Tag Archives: Patient Care

Nurses to follow ‘moral compass’ on poor standards

As reported in the Nursing Times, Liz Redfern, a former deputy chief nursing officer who joined the NHS as a cadet nurse in 1970, was speaking after receiving an honorary doctorate from the University of Brighton.

    “Some of my proudest moments are when I have spoken up against poor practice whatever the consequences for me”

    Liz Redfern

“There will have been times already that have made you uncomfortable when you have seen practice that fell short of your own personal standards,” she told an audience of newly-graduating nurses.

“You know what you are witnessing is wrong – either technically or morally – and sometimes you will have spoken out and sometimes not,” she said.

People should not be nurses if they do not have a love of the job.

Nursing is a wonderful profession but it has changed drastically over the past 30 years and if the news headlines are anything to go by the changes are not for the better.

More and more cases of neglect and abuse.

Nursing used to be about patient care and supervision of care staff and the delivery of care.

Nursing is now very much a written paper trail of evidence and a disproportionate amount of time is spent ensuring paperwork is kept up to date.

The delivery of care and supervision of staff is now the lesser part of the job but is it not the most important?

Of course it is!

Excellent patient care is the goal for the CQC, NHS, UK government and it is very much the goal for nurses but with poor staffing levels and so much paperwork, how is it possible to do everything? 

An elderly person can have anything from 5 to 15 nursing care plans for a multitude of health and physical issues and numerous assessments to be completed.  

These care plans are basically in depth essays of each issue and how in agreement with the person the nurse or carer is going to deliver the care specific to that issue. Time consuming!

Click here to check out our Nursing Care Management Solution

Helping nurses and carers to write excellent detailed, person centred, Nursing Care Plans quickly and easily. 

Rise in potentially risky 12‐hour shifts among nursing staff

There has been an increase in the use of 12-hour nursing shifts that may potentially be influencing patient care, according a review commissioned by the chief nursing officer for England.
It appears to confirm anecdotal evidence of a rise in popularity of longer shifts and acknowledgement by staff that they leave them feeling more tired than eight-hour shifts.
The independent report, undertaken by some of the country’s leading nurse researchers, investigated the prevalence and impact of 12-hour shifts in nursing, looking at links between shift length and patient outcomes.
It concentrated predominantly on registered nurse but the researchers suggested there was no reason to suggest that their findings did not also apply to healthcare support workers.
The study reported that 12-hour shifts have become more prevalent in the NHS – 31% of staff nurses on wards reported working 12-hour shifts in 2005 compared with 52% in 2009.
For independent care homes, there was an increase from 41% to 69% over the same period.
The finding on prevalence chimes with previous findings from the Nursing Times annual survey.
But the new study also highlighted the risks of long hours in terms of performance, fatigue, stress and patient safety.
The research follows a gradual shift away from traditional shift work patterns based on three eight-hour shifts per day over the past 20 years.
Many hospitals have moved to 12-hour shifts because managers believe it is a more cost effective way of providing 24-hour care, with lower costs and greater continuity of staffing.
Meanwhile, some nurses also prefer to work longer daily hours with fewer shifts, which gives them greater flexibility and more days away from work.
The new report – titled 12-hour shifts: prevalence views and impact – was commissioned in 2013 by the CNO as part of work set out in the national nursing strategy Compassion in Practice.
Researchers – from the National Nursing Research Unit at King’s College London and Southampton University – reviewed 26 studies carried out from 1982 to 2014 in the UK, US and European Union.
Among the data sources were surveys conducted for the Royal College of Nursing and those done as part of last year’s seminal RN4Cast study on nurse staffing trends.
The researchers warned that the level of evidence they found on the impact of different shift lengths was “weak to moderate”.
However, in general, most of the studies appeared to show “some degree of negativity” linked with 12-hour shifts – either for nurses, patients or both.
For example, nurses working 12-hour shifts are found to be at increased risk of occupational hazards including needle stick injuries and musculoskeletal disorders.
“Many of the adverse outcomes studies relate to fatigue which can also jeopardise patient safety,” said the report. “Other factors can affect the quality and safety of nurses’ work, such as shift rotation, hours and the number of consecutive days worked, and unplanned or extended shift times.”
Professor Jill Maben, chair of nursing research King’s College, said: “Our work shows that in spite of limited evidence, 12-hour shifts have increased across the NHS without fully understanding the risks to patient safety and staff wellbeing.”
Lead study author Jane Ball, principal research fellow at the University of Southampton, added that the analysis found that working 12-hour or longer shifts was associated with care being rated as “poor quality” and an increased risk that necessary nursing care was left undone.
“It seems clear that there are risks associated with a move to longer shifts and they need to be managed very carefully,” she said.
Professor Peter Griffiths, chair of health services research at Southampton, noted that the findings “mirror” those of the European-wide RN4Cast study, which showed that longer shifts were linked with nurses reporting “lower quality care, more missed care and higher levels of nurse burnout”.
“Meanwhile, the overall job satisfaction reported is no better for those working 12-hour shifts than those working eight-hour shifts,” he said.
The research was commissioned under action area five – titled Ensuring we have the right staff, with the right skills, in the right place – of the Compassion in Practice strategy.
CNO Jane Cummings said: “This report is a welcome addition to the work we are undertaking as part of the Compassion in Practice Programme and its findings will be carefully considered.
“It is really important that we continue to develop a body of research to inform safe staffing to support senior local professional judgements,” she added.
Source Nursing Times

