Monthly Archives: February 2010

Feeding friends and family in hospital

Miniature Food - Pistachio Tea Tray
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Feeding in Hospital

Maybe those Third World Countries where the families go in to feed members have a thing or two.

Conservatives claim 50,000 patients died from malnutrition in one year – don’t know about this, but do know that an elderly female relative didn’t eat whilst in Hospital.  She is deaf and blind, and staff were leaving the tray at the end of her bed.  She had no idea it was there, couldn’t get up because her pelvis was broken, and I saw trays being taken away without being touched.

Eventually she complained to me that “I am starving.  I haven’t eaten whilst I have been here”.

Solution?  I went in three times a day at meal-times to feed her.

So why not get Sister to have a word with relatives, get family to arrange a rota for friends and relatives to come in one at a time to feed their relative, and give them a card with acceptable and ‘forbidden food’ listed?

  • Relatives feel they are involved
  • Nursing staff don’t have to make time to feed elderly
  • Patient will get special treats of food they like
  • It will also cut down the hygiene hazard when a large group of relatives clusters around a patient at one time

Leaving more staff time to feed those with no relatives who need assistance.

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Study of older female cancer survivors

Case Western Reserve University
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Older Female Cancer Survivors Have Added Health Issues Compared To Their Counterparts

As cancer survivors live longer, questions arise about what kind of care long-term they require.

Survivorship for older patients now seems top of the agenda;  in Britain the NHS has now come out with statements that they are doing more to help this age group,  and a recently published study from Case Western Reserve University’s Mandel School of Applied Social Sciences in the USA found 245 older married women who survived cancer had more health problems as compared to a sample of 245 married women without cancer.

The article, “Health and Well-Being in Older Married Female Cancer Survivors,” was published as part of a special supplement of the Journal of the American Geriatrics Society, along with other articles that resulted from a conference at CWRU on geriatric oncology, said Aloen Townsend, the lead researcher and associate professor of social work.

“There is a pressing need to study older cancer survivors,” Townsend said. “It is critical to disentangle the experiences that are unique to older cancer survivors from experiences that are common to aging individuals.”

Health care for cancer survivors is a growing concern, according to the researchers.

http://www.cancercompass.com/cancer-news/article/32923.htm?c=NL20100224

http://www.case.edu/

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Tips for managing Nausea

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Tips from Lisa Fayed

Lisa Fayed edits a very succesful website as part of the  http://www.About.com  family, and recently had this Guide to handling nausea:

Nausea is one the most common side effects …. and can also be one of the most miserable ones. Although nausea may seem like a harmless side effect of chemotherapy, it can lead to a loss of appetite and in turn,  dehydration, which can be serious.

If you get an attack, here are her Tips

1. Eat small meals throughout the day. It is easier to keep down small amounts of food when you are nauseated than  large amounts, even when you feel really hungry. Wait until the nausea has passed before attempting to eat larger amounts.

2. Do not eat fatty, greasy foods right before or during treatment. Fatty and greasy foods are often difficult to digest in the first place, let alone with bouts of nausea. Plus, another goal is to keep the food you eat down, and greasy foods can often make nausea worse, leading to vomiting.

3. Rest after eating, but do not lay completely flat. Try laying in an upright position or in a recliner. This will aid in digestion.

4. Avoid strong scents or odors. This may mean no cooking in the home for the rest of the family while you are at home. You may want to dine out for some meals to avoid scent or food aversions.

5. Avoid your favorite foods during treatment if you are experiencing nausea. Your body may learn to associate these foods with nausea and vomiting, a condition called a conditioned food aversion. This may make them difficult to eat when you are feeling less nauseous.

(I found I was suddenly sick when faced with my favourite foods – and found she is right).

6. Talk to your doctor or Clinical Nurse specialist about your nausea. Most people need to drink large amounts of fluids a day and if you are vomiting, this is not being achieved.

7. No smoking. Some people continue to smoke during treatment, but this habit can easily upset the stomach, worsening the nausea. If you are having trouble kicking the habit during treatment, talk to your doctor. Several smoking cessation therapies are available to help you in your quest to quit.

