If you are alone and frightened, get together and get strong.

This came from ‘Practise Manager’, but seems based on a press release from the GMC of The British Medical Association who paid for a very interesting survey.

The medical Profession seems to be based on the old British Public Schools mentality – “I had it so bad when I was your age, I’m going to make it really hard for you”.

As I have said so many times before:

1) The majority of NHS employees are women.

2) The majority of NHS employees are working class.

3) The majority of NHS employees are from ethnic minorities.

So how come it is so male, white and upper class?

Because of bullying.

And why are patients treated so badly – because they are frightened and intimidated.

GMC survey questioned 54,000 doctors in training about their views on the quality of their training

 

 

A survey of 54,000 doctors in training found that nearly one in five had witnessed someone being bullied in their current post, and more than one in four had experienced undermining behaviour themselves.

 

The findings of the General Medical Council survey also reveal that more than 2,000 doctors in training (5.2%) had raised a concern about patient safety in 2013 and 13.2% said they had experienced bullying at work.

 

Niall Dickson, chief executive of the GMC, said: “The survey provides us and employers with crucial information about the quality of the training environment, which is also where patients receive care and treatment.  These doctors are in an ideal position to alert us to potential problems and employers will also want to reflect on these results.

 

“Patient safety remains our top priority and all doctors irrespective of their seniority should feel supported in improving the standards of care for their patients.”

 

Dean Royles, chief executive of the NHS Employers organisation, said: “These are very insightful reports that get further into the detail of some key issues in medical care. We know doctors can work in stressful situations, especially when vacancies exist or demand for care rises, but everyone would recognise that it is unacceptable for this to spill over into bullying.

 

Dr Kitty Mohan, co-chair of the BMA’s Junior Doctors’ Committee added: “The GMC’s national trainee survey is an invaluable tool that helps assess the quality of junior doctor training throughout the UK..

 

“We must do more to combat any environment that allows bullying or harassment by encouraging NHS staff to share their concerns immediately. Junior doctors have a right to carry out their job in a workplace that is free from any form of intimidation.

 

“The BMA shares the GMC’s recommendations aimed at tackling the key patient safety challenges that were highlighted in the Francis report. To guarantee patient safety, we must establish a culture where the NHS actively listens to its workforce and acts upon any concerns raised.

 

 

 

“Building a new ethos of openness, transparency and mutual support amongst NHS staff is the key to guaranteeing patient safety and the wellbeing of all those who work in our health service.”

If you are alone and frightened, get together and get strong.

 

Neil Harris

(a don’t stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com

More signs that closing A and E's costs lives.

When troublesome people like me campaign to stop the closures of Accident and Emergencies, the NHS always argues that bigger is better and usually cite the improvement in Stroke survival rates in London following the reduction in the number of hospitals treating strokes.

What they never say is that the old way of treating strokes was terrible – a national scandal. Survival rates improved because for the first time patients had early access to proper treatment.

I’ve previously posted the Daily Mail article referred to in this article – which showed how mortality rates go up for patients whose local A and E is closed causing journey times to go up.

This is a posting on Steve Baker’s Website (Member of Parliament for High Wycombe), his local A and E shut in 2005 and High Wycombe’s patients now go to Wexham Park Hospital in Slough. These are early figures – I’ll keep you posted.

Death rates for emergency patients admitted to Wexham Park from Wycombe

Posted by  Steve Baker  Jun-25-2013

When the Daily Mail published Shocking proof A&E closures cost lives: Death rate jumps more than a THIRD after department closes, I asked for the exact Freedom of Information request they had submitted so I could obtain comparable figures for Wycombe from Wexham Park and Stoke Mandeville.

 

We sent the requests on 4 June. The Act requires a response within 20 working days. I received figures from Heatherwood and Wexham Park Hospitals NHS Foundation Trust (HWPH) on 13 June (ZIP). I am still waiting for figures from Buckinghamshire Healthcare NHS Trust.  HWPH had an online form; we had to send post to Bucks. We prompted Bucks today: apparently the request arrived at the relevant office on 20 Jun…

 

Here’s what we know for HWPH:

The death rate for all emergency admissions to HWPH has been falling. However, the rate for people admitted to HWPH in emergency from Wycombe has mostly been rising since we lost A&E in 2005.

