Monthly Archives: December 2013

Hospital patients to have named doctors, Jeremy Hunt declares

The current “collusion to avoid responsibility” is addressed by Miranda Prynne, who reports for The Telegraph 24th December 2013 (it would seem amazing to an outsider from a Private or Insurance based system that this should not have been the case):

Hospital patients to have named doctors, Jeremy Hunt declares

Patients will have named doctors and nurses listed above their hospital beds who will act as “champions” for their care, the health secretary has revealed

“Hospital patients will be given a named doctor and nurse who will be listed above their bed so they know “where the buck stops”, the Health Secretary Jeremy Hunt confirmed today.

The move set to take effect in 2014 is designed to ensure staff take personal responsibility for their patients and prevent a repeat of the Mid-Staffordshire NHS scandal.

Last month The Telegraph first revealed the planswhich place a new “duty of candour” on healthcare professionals, who will be obliged to disclose safety errors and near-misses.

Under the changes medics will also receive lighter penalties for errors if they admit to them while NHS trusts who are found to have covered up failings will be forced to pay all or part of related compensation claims, instead of being covered by a national insurance scheme.

Writing in the Daily Mailtoday, Mr Hunt confirmed the changes are to go ahead in the New Year, in line with key recommendations of the £13 million Francis inquiry into the deaths of hundreds of patients at Mid Staffs.

He said: “A human touch can make all the difference.

“A name you know and a face you trust to guide you throughout your stay can transform your experience…..”

Of interest: The Collusion of anonymity.

Can my doctor be my Facebook friend?

Can my doctor be my Facebook friend?

The doctor-patient relationship can be a close one – but in this week’s Scrubbing Up column, Dr Naeem Nazem of the MDDUS asks – can that relationship be extended into social media?

“Whether you embrace it or not, the vast majority of people use social media as part of their everyday lives.

 

Recent figures show there are a staggering 24 million – and counting – active Facebook users in the UK, while one in four people (15 million) have Twitter accounts.

 

There are undoubted benefits as social media offers a platform for doctors to network effectively, share views and develop their own knowledge and expertise.

 

For patients engaging with social media, it can educate and raise awareness by giving them greater access to healthcare information.

 

But if you would trust your doctor with your life, could you be their Facebook friend?

‘Blurring boundaries’

On the face of it, it doesn’t seem like an unreasonable question – or request.

 

However, patients interacting with their doctors on social media may inadvertently create an uncomfortable and awkward situation.

 

It also risks blurring the boundaries in the doctor-patient relationship which could impact on the quality of care they receive.

We have encountered a range of cases where doctors have sought advice from us regarding social media issues, from critical or abusive posts from patients to hate campaigns.”

Patients should consider that doctors are bound by guidelines…..”

Hypocritical Politicians – and their lack of courage compared to the BMA

In the Telegraph Laura Donnelly on 23rd August 2013 reports the BMA position in defense of its decision to offer staff Private Medical Insurance.

BMA accused of hypocrisy after offering private insurance (PMI) to all staff

The British Medical association has been accused of hypocrisy after offering private medical insurance to all its staff, (Private Commissioning) despite opposing Government reforms to create a more competitive market in healthcare.

There will always be hypocrisy in Health Care until we have leaders with the vision to open the debate properly. Is it more important to make utilitarian decisions for the many than to make every decision perfect for the individual? And should the debate be open (rationing)? When it comes to staff, the BMA showed  it had the courage and integrity needed, and has every right to make this decision to offer PMI. What is more important is why they thought they needed to make the offer….It is now time for the health boards and PCTs to have the courage to reveal how many of their directors have PMI, so that their public can question why..

And hypocrisy is not confined to Hospitals, Trade Unions or National Politicians.

Kirsty Buchannon and Matthew Davies report in The Express on August 4th 2013:

Civic ‘hypocrisy’ on public health

TOWN halls with a duty to improve public health are ploughing hundreds of millions of pounds into international companies selling alcohol and cigarettes.

The Mail Nick Craven reports 26th October 2013, following a number of charities accusing Mr Hunt of Hypocrisy over care of the elderly. He may be justified on utilitarian principles but we have not heard the debate…, and he has not had the courage to open it..

