TV Hospital Dramas-in perspective

Anthony Sumara the “ new “ Chief Executive of Mid Staffordshire foundation trust has decided in his wisdom that TV hospital dramas can be exciting and entertaining but they are often filled with unprofessional behaviour

He argues that such programmes are painting the NHS and its doctors and nurses in a poor light and not reflecting real hospital life.

And goes on to say “For example, what impression of a career in the NHS is set in the minds of young people aspiring to be the future generation of nurses, doctors or chief executives when they watch programmes filled with unprofessionalism and poor conduct?

Just in the past month or so, there have been numerous instances of this.

In Holby City and Casualty, nurses, doctors and other staff gossip, flirt and argue with each other, usually while treating a patient at the same time.

But, not to worry, the patient doesn't mind and more often than not joins in.

Patient confidentiality is breached constantly.

Cases are discussed regularly between staff, and even with other patients, in full earshot of anyone that can hear, including the patient themselves while nurses refer to patients affectionately as 'alkies' or 'the woman who never shuts up'.

Data breaches are common, with patient records left in public areas or worse, downloaded onto portable devices only to be lost later in the programme.

Eating, drinking and smoking directly outside A&E are also common practice while on duty and in areas where signs are clearly displayed to the contrary, as is the use of mobile phones to make personal calls.”

The above statement concerns me greatly: Mr Sumara has been brought into Mid Staffs to rectify the appalling record of patient deaths, but it seems he cannot tell fact from fiction, TV Hospital dramas are just that, dramas, they are stories written by script writers to entertain the public.

And contrary to his beliefs in the ‘real world’ patient confidentiality IS breached; Cases ARE discussed regularly between staff, in full earshot of anyone that can hear,

Data breaches ARE common, with patient records left in public areas or worse, downloaded onto portable devices only to be lost .

The use of mobile phones to make personal calls, eating, and drinking directly outside A&E ARE also common practices.

I know I have seen it happen, it may have been a few years ago but it still happens.

But back to the point, Mr Sumara is afraid that young people aspiring to be the future generation of nurses, doctors or chief executives will be corrupted by Holby City and Casualty, to be honest if “young people” are believing that the Medical “soaps” are true to life then I for one wouldn’t like to be treated by them, because they would lack the ability to distinguish between entertainment and the hard world of medicine.

But I think that the majority of those aspiring to become nurses or doctors have a good grasp of the difference between fact and fiction, unlike Mr Sumara.

I also think that Mr Sumara doesn’t have enough work to do, if he can spend his time watching Holby City and Casualty instead of reforming the abysmal mortality rates at Mid Staffs and assuring patients that the hospital is not a prelude to the cemetery.


Angus

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The doctor who died as a result of Labour's ISTCs

From the Telegraph:
By Andrew Gilligan.

The whole thing.

Dr Hubley’s is just the most serious in a growing list of cases which raise serious concerns about the safety of 'independent sector treatment centres', writes Andrew Gilligan.

Dr John Hubley's operation to remove a gall bladder was supposed to take an hour, and he was expecting to be home the same evening. Instead, in a "torrent" of blood, he was dead.

What killed him was not the operation, one of the simplest there is. Neither the pathologist at the inquest, nor one of the country's most eminent experts in the field, had ever heard of it being fatal. No, what killed Dr Hubley was a Government initiative.

If Dr Hubley had been treated at a proper hospital, heard the inquest, he would have lived. Instead, he was sent to one of New Labour's "independent sector treatment centres" – clinics run by private companies, but taking only NHS patients and wholly funded by the state.

To ministers, ever questing for the quick fix, ever faithful when it came to privatisation's magic healing powers, the ISTCs were a godsend. Ben Bradshaw, then a junior health minister, said they were "providing NHS patients with fast access to high-quality treatment and galvanising the NHS to raise its game". There are now around 40, cutting waiting lists around the country. But many ISTCs are also cutting corners.

