The NHS - Run For The Patients?

Picture the scene - Southend Hospital's phlebotomy service:

Under the automated system, outpatients have to book in and get a number from a touch screen before waiting for their number to come up on another screen.

They must then proceed to the hospital’s phlebotomy department on the mezzanine floor, where they face another wait for the number to come up again.

And woe betide you if this system doesn't suit your personal circumstances:

Rosemary Debenham was waiting with her daughter and grandson, who needed a blood test, when the drama unfolded.

Mrs Debenham said: “An elderly gentleman with two walking sticks came into the upstairs department. He said as he was not very mobile and he was frightened of missing his slot, he would wait upstairs until his number was called.”

What could possibly go wrong?

“He was told it could be a two-hour wait, but he was quite happy with this saying he had a newspaper and was content to wait.

“A member of staff then told him he had to wait downstairs and if he didn’t go he would call security. The elderly gentleman was then forcibly removed by security from the upstairs department.”

NHS staff. Angels, all.

Are You Sure It Wasn’t A Siberian Filigree Hamster?

Staff spotted Mr Ketley stumbling around a corridor with the rat hanging from his neck by its teeth and nurses knocked it off and killed it. Hospital officials said it was a field mouse.

Ah, yes, the well-known man-eating field mouse…

But his mother Pat Boardman told the Mirror: "That's an outrageous claim. He had large, open bite marks.

"I'm appalled that this sort of thing could happen to my son in an NHS hospital in this day and age.

"He was completely helpless and terrified. It's a disgrace. He was very scared and the staff had to show him they had killed the rat to prove it could no longer hurt him."

The field mouse, I guess you mean? If you know what's good for you....

"I put my hand inside and felt an organ and I pulled it..."

File that one under 'things you don't want to hear at an inquest'...

Dr Carter said as a result of the death operating procedure had been modified slightly and the new method communicated "worldwide".

The 'new method', presumably, being 'Don't let the trainee have a go, and if you do and they mess it up, don't then rummage around in there like you were looking in your cutlery drawer for that pickle-fork you know you had just a few weeks ago'....

Yes, They Really Should Have, Shouldn't They?

"I can't believe they did what they did. Someone should have checked everything they needed was there before they got my mum into theatre.

"I just hope we don't experience anything like it again."

So much for the NHS being the wonder of the world...

Adam Brooks, clinical director for specialist support, which covers operating theatres at NUH, said: "We're sorry that Mrs Taylor's operation was delayed on 1 December.

"The specialist equipment (metal plates and screws) needed for her surgery had not returned from being sterilised – which is vital for the safety of such a procedure. We apologised to Mrs Taylor at the time and were able to reschedule her operation for the following week.

"All of our theatres equipment at NUH goes through a thorough checking process to ensure everything is of the highest quality and within sterilisation dates."

Look, Adam, no-one's suggesting that it doesn't, or that it should be any different. What they do expect is that your surgical staff should ensure they have everything they need to hand before they start searching for a place to stick the epidural.

It's only common sense, after all. Haven't your staff ever put together anything bought from MFI or IKEA?

Oh, Well, So Long As The Paperwork's In Place....

A father has hit out after a York Hospital doctor failed to consult next of kin before filling in a “do not attempt resuscitation” form for his son.

Gosh, and they said this’d never happen!

… kidney patient Andrew Watson’s condition deteriorated one night while his parents, Peter and Sheila, were asleep at their home in Wigginton.

Peter Watson only found out the following afternoon about the decision not to attempt cardiopulmonary resuscitation if his son went into cardio respiratory arrest.

Whoops! However, the hospital has an excuse ready.

Not a good one, admittedly:

However, hospital bosses said a DNACPR form was not a consent form, but was intended as a record that a discussion about the decision had taken place.

*BZZZZZT!*

Still wrong. Because no discussion had…

Mr Watson said he disputed some of the findings of an investigation into the incident.

He said: “I do not intend to let this lie, as I do not want any patient, partner or next of kin to be put through the same distress that we had to suffer, and I don’t believe the trust will do anything constructive if left to manage it themselves.”

Does anyone? Anyone at all? Bueller?

Sarah Lovell, directorate manager for acute and general medicine, who investigated the matter, said in a report that Andrew had not been well enough for the decision to have been discussed with him and the doctor concerned had intended to discuss it with his next of kin.

Well, that road to hell is just paved with intentions, eh, Sarah?

She acknowledged staff could have made more pro-active attempts to arrange for a discussion much earlier in the day.

And could have, say, not simply filled the form in regardless….

The Sinking Ship Suffers A Bit Of A Manpower Problem...

