The Weekly News. Week Starting 7th April

Monday, 7th April 2008

Report calls on Hospitals to say ‘sorry’ for mistakes.

The Healthcare Commission has urged hospitals to apologise to patients when mistakes are made in the provision of care. In their report, Spotlight on Complaints, the Healthcare commission—the independent inspection body for the NHS—found that many hospitals failed to treat complaints seriously. It called on NHS trusts, which manage hospitals, to learn from complaints as well as to improve the way complaints are handled.

A key recommendation proposed by the report was that Hospitals should learn how to say sorry for mistakes in patient care. Often, all patients want is an apology or an acknowledgement that their standards of care did not meet acceptable levels The Commission’s research found that 52% of complainants simply wanted an apology, a better explanation or recognition of the event in question. it is clear from the complaints referred on to the Commission that trusts have some way to go before they are effectively resolving the complaints they do receive, and learning from the issues their patients raise.

Anna Walker, the Commission’s Chief Executive, said: “It is often a distressing and frustrating time for patients who feel they haven’t received the care they deserve. It is striking that so many people simply want an apology and steps taken to ensure the problem is not repeated.

In its review of complaints made against NHS Hospitals, the report found that the key issues that led to complaints were a lack of basic nursing care, poor communications, overly brisk GP consultations and a lack of help for mental health service users. Also, these complaints often centered around fundamental basics of patient care such as communication between clinical staff, standards of care, safety an requirements of nursing care such as nutrition, privacy and dignity. The report is based on 10,336 complaints reviewed by the Commission from August 2006-July 2007.

Doctors with MRSA continue to treat patients

Hundreds of hospital trusts are allowing doctors and nurses testing positive for superbugs to continue to treat patients as normal.

Many trusts were found to fail to immediately remove healthcare professionals from duty even when they are carrying the potentially lethal methicillin resistant staphylococcus aureus (MRSA), which can be spread by human contact. This in contrast to health services in countries such as Holland, who suspend staff from service immediately if they are found to be carrying MRSA, and, incidentally, have one of the lowest rates of MRSA in Europe.

The survey of hospital trusts by the Independent on Sunday also found that many trusts fail to routinely screen staff for MRSA or record those who are found to be infected.

This approach to infection control was described by many trusts as being completely within the government guidelines. The policies also claim support from a number of unions, who claim that sending infected staff home would lead to staff shortages, as well as damage healthcare staff’s financial wellbeing and career prospects.

However, the findings are not without controversy. Patient groups and Medical experts have criticized the approach of these Hospital Trusts, as well as the Government’s failure to clamp down on this trend.

The Chairman of MRSA Action UK, Derek Butler, commented, "This is one of the hidden problems of MRSA. We are talking about people who come in from the outside every day and could well be bringing this infection in with them. Staff should be screened regularly and if they are colonized with this infection they should be taken off duty until they are clear.”

Unlicensed Drugs Prescribed to Children

Research has found that significant amounts of children in the UK are being prescribed anti-psychotic drugs that are unlicensed. The long-term safety of the drugs for children—which are used to treat illnesses such as hyperactivity and autism—has not been established. The drugs are licensed for use amongst adults, but adequate levels of clinical trials have not been conducted for their use on those under the age of 15.

Some experts fear the drugs could negatively affect the development of a child’s brain, as well as lead to cardiovascular problems. Others have called for a limit to be established in the prescription of the drugs to children. Professor Dr Healy, a specialist in psychological medicine at Cardiff University, said "There is no end to the problems drugs can cause so we really need to restrict the conditions which people should get them for so that the risks are warranted".

Tuesday, 8th April 2008

£75,000 not enough for head of ‘superbug’ hospital trust

The head of a Hospital Trust which saw the UK’s biggest ‘superbug’ outbreak is taking legal action to receive a bigger pay-off. Rose Gibb resigned from her role as Chief Executive of Maidstone and Tunbridge Wells NHS Trust before the publication of a report criticizing the trust’s handing of an outbreak of the Clostridium Difficile infection, which killed 90 people across the trust’s 3 hospitals.

Following her resignation, the trust agreed to give Ms Gibb a £75,000 payout—the equivalent of six-months pay. Rose Gibb, unsatisfied with this, has lodged papers in the high court in order to claim an undisclosed amount.

This news has upset the families of those who died in the outbreak. Steve Stroud, whose relative Doreen Ford passed away, advised Ms Gibb to “walk away and count her blessings”, adding, “if there is money to pay her more, I’d like some of it to go to the families that have suffered”.

