Friday, 13 April 2012

Plans to close ambulance stations

Plans to close ambulance stations: The number of ambulance stations in the East Midlands could be slashed if new plans are approved. BBC Northampton

Care home nurse death cover-up

Care home nurse death cover-up:
A senior care home nurse who failed to check on a dying resident, then faked records to show she had served him cake and juice, may be struck off. Evening Telegraph

Patients Association issues statement on late night discharges

Patients Association issues statement on late night discharges:
Overnight discharges from NHS hospitals
Katherine Murphy Chief Executive at the Patients Association comments,
“Discharging patients often elderly and vulnerable late at night is totally inconsiderate and unacceptable and displays no compassion or thought for the individual patient.
Hospitals may think it is convenient for them to ask people to leave in the middle of the night but is it convenient and safe for a patient who may well have been in hospital for a considerable amount of time, to go home without any warning to an empty cold house – how patient centred is this?  This is totally unacceptable practice in what is supposed to be a caring environment.  We regularly receive calls to our Helpline from patients and relatives shocked at this callous, cruel and thoughtless behaviour.
NHS Managers need to recognise that discharging vulnerable patients at night is a poor reflection on their management skills and those Trusts that are guilty of doing this must be penalised.
The Patients Association today calls for intervention from the Department of Health, the Care Quality Commission and the Secretary of State for Health.  No patient, unless they are in agreement and it is clinically safe to do so should be discharged after 6pm it is inappropriate”. Patients Association

Changes to the professional use of controlled drugs by pharmacists and nurses

Changes to the professional use of controlled drugs by pharmacists and nurses:
The Royal Pharmaceutical Society is delighted to be able to confirm that legislation which introduces a number of changes to the professional use of controlled drugs by pharmacists and nurses was laid before parliament on the 30 March 2012 and will be coming into force on 23 April 2012. NHS Networks

Guidance on direct access to diagnostic tests for cancer published

Guidance on direct access to diagnostic tests for cancer published:
Guidance on direct referral by GPs to specific diagnostic tests for the assessment of particular symptoms where cancer may be suspected but the urgent GP referral (two week wait) process is not applicable, has been published.
The guidance aims to help GPs in determining which patients would be suitable for direct referral to local services providing the diagnostic tests.
It deals specifically with the circumstances and symptoms that may warrant such referrals and is aimed at health care professionals across primary and secondary care and those who both provide and commission services.
The guidance, which was commissioned by the Cancer Diagnostics Advisory Board, forms part of the broader programme to support the implementation of direct access to diagnostics.
Read the guidance
Cancer survival rates in England are lower than the best outcomes in Europe and the Government has set a level of ambition to save an additional 5,000 lives each year by in England by 2014/15 – equivalent to the European average.
In the majority of cases the GP is the first medical professional to see a patient with symptoms suspicious of cancer and GPs need easy access to the right diagnostic tests to help them diagnose or exclude cancer earlier.
Improving earlier diagnosis is key to improving cancer survival and the actions to achieve this are set out in Improving Outcomes: A Strategy for Cancer, published in January 2011.
Department of Health

Reforms in the 1990s were supposed to make nursing care better. Instead, there's a widely shared sense that this was how today's compassion deficit began. How did we come to this?

Late-night hospital discharges to be probed

Late-night hospital discharges to be probed:
Hospitals are ‘throwing patients out of hospitals’ late at night to free up beds, according to an investigation by The Times.
The newspaper estimates that each year more than 400,000 patients are discharged from hospital between 11pm and 6am: many of whom could be elderly or vulnerable patients with inadequate care and support.
The Times sent Freedom of Information requests to 170 NHS hospital trusts and analysed data from 100 that responded. These recorded 239,233 late-night discharges in the past year, which would equate to over 400,000 across the country. This represents around 3.5% of NHS hospital discharges each year.
The Times report included case studies of several patients who had been discharged inappropriately. However, the data reported tells us only the raw number of patients discharged during the seven-hour window. It does not explain why they were discharged, what the patients experienced or how many of the discharges were inappropriate.
Sir Bruce Keogh, Medical Director of the NHS told The Times that he will now investigate the issue of late-night discharges. Sir Bruce said “Patients should only be discharged when it’s clinically appropriate, safe and convenient for them and their families. It is simply not fair to be sending people home late at night. We will look at this.”

Why might patients be discharged at night?

Although the story has been front-page news, it does not explain why so many patients are being discharged at night or how many of these discharges are inappropriate.
Individual patients’ stories support the case that some are being discharged wrongly at night to free up beds but not all night-time discharges will be inappropriate. A small proportion of patients will always leave hospital at night for a variety of legitimate reasons, as some news sources have highlighted:
  • Alcohol-related admissions: binge drinking is thought to cause over a million NHS hospitalisations each year, and drunk patients attending A&E may sometimes be transferred to wards so their health can be monitored. They may be discharged or choose to leave at night once they are more sober.
  • Births: women who give birth to healthy babies often have no need to remain in hospital, and may choose to return home soon after their delivery rather than staying in hospital for the rest of the night.
  • Cleared emergencies: patients brought in at night for suspected emergencies can sometimes be briefly booked into wards for checks and tests. Once it is considered safe for patients to return home they may be discharged the same night.
  • Record-keeping practices: the way discharges are recorded in hospitals may not be totally accurate. For example, discharges recorded on paper might be keyed into computer systems at quieter periods such as night-time, suggesting a late-night discharge. Also, errors might occur when entering discharge times.
  • Deaths: some hospital record systems count a patient as discharged if they die while in hospital. Therefore the figures are likely to include a number of patient deaths recorded during the seven-hour period from 11pm to 6am.
Overall, while there is evidence that inappropriate late-night admission does occur in the NHS, it is hard to judge the scale of the problem without more revealing data. Sir Bruce Keogh, Medical Director of the NHS has said he will investigate the matter.

How can I give feedback on my hospital stay?

You can use the NHS Choices site to give feedback. As well as rating your hospital, you can also read and leave feedback on your GP practice, dental practice or optician. You can add positive and negative ratings and comment on what you have experienced. To post your views, simply find your facility in our NHS services directory and click the button marked “Rate and comment” to begin.

How can I make a complaint?

If you are not happy with the care or treatment you or a relative have received, or you have been refused treatment for a condition, you have the right to:
  • make a complaint
  • have your complaint properly investigated
  • be given a full and prompt reply
The NHS has its own complaints procedure, which is the first step you can take for any complaint. You can find detailed information about the NHS complaint procedure on NHS Choices.
If you aren’t satisfied with the way the NHS deals with your complaint, you can take it to the independent Parliamentary and Health Service Ombudsman.
Under the NHS Constitution you can also make a claim for judicial review if you think you have been directly affected by an unlawful act or decision of an NHS body, and receive compensation if you have been harmed.

You can also raise your concerns by contacting regulatory bodies such as the Care Quality Commission. Read more about this in other options for complaints.

Links To The Headlines

Scandal of NHS patients 'thrown out in the dark'. The Times, April 12 2012 [Paid content, avaiable via subscription from The Times online]
Overnight discharges from NHS hospitals to be examined. BBC News, April 12 2012
NHS patients 'discharged overnight'. The Daily Telegraph, April 12 2012
NHS patients 'discharged overnight'. The Independent, April 12 2012
NHS chief to investigate overnight discharges. The Guardian, April 12 2012
8000 NHS patients discharged in middle of night 'every week'. Metro, April 12 2012

Health News from NHS Choices