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Monthly Archives: October 2013

Become a patient/carer member of the group developing guidelines on the treatment of low back pain

The Public Involvement Programme and the National Clinical Guidelines Centre are seeking applications from patients and carers to be part of a group that will develop a clinical guideline for the care of people with low back pain.
Members of this group will play a key role in making sure that the views, experiences and interests of patients and their carers inform the development of the guideline and the recommendations of the NHS. All group members will be asked to attend regular meetings and to prepare for them in advance, including reading relevant papers.
Applications are welcomed from people with experience or knowledge of low back pain, for example, someone who has suffered from or cared for someone who has suffered from lower back pain.
For more information and to find out how to apply, please follow this link to the NICE website- http://www.nice.org.uk/getinvolved/joinnwc/LayMemberLowBackPainUpdateGDG.jsp

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Simon Stevens appointed new NHS England Chief Executive

Simon Stevens has been appointed to lead NHS England, when Sir David Nicholson resigns next April. The forty-seven year old is currently president of private US health firm, United Healthcare. He has previously worked as an NHS manager and has acted as a health advisor to Labour. His appointment as chief executive of NHS England comes at a time when there are growing demands for care.
Mr Stevens has worked in the US for the last three years. A former NHS graduate trainee, he  worked in a number of management positions during the late 1980s and 1990s including Guy’s and St Thomas’s Hospital Trust in London and a mental health service in Northumberland. Mr Stevens was a former Labour councillor and became a government special advisor to Alan Milburn, in New Labour’s early years in 1997. He co-authored the 2000 NHS Plan, which was widely credited with reviving the NHS and increasing investment for the NHS. The NHS plan led to huge falls in waiting times for treatment, improved A&E performance outcomes and improved patient outcomes with cancer and heart disease.
He was a strong advocate for increasing the use of the private sector and worked directly with Tony Blair from 2001 and 2004. He then became lead of the European arm of United Healthcare, before becoming the senior executive in the US.
Mr Stevens was offered the same salary as Sir David at £211 000 per year, however, according to NHS England, he took a voluntary 10% pay cut to £189 900, to reflect the intense ‘NHS spending pressures’.
Christina McAnea, head of health at union Unison, told the Today programme on BBC Radio 4: “I am surprised that they haven’t been able to find someone within the NHS… and somewhat concerned that this is the Tory-Lib Dem government trying to install American medical values.”
However Sir Malcolm Grant, chairman of NHS England responded: ‘’ “We wanted the best in the world and we’ve got I think the best in the world. Of course we’ve got somebody who’s got experience both of the public health system in this country and of the best of American healthcare.
“The NHS has to be open to ideas from across the world. All nations are facing a crisis in the affordability of healthcare and the American experience is valuable to us.”
Mr Stevens said: “It will be a privilege to lead NHS England – at a time when the stakes have never been higher – because I believe in the NHS, and because I believe that a broad new partnership of patients, carers, staff and the public can together chart a successful future for our health service.”
NHS England chairman Prof Sir Malcolm Grant said: “I am delighted that Simon will be taking on this exceptionally challenging leadership role for the NHS”.

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King’s Fund: ‘Improve patient involvement in care’

The NHS watchdog Care Quality Commission (CQC) has expressed concern over the quality of care provided to patients in 44 out of 161 acute hospital trusts in England. It is a significant increase on previous figure of 14 previously reported by Professor Sir Bruce Keogh, NHS Medical Director.
The CQC has grouped the 161 trusts into six bands to determine which hospitals require monitoring most urgently. Band one is the most worrying and band six is the least. The CQC is concerned with the first two bands.  Twenty four trusts have been rated as band one with 20 trusts included in band two.
The CQC calls these bands ‘smoke detectors’, which helps them to highlight hospitals which were outside the expected range of performance in a particular area. The banding will not be used as a final rating, but as a screening tool for inspections. This monitoring exercise is part of a new hospital inspection regime, which will see inspectors inspecting every trust by 2015. The first wave of inspections started in September and it is expected that the first 18 inspections will have taken place by Christmas 2013.
The inspection criteria include rates of hospital –acquired infections; patients’ trust in the medical staff, as well as waiting times for treatment in A&E. It will result in every trust being given a rating of either ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’ as part of a shake-up in the system ordered after the Stafford Hospital scandal.
The trusts are scored in 150 areas with the ratings described as follows:

  • Band one covers trusts rated at 7.5% below the normal standards of performance
  • Band two are 5.5% below
  • Band three ratings are 4.5% below (31 trusts)
  • Band four ratings are 3.5% below (25 trusts)
  • Band five ratings are 2.5% below (24 trusts)