A leading surgeon quit an NHS hospital in disgust, claiming that patients routinely suffered due to a lack of resources.

But I bet the hospital administrator's office doesn't suffer a lack of deep-pile carpet and personal coffee machines...

He is one of five surgeons to have quit the hospital in the last year.

And you'd think that would prompt questions in high places, wouldn't you?

“Something has happened but don’t worry, it is ok.”

Really? Not the words I'd use to describe this, and maybe the hospital had a rethink, because later - incredibly - there was no mention of it:

‘She said she would tell me when I came in to visit in the afternoon but when I got there they didn’t even mention it.

‘All I know is that Anthony woke up and he said the man had his hands round his neck and that someone must have pulled him off, and then they took him off.

‘He wasn’t all that good. I wouldn’t say he was dangerously ill but he just said he didn’t feel all that right. They kept asking him to drink water.

‘But Anthony was one of those people who didn’t like to make a fuss. He’d just say, “Oh I’m all right.”

But wait, you say, how was this allowed to happen in the first place? Wasn't he under guard?

Well, incredibly, the answer appears to have been 'Yes':

The UK Border Agency confirmed it is in the process of attempting to remove the Iranian man. A spokesman said: ‘We are reviewing this incident and, if necessary, will take appropriate action.

‘The detainee was handcuffed and accompanied by three escorts when the incident occurred.’

What were they doing?

NHS – More Concerned About Punishing The Leaker…

…than resolving questions about the competency of their staff:

NHS officials have called in police officers as part of an investigation to identify a hospital worker whose leak of confidential information highlighted serious allegations about the work of a doctor.

And no doubt that effort is 100% greater than that they expended on the actual allegations…

Now Staffordshire Police is applying for a court order to force an internet provider to name the mystery worker who revealed that some of the work of University Hospital of North Staffordshire (UHNS) radiologist Dr Changez Jadun was branded 'negligent'.

Branded by whom? Some troublemaker with a grudge?

No. His own colleagues:

The documents showed how two external and one internal inquiry had been carried out into the safety of Dr Jadun's work.

Fears over the safety of his work were raised by both a national expert and then three of his fellow consultants.

The paperwork contained the names of a number of Dr Jadun's patients; and hospital bosses say that broke the law.

And can they spare some time away from the international manhunt to deal with the allegations?

After a string of new reviews into dozens of patients Dr Jadun operated on, the radiologist is to be allowed back to work full-time.

Ah. Great. So we don't know why the allegations were made, nor whether there was any basis to them. But I think we can guess why the unknown leaker felt he/she had no option but to take this route...

NHS loses CD of 1.6 MILLION patients' records

An NHS trust has told patients that it is acting to improve its data handling practices after a rebuke from the Information Commissioner's Office (ICO) for losing a CD containing details on 1.6 million people.

Chief executive of NHS Kent and Medway Ann Sutton said that information is now more secure following the implementation of encryption systems to replace the use of floppy discs and CDs.

Last week the trust was handed an undertaking by the information watchdog after sending the personal information to a landfill during an office move in March. The ICO said the data contained the names, addresses, dates of birth, NHS numbers and GP details of those affected.

Source: The Register.

Are The Words ‘No, Love, It’s Supposed To Look Like That’ So Hard Then..?

GPs should not refer women who are well but worried for female genital cosmetic surgery on the NHS, say experts.

Well, duh!

Specialists at a Central London teaching hospital say they received 30 such referrals, mainly from family doctors, over the past three years.

This included eight schoolgirls - one as young as 11 - the British Journal of Obstetrics and Gynaecology reports.

Experts say doctors need clear guidance on how best to care for women who mistakenly believe they need surgery.

Sorry, why? Don’t they do five years at medical school? How hard can it be?

The British Association of Aesthetic Plastic Surgeons says medics need to determine whether a problem exists or whether an alternative solution may be preferable, but offers no advice on how to judge the problem, say the researchers from University College London's Women's Health Institute.

If it’s not an actual clinical problem, what sort of advice should you need?

They say it may be simpler to ban the procedure in the NHS altogether, leaving it to private practices.

Well, I’m all for this on cost grounds, actually, but then what about those who do have a real, clinical problem? Where do they go?

I mean, good grief, why is it so bloody hard for supposed ‘professionals’ to just do the damned job they are paid for?

Dr Sarah Creighton and colleagues believe the future demand for so-called "designer vagina" operations or labial reductions is potentially infinite and is driven by society's wider and growing desire for cosmetic surgery in general and changing expectations about what is a desirable appearance for women.

Yes, you can certainly blame the media and women’s magazines and fads started by the permatanned chavs of Essex and Cheshire for the desire for such surgery.