Scanner could be ‘game changer’ in pressure ulcer prevention

Nursing teams at UK hospitals are trialling a hand-held scanner that could transform diagnosis and prevention of pressure ulcers, according to the US nurse behind the idea.

The device is designed to detect the early warning signs of pressure-related skin damage days before it is visible to the naked eye, allowing nurses to take swift preventative action.

    “We still have a gold standard that looks at the redness of skin. It’s just crazy”

    Barbara Bates-Jensen

Its inventors claim it could reduce wider infection risk and slash costs associated with largely preventable ulcers.

The SEM – sub-epidural moisture – Scanner was the brainchild of Barbara Bates-Jensen, professor of nursing and medicine at the University of California, Los Angeles.

In an exclusive interview with Nursing Times, she described it as a “game changer” in the field of tissue viability.

“It gives us an objective tool that allows us to look at damage that might be occurring beneath the skin’s surface long before that damage shows up on the surface of the skin. I think that completely changes things,” she said.

“Pressure ulcers are a major financial burden, not to mention the suffering of patients, and yet we still have a gold standard that looks at the redness of skin. It’s just crazy,” she said.

Professor Bates-Jensen worked with colleagues from her university’s engineering and computer science departments to create a prototype scanner. The device was then taken forward by a medical technology company, Bruin Biometrics.

The scanner, which works by measuring changes in moisture under the skin, is placed on areas where damage is most likely to occur, such as the heels and sacrum, providing an almost instant reading.

“I knew it had to be point of care and super easy, so couldn’t require a 45-page user manual, as nurses just don’t have the time to use something like that,” said Professor Bates-Jensen.

She said that it also produced consistent results for all skin types, so could reduce higher rates of pressure ulcers among black and minority ethnic patients and, therefore, help tackle health inequalities.

Professor Bates-Jensen said the ability to gather data over time was another major advantage of the technology that could help show the impact of prevention work and motivate nursing teams.

“Preventing pressure ulcers is about providing individualised care that has to be delivered consistently over a long period of time and there is no real easy way of measuring you are doing a good job,” she said.

“Something like the SEM Scanner allows us to gather objective data that shows nurses’ prevention interventions are working.”

She acknowledged that the device was not “perfect”, but said it was “so much better than what we have”.

A study, published recently in the Journal of Tissue Viability, found the scanner produced standard, consistent readings when used by different people with different levels of skills and experience.

The scanner has been available in the UK since last year, where it is currently being trialled by nurses at two trusts in the North.

Nurses at Wrightington, Wigan and Leigh Foundation Trust started using the technology in December. They have six scanners, which they have been using on four wards.

Tissue viability specialist nurse Lindsey Bullough said she was keen to test the scanner in order to improve on current pressure ulcer assessments.

“I thought it was a good idea because we haven’t got anything definitive to say there is underlying pressure damage,” she told Nursing Times. “We use the Waterlow assessment tool but there can be quite a lot of anomalies with that and variable reliability.”

The fact the scanner was so simple to use, meant that it could be used by healthcare assistants as well as registered nurses, said Ms Bullough.

