Thursday, 12 January 2012
CAR crash victims or people with stab wounds in Northampton will be given access to the best medical care in the region quicker than ever before under plans unveiled by the NHS. Northampton Chronicle and Echo
EXTRA staff will be put in place in the under-pressure accident and emergency department of Northampton General Hospital using a share of £3 million new investment. Northampton Chronicle and Echo
The Government has accepted the latest recommendations from the independent NHS Future Forum, Health Secretary Andrew Lansley announced today.
The NHS Future Forum was asked to carry out conversations with health and care professionals, patients and service users and to provide independent advice on education and training, information, integrated care, and the NHS’s role in the public’s health.
The Government has now accepted the recommendations following the Future Forum’s report, and specifically on:
- Education and training: Employers and professionals will have a greater say in developing the health workforce in the future, such as through local plans. And for the first time the Government will introduce an outcomes framework for education and training.
- Integrated care: The Government fully accepts the need to orientate the whole health system around patients. So for the first time, patient experience of integrated care will be measured as part of the Outcomes Framework.
- The NHS’s role in the public’s health: Following the Forum’s recommendation on ‘every contact counts’, the Government will consult on a new responsibility for healthcare professionals to promote healthy living through their daily contact with patients.
- Information: The Government will consider the Forum’s recommendation for discharge summaries being made available to GPs and patients at the point of discharge, as part of the Information Strategy published later this year.
Also published today is Liberating the NHS: Developing the Healthcare Workforce, which details the response to the Forum’s recommendations on education and training.
Andrew Lansley said: ‘As we modernise the health and care system to meet the challenges of the future, it is essential the thoughts of clinicians and, importantly, patients, are listened to. So the NHS Future Forum has again provided invaluable feedback on what the NHS needs to do to improve results and put the NHS truly on the side of patients. I’m pleased to accept all its recommendations.’
Chair of the NHS Future Forum Professor Steve Field said: ‘We are making robust and ambitious recommendations to the NHS and to Government. We have heard an enormous amount of support for the shift to patient centred care but also frustration that this has not yet been achieved. This must now become a reality for patients across England and health and social care professionals must lead the way.’
The NHS Future Forum listened to more than 11,000 people face to face at more than 300 events as well as engaging with people online, and also received more than 150 formal responses. Department of Health
A programme that aims to provide guidance, tools, and support materials, to enable procurement practitioners across the health and social care sector, to drive reductions in carbon emissions associated with goods and services procured, and to realise financial benefits consistent with low carbon solutions.
Strategy: A copy of the P4CR strategy, and other supporting material can be accessed via the Sustainable Development Unit website, where you can access the strategy and the associated supporting materials.
Training: Training modules aimed at procurement professionals have now been launched. Go to the National Sustainable Public Procurement Programme for more information.
Case studies: Case studies have been published to demonstrate how procurement activity can contribute to carbon reduction, without an adverse impact on costs or resources. To view the case studies please click below:-
Department of Health
This study found that mergers are unlikely to be the most effective way of dealing with poorly performing NHS hospitals. It looked at the wave of hospital consolidation in the late 1990s and early 2000s – in which around half the acute hospitals in England were involved in a merger – and found that these mergers brought few benefits.
Treasury guidance requires the boards of all public sector organisations to publish a public statement of risk appetite. These publications aim to support boards around risk appetite as well as informing partners, suppliers and commissioners on this topic.
Helpers being asked to look after intensive care patients and administer drugs without proper training, study finds
Healthcare assistants are taking on jobs, including looking after intensive care patients, for which they are not always properly trained, according to research.
A survey of more than 2,500 NHS staff found examples of healthcare assistants (HCAs) working beyond their competence, sometimes putting patients at risk.
Nurses cited cases in which HCAs had administered drugs without proper training, while others were left in sole charge of patients with complex needs.
Examples from the 2,554 people who responded to the Nursing Standard survey – made up mostly of qualified nurses and nursing students – said HCAs were also managing colleagues and running units and clinics.
Some nurses said HCAs had received training, but others said this was lacking or that HCAs were not competent in interpreting information about patients.
One respondent said HCAs were involved in "caring for 'low-risk' ventilated tracheostomy patients in an intensive care environment". The respondent added: "The registered nurse working next to them is expected to supervise and overlook everything they do, but this is an impossible task when they themselves are looking after a level three ventilated patient.
"As far as I'm concerned, this is dangerous practice and unfair on all parties concerned."
Several respondents said HCAs monitored patients' vital signs but did not understand the results.