But you can’t blame the GPs’ reluctance to address those issues with their patients, and to send them for unnecessary and costly surgery on the NHS, on that.

Can you?

The Fundamental Problem With Nursing...

Sir Stephen Moss, chairman of Stafford Hospital and himself a nurse for 40 years, said that “too many patients and families” are being let down but that staff shortages are not to blame.

He suggested the problems lie in the training nurses receive as well as the way they work on hospital wards, and plans to lead a new campaign to improve standards.

I take it ‘the way they work on hospital wards’ is code for ‘they should put down ‘Heat’ magazine occasionally and check to see if elderly patients are starving to death’?

Unions and professional bodies have suggested that the problems are down to staff being over-worked or forced to focus on Government targets rather than providing personal care.

Because if it wasn’t for the government telling them how to do every tiny small task, they’d be completely unable to understand that patients need to be fed and floors need to be washed?

But other commentators have claimed that too much care is now provided by cheap healthcare assistants, who do not need to meet national training standards and who are not regulated by a professional body; or that nurses think they are “above” feeding and cleaning patients now that they have to be university-educated.

Surely not!

Sir Stephen is drawing together a group of seven “big hitters” in the health service to suggest ways that hospital care can be improved.

Their plans, to be disclosed in September, will focus on how nurses can be trained for “the real world of the NHS rather than the classroom” .

I can’t say this isn’t welcome, but I fear it’s too little, and far too late.

Nostalgia Alert! Rationing's Back In Fashion!

Health service trusts are “imposing pain and inconvenience” by making patients wait longer than necessary, in some cases as long as four months, the study found.

Executives believe the delays mean some people will remove themselves from lists “either by dying or by paying for their own treatment” claims the report, by an independent watchdog that advises the NHS.

And this surprises people? It was always bound to happen…

But managers, who are already rationing surgery for cataracts, hips, knees and tonsils, say they must restrict treatment as the NHS is under orders to make £20 billion of efficiency savings by 2015.

Because, clearly, there are no other possible ways of making those efficiency savings, I suppose?

H/T: AC1

Those Selfless, Caring NHS Staff....

An elderly hospital patient suffered severe brain damage and died after staff turned down the volume on an alarm system monitoring his heart.

Ahhh, those caring NHS staff…

An investigation found the volume of the heart-monitor alarm had been turned down to 40 per cent of its maximum on November 21, 2008.

The speakers had also been turned the wrong way and covered in paperwork.

An accident? Carelessness?

No…

An inquest sitting with a jury at Hanley Town Hall yesterday heard the volume could not have been reduced accidentally as someone has to change the settings on a computer system.

Under questioning, the staff adopt the sort of attitude you’d expect from state-run healthcare ‘professionals’:

Margaret Archer, a sister at the hospital at the time of the incident, said she had not heard the crisis alarm sound when Mr Bough’s condition worsened.

North Staffordshire coroner Ian Smith asked her: ‘Is this a case where someone on your shift has just turned the volume down, or has it been like this for some considerable time?’

She replied: ‘I don’t know. I wouldn’t have allowed anyone to do it.’

Are you sure?

Because clearly you didn’t notice the speakers or the paperwork, so we can only conclude you were quite happy to allow that…

After restarting Mr Bough’s heart, Dr Satchi checked the telemetry system that monitors the heart rates of up to ten patients on the ward.

‘I checked the monitor, which appeared to still be flashing red, but there was no audible alarm,’ he said.

‘I checked the screen to see if it had detected an abnormal heart rhythm and it had done so for between 15 and 17 minutes.’

Mr Smith told Dr Satchi: ‘Had he been treated promptly, the likelihood is you would have got his heart back earlier and he wouldn’t have suffered the significant brain damage he did.’

Dr Satchi replied: ‘Yes.’

And the verdict?

As Mr Bough’s relatives sobbed in the gallery, the coroner ruled that he died of natural causes ‘exacerbated by an act of omission causing alerts from the heart monitoring to not be seen or heard’

Why not call it what it was – criminal negligence?

Hospital pillows riddled with infection

Hospital patients are at risk of catching infections such as MRSA and C. difficile from "biohazard" pillows which are ridden with 30 different bugs, according to a new study.

Nurses are required to regularly wash their hands and disinfect bed frames and mattresses, but underestimate the risk of infection from dirty pillows, a report said.

But dead skin, dandruff, dirty air and contaminated fluids found on pillows in hospital wards expose patients to the risk of diseases ranging from seasonal flu to chickenpox, hepatitis and even leprosy, it was claimed.

The study by The Barts and The London NHS Trust found 30 different types of infection in a sample of pillows taken from hospital wards, posing a significant risk of infection.