“That’s one of the best things about it,” she said. “We would only allow trained members of staff do the Waterlow scoring but now nursing assistants, who do most of the hands on care, can do the scanning as well, reporting back to the nurses.”

She said the technology had helped raise awareness of the possibility of underlying damage that may not be immediately obvious. “It’s made people more aware,” she said.

“For example, if someone has had a fall at home you may not know how long that person has been lying on the floor and in what position,” she said. “But with this device you can say this person has got some underlying tissue damage, so we need specialised equipment such as a higher spec mattress from the outset.”

As well as enabling a swift assessment when people were admitted, Ms Bullough said the scanner was helping ensure patients did not develop pressure ulcers following discharge.

“Previously patients may have gone home with underlying tissue damage that emerged a few days after discharge. We can now say ‘we have scanned this patient and we are allowing them to go home free from pressure damage’,” she said.

There have been no hospital-acquired pressure ulcers on the four wards involved in the trial over the past few months and the pilot will now be extended to a surgical ward.
 
Since February, the scanner has also been trialled at Doncaster and Bassetlaw Hospitals Foundation Trust.

Tracy Vernon, lead nurse for tissue viability, told Nursing Times that the trust was exploring how the technology might fit in with a range of other measures to reduce pressure ulcers, including a new bespoke ward-based training programme for staff.

She said the scanners could be useful in differentiating between moisture lesions and pressure ulcers, and might also help identify a deep tissue injury from a bruise.

“Quite often we see a dark area on the body, yet nurses don’t really know what it is at that point so keep monitoring it,” she said.

Ms Vernon added that it was too early to gauge the impact of the scanner on patient care.

Meanwhile, a separate group of US engineers have created a “smart bandage” that uses electrical currents to detect early tissue damage, as reported last month by Nursing Times.

They hope their findings, published in the journal Nature Communications, could also provide a major boost to pressure ulcer prevention.

Source The Nursing Times

‘Care declining’ NHS workers think

Half of NHS workers believe patient care has declined over the past two years, with more than three quarters identifying the root cause as a lack of funding, a survey has found.

The research also showed that 91% of workers reported worsening staff shortages over the same period.

Independent campaign group 38 Degrees questioned 3,547 NHS staff in an online survey, and found the majority of them, 51%, reported an increase in patient waiting times.

More than one quarter of the staff polled said they had seen the number of patients being treated in corridors rise, while 78% reported clinical staff having less time for patient care.

Only 1% of those questioned said the best way to solve the NHS crisis was to give more contracts to private providers, w hile more than four in five said the solution was to increase overall funding for the NHS.

David Babbs, executive director of 38 Degrees said: “These figures bring to life the devastating impact of funding cuts and privatisation on our NHS.

They paint a picture of doctors, nurses and midwives stretched to the limit, but ignored by politicians.

“But they also show that there’s still hope for our NHS. The message from doctors and nurses is clear: our health service needs more money and less privatisation.”

He added that the figures should sound alarm bells for politicians, too many of whom had turned their backs on the principle that the NHS existed to save lives, not to make money.

A Department of Health spokesman said: “The Commonwealth Fund rank the NHS as the safest healthcare system in the world and this week’s NHS survey of 624,000 staff found the majority are happy with the quality of patient care.

“Our relentless drive to improve safety means we have 23,200 more clinical staff than in 2010, a tough new inspection regime and a plan to halve avoidable harm by 2017.”