Norovirus outbreak at Wrexham Maelor hospital: three wards still closed

The Daily Post By Eryl Crump reports 23rd December 2013:

“Norovirus outbreak at Wrexham Maelor hospital: three wards still closed

 

Vomiting bug first shut wards on Friday

Wrexham Maelor hospital – Phil Noble

Three wards at the Wrexham Maelor Hospital remain closed after an outbreak of a sickness and diarrhoea bug.

An infection control team are visiting each of the wards and are expected to confirm later if the wards can reopen or not.

A Betsi Cadwaladr University Health Board (BCUHB) spokesman said the wards that have been symptom-free for 48 hours will be able to re-open once they’ve had extra cleaning.

At the end of last week BCUHB said 11 patients had experienced symptoms of the bug and urged people not to bring babies or young people on to the wards…..”

Both this and the previous posting on Bristol Children’s Hospital are further evidence of implosion. Watch for Board Resignations…

Senior NHS doctors who refuse to work weekends face the sack

Sophie Borland reports in The Mail 15th December 2013:

Senior NHS doctors who refuse to work weekends face the sack: Hospitals with poor records could also face fines of up to £12

  • NHS’s top doctor said system ‘not built around patient convenience’
  • Professor Sir Bruce Keough wants to introduce penalties for hospitals where patients experience poor care at weekends
  • Follows research showing lives lost needlessly because of shortage of senior doctors on Saturdays and Sundays

This would be fine – if we had enough doctors. We don’t. Poor manpower planning has let to a 10 year lead-in shortage, and the only way for administrators to respond to the “knee jerk” response from the Minister is to import doctors from other countries, usually those who least need to lose their medical professionals…. I will be interested to see who is staffing the GP posts in the Welsh Valleys in 5 year’s time, when the current 1970s imports are retired. Plus ca change…. It is unethical to ration by deliberate undercapacity, and denying British students with the desire and the ability, to be doctors when they are so needed.

How can feedback change the NHS? – discussion roundup in The Guardian and BMJ

There is no comment on NHSreality and the urgency of the need for change … but these group discussions are a good start.

The BMA invites younger doctors to take part in a discussion group.

The Guardian has an interesting discussion group around the Health Services….Sarah Johnson theguardian.com, Friday 20 December 2013 summarises:

The themes of the chosen discussions are listed below:

What can whistleblowers expect when they raise concerns?

What can we do to improve NHS culture?

How can feedback influence the NHS?

What is being done?

What practical steps can be taken to encourage and instil a duty of candour in hospitals?

NHS chief admits to dismay at Jeremy Hunt’s meddling – but thinks the system will “cope”!

If we are ever to get more than an adequate Regional Health Service we need to aspire to quality, and to have the tools to achieve that quality. The rules for the various ministers for the “no rationing” Health Services they run prohibit the actions needed. The system is not coping now and certainly wont cope over the holiday period.

Daniel Boffey, policy editor at The Observer, Saturday 21 December 2013 reports:

NHS chief admits to dismay at Jeremy Hunt’s meddling

NHS England chairman Sir Malcolm Grant reveals frustration at health secretary’s attempts to micro-manage service
“Sir Malcolm Grant, chairman of NHS England, has revealed his frustration at attempts by the health secretary, Jeremy Hunt, to micro-manage Britain’s health service.Grant said politicians should stop meddling in the NHS at a time when clinicians were supposed to have been put in charge under recent reforms, and admitted fighting with Hunt over attempts to interfere through a detailed blueprint called the NHS mandate, which was published this year. Grant also revealed that he had been forced to block ministers’ attempts to punish clinicians who failed to meet certain care standards by reducing their budgets.

Grant, a former provost at University College London, said: “I am a staunch believer that the NHS is one of the finest social institutions in the world and the people who make it that are the frontline staff. I think the way we design the structure to incentivise people is right, and to take money away and penalise poor performance is not the best way to get the best out of people.”

He denied rumours he had considered quitting his role over his battles with Hunt, in particular over the NHS mandate, saying: “That would have been an abdication of responsibility. We had, shall we say, some really difficult discussions, which is absolutely right, it is what you would expect.”

In a wide-ranging interview with the Observer to launch a new era for the NHS, Grant also claimed to be “quietly confident” that the service would cope with what is expected to be its busiest winter. He admitted to being surprised by the record number of people attending A&E departments in recent weeks. The “big uncertainty”would arise if there was a major change in the weather, but he said the system “will cope”…….