Dr Hubley, for example, had a haemorrhage on the operating table – but the clinic, although it carried out dozens of operations a week, did not have enough swabs to stem the bleeding.

Incredibly, it didn't even hold any emergency blood stocks to replace the blood Dr Hubley had lost.

The surgeons wanted to ring the local NHS hospital and ask for blood, but there wasn't a phone in the operating theatre. Someone had to go outside and rummage around for his mobile. The blood took almost two hours to arrive in sufficient quantity. By that time, it was much too late.

Dr Hubley's is just the most serious in a growing list of cases which raise serious concerns about the safety of these clinics. So far, these have mostly been local stories. It's time to start joining them up.

On Wednesday, this newspaper reported that ISTCs operated by a company called Clinicenta across North London had been closed by the NHS "in the interests of patient safety" after "a number of incidents" understood to include up to two deaths.

This particular contract has only been going for six months, and has served just a handful of patients. Two deaths already, if that is the case, would seem poor odds. Clinicenta is part of Carillion, a construction company. What do builders know about surgery?

Earlier this year, a survey for the BBC in the West Country found that almost a third of leading trauma and orthopaedic surgeons believed their local ISTC did not operate safely. Four surgeons reported avoidable patient deaths. Twelve reported avoidable poor outcomes, with one saying: "The results are very poor and I have to redo the operations, with unhappy results."

Dr Mark Porter, of the BMA consultants' committee, tells me: "We have been extremely concerned about where ISTCs get their staff from. They sometimes use short-term staff from abroad, whose quality control is questionable compared to an NHS consultant." And the public is paying through the nose for it all. Earlier this year, Edinburgh University found that, under fixed-cost contracts, the ISTCs had been paid £1 billion for operations that never took place.

You may think private is better. If it's the London Clinic, it probably is. But these are new outfits, specifically set up to make money from the taxpayer. If someone tries to send you to one, just say no, because NHS patients are finding themselves transferred into a semi-private netherworld without the same checks and safeguards.

The coroner condemned the ISTC where Dr Hubley died as a "Mickey Mouse" operation. The clinic responded: "We met all the criteria and all the regulations. [Blood] was not a requirement."

Blood was not a requirement. Let that be the epitaph for this literally fatal wheeze.


No comment from me needed.


Angus

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Too fat to retire

The latest “research” has found that those that retired in the last 10 years were less mobile and less able to look after themselves than the generation before them at the same stage of life.

And goes on to say;- They believe an "epidemic of obesity" explains why the so-called baby-boomer generation are less able to carry out the basic tasks of life than those born before the Second World War.

The findings are significant because they suggest that unhealthy lifestyles are finally offsetting the advances of medical science in society.

They also raise serious concerns about the provision for elderly care as the results suggest people will live longer but less independent lives in the future.

They found that for the first time the "abilities" of those retiring after the year 2000 were lower than the "abilities" of those who had retired in the 1980s and 1990s.

The abilities included walking up and down stairs or to the shops, managing household chores, and basic tasks like dressing oneself, getting in and out of bed or eating.

Ever since the Second World War the health of pensioners has generally been on the up and life-expectancy has increased because of breakthroughs in medical science.

But since the 1960s, obesity levels, and unhealthy sedentary lifestyles, have also increased and at the beginning of this century they finally began to take their toll, claim the researchers.

In the 1960s only around 13 per cent of the population were considered obese compared with 32 per cent in 2000, they said.

With levels expected to reach 45 per cent in the next 20 years the problem is likely to get worse, the study added.

"If this is true, it's something we need to address," said Prof Seeman. "If this trend continues unchecked, it will put increasing pressure on our society to take care of these disabled individuals.

Scary huh?

But don’t worry, this research was done in America, more scare mongering to frighten us into the ‘perfect’ mold that the Gov wants us to conform to.