Some HCAs took blood pressure readings "but do not know what is normal or not" while others fail to notice when a patient is deteriorating, according to the survey.
Other examples included HCAs drawing up care plans with no training, interpreting blood levels, caring for complex wounds and carrying out electrocardiograms (ECGs) for heart patients.
HCAs also gave antipsychotic medication without proper training, and one respondent said: "As a nurse manager, I tend to supervise any practice that is deemed complex. ECGs are the most common, but prior to being a manager I witnessed an HCA doing a catheterisation. They had no training and I was horrified."
There were further cases in which HCAs acted as members of emergency or resuscitation teams and "gave medication without knowing what the drugs are for and side effects".
Standards set by the Nursing and Midwifery Council (NMC) say nurses can delegate aspects of patient care to HCAs, including administering medicines. However, the nurse is "accountable to ensure that the … care assistant is competent to carry out the task".
But one nurse in the survey said: "There is sometimes an attitude from unregistered staff that it doesn't matter what they do because ultimately it is the registered nurse looking after the patient who will take responsibility.
"No matter how hard we try to uphold standards, it is impossible to be aware of everything going on with our patients, and we have to rely on support staff to provide a high standard of care without having to directly supervise them at all times."
In October, the government unveiled plans for a code of conduct and training for HCAs, but ministers are not in favour of statutory regulation.
The plan is designed to "bring clarity" to the training HCAs need to deliver more advanced tasks, although this training will be voluntary.
Dr Peter Carter, the head of the Royal College of Nursing (RCN), has said the NHS is too reliant on untrained HCAs who are asked to pick up nursing skills as they go along. He said assistants were employed to help nurses with basic tasks such as washing and feeding, but ended up doing much more.
Tanis Hand, an HCA adviser for the RCN, told Nursing Standard: "It is important for nurses to understand the principles of delegation and that HCAs are not put into situations that they are not fully prepared for."
Howard Catton, the RCN's head of policy, said: "These findings make it clear that, if we want to maximise patient safety, we need to push forward with mandatory regulation of support workers.
"There is also a clear need for education and training of support staff to ensure we do not separate tasks from the knowledge required for clinical assessment and decision-making."
The head of nursing for the union Unison, Gail Adams, said: "This list reaffirms our findings that HCAs are delivering most bedside nursing as well as many extended roles. I question whether some of these roles are appropriate, given the lack of consistency and training."
Carter said of the survey: "Today's findings add further weight to the case for mandatory regulation and guaranteed training standards for HCAs, which the RCN has been calling for for some years and throughout the health and social care bill process.
"The RCN is clear. A voluntary or optional scheme does not go far enough – not only would it continue to put patients at risk, it would also do a great disservice to the hardworking, dedicated HCAs who would welcome regulation."
Lord Howe, the health minister, said: "Healthcare assistants aim to give the very highest quality of care to patients, but they shouldn't be allowed to carry out tasks they are not qualified for.
"Employers must take responsibility for the quality of services provided, and professionals like nurses must ensure appropriate delegation and supervision of tasks." The Guardian
Heads of two royal colleges want urgent action over poor language skills and 'stifling effect' of working time directive
NHS patients are at risk because of European laws that govern how overseas doctors work in the UK, the heads of two royal colleges have said.
They claimed "urgent action" was needed on the issue of EU doctors' language skills and criticised the restriction on the number of hours a week trainees can work for.
In a letter to the Daily Telegraph, Professor Norman Williams, the president of the Royal College of Surgeons, and Sir Richard Thompson, the president of the Royal College of Physicians, wrote: "The language competency of doctors from the EU working in Britain, and the stifling effect of the European working time directive [EWTD] on the time that trainee doctors have to learn on the job, need urgent action.
"EU laws that apply to all sectors can have unintended consequences in healthcare that can put patients at risk, whether in Britain or other member states.
"The increased mobility of health professionals in the EU has highlighted huge variations both in the practical abilities of professionals of similar grades, and in the systems set up to ensure quality, in different member states."
The letter also urged the European commission to introduce an alert system when a doctor was struck off in another country.
The health secretary, Andrew Lansley, said he had already taken steps to stop doctors with poor English practising in the UK.
"We agree that for too long patients have been let down by European rules which allowed doctors to operate in the UK without the necessary safeguards," he said.
"That's why I announced last year new rules on checking doctors' language skills and new powers to take action against doctors who can't speak English properly.
"We want to revise the EWTD to give the NHS the flexibility it needs on training. Our overriding concern must be to protect patients."
The EWTD limits the length of a doctor's working week to 48 hours. The Guardian