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Health Insight May 2001:
In brief

  The inspections of NHS hospitals to assess their cleanliness, which the government introduced last autumn, have led to the ‘naming and shaming’ of forty-one hospitals across England. This includes ten hospitals considered to be in need of ‘special measures’. The forty-one hospitals will be inspected fortnightly to monitor the improvements being made. Managers from some of the hospitals named have protested at their inclusion on the list; controversially, some hospitals were assessed by Patient Environmental Action Teams, whereas self-assessment was used for others. The DoH has the option of taking over trusts which are ‘persistently failing’ on cleanliness, but none of the named hospitals has as yet been given a deadline by which it must improve standards. Alan Milburn said the results of the inspections showed that considerable progress had been made in cleaning up the country’s hospitals, ninety per cent of which had a standard that was either excellent or acceptable.

Source: Health Service Journal 12 April, Press release (DoH)

A major study has been published which supports the view that current immunisation practices in the UK are safe. It had been suggested that immunisation increased the risk of sudden infant death. However, analysis of data on 325 cases of sudden infant death (in Newcastle-upon-Tyne, Leeds, Bristol and Exeter) found that these children had received fewer immunisations than other children. Far from being positively associated with the condition, immunisation may give a degree of protection.

Source: BMJ 7 April

It is now expected that failsafe systems will be introduced throughout the NHS to rule out the possibility of fatal errors in spinal injections. This follows a coroner’s verdict of ‘accidental death’ in the case of a leukaemia patient who had a drug intended for intravenous use wrongly injected into his spine. (The family of the victim said they had been hoping that the verdict would be ‘unlawful killing’.) There have been fourteen similar incidents in the last fifteen years. Three separate reports into the latest incident were released on the same day as the coroner’s verdict. The government has promised that action will now be taken.

Source: BMJ 28 April, BBC Online

A doctor is now awaiting sentencing after being found guilty of what is believed to be the biggest ever single-handed fraud against the NHS. Dr Dimitri Padelis ran a locum agency and fraudulently obtained an estimated £4m from bogus invoices, overcharging, and inflated expense claims.

Source: BMJ 28 April

Draft legislation has been published on new regulatory bodies for nurses, midwives and the allied health professions. A new Nursing & Midwifery Council will replace the UK Central Council for Nursing, Midwifery & Health Visiting and the four national boards. A Health Professions Council will replace the Council for Professions Supplementary to Medicine. Health minister Lord Philip Hunt said, ‘We are determined to strengthen public protection by making regulatory bodies more responsive to patients’ needs as well as smaller and more strategic. We want to increase public involvement by having more lay people including consumer representatives on these councils.’ The draft orders for the two new councils may seen respectively on www.doh.gov.uk/nmcorder and www.doh.gov.uk/pcorder.

Source: Press release (DoH)

The final report has been published on the results of the second National Survey of NHS Patients in England. The survey was conducted in 1999 and the initial results were published in April last year. Seventy-four per cent of 112,000 patients, to whom were posted self-completion questionnaires, responded. Key findings include that men and older people were generally more satisfied with their care, and that over-65s were less likely to report being in pain. Patients outside London were more satisfied than those in the capital. More information on www.doh.gov.uk/public/england.htm.

Source: Press release (DoH)

A national strategy aimed at involving patients in decisions about their medicines and thereby reducing avoidable illness and cutting waste has been announced by health minister Lord Philip Hunt. He said £1.3m would be spent over the next two years on a task force to bring together patient representatives, the NHS, social care, health professionals and the pharmaceutical industry.

Source: Press release (DoH)

Another 124 primary care trusts have been established, bringing the total to 164. There are still 260 primary care groups which have not as yet become trusts. The government wants to see all primary care delivered by trusts by 2004. Health minister John Denham said that trusts enabled GPs to work independently and provide more innovative local services.

Source: Press release (DoH)

The General Medical Council (GMC) has published for the first time a register of members’ interests, and posted it on the internet. The register has been compiled partly in response to claims that Freemasonry connections may in the past have been pursued to try to influence the outcome of misconduct hearings. The stated aim of the register, according to the GMC, is ‘not to satisfy curiosity but to support transparency and probity, and to maintain confidence in the regulatory process.’ Declarations are voluntary, but the GMC has made it clear that it expects members to comply with the registration request. Members are asked to list interests that concern their employment or practice; membership, fellowships, and offices held in professional bodies; links with local, national, and community organisations; consultancies and directorships, and membership of the freemasons or a political party.

Source: BMJ 14 April

Specialised wards aimed at the needs of adolescents should be set up in every hospital, say researchers. A study published in the BMJ shows that teenagers may well occupy more beds in hospitals than younger children. However, many of the areas they stay in cater for the under-twelves, in terms of decoration, equipment and privacy. Russell Viner, the only consultant in ‘adolescent medicine’ in the UK, looked at the number of ‘bed days’ taken in English, Welsh, and Scottish hospitals for 12 and 19-year olds respectively. His findings suggest that there is a case for every district general hospital to have a teenage ward of 12–15 beds. Only a quarter of England’s hospitals make separate provision in this way. Sue Burr, from the Royal College of Nursing, said the situation has worsened over the last 10–15 years. ‘The age of patients on children’s wards has got younger and the age of those on adults wards has got older … It is ridiculous these days that we still do not have the services for teenagers.’

