scandal.

NHS Health Trusts in England undergo checks amid fears that patients are starving

Health trusts undergo checks amid fears that patients are starving - article in the Daily Telegraph

Extract:

"A total of 23 NHS trusts in England are to be inspected amid concerns that they are failing to feed frail and vulnerable elderly people properly, the Healthcare Commission announced today.

Inspectors will go through files, observe wards and speak to staff who will be interviewed anonymously."

There have been reports of elderly people starving in hospitals and in care homes before. (Click on the 'Elderly people starving' tag below.) - This shocking institutional negligence can only flourish when there is inadequate monitoring of these institutions and when sanctions against such negligence are not sufficiently severe.

I do hope that the inspectors will speak to some of the elderly people themselves, as well as to members of staff.


Lose weight by eating less salt! Go on! - Try it!
See my website www.wildeaboutsteroids.co.uk
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)