 

However, death rates for Wycombe people admitted to HWPH in emergency have worsened towards the same rate as all patients. Tempting as it is, I’m not jumping to conclusions without seeing more data. I have already seen too many arguments about mortality statistics to leap to a bad conclusion.

 

What is much clearer is the increased number of people from Wycombe going to HWPH, both after A&E shut in 2005 and again in 2012 as the downgrading of the

Emergency Medical Centre to a Minor Injuries and Illness Unit approached – see the green line marked with triangles. It bears out another Daily Mail article centred on Wycombe: Proof that A&E closures cause huge increase in patient waiting times and lead to hundreds of cancelled operations.

 

There is much to do. We need the data for Stoke Mandeville. We need Sir Bruce

Keogh’s report into excess mortality rates in Buckinghamshire and elsewhere. We need a transformed Care Quality Comission to drive up standards. We need our local Clinical Commissioning Groups and the Health and Wellbeing Board to grasp the problem of emergency care. We also need Bucks County Council’s Health and Adult Social Care Select Committee to rise to the serious challenge of holding the NHS to account on behalf of local people.

 

I’ll be in close touch with all those issues.

 

Steve Baker is MP for Wycombe.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutstpeters.blogspot.com

Latest Accident and Emergency analysis.

I’ve edited this Guardian article, based on Accident and Emergency statistics published yesterday. It’s almost word for word what the BBC said today, so someone’s been copying a press release.

In fact if you’ve been following this Blog or my other one, you’ll have been reading me making provocative statements – all of which are borne out by these statistics.

1) While the number of elderly people attending A and E is rising it isn’t rising more than the proportion of elderly people in the population.

2) 53% of people attending A and E need treatment and it’s usually urgent. Only 47% don’t. How do they know they don't need treatment until they receive that advice?

3) Closing the NHS Direct helpline is probably responsible for the increase in those attendances.

4) The increase in attendances is not at A and E but in the walk-in centres and minor injury units that are there to take pressure off A and E. I have often complained that their stats should be excluded – they only inflate the figures. A and E attendances have barely risen.

5) The long waits are caused by too many beds and wards having closed –there aren’t enough to admit those patients who need admitting to hospital.

Of course it's so much easier to blame the patients....

Haroon Siddique         

The Guardian, Tuesday 3 December 2013

 

 

Attendances at A&E departments in England have risen significantly in recent years, with more than 600,000 more people using their services last winter than under the previous government, official NHS statistics have revealed. The figures show comprehensively for the first time the rise in numbers presided over by the coalition government, as fears mount of an impending "winter crisis", and prompted charities to warn that the situation could get worse.

 

Caroline Abrahams, charity director at Age UK, said: "The numbers could continue to increase since the social care system is being stripped to the bone, with access to high-quality social care becoming ever more difficult as vital services are withdrawn or reduced as a result of the current crisis in care. The NHS will struggle to cope with the increasing pressures brought on by lack of social care provision unless the system is radically reformed and given adequate funding."

 

The figures, published on Tuesday by the Health and Social Care Information Centre (HSCIC), show that the most deprived 10% of society are twice as likely to go to A&E as those in the least deprived 10%. They also reveal that the proportion of old people attending major A&E units has risen from 19% to 21% over the past four years, with nearly half of them being admitted to hospital, a situation Jane Harris, policy director at disability charity Leonard Cheshire, claimed was avoidable. She said the government "should be investing in a better care system. Disabled and older people and families shouldn't feel they have to go to A&E unless it really is an emergency".

 

Attendances at A&E departments were up 11%, to 21.7 million, over the past four years, compared with a 3.2% growth in the population during the same period, mainly due to a rise at minor injury units, the statistics showed. Almost half (47.2%) of people who attended A&E received only guidance or advice or no treatment, which will add to concerns that A&E services are seeing patients who could be treated more efficiently elsewhere.

 

Measures taken by Jeremy Hunt, the health secretary, to alleviate pressure on A&E include a named GP for elderly patients in their local surgery and making surgeries open for longer hours, although the HSCIC statistics show that attendances overnight are a small proportion of the total.

 

Dr Mark Porter, chair of the council of the British Medical Association, said patients needed to know how and where to access appropriate care. "Key to this is having an effective out-of-hours telephone service, yet the disastrous introduction of NHS111 replaced a clinician-led service with a call centre and was responsible for many people being wrongly directed to emergency departments," he said.

