Friday, 13 January 2012

Coroner rules woman could have been saved from post-operative infections

Coroner rules woman could have been saved from post-operative infections:

PROMPT medical intervention by staff at Northampton General Hospital may have saved a 23-year-old woman who died from post-operative infections, the county coroner has ruled. Northampton Chronicle and Echo

After the Future Forum's report on integrated care, what now?

After the Future Forum's report on integrated care, what now?: Primary care must be at the heart of delivering integrated care; in his blog, Chris Ham looks at the changes needed in general practice to achieve this goal. Kings Fund

Lansley to increase NHS litigation fund

Lansley to increase NHS litigation fund: Extra £185m goes into NHS Litigation Authority to cover huge increase in claims made against the NHS Public Service

CfH issues tablets safety warning

CfH issues tablets safety warning: NHS Connecting for Health has warned trusts about the risks of using tablet devices - saying they are much more likely to be stolen and to be used to inadvertently share patient information than other technology. E-Health Insider

NMC clarifies its position on healthcare support workers

NMC clarifies its position on healthcare support workers

Can NHS hospitals do more with less?

Can NHS hospitals do more with less?:

This review of hospital efficiency has found that there are many ways in which hospitals could improve efficiency and reduce the need for cutbacks in services for patients. It cites length of stay and day surgery rates as examples of where there are still opportunities for efficiency to be improved.

Learning disability reports

Learning disability reports:

CQC have published a further ten reports from their targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities

Government will 'look closely' at Welfare Bill defeats - BBC News

Government will 'look closely' at Welfare Bill defeats - BBC News:

BBC News
Government will 'look closely' at Welfare Bill defeats
BBC News
The government will "look seriously" at the House of Lords' decision to reject key elements of the Welfare Reform Bill, Sir George Young has told MPs. His comments came after peers voted down proposals to restrict benefits for cancer patients and young ...
Welfare minister David Freud, who presided over a hattrick of welfare bill ...The Guardian (blog)

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High risk healthcare 'will suffer if medical cover is privatised'

High risk healthcare 'will suffer if medical cover is privatised':

BMA warns that proposals to replace NHS Litigation Authority with private model 'mimics worst aspects of US healthcare'

Potentially life-saving procedures could disappear from the health service because the high risks involved will force doctors to take out unaffordably expensive medical insurance, the British Medical Association has warned after it emerged that the NHS compensation fund may be privatised to curb the burgeoning cost of medical litigation.

Documents obtained under the Freedom of Information act show that last October officials in the Cabinet Office drew up a "business assessment" for the NHS Ligation Authority (NHSLA), which pays out legal fees and compensation claims in medical negligence cases, for a "credible business plan" that would be an "alternative to [the] existing service delivery model".

The plan says the Confederation of British Industry has identified the litigation authority as a "potential opportunity" and suggests the "need for a joint venture partner" that could provide "investment, expertise, access to markets". A month later the authority, which paid out £1bn last year in compensation – up from £280m in 2001 – was asked about pursuing a course of "mutualisation".

Doctors' leaders said any move towards a privatised model would mimic the worst aspects of US healthcare. In America there are well-documented cases where physicians simply do not take up jobs in risky specialisms such as obstetrics, where the cost of insuring operations are too high or where insurance companies fail to honour their moral obligations to pay out.

Mark Porter, chair of the consultants committee at the BMA, said: "We do not want to go down the US route of private insurance. You can travel whole sections of the east coast and not find an obstetrician."

"Only a pooling of risk across the NHS can protect hospitals from catastrophic events. We did not know that certain arthritic drugs caused heart attacks 15 years ago when they were started being prescribed. But that is what happened. Medical techniques are a risky area. You can never engineer risks out completely. And no one hospital or doctor could ever bear the costs of a catastrophic event. That's why we have an NHS-wide insurance scheme for doctors and patients."

The government began a review of the litigation authority last March – undertaken by Marsh, one of the world's biggest insurance brokers – but has yet to make its findings public. In an email from a civil servant in the Cabinet Office to the litigation authority, the recommendation is described as a "Marsh show stopper".

The proposals also expose a divide between Downing Street and the Cabinet Office, which are at the forefront of public sector reform, and the Department of Health. The paper says the "Cabinet Office [was] requested by No 10 to include specifically look at NHSLA … DH has agreed to keep open (sceptical) mind".

It emerged on Thursday that Andrew Lansley, the health secretary, had secured £185m in new funding for the authority this year, partly to offset an anticipated legal ruling that might mean bigger payouts for victims of clinical negligence.

There is little doubt that payouts are rising. Cerebral palsy victims now get £6m each – three times the amounts courts awarded a decade ago. Even in the UK private sector obstetricians are faced with insurance premiums of £50,000 a year.

Doctors say the reason is not a "compensation culture" but that payouts are not capped and that patients can take legal action against the NHS 25 years after an operation occurred. Sir Sabaratnam Arulkumaran, the head of obstetrics and gynaecology at St George's hospital, Tooting, said centres of excellence would be penalised for taking on harder cases.

"We are referred cases that are likely to have much more risk. Premiums would reflect that and [St George's] pays £5m in maternity contributions to the NHS litigation authority to deliver 5,400 babies every year. Instead of changing the NHSLA the government needs to look at capping payouts and paying in instalments so that if the patient were to die the payout could be stopped. That would cut costs."

Andy Slaughter MP, Labour's justice spokesman who obtained the documents, said the government was turning the NHS over to the private insurance industry. "Despite the doubts of the Department of Health, the NHS and practitioners, the Cabinet Office still continues to fly in the face of public and professional opinion," he said. "Cameron and Lansley are combining disruptive top-down reorganisation with an aggressive bottom-up programme of selling as many subunits of the NHS as possible to insurers and private health interests."

Sources within the Department of Health said the plans represented "blue sky thinking" and that the litigation authority was "under review". When pressed for a statement it said: "There are no plans to change the structure of the NHS Litigation Authority, and it will continue to provide cover to its members and their employees." The Guardian

Health Secretary vows to sue private clinics who refuse to remove faulty implants

Health Secretary vows to sue private clinics who refuse to remove faulty implants: Andrew Lansley, the Health Secretary, will sue cosmetic surgeries which refuse to give free operations to women wanting their PIP breast implants removed. The Daily Telegraph

GPs want the NHS reforms stopped: survey

GPs want the NHS reforms stopped: survey: Three quarters of GPs think the reforms to the NHS will harm patient care and must be stopped, a survey has found. The Daily Telegraph

Half of care home residents exposed to medication errors

Half of care home residents exposed to medication errors: Half of care home residents are at risk of harm from mistakes made in giving out their medication, research suggests. The Daily Telegraph