Source: BBC Online

Doctors believe that at least 200 people a year die as a result of accidents linked to sedatives administered by hospital doctors, before they carry out diagnosis or treatment. More than one million patients each year are given medication to ease anxiety, but few doctors are trained to administer such drugs. There is mounting concern that overdoses tip patients towards losing consciousness and that guidance on the use of sedatives, along with other drugs such as painkillers, is not being followed. A working party commissioned by the United Kingdom Academy of Medical Royal Colleges will soon demand compulsory training in giving sedatives to accompany procedures such as endoscopy and some X-ray examinations; these should not need anaesthetists, who are in short supply. Rory McCloy, a member of the working party said, ‘There are undoubtedly people dying because of the inappropriate use of sedation.’ The figure nationally across all procedures was probably between one in 3,000 and one in 5,000, far higher than the one in nearly 200,000 associated with being given anaesthetics.

Source: Guardian 7 April

The Prime Minister has launched the publication of a report looking at the competitiveness of the UK-based pharmaceutical industry. The Pharmaceutical Industry Competitiveness Task Force (PICTF) was set up by Tony Blair in March 2000. The PICTF is a joint initiative by the government and industry to see what action needs to be taken to ensure the UK remains an attractive place for the pharmaceutical industry. Copies of the report are available on the website at www.doh.gov.uk/pictf.

Source: Press release (DoH)

Public Health Minister, Yvette Cooper, has announced pilot schemes offering health checks for people retiring from work. The schemes could include checks and advice on blood pressure, fuel and heating, fitness level, diet, immunisation, and screening programmes. Research shows that many current health activities fail to cater for people who have retired, and that health checks or information are seldom offered to employees before retirement. The pilots will test different ways of targeting health checks at people aged 50–65 who are approaching, or just past, retirement, and who do not have access to pre-retirement help from their employees. Around £800,000 is being made available to fund the pilots over the next year.

Source: Press release (DoH)

The Royal College of Physicians (RCP) has reaffirmed its support for the current legal and ethical framework which surrounds medical treatment for dying patients. The position statement, ‘Medical Treatment at the End of Life’, was published in the March/April issue of Clinical Medicine, the journal of the RCP. The College draws the distinction between acts where there is a clear intention to end life and acts that are mainly therapeutic, with a foreseen but unintended consequence that life may be shortened. For the purpose of the position statement, euthanasia is the active, intentional, ending of the life of a competent patient, by a doctor, at that patient’s request. On that definition the RCP concludes that it does not support legislative change to legalise acts where there is a clear intention to end the life of the patient, nor any change in the law on assisting suicide, but accepts that there is a wider professional and lay view on this topic that requires continuing review.

Source: Press release (Royal College of Physicians)

One in five GPs admitted in a survey that they have broken prescribing laws in an attempt to ensure that their poorer patients get the medicines they need. They have used such tactics as ‘proxy prescriptions’, whereby a patient who cannot afford the £6.10 prescription charge has a prescription made out in the name of a relative who has an exemption because of a chronic condition. (Some chronic conditions carry an exemption, for example diabetes, whereas others like asthma do not.) Six per cent of GPs said they sometimes paid poor patients’ prescription charges themselves. The survey was conducted by the newspaper Doctor, which has called for a public debate on prescription charges.

Source: BBC Online

Seven British Muslims have died from a rare strain of meningitis after a pilgrimage to Mecca. Another twenty-two cases have also been reported. GPs are advised that pilgrims should have a quadruple vaccination against meningitis. None of the cases investigated so far by the Public Health Laboratory Service had been vaccinated.

Source: The Sunday Times 22 April

The DoH says that the number on hospital waiting lists fell by 6,200 in February. The figure stood at 1,033,000. The number of patients waiting more than a year for an operation was 45,000. Treatment times for cancer cases have also fallen. The DoH reports encouraging progress in pilot projects across England aimed at cutting cancer treatment times to a minimum.

Source: Press releases (DoH)

GPs have been once more encouraged to refer patients with conditions like heart disease and diabetes for supervised exercise programmes as part of their treatment. The DoH has published national standards for exercise referral schemes, which can be seen on www.doh.gov.uk/exercisereferrals.

Source: Press release (DoH)

The controversial Private Finance Initiative for procurement of new NHS buildings has come under fire from the Office of Health Economics, in a report written by a former Treasury adviser. The report says the evidence in favour of the effectiveness of PFI schemes is poor and that the approach is being ‘artificially promoted and protected.’

Source: BMJ 21 April


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