Source Belfast Telegraph

Calls for minimum NHS staffing levels

A DOCTORS’ organisation is calling on all political parties to commit to minimum staffing levels within the NHS to prevent serious failings in care.
The Royal College of Physicians of Edinburgh (RCPE) said that major cultural change was needed within the NHS to improve the service.
In an editorial published today, the RCPE reviews the reports of 10 major inquiries and reviews into serious failings in care in the UK since 2000, including Mid Staffordshire, Bristol, Lanarkshire and the Vale of Leven.
The editorial’s authors said it did not appear the NHS was learning all it could from failures or making the most of opportunities they offered for improvement.
The article, by RCPE President Prof Derek Bell and the Chair of the RCPE Lay Advisory Group and former Chief Nursing Officer for Scotland, Anne Jarvie, made six recommendations.
It called for all political parties to commit to developing and implementing minimum staffing levels for all professions within hospital settings as a policy priority.
It said: “We need to develop minimum staffing levels for doctors in the medical specialties and other professions in hospitals and this is urgently required for medical staff for out of hours including weekends and Hospital at Night rotas.
“There is strong evidence to show the increased risk of death and poorer outcomes in patients when treated out of hours when staff capacity is reduced, and a solid case for developing seven-day working.
“Returning to the experience of the aviation industry, we would not expect passengers to accept a higher risk of their flight crashing in the evenings or at weekends due to reduced staffing or inexperience, so why should patients accept this for their NHS?”
Other recommendations included that managers should be encouraged to support professionals in their clinical decision-making and should work within Boards and Trusts to foster a supportive environment for staff.
It also recommended that doctors, nurses and other health professionals should be reminded of their value to the NHS and of their responsibility to provide the highest quality of care to patients
Professor Bell said: “Doctors, patients and the wider public care passionately about the NHS throughout the UK.
“While there are no guarantees, and further failings in care may emerge, the potential for ‘where next?’ will only reduce if we work collectively and collaboratively to strengthen the NHS which we all value greatly.
“This will not be easy and will require incremental change and recognition of what can be improved through regulation and what will require staff engagement and cultural change.
“As a starting point, we wish to work with the leaders of all political parties in the UK and will be asking them to publicly commit, before the General Election, to implementing minimum staffing levels within the NHS.
“In parallel, we will engage with other stakeholders including patients, the medical and nursing professions, NHS managers, NHS Boards and Trusts to work collectively to address the issues raised.”
Source The Scotsman

GPs who put money before patient care and who is really to blame for the dawn queues outside health centre

One shameful statistic, if that is the right word, lies behind the dawn queues outside the Sunbury Health Centre in Surrey. 