While used linen and bedding is changed and laundered between patients and is routinely cleaned, the study found a "very high and unacceptable percentage" of damaged pillows on three test wards.

Tears to the lining or stitching of pillows mean they cannot be effectively cleaned and patients could be exposed to infection through the mouth, nose, eyes and ears, the report said.

Germs are released through tears and the stitching of standard NHS pillows when pressure is applied – for example when a patient lays their head down, it added.

Source: Telegraph

Elderly told: Bang tambourine to call for nurses' help

HOSPITAL chiefs have apologised after giving elderly patients a TAMBOURINE to call for nurses in an emergency.

The musical instrument was left in a day room after older patients feared they were too far away for nurses to hear any cries for help.

A pair of maracas were also handed out as a back-up — in case the tambourine failed.

But an NHS watchdog complained and bosses are now providing a hand bell - and making sure patients are accompanied.

Cardiff Royal Infirmary is well known for its long corridors and has been used to film episodes of TV's Dr Who.

Staff put the tambourine in the West Wing day room following complaints from frail patients that they struggled to get the attention of staff.

Source: The Sun

Accountability? What Accountability..?

A GP who sent a four-year-old girl home with a fatal pneumonia infection can continue practicing medicine after a hearing found he had “learned his lesson”.

Oh, really?

Dr Shoab Ibrahim failed to listen to the concerns of the girl’s parents and did not carry out “simple but important” tests that would have shown she was seriously ill.

Yes, clearly a very easy mistake to make for someone whose job consists mostly of listening to patients and then ordering tests….

/facepalm

Ibrahim, who practices at the Robert Frew Medical Centre, in Silva Island Way, Wickford, was told by the General Medical Council he was guilty of misconduct in his treatment of the girl, but that his failings were “highly unlikely to be repeated”.

Panel chairman Sheleen McCormack told him: “You have shown insight into your misconduct and you have remedied the deficiencies in this case.

“The panel does not consider your fitness to practice is impaired.”

That doesn’t seem to jibe with this part of the summing up, though:

Ms McCormack said the girl’s parents had been “clear, consistent and reliable” in their evidence, whereas the doctor was “inconsistent in several material respects”.

That sounds very, very close to ‘We caught you out in a lie several times’. Doesn’t it?

Ibrahim, who qualified in Pakistan in 1988, can now continue practicing without restrictions as a result of the decision.

Great. Glad he isn’t my GP.

Bullied by the NHS, cancer patient who complained about his treatment online

A cancer patient who wrote an online diary highlighting failings in his hospital care has been threatened with legal action by a ‘bullying’ NHS trust.

Retired publican Daniel Sencier, 59, was so worried about delays and damaging administrative problems at his local hospital that he arranged to have surgery for his prostate cancer in another part of the country.

Following his successful operation Mr Sencier campaigned for improvements at Cumberland Infirmary in Carlisle because he wanted to help other patients. He lodged a formal complaint and an internal inquiry resulted in an eight-point ‘action plan’ to improve procedures.

But instead of apologising to Mr Sencier, NHS bosses have hired lawyers with orders to clamp down on his blog.

A letter sent by solicitors Ward Hadaway, acting for North Cumbria University Hospitals NHS Trust, warned him: ‘The Trust will monitor the content of your blog and if it contains information that is not factually correct or which contains unsubstantiated criticism of the care you received at the Trust, the Trust will have no hesitation in considering taking legal action against you.’

Mr Sencier and his supporters were planning a demonstration outside the hospital, but legal action has been threatened over that too.

The father of five said he was appalled that health service managers would rather spend ‘thousands of pounds’ to pursue him than put into effect the low-cost measures to improve patient-doctor communication he has called for.

Source: Daily Mail

Ice, Ice Baby...

Debra Sanderson said her son was told by doctors at Royal Blackburn Hospital his leg needed to be packed with ice to reduce heavy swelling so he could undergo an operation.

But when she asked nurses for ice, Mrs Sanderson said she was told they had run out.

Run out of ice? Isn’t it just frozen water?

Can’t they make some, or has the NHS lost the recipe?

She said she was forced to visit a supermarket twice a day to buy ice cubes herself for her son, who spent 10 days in hospital after injuring his ankle while playing football.

I’d be damned if I’d do that!

Especially as it turned out there was no need – there was ice available, it was just that the useless, lazy, incompetent staff couldn’t be bothered to go get some, recommended by the doctor or not:

Hospital bosses said ice had been available elsewhere in the hospital, but the trust admitted this had not been made clear to the family.