Last winter, 10.6 million people attended A&E, compared with 10 million in 2009-10. The number of people visiting A&E has been above 5 million in every quarter since the coalition government came to power, compared with exceeding 5 million in only three quarters (from April to December 2009) between April 2004 and March 2010. In the last full quarter (January to March 2010) of the previous government, attendances stood at 4.9 million, compared with 5.3 million in the same period this year.

Neil Harris

(a don’t stop till you drop production)

Trafford General Hospital - a very sad day.

I’m a long way away from Manchester, so for me this story is just a sad footnote to history. For people in Manchester this is a very real problem and has been the subject of a fierce campaign to save a much loved hospital.

This is from the BBC News site, but much edited by me;

 

The A&E department of the hospital where the first NHS patient was treated has closed despite a campaign by residents to save it.

Trafford General Hospital, which had the second smallest A&E in England, is being downgraded as it was used by too few patients.

The Department of Health has given nearby Wythenshawe Hospital £12m to help it cope with extra demand.

Campaigners said patients will face longer journeys to other hospitals.

The hospital's A&E has been downgraded to an urgent care centre, which will now close between midnight and 08:00.

It will later be further downgraded again to a minor injuries unit.

Protesters, who set up the Save Trafford General group, said other local hospitals were already stretched to capacity.

Then named Park Hospital, it was the first NHS hospital opened by the Minister for Health, Nye Bevan in 1948.

Of course, it won’t end there. The A and E may have been tiny but losing it downgrades the whole hospital, which now becomes just a base for specialist units which can easily be moved away too. The loss of patients coming in through the A and E portal deprives it of patients and revenue which threatens the viability of other departments. The A and E is the heart and soul of a hospital.

In future other local hospitals will lose their A and E’s too and further closures and consolidations will result.

All adding up to larger and larger hospitals further away from their patients communities. Instead of efficiency, costs will rise.

If you don’t believe me check out my ‘Merger Mania’ series on ‘Pages’, which reviews an excellent academic review of the effects of previous ‘Merger Mania’s’.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

Apologies.

I’m meant to be reviewing the government/NHS response to The Francis Report. I’ve downloaded it and I already did a quick blog – based on press reports only.

The detailed review is still to come, unfortunately, I can’t do it justice.

A month ago I had a Thrombosis, went to Accident and Emergency and was treated reasonably well. Then in the follow up it all went wrong. Doctors didn’t bother, no one listened.

In reading the detailed proposals to prevent failings – system failings as well as individual ones, it was just too personal for me to be able to be impartial or even sensible about it. As I read through all the things that are supposed to be changed, so many have just happened to me that I couldn't write about it.

I need some time to get over my recent problems (daily injections for the next 6 months make it a little difficult to forget) before I can do a reasonable job. I hope to come back to it.

So sorry about that. My own medical problems are turning me into a wuss.

The reports can be found at;

https://www.gov.uk/government/publications/mid-staffordshire-nhs-ft-public-inquiry-government-response

Why not take a look for yourself?

I'd welcome your views - post a comment or send me an e-mail at;

neilwithpromisestokeep@gmail.com

 

Neil Harris

(a don't stop till you drop production)

 

First response to the health Minister's response.

The Government’s responses to the Francis report are now out; I’ve only scanned the headlines so far because it’s a mass of documents and a lot of data to download. I’ll do a proper analysis in a couple of days.

So far pressure is being put on the Royal College of Nursing to split its union function away from its regulatory one – which I have called for a long time. No mention of doing the same for the BMA – it’s just as important that Doctors are both regulated and represented properly and one organisation can’t both punish and protect at the same time.

Every patient will have a named nurse – which sounds fine as it makes one person responsible. However there are three shifts a day, sickness and holidays as well as courses to attend etc. it means if the named nurse isn’t there nothing will happen. Better to have a named Doctor to supervise overall treatment and be responsible but of course that is never going to happen.

The problem is that patients often rarely see a nurse – most work is done by unqualified care assistants. There should be a regulatory body for them with the ability to ‘strike off’ a care assistant. That’s not happening.

The new criminal offence I dealt with a few days ago if you scroll back – a pointless gimmick.