By contrast, there are 37 trusts in band six, with performance typically deemed to be 2% above the norm.
The Patients Association described the CQC’s concerns about the 44 trusts as hugely worrying but also not a major surprise, given the evidence it collects about poor care and safety breaches.
Katherine Murphy, Chief Executive of the Patients Association, said: “It’s hugely worrying that there is such a high number of trusts where the CQC has concerns about the quality and safety of the care being delivered. But it doesn’t come as much of a surprise because we know from our work that elements of poor care are widespread in the NHS.
“We don’t think there’s any hospital that’s providing 100% high-quality, safe care. Calls to our helpline tell us that things like misdiagnosis, cancelled operations and poor care in hospital, especially elderly patients not being cared for with the compassion and dignity they deserve, happen frequently in hospitals all over the country. This problem is so endemic in the NHS,”
Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, has said “This information highlights the hospitals where we have potential concerns about the quality and safety of services. Our greatest concerns focus on the 24 trusts in band one, which we have prioritised for inspections.”

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Six other NHS trusts at risk of ‘bankruptcy’

Six other NHS trusts face joining South London Healthcare in “administration” as they have taken on projects viewed by ministers as “unsustainable”, it has emerged.

South London Healthcare NHS Trust will be the first in the country to be put under the control of a special administrator tasked with securing its finances.

The trust, which runs three hospitals, has been criticised over standards of care after being saddled with large debts from PFI deals.

Despite efforts to improve its financial performance, it is still thought to be on track to lose between £30 and £75 million a year for the next five years.

It was formally warned last night that it would be the first NHS body to be taken over by Whitehall-appointed administrators under the “unsustainable providers’ regime”.

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‘NHS must treat unhealthy lifestyles, not killer diseases’

The NHS must focus on treating unhealthy lifestyles rather than killer diseases because they place the greatest burden on doctors, according to health leaders in London.

Four in every five deaths in London today are due to unhealthy lifestyles.
Dr Anne Rainsberry, regional director of NHS England, said health services must be reformed “radically” to avoid increasing the current strain on resources and creating a £4 billion hole in NHS finances by 2020.

Failing to change the way services for patients are organised, for example moving investment from hospitals to community care, will result in longer waiting times for treatment and limited or unsafe services at weekends, she said.

The NHS was initially set up to tackle deadly diseases but improvements in medicine and our standard of living, along with an ageing population, mean that the demands on doctors have changed dramatically.

Four in every five deaths in London today are due to unhealthy lifestyles, including factors such as smoking, alcohol, bad diets and a lack of exercise.

“We need to look more at how we can help people to stay well, rather than focusing on treating them once they are ill,” Dr Rainsberry said.

“Investing more in hospitals is not the answer; we need to focus more on prevention and improve our primary and community care services to coordinate services closer to where patients live.”

Dr Andy Mitchell, Medical Director for NHS England in London, added: “The NHS has spent the last 65 years treating disease and ill health. Now we are treating more and more conditions that stem from what we are doing to ourselves.

“London’s hospitals are at breaking point and the demand for health care will outstrip the funding available in just seven years unless we fundamentally change the way services are delivered.”

Their comments came as NHS England in London launched a new report which warns that the capital’s health system is “unsustainable” and in urgent need of reform.

Maintaining all hospitals in London in their current form would lead to a funding gap of £4 billion by 2020, and the range of services provided at each must be narrowed in order to ensure safe staffing levels, it said.

Downgrading or closing some hospitals while centralising specialist services across a smaller number of locations in the capital could help ensure that minimum quality standards are met, the report claimed.

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Lack of nationwide standards means hospital food ‘worse than prison meals’

The standard of hospital meals varies so much across the country it is often worse than prison food, according to a new report.

The lack of minimum standards for food served on hospital wards in England means many patients are having put up with poor meals with little nutritional value.
The report, to be published recently, warned that the lack of minimum standards for food served on hospital wards in England means many patients are having put up with poor meals with little nutritional value.

Local health authorities are allowed to determine how much they spend on food in their hospitals, leading to wide fluctuations in quality. Many hospitals in England operate on a food budget of less than £3 per patient per day, with less than £1 spent on each meal.

The new report has been written by The Campaign for Better Hospital Food, which is backed by several high-profile chefs and cookery writers, including Loyd Grossman and Albert Roux.

It says more than 82,000 uneaten hospital meals are thrown away each day and that 67 per cent of hospital staff would not want to eat the food they serve to patients.

Calling for minimum standards of nutrition to be set nationwide for hospital food, the campaign said: “While a handful of hospitals in England have introduced hospital food standards to improve patients’ meals, the government’s reliance on voluntary initiatives to encourage the adoption of food standards at all hospitals has failed.”

