The Week in News. Week Starting 17th March.

 

 

Government plans to shift hospital services into new ‘super clinics’ are flawed, according to an expert.

 The proposed clinics, announced last year by Health Minister Lord Darzi, will house GP services and also take over much of the work of local hospitals in providing secondary care services—for example, physiotherapy—all in one building. This would be done with the aim of providing convenient, quick and accessible care.

 Mark Roland, director of the University of Manchester’s National Primary Care Research and Development Centre, has said he has ‘serious concerns’ about the proposals, based on his study of 30 pilot schemes.

 He asserted that the current GP system offers greater accessibility for patients and currently provides them with more choice than the new system will. He also raised concerns over the fact that Doctors and Nurses taking on extra responsibilities under the new system are provided with no mandatory training. In Professor Roland’s estimation, this could damage quality of care.

 Professor Roland said: "Primary care trusts have already been told to start setting up polyclinics, but I think the government has to rethink its approach."

 

 

A survey conducted by the Conservative Party has found that a large number women in labour were turned away from maternity wards last year because they were full to capacity.

 As many as 42% of the 103 Hospital Trusts surveyed reported that they had been unable to offer maternity services, or had sent women to other sites to give birth during 2007.

 Some maternity wards had worse records than others. The University Hospitals of Leicester NHS Trust admitted turning away 28 women in one year. Worryingly, this trust is one of the biggest maternity providers in England.

This does not bode well for the government, who stated in their 2005 manifesto that all women will have a choice over where they give birth by 2009. Nor does it seem likely, given the findings, that every woman will be supported by the same midwife throughout their pregnancy—another manifesto pledge promised for 2009.

 A representative of the National Childbirth Trust said: "Parents lose all sense of control when they are told that the unit at which they have planned to give birth has been closed temporarily, at short notice. It is a major cause of anxiety to telephone, or even arrive at a maternity unit, when in labour to find the doors are shut. Unscheduled closures should only occur in very exceptional circumstances when to keep a unit open would be unsafe."

 

A report commissioned by government ministers has found that days lost through ill-health costs the economy 100bn a year. Some 175m working days are lost a year due to health-conditions.

 The report, which was carried out by Dame Carol Black, recommended the introduction of a new ‘fit note’ system, alongside ‘fit for work’ schemes, to help people back into the workplace. A ‘fit note’ would be issued by a doctor to spell out what tasks an individual would be able to do. It is hoped that this would encourage people on long-term sick leave back into the workplace, and encourage employers to support them in this.

 The fit for work schemes would consist of specialized secondary care which appoint patients a case manager. The case manager judges the patients needs and create a programme to get the individual back to work. The case manager would draw on advice on occupational therapy, counselling, and financial and family matters.

 Commenting on her report, Dame Carol said, "£100bn sounds a large figure. But I think the cost to human life is much larger. For most people their work is a key factor in their self-worth, family esteem and identity. But it is so easy to fall out of work and move to a place where your confidence and well-being suffers. We must do more to help people, because if you intervene at an early stage you can stop the longer-term problems emerging."

 

The Welsh Ambulance Service has introduced eight new ambulances designed to cater for obese patients.

 The vehicles, which will be available across Wales, include a specially produced stretcher that is wider and capable of carrying greater weight than previous models, and a winch to reduce manual handling by as much as possible.

 Tony Cowley, Welsh Ambulances National Fleet Manager—who designed and developed the new vehicles—said, "Having vehicles like this enables our staff to transport patients with this medical problem without injuring themselves or the patient while also preserving the patient's dignity.  They are part of our high dependency service which frees up emergency ambulances by transporting patients who don't need a blue light full-on emergency response. But if there is a call to transport a patient who is above the normal criteria, that is clinically obese, more than 20% above normal body weight, then these vehicles come into their own”.

 

 

An enquiry has been launched into the mortality rates at a hospitals run by the Staffordshire NHS trust. The enquiry, to be conducted by the Healthcare Commission, was launched after patients raised concerns about abnormally high mortality rates across the hospitals.

 Nigel Ellis, the commission's head of investigations, said: "The figures at Mid Staffordshire Foundation Trust are out of normal range which is why we are carrying out this investigation to get a clear picture of what is going on."

 The Trusts’ Chief Executive, Martin Yeats, maintained that the mortality rate did not signify patient danger but rather a problem in the recording of data. Commenting on the news, he said: "We worked with the Strategic Health Authority and investigated this apparently high mortality rate and concluded that it was due to problems in the way we were recording and coding information about patients,".

 

 

People travelling abroad to undergo operations and surgery are left with unpleasant complications, a survey by the consumer group Which? Has found.

 The survey, conducted in their magazine, reveals that 18% of respondents had health problems after surgery abroad. Of this 18%, many patients contracted infections, and one patient reported being left leaking fluid following a liposuction procedure. A further 8% of respondents required urgent NHS treatment following surgery. More than a quarter reportedly did not receive the proper follow-up treatment needed after surgery.

 The phenomenon of patients choosing to travel abroad for a surgical procedure is growing. An estimated 80,000 people went beyond the UK for treatment in 2006. The comparatively low price of procedures is fuelling the demand for this. However, the costs to safety and comprehensive care can overweigh this.

 Michael Summers, the vice-chairman of the Patients Association, warned patients against making expeditions abroad for cheaper procedures, pointing out that "there is a lot more to this than just saving money - frankly, a 50% satisfaction rate is just not good enough, and if you come back to this country with problems after surgery, the NHS doctor won't know exactly what has been done to you, won't have seen the x-rays. It's a frightening prospect."