Angus

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Nurses, worth every penny

Nurses do not currently need degrees, but must take extra training to climb the NHS ladder.

Here is a quick breakdown of nursing posts, responsibilities and salaries.


Role: Nurse consultantNumber: 860Salary: £38k - £65kRole: Providing expert advice to patients and junior staff, and co-ordinating clinical research.Required qualifications: Diploma plus significant experience and specialist training.

Role: Modern matron/community matronNumber: 6,800Salary: £38k - £46kRole: Supervising ward managers, ensuring cleanliness standards are met and training junior staffRequired qualifications: Diploma plus specialist training, or experience equivalent to a master’s degree

Role: Nurse managerNumber: 7,600Salary: £30k - £40kRole: Managing wards and budgets, in addition to clinical work assessing and caring for patientsRequired qualifications: Diploma plus managerial training

Role: Nurse specialist/ team leaderNumber: Approx 40,000Salary: £25k - £34kRole: Taking lead in care for patients suffering from particular conditions, eg diabetes or Parkinson'sRequired qualifications: Diploma plus specialist clinical training

Role: MidwifeNumber: 25,000Salary: £25k - £34kRole: Supporting women during pregnancy and taking lead during labour and birthRequired qualifications: Degree in midwifery. Qualified nurses can become midwives by completing 18 month course.

Role: NurseNumber: 300,000Salary: £20k - £27kRole: Range of clinical roles from checking temperatures to administering blood transfusions.Required qualifications: Two or three year nursing diploma. Five good GCSEs usually required to win place at diploma course colleges.

Role: Healthcare assistant/auxiliary nurse/clinical support workerNumber: 180,000Salary: £13k - £18kRole: Washing, dressing and feeding and patients, making beds, and monitoring symptoms.Required qualifications: None, although assistants can take NVQs to become clinical support workers and qualify for nursing diploma course.

I have great respect for the majority of nurses, they do a wonderful job in very difficult circumstances.

I know this is over simplifying the situation and some nurses will go ballistic, but these are not my descriptions, so if there are any nurses out there who have the full story let me know.

And be gentle, I haven’t been well you know.

Angus

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Statins; be careful.

I wrote about his on another blog back in June this year, and it appears I may have been right:

The Medicines and Healthcare products Regulatory Agency is updating the product information on all statins to warn GPs and patients of a string of potentially dangerous side-effects.

The UK drug regulator has announced it will amend both the summaries of product characteristics and patient information leaflets to include warnings about side-effects caused by the drugs, including depression, sexual dysfunction and lung conditions.

In its November Drug Safety Update, the MHRA said a European-wide review on statins conducted in February 2008 found there was a need for fresh advice and information on the side-effects of statins.

‘The headline message from the review was that the balance of risks and benefits of statins remains positive,’ it stated.

‘However, the review also identified the need for the product information for all statins to reflect the issues identified from analyses of clinical trial and post-marketing data from adverse drug reactions. These included sleep disturbance, memory loss, sexual disturbances, depression, and interstitial pneumopathy.

‘On the basis of the data examined for individual statins and the class as a whole, the review concluded that there is sufficient evidence to support a possible causal relationship between statin use and the above adverse reactions.’

GPs are also warned to ‘be aware of the changes’ and discuss them with patients.

Dr Stewart Findlay, a GP in Bishop Auckland, County Durham, and a member of the Primary Care Cardiovascular Society board, said: ‘Sleep disturbances are quite common in primary care, but the others are not that common.'

'Generally, statins are well-tolerated drugs, but this might prompt us to keep an eye out. If a condition comes on soon after statins are started, it might be worth stopping them to see if it improves.’

I still take statins, and I still get the side effects; muscle pains, sleep disturbance, depression and breathlessness and I have had them since I started taking them, but when I mentioned these to my GP there was no real feedback, or advice.

So my advice-non medical of course is if you are offered statins because of your cholesterol levels, think very carefully before taking them, and if you suffer any of the serious side effects mentioned go back to your GP as soon as you can to discuss alternatives.