It is this: the surgery was originally designed for 6,000 patients, but now serves nearly 19,000.
Had the building in which the practice is based been a block of flats, say – and not part of the beleaguered NHS – it would surely have been closed down by now on the grounds of overcrowding.
Instead, the sick and the elderly find the phones at Sunbury continuously engaged (a fifth of those using the centre had to wait more than ten minutes for someone to answer their call, according to a patient survey) and, even if they do get through, it is impossible to book a same-day appointment, and face up two weeks to see a doctor.
Hence the reason why nursery teaching assistant Talitha Taylor, 34, foster carer Georgina White, 58, and retired Ray Samphire, 68, were among those who, once again, were waiting in the cold and dark outside the centre from 6.18am yesterday; a scene repeated at GP surgeries up and down the country. ‘Crazy’, 
Mr Samphire called it.
Nevertheless, the surgery passed a recent Care Quality Commission (CQC) inspection with ‘flying colours’, which perhaps tells us more about the CQC than the Sunbury Health Centre.
So what has gone wrong, or rather who is to blame for the scandal?
Not the doctors who run the centre, it seems, if a newsletter issued by the centre is taken at face value. 
The extra demand is a result of new housing developments springing up in the area, the doctors say, and the ‘very old and tired’ health centre simply cannot cope with the influx.
They applied to NHS England for permission to redevelop the building, but ‘we still have no news’. 
They applied for a grant to improve the centre ‘but, again, we have not heard anything more!’
They have had meetings with the local council but ‘despite our concerns, the council continues to grant 
planning permission and allow “new builds’’ in the area with no consultation.’
The bottom line? Sunbury Health Centre is 84 per cent undersized (the surgery’s phrase.) All this is true and has undoubtedly contributed to the crisis.
Indeed, the surgery – now one of the biggest in Britain – occupies less than half the existing building (the other half is occupied by Virgin, a private health care provider, which is responsible for the district nursing team.) But is this the whole story?
The fact remains that more patients equals more money – for GPs. As its patient roll has increased, so has the NHS money flowing in to the surgery, which, like other practices, is paid £73.56 per patient a year. 
Or, to put it another way, 6,000 patients means £441,360, for Sunbury, but 19,000 patients means £1,397,640. Nor is this the full extent of the financial incentives for GPs
Under the latest GP contracts, they are also paid £7.64 for vaccinations such as flu and MMR jabs and £55 for every patient diagnosed with dementia; GPs qualify for the payment if they diagnose the patients themselves (with no checks as to whether their assessment is right), or if they update their records when their patients receive diagnosis in hospital.
Some GPs have condemned the scheme as an ‘ethical travesty’ which amounts to ‘cash for diagnosis’.
Either way, it means that a practice such as Sunbury – where patients have to queue at dawn to see their doctor – is also extremely lucrative. 
The council would be very keen to support new or improved health facilities in Lower Sunbury 
This is the perverse irony at the heart of this scandal. Once upon of time, of course, the NHS – and, in particular, the service provided by GPs – was the envy of the world. 
But under the new system, introduced by the last Labour government in 2004, doctors were allowed to opt out of evening and weekend work – which nine out of ten practices, including Sunbury, did.
This brought the average GP’s basic salary down to £55,000, but, at the same time, new rules on bonus pay contained in the deal pushed their average pre-tax pay above £100,000.
The new rules stated that GPs would earn bonuses for meeting certain performance targets – from distributing anti-smoking information to diagnosing illnesses such as depression. No cap was placed on the amount they could earn from the new contracts.
As for patients, well, the daily scene outside the Sunbury Health Centre speaks for itself. Behind those scenes are patients like pensioner Mr Samphire and other personal testimonies written, in black and white on the centre’s own website.
‘I called every ten minutes from 7am until 8.45am (when I finally spoke to someone to only be told that all the appointments had gone … looking to changing doctors. Wouldn’t wish this practice on my worst enemy,’ wrote one patient.Another added: ‘Tried for two hours to get past the engaged tone then waited in a queue of five to wait to be answered.’
A third revealed: ‘I have been on hold for 45 minutes, told I am caller number one for 35 minutes and still haven’t spoken to receptionist. When I tried the automated system yesterday, soonest appointment was a week’s time – even though the medical centre is next door to my house.’
The surgery has 12 GPs, four of them recruited in the past two years to cope with increased demand, and hopes to recruit more. But two new housing developments are also in the pipeline which are likely to place further strain on the oversubscribed health centre. The first of these, at the famous Kempton Park race track, could see more than 1,000 homes being built.
A second is an application to build 196 houses on the site of London Irish rugby club’s former training ground in Sunbury, which is currently going through the planning process at Spelthorne Borough Council.
‘The council would be very keen to support new or improved health facilities in Lower Sunbury,’ said head of planning John Brooks. ‘However, these need to be supported by the relevant health funding bodies. To date, they have not given us specific proposals and neither have they made specific funding requests.’
In fact, more GP practices than ever are reaching capacity and applying for permission to refuse new patients, with the number of requests to reject additional patients soaring by 160 per cent in three years, according to GP magazine Pulse.
Has the Sunbury Health Centre made such an application? After all, the surgery has blamed the crisis on a dramatic increase in the number of patients (19,000, remember) now on its roll?
A spokesman for the centre said no such request had been made ‘because closing the list would be detrimental to local people who may wish to register with us as patients.’

Source Mail Online

Stop reorganising the NHS and invest more, says Royal College of Physicians

Ministers must stop reorganising the NHS and fund it properly, a Royal College has said ahead of the party conferences
The Royal College of Physicians has called on the political parties to stop reorganising the NHS, to increase funding and to commit to a health service free at the point of delivery.
The manifesto, published ahead of the party conferences, warns of an ‘impending financial crisis’ unless action is taken.
The Coalition carried out the biggest reorganisation of the NHS in its history shortly after coming to power, scrapping primary care trusts and middle management layers and replacing them with clinical commissioning groups run by frontline staff.
At the same time the service was having to make unprecedented savings in the face of flat budget growth and increasing demand.
The overall NHS budget is around £110bn and has had to make £20bn savings over the last four years.
However experts believe there could be a £30bn funding gap by 2021 if budgets remain frozen and demand continues to increase.
RCP president Professor Jane Dacre, who will be attending party conferences with other senior RCP representatives, said: ‘The NHS has suffered badly from the instability caused by constant reorganisation, and funding policies that have made it harder for hospitals, GPs and community services to work together to improve patient care.
“The next government must commit to a long term vision that brings joined-up care to patients wherever they are.
“They must also increase funding quickly to safeguard the NHS from an impending financial crisis, and reassure the public that the NHS will remain free at the point of delivery.”
The College said the next government must remove the financial and structural barriers to joined-up care for patients, make it easier for hospitals, GPs and social care teams to work together, and there should be an urgent review of putting out patient services to tender.
Quality of patient care must be prioritised over competition, it was warned, and fines that target one section of the health service such as those when patients are readmitted to hospital should be scrapped.
The manifesto said hospitals are under resourced and under pressure and a crisis can only be avoided with increased funding.
It went on to call for a ten-year vision of the NHS to be lead out clearly, setting the tone for spending and policy decisions without any further ‘big bang’ changes to the structure of the health service.
New laws should be introduced to curb smoking and alcohol consumption such as the introduction of plain packaging on cigarettes and a minimum unit price on drinks. 
The College also called for a tax on sugary soft drinks.
Source The Telegraph