The ‘duty of candour’, will require that patients or families are told when there has been a medical error – at the moment they get hushed up. It’s alright as far as it goes but doesn’t go far enough.

It may be that I just reviewed the report without meaning to, hopefully there is some more in it besides.

I think my fear is that the Health Secretary, who still practises on a part time basis, is still too concerned about the sensitivities of the health professionals.

Neil Harris

(a don’t stop till you drop production)

Breaking my own rules.

Rules are meant to be broken, time to break my own rules.

I’d been taken to St. Peter’s Hospital, Chertsey last year with a broken ankle but was diagnosed with a sprain and sent home with it all plastered up, to come back a week later.

In fact it was dislocated and broken – no hairline fracture either. I was horrified by this treatment and started a Blog campaign to be a focus for whistle blowers and a demand to change things. It’s nearly a year ago – I’ll do a review of what happened for the anniversary.

I started this Blog because
helpmesortoutstpeters.blogspot.com

which I’d intended to be a purely local health campaign was becoming dominated by me watching music, doing silly things and generally having fun. (Hey I’m really ill, why not live a little?)

The serious health articles I was also writing were getting squeezed out and so I decided they needed a home of their own, right here. No pictures, no silliness; just sensible reports and commentary on health issues.

Yet what I thought was an isolated event at one hospital now seems to be a general problem and so today I'm breaking my own rules.

At the end of October I had a Thrombosis – it’s a side effect of my medication and of my cancer. It wasn’t a surprise and I got myself off to my Accident and Emergency in good time, steering well clear of St. Peter’s.

I spent a long, hard day there, got a scan, an injection and a short briefing into the world of Anti coagulation. After a week of injections and doing well, I was moved onto warfarin tablets and to a routine nurse led clinic.

In fact, before I got there, the warfarin dose was far too high and it wasn’t monitored properly. The result was a sky high INR which didn’t come back down for a very long time. The long suffering nurses and phlebotomists were seeing me every couple of days, my arms looked like a junkies arms and I got really ill. It's also dangerous.

Near the end, waiting for a Doctor (first one for two and a half weeks), I lost it after a wait of five and a half hours in some pain. I told her what I thought of them all.

I refused a further blood test and left. Two days later more arguments. Now I’m being treated by my oncologist.

They made me really ill, made me worse than I needed to be and left me giving myself injections every day for 6 months – a reduced quality of life at the end of my life.

I’m too ill/tired/ground down to fight them over it.

What could I prove anyway? No one Doctor was dealing with me, it’s just that no one bothered. I’m sure the way I was dealt with fitted in with some plan or ‘pathway’, it’s just they got it wrong and then no one was interested enough to do anything about it until it was too late.

Meanwhile, a Sister was running everything at the clinic, slowly sinking under the weight of numbers, her life being made worse by me.

Unfortunately, I wasn’t alone. I started picking up stories of unhappy, neglected patients all around me; angry and disappointed by the treatment they’d had, yet too frightened or timid to do anything.

I’ve had a lifelong commitment to the NHS; been doing the marches and pickets, the petitions and the protests. It’s not the NHS as it was meant to be; it’s an organisation of high salaries for a minority, big profits for private companies (and some Doctors making money) and a general lack of care amongst all Doctors. The rest are struggling on low pay and being treated badly. Not a good way to run a caring environment.

No one could say that the NHS of the 1950’s was great – the staff were generally the pre-war generation of very conservative, old fashioned and money grabbing Doctors and surgeons.

The ideals grew over time and they were at their peak, ironically, in the conservative 1980’s when the new post war generation of young Doctors had risen to levels of influence.

It’s been downhill ever since and is now so low in terms of commitment, morale and idealism that I despair. I am now frightened of being in hospital, just when I need them.

I’m really glad I did these Blogs, that I fought back. I only wish I’d done it sooner and had had enough time and strength to have done a better job of it.

Sadly, I won’t see how things work out although my fears of the future are such that I don’t know that I really want to be around to see it. I do know that the future will bring more privatisation, poorer working conditions for staff who are going to be paid less and treated even worse while a few fat cats are going to cream off as much money as they can get away with.

And how do you deal with frightened patients, too ill or worried to make a fuss?

Neil Harris

(a don’t stop till you drop production)
home: helpmesortoutthenhs.blogspot.com