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Complaints against doctors double since 2007

Figures released by the General Medical Council (GMC) have revealed that the number of complaints against doctors has more than doubled in the past six years, from just below 4,000 in 2007 to over 8,100 in 2012.
Most of the complaints came from patients, or their friends or relatives, with the number of complaints made by the general public increasing by 87% to 5,014 between 2007 and 2012. There was also a significant rise in the number of reports received from doctors’ employers or colleagues calling their fitness to practise into question.  About a third of the complaints led to a full investigation by the regulator.
The GMC says that the total number of complaints is small compared to the number of interactions between doctors and patients and that the figures did not indicate a fall in standards but merely  reflect  an increase in expectations among patients and a rise in the number of doctors willing to speak out about colleagues.
Katherine Murphy, Chief Executive of the Patients Association, said “The report issued by the GMC today comes as absolutely no surprise to us at all.  Patients frequently contact our Helpline to ask for advice on raising concerns about their medical care.
“Many tell us that they have previously raised a concern with their GP and have been removed from their doctor’s list as a result. Other patients tell us that they have heard of others who have been removed from the list and as a result feel uncomfortable raising a concern directly with their GP.
“The simple fact of the matter is that the complaints system, whether in hospitals or GP practices, does not work in the interest of patients, and as a result it hinders the ability of the NHS to listen and learn.  This has to change.”

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Patients charged £4 to park at hospitals

Patients and their relatives are being charged as much as £4 per hour to park at hospitals, according to figures released on Tuesday.

The Birmingham Women’s NHS Foundation Trust charges £4 an hour for parking, which is more than three times the national average.
The £4 charge for patient and visitor parking at the Birmingham Women’s NHS Foundation Trust is more than three times the national average of £1.15 per hour.
A further four hospitals charge £3 per hour for parking, including the Liverpool Heart and Chest Hospital NHS Foundation Trust and the Countess of Chester Hospital NHS Foundation Trust.
Rates in London were particularly high, with the Royal Free London NHS Foundation Trust and the Whittington Hospital NHS Trust both charging £3 per hour, and Chelsea and Westminster Hospital NHS Foundation Trust charging £2.50.
Figures released by the Health and Social Care Information Centre revealed that at 15 hospitals in England parking costs more than £2 per hour, while at dozens of other sites – along with those in much of Scotland, Wales and Northern Ireland – the service is free.
A Department of Health spokeswoman said: “Patients who have to attend hospital regularly or for long periods of time have a fundamental right to fair and appropriate car parking concessions, and we expect hospital trusts to provide them.”
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Hidden cameras could be part of new inspection regime

New Adult Social Care Chief Inspector Andrea Sutcliffe has announced that hidden cameras and mystery shoppers may be introduced as part of the Care Quality Commission’s revamped inspection regime, due to be introduced next year. She confirmed that she is keen to explore the role such techniques could play in helping to uncover abuse and neglect, while  admitting that difficult issues over privacy and dignity would have to be addressed first before any such scheme would be introduced.
From next autumn, services will be given an Ofsted-style rating of either outstanding, good, requires improvement or inadequate to reflect the system being introduced for hospitals. The inspections will aim to determine whether services are safe, caring, effective, well led and responsive to people’s needs. The make-up of the inspection teams will also change to include more experts in the care sector.
The Patients Association has reacted cautiously to this announcement, voicing its concerns that hidden cameras in care facilities may compromise the privacy of patients and could distract from the need to ensure adequate staffing.
Katherine Murphy, Chief Executive of the Patients Association, said “Where poor care exists it is obviously important that we seek to detect it and take action. But it is even more important that we tackle the problems that allow poor care to take place in care homes.
“Caring for the sick and elderly is a vital function in our society, and as such should only be carried out by those  with the skills, personality and temperament to do the job well and with compassion, ensuring the dignity of those for whom  they are caring.
“When adult care services are being commissioned, the key focus must be on the quality of care that will be delivered, and not the quantity of patients that it will be delivered to.
“There should be clear lines of accountability so that those care providers that are not doing enough to ensure that care is of high quality are held to account. This, along with an improved regulatory regime with in depth inspections at its core, will drive up standards of care in our care homes.”

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Dramatic fall in death rates for Hip Replacements

A study published in the Lancet have found that death rates for those who receive a hip replacement have now halved between 2003 and 2011.

Death within 90 days of surgery are rare, but have found to have fallen to 0.29% from 0.56%, a study of 400,000 patients has shown.

It is thought that the decrease is due to  better post operative care and advances in the drugs used in the procedures.

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