Too few nurses to cope: Patients suffer as staff numbers fall due to £20 billion coalition cuts

Dr Peter Carter, chief executive of the Royal College of Nursing, said: “It is a shocking indictment of a workforce planning strategy which puts finances ahead of patients.”

Patients are having to wait longer to see a nurse in hospital as the UK lags behind the rest of the world on staffing levels.

Those in pain, or are too frail to use the toilet or get a glass of water themselves are being left to cope on their own because of the onset of £20billion Coalition cuts to the NHS.

Dr Peter Carter, chief executive of the Royal College of Nursing, said: “It is a shocking indictment of a workforce planning strategy which puts finances ahead of patients.”

The shocking situation is actually getting worse, data from the Organisation for Economic Co-operation and Development revealed.

We now have a ratio of just 8.41 nurses to 1,000 people – a slump from 9.97 in 2009.

Switzerland has 16.6 nurses per 1,000 people, Germany has 11.37 and Luxembourg has 11.27 – all up from 2009.

The UK ranks only just above Slovenia, in eastern Europe, which has 8.33 per 1,000 people.

Dr Carter added: “It’s startling that while countries such as Germany, Switzerland and Luxembourg have been investing in and expanding their nursing workforce, UK numbers have gone down.”

The RCN, which is hosting its annual congress in Liverpool, has warned the NHS is operating with 20,000 fewer nurses than needed for safe care.

Katherine Murphy, chief executive of the Patients Association, said: “An inadequate number of nurses has a huge impact on patient care.

“Some patients are frail and need assistance for basic tasks such as eating, drinking and going to the toilet.

“They cannot be expected to look after themselves while in hospital.”

Cash-strapped hospitals are not hiring enough qualified, experienced nurses and 10 per cent of posts are vacant.

Many nurses are skipping breaks and doing unpaid overtime in a desperate bid to see all their patients.

The numbers of nurses, midwives and health visitors fell by more than 3,000 between February 2010 and February 2012 to just over 308,000.

However, the Government claims it is now investing in nurses – and says staffing levels are going up.

Campaigners say any increase hides the fact that experienced, older nurses are being dumped and replaced by cheaper, newly qualified staff.

Many of the nursing jobs currently being advertised are for band five positions – the lowest grade for nurses, with a starting salary of just over £21,000.

Ms Murphy said: “The NHS should start focusing more resources on hiring and retaining skilled nurses and stop the wastage of talent and money spent on training them.”

The NHS will have to find £2billion in savings next year due to the UK’s ageing population, according to watchdog Monitor.

The Department of Health said it was confident it would make the savings necessary. But Unison’s Christina McAnea warned: “They can’t expect staff to plug this hole in NHS funding by cutting pay.”