Wednesday, 9th April 2008

‘Patient care is not a priority’, according to over half of all NHS staff.

More than half of NHS staff have reported that they do not feel patient care is the top priority at their place of work, according to the results of a survey conducted by the Healthcare Commission.

The Commission, which is the independent inspection body for the NHS, received completed surveys from 155,992 employees from all of the UK’s 391 NHS Trusts. The findings were part of an annual survey of NHS staff opinion.

Unions have highlighted increasing privatization and financial targets as a cause of patient care failing to be a top priority. The head of health at the public sector union UNISON, Karen Jennings, said: It seems obvious that patients must be the top priority for trusts, but this survey shows that less than half of NHS staff feel this is the case in their hospital. Trusts must refocus their attention on their patients and away from competition and privatization.”

The survey also found that wide variation exists between hospitals in their efforts to tackle MRSA. For example, variation in staff’s feedback on the availability of hand-washing equipment between hospitals was found to exist.

Thursday, 10th April 2008

Ambulance Service found to have put patient safety at risk

A healthcare watchdog has concluded that an ambulance service compromised patient and staff safety in trying to improve its performance. The Staffordshire Ambulance Service NHS Trust also issued drugs to staff that they were legally not entitled to have. The findings were contained in a recent report, published by the healthcare commission—the independent inspection body for the NHS—that found that the achievements of the trust were marred by an approach which prioritized innovation and improvement before patient safety.

The commission discovered that ambulance staff and volunteer community first responders were handling controlled sedatives diazepam and midazolam, as well as other drugs which they were not, under regulations, allowed. Medicines belonging to the trust were also found to have gone missing on numerous occasions. Furthermore, staff that had not received appropriate advanced driving training were also found to have driven ambulances at speed with the sirens and blue lights in operation.

Anna walker, chief executive of the Healthcare Commission, said: “patients, staff and the public could have been seriously hurt as a result of the compromised safety culture. The trust sought to be innovative, and that is to be applauded, but it did not have effective systems in place to handle this innovation safely.

The trust has subsequently merged with the West Midlands Ambulance Service, a spokesman of which reported that they had since "made massive strides to tackle the issues".

Out-Of-Hours Care putting Patients at risk

Changes made to out-of-hours care have placed patients at risk, according to an influential group representing NHS staff. The NHS Alliance—an independent organization that represents NHS staff working outside of hospitals—have identified the 2004 GP contract as the key reason for the breakdown in out-of-hours care.

Under the terms of the 2004 contract, GPS were presented the option of opting-out of out-of-hours care, which 90% decided to do. The responsibility to provide out-of-hours care subsequently shifted to Primary Care Trusts (PCTS), which since 2002 have controlled local heath care. PCTs now commission out a range of agencies—including private services, NHS phone lines and walk-in centers—to fill the void left by GPs.

However, these changes have been accompanied by a rise in complaints, widespread confusion and an increase in patient risk. Patients are especially confused about where to turn for out-of-hours care, and are uninformed about both the changes in provision ushered in by the 2004 GP contract and the increasingly complex range of replacement services available.

The report recommends returning out-of-hours care to GPs. The NHS alliance suggest a system in which GPs work together, as well as with paramedics and nurses, to provide comprehensive out-of hours and weekend care. A spokeswoman for the Patients Association said: "patients would be delighted if this was to happen.”

‘Breach of human-rights’ to be challenged in high courts

A failed asylum-seeker from Palestine is to go to the High Court to challenge rules that deny him access to NHS care. The man, whose asylum application failed but is unable to return to the West Bank in Palestine, has been denied access to treatment for chronic liver disease by his local NHS hospital. This is under national rules which state that illegal migrants and failed asylum-seekers are unable to access free healthcare on the NHS. This is the case even when the individual in question is unable to return to their country of origin because of travel restrictions or serious ill-health. Only in cases of life or death, or where a risk to public health is present, are exceptions to this made. This policy is leaving many individuals, who cannot return to their country of origin, without any access to healthcare and suffering as a result.

The unnamed man’s legal team will argue that denying him access to care is wrong, during the two day hearing. If their case is successful it could have implications for 11,000 people who are currently in the same situation in the UK

Adam Hundt, the lawyer who is representing the man’s case, said: "My client is effectively stuck in the UK, even though he is doing all that he can to return home. He has never broken the law, and the Home Office recognises that it has to provide him with accommodation so as not to breach his human rights. It seems perverse that housing is considered a basic human right and that health care is not."