Angus


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Are Government targets killing patients?

Deadly superbugs have increased despite a crackdown on the best-known infections such as MRSA, a parliamentary report will warn this week.

While rates of MRSA and Clostridium difficile are falling, after scandals over major outbreaks, other potentially fatal infections which receive less attention appear to be soaring, the Commons public accounts committee will say.

Around 300,000 infections are diagnosed in English hospitals every year – but many more potentially fatal bugs may be going undetected, because of a lack of surveillance, research has found.

A voluntary scheme charting all bloodstream infections found numbers increased by 30 per cent between 2003 and 2007, in what the committee's chairman Edward Leigh described as a "rising tide" of infections threatening all hospital patients.

The report is expected to show increasing numbers of cases of E-coli, linked to surgical site infections and urinary tract problems, and in cases of the bacterial infection klebsiella.

The Sunday Telegraph has established that the NHS' most senior doctors and scientists responsible for infection control believe their efforts are being hindered by Government waiting targets.

An anonymous survey of 170 NHS directors of infection control found that 59 per cent had experienced a clash between their efforts to block the spread of disease and rules which say new patients must be found a bed within four hours.

Infection experts say NHS managers are so fearful of missing the four hour target for Accident and Emergency patients to be admitted to a ward, that infected patients are being shunted around overcrowded hospitals, hastening the spread of disease, in a rush to clear space for new arrivals.

The four hour target has already been implicated in a series of NHS hospital scandals, in which hundreds died, but, on each occasion, ministers have insisted that poor management, rather than the target, was to blame.

In total, 100 of 170 directors at England's hospital trusts reported difficulties as a result of the four hour target, in research carried out for the National Audit Office.

A Department of Health spokesman said MRSA bloodstream infections had fallen by 74 per cent since 2003/04 and C. difficile infections by 35 per cent between 2007/08 and 2008/009.

So why have more than 30,000 people died between 2004 to 2008 after contracting the hospital infections MRSA and Clostridium difficile?

Angus

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GPs on the turn?

From Pulse:

A poll of 326 GPs reveals that in the wake of the major parties’ political conferences, the profession’s support for the Government is at its lowest level yet.

Just 8% said they would vote Labour in the next election, which is expected to be held early next summer. 52% said they would vote for the Conservatives and 22% for the Liberal Democrats.

7 respondents – equivalent to 2% of those polled – listed the British National Party as their preferred choice.

The poll will come as a blow to the Government, which has sought to portray Labour as the natural party of the health service. Health minister Mike O’Brien told Pulse last month: ‘Nothing better symbolises what Labour is about than the NHS.’

But even compared to recent surveys, the drop in support for the Government is striking. A poll of nearly 1,400 GPs in January found 15% would vote Labour, with 50% for the Conservatives and 19% for the Liberal Democrats.

Dr Paul Charlson, chair of the Conservative Medical Society, hailed the survey’s findings as a ‘resounding endorsement’.

‘The idea that GPs are to be trusted with real budgets to spend on commissioning care on behalf of their patients is particularly attractive to GPs who have become frustrated at the lack of progress in practice-based commissioning,’ he said.

‘Andrew Lansley and his team have taken the time and trouble to listen and understand what needs to happen at the grassroots to ensure that the NHS flourishes.’

Dr David Stokoe, a GP in Liverpool, said he was planning to vote Conservative, largely because of a lack of confidence in the Prime Minister.

‘I don’t have any evidence that they will be better for health than the others – but surely they can’t be worse,’ he said.

Dr Andrew Mimnagh, chair of Sefton LMC, said he was still an undecided voter.

‘I believe there are two certainties for GPs during the next parliament regardless of controlling party,’ he said. ‘They will be working longer and harder to the detriment of their personal life. And they will have less disposable income.’

Unlike the rest of us?

Angus

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