Source The Mirror

Wilful neglect of patients offence to become law by 2015

Wilful neglect could become a criminal offence next year after the government last night tabled amendments to the Criminal Justice and Courts Bill.
According to the new clauses, the offence would focus on the conduct and behaviour of individuals, rather than the outcomes of their actions.
“This is not about punishing honest mistakes; it is about closing the gap in current laws so that this type of poor care cannot go unpunished”
They would apply to all formal and, healthcare and social care settings for adults and children, covering public and private sectors in England and Wales.
The offence would also apply to individuals and organisations, with the former facing a maximum jail sentence of up to five years if found guilty. Organisations would face penalties similar to corporate manslaughter, including fines and publicity orders by a court
The government said the offence was not about punishing staff who make honest mistakes, but about providing “robust sanctions for deliberate or reckless actions, or failures to act”.
It follows recommnedations made by Robert Francis QC in relation to the public inquiry into the scandal of poor care at Mid Staffordshire Foundation Trust, which were supported by the national review into patient safety led by US expert Professor Don Berwick.
The government said the test for prosecuting organisations for wilful neglect would be “whether the conduct of the organisation falls far below what can reasonably be expected”.
The Department of Health estimates that the law could lead to 240 criminal prosecutions a year at an annual cost to the criminal justice system of £2.2m.
Ministers said the laws mirror offences already in place for the ill treatment of mental health patients under section 44 of the Menal Capacity Act 2005.
Health minister Norman Lamb said: “The NHS is full of caring and compassionate staff delivering the best care for patients. But the Francis inquiry showed that sometimes the standard of care is not good enough. That’s why we are making it a criminal offence when a patient suffers ill treatment or wilful neglect.
“This is not about punishing honest mistakes; it is about closing the gap in current laws so that this type of poor care cannot go unpunished,” he said.
“The proposal is part of a package of measures after Francis to ensure better protections for patients, more support for NHS staff and greater transparency and openness in the NHS,” he added.
But Nick Clements, head of medical services at the Medical Protection Society, described the new offence as “extremely disappointing”.
He said: “This criminal sanction will have a huge impact on the professional lives of doctors, and it must be given time to receive the serious scrutiny it warrants; not just rushed through as an amendment to an existing bill.
“[The society] strongly opposes the new criminal sanctions as we believe the current regulatory, disciplinary and criminal framework is already effective at censuring unprofessional behaviour and there is no justification for new legislation.”
Source Nursing Times

Ignorance of care quality is ‘true scandal’ facing NHS, warns health chief

The NHS is treated as a “public religion” despite the fact those running services have no idea what quality of care they are providing, a health service leader has warned.

Tim Kelsey, NHS England national director for patients and information, made a plea for more transparency and better use of data as he defended controversial plans for a giant database of GP records.

The national scheme was delayed in February amid a growing public backlash against the use of patients’ information, and concerns that data would be at risk of misuse.
 
Mr Kelsey told the NHS Confederation conference in Liverpool on Friday that he believed that the plans were vital to improve patient safety, and improve the patient experience.

He suggested many people would be shocked at how little central data is held on the basic care received by patients.

“The true scandal in our health service is ignorance,” he said.

“If you think about cancer, I couldn’t tell you how many people are receiving chemotherapy,” he said. “Not even how many people are receiving treatment, let alone at what benefit.”

The plans for care.data – a database of GP records – have been delayed until next year, and will follow pilot schemes in a number of local areas.

Mr Kelsey said he hoped that a number of new safeguards would provide the public with assurances that the data would only be used to improve patient health care.

He said: “We are completely flying blind. The NHS – such an important, highly valued public religion actually – is offering a service that on the whole has no idea of its quality.”

The NHS official said his own family’s attempts to blow the whistle on poor health care had convinced him of the need to have more transparent information published about services.

He said his mother had been “hounded out” as a GP after attempting to warn that a hospital consultant appeared to be repeatedly missing cases of breast cancer.

Published data comparing NHS services could reveal high death rates and poor services, he said, instead of leaving it to individuals to warn of suspicions over poor care.

He said the NHS repeatedly treated whistle-blowers appallingly, ending careers.

“My experience of whistle-blowers has universally been tragic and there is no good things that come to those who break the bounds of their organisation and tell the truth. Its almost always a catastrophic emotional experience for those people,” he said.

Mr Kelsey said the plans for the giant GP database were “the biggest data revolution” any public service had embarked on, while admitting that many questioned him as to whether the situation had turned into “a car crash”.

He said: “We chose to delay the programme earlier this year after a multiplicity of highly-justified concerns about the way it was being rolled out.”

“We paused it because there was this enormous outcry, and uncertainty about what was happening.”

He said officials had now introduced important safeguards in response to several of the concerns and said the NHS should be “celebrating” the fact that the backlash had led to a big public conversation about the plans.

Mr Kelsey dealt directly with a number of concerns raised, in particular an investigation by The Daily Telegraph, which found in February that NHS hospital records had previously been sold for insurance purposes.

He said: “Data of this sort can only ever be used now for health benefit – so we can rule out the emerging concerns that maybe people would use this for insurance or for junk mail. That is not legally permitted any longer.”

Source The Telegraph