Well, no. I bet it wasn’t:

Mrs Sanderson, 45, of Sutton Avenue, Burnley, said her son was taken to Blackburn by ambulance and was visited by a consultant the following day.

She said she was told her son’s leg would need to be kept elevated and packed with ice.

“When we went in to see him on the Sunday he was in some discomfort,” she said.

“I asked the nurses if he could have his ice replaced because it had begun to melt.

“When we went back that evening it still hadn’t been done.

“I asked a nurse again because nearly five hours had elapsed. She said ‘unfortunately we’ve no ice’.

“I said, ‘I’m sure in a hospital this size there is somewhere you can get some ice’, and she said ‘we can’t, the machines are all broken’.

Translation: ‘The ones nearest our station are broken and we can’t be arsed to put our copies of ‘Heat’ and ‘Hello!’ down for the five minutes it’d take to go get it.’

Mrs Sanderson said: “It’s not so much the money, because the ice cost about £3 a day.

"It’s that I don’t want it to happen to anybody else.

“We’ve had an email saying it was a lack of communication, but it wasn’t a lack of communication in my opinion, it was neglect.”

Yes. Yes, it was…

Lynn Wissett, deputy chief executive of East Lancashire Hospitals NHS Trust, said it had contacted the family within four hours of receiving Mr Birtwistle’s email and met with them the next day.

She said: “The patient’s leg needed a very large amount of ice to reduce the swelling, meaning ice flowing through the ward’s machine was not quite enough.

“There are a number of machines across the hospital and the trust has always had enough ice to meet the needs of patients.

“Unfortunately, the availability of ice elsewhere in the hospital had not been made clear to the patient and his family.

“At our meeting, we explained that enough ice was always available to meet all of our patients’ needs, and further explained this patient’s treatment plan.

“We are, as with any patient, happy to meet with this patient and his family again.”

I’m not generally in favour of the compensation culture, but in this case, maybe if it came directly out of the lackadaisical staff’s wage packet, it’d actually make a difference?

Third World Healthcare...

41-year-old Mr Thompson had taken a cocktail of drink and drugs but instead of taking him to accident and emergency, staff at the Edale House unit at the Manchester Royal Infirmary left him sprawled on the floor, where he eventually died.

And before they discovered that he was dead….

CCTV captured staff pulling the lifeless body of Peter Thompson along the floor like they were 'dragging the body of a dead animal'.

The family are appalled at the CCTV footage. And at the attitude of the staff.

Senior nurse Helen De Lacy-Leacey said she alerted night staff that the patient was outside the doors of the ward and asked them to: 'keep an eye on him and make sure he is okay'.

And did they?

Well….

… night manager Steve Soobhug said leaving him to sleep outside was 'the appropriate method of handling the situation at the time'.

If he’d just been drunk rather than dying (in some Third World-standard hospital), you might - might - have had a point. But he wasn’t.

Fellow senior staff nurse Miss Dini Oyebadejo said she checked on the patient several more times overnight but discovered him 'stiff' at 6.15am and raised the alarm.

Eh? Rigor mortis had set in? So all those ‘checks’ you claimed to have done failed to pick up the absence of life?

No wonder the coroner’s asking questions…

I Think I Preferred You When You Were Denying People Cancer Drugs, Frankly…

Fast-food chains could be told to cut the size of portions of chips, the chairman of the NHS watchdog says.

Shouldn’t the NHS watchdog have far more important things to concern itself with, given the poor performance of so many of its hospitals?

Sir Michael Rawlins said the National Institute of Health and Clinical Excellence (Nice) may produce guidelines to recommend smaller servings to help combat obesity.

Well, that’s fine, then. Guidelines can be ignored, can’t they?

Sir Michael, who leaves Nice next year to become president of the Royal Society of Medicine, said: ‘Someone had actually reduced the number of chips in a standard portion.

‘Nobody noticed, which is quite interesting. Nice could suggest it.

‘It could be a recommendation. When it comes to obesity we have to do more to help people reduce their intake of food.

'It is not a single bullet but a whole variety of things that we need to do to help people and help communities.’

I really don’t think we need that kind of ‘help’. I’m pretty sure we don’t need to pay you to come up with it, either…

The watchdog is drawing up guidelines to help councils and health trusts tackle obesity.

This is expected to be published in November 2012 following public consultation.

What sort of public consultation?

The sort where the public point out what useless, counter-productive nannying claptrap you’ve come up with, and you then go ahead regardless?

The details are unlikely to include specific advice telling fast-food chains and restaurants to cut chip portions.

However, Sir Michael indicated that in future the watchdog could suggest such measures.

Suggest away. I’m sure everyone will feel free to treat your suggestions with all the attention they really deserve.

None.