9. Drink fluids at room temperature. Cold or warm beverages may increase or trigger nausea in already sensitive stomachs.

And on a personal note, Tonic Water (Schweppes) works for me.  It goes horribly flat very quickly if you buy the large bottles, but you can get it in small ring-pull cans, which make an ideal dose.

www.about.com/cancer

This is part of the New York Times website family.

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Give us your ideas to save NHS money

NHS logo
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If we want to keep an NHS ‘free at the point of delivery’, WE have to fight for this.

It is no use expecting ‘them’ to sort out the NHS’s problems.  It belongs to us – and as ‘our’ service it is up to us to suggest where the cuts come.  Whatever you believe, there are going to be massive cuts, whichever party gets in.  So look around, suggest where the cuts can come – and I will pass on sensible suggestions.

Here are some ideas.  Do send more:

Being a realistic cynic, before the mad Consultants, Ministers and Uncle Tom Cobley are allowed to set up their ‘cost-cutting exercises’, perhaps we can all come up with ideas for saving money without the stupidity of cutting doctors, nurses, technicians etc.

LATEST SUGGESTION :  before the PCT/NHS outsources services, get Staff to discuss these.  One area has outsourced its Ambulance service to a private company.  Fine in theory;  in practice it meant a 101 year old patient was told at 3pm she could go home from A & E.  Sister told her daughter bad news was there wasn’t an Ambulance available until 3 AM – twelve hours wait!  Sister used her contacts, found there was an Ambulance going to another village 2 miles from the patient’s home, and arranged with the Ambulance crew to take two patients. She got stick from the dispatcher – obviously cross that his company had lost a lucrative journey fee.  Staff could have pointed out that this could happen, and something could have been negotiated in the contract.

1. One patient suggests for starters that some of the staff must know where savings could be made, and there should be  rewards for suggestions if taken up.

2. These same staff should be consulted where and when the NHS feels there is a need for change.  Currently, expensive outside Consultants are bought in – if these were ditched – this could save the NHS millions.  Professor Steve Field, Chair of Royal College of General Practictioners,  says NHS spending on external consultants is a ‘scandal’, telling his audience of around 1,000 GPs that the  money should be reinvested in services.

3. How many Ambulances have to turn back because someone has forgotten to put the patients’ notes in with them?  This happened to a friend being transferred between a South London and a North London Hospital.  Setting off at 11pm, the Ambulance finally arrived at its destination around 2.30 AM, having had to turn back for the notes. I dread to think what the overtime bill was for that mistake.   So why not tape a notice HAVE YOU GOT THE PATIENTS’ NOTES? inside Ambulance doors, to act as a simple reminder.

4. Private hospitals work their radiotherapy units 12 hours a day.  The NHS one near me works 8 hours a day.  Radiotherapy machinery is a huge capital cost – so surely it is more efficient to keep this machinery working 12 hours a day, and overheads and capital replacement  costs could be saved if the machinery was working longer hours?  And patients wouldn’t have to wait so long for an appointment.

5. And why is Friday the signal for theatres, physio depts., etc. to close down at mid-day?  Patients still need treatment, and again, private hospitals are often open until 8 pm.

Nurses, doctors, technicians, physios etc. and patients – you must have simple ideas that would save money and stop the need to employ outside Consultants.  Send these to tto@btinternet.com – either anonymously, or if you want to be acknowledged put your name at the end of the email.

And I will even send it on to the appropriate department with the suggestion that this is deserving of a monetary reward.

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Women Only!

Warning – this is a sexist article!

Girls – next time you get Flu, don’t struggle on, but make sure you say it is the new strain called ‘Man Flu’.  You will get much more sympathy from everyone – except your doctor – as confirmed on the satirical website Newsbiscuit.

According to them, a  woman from Stroud has caught Man Flu, prompting fears that women may have become susceptible to a new strain of the disease for the first time. Thirty-five-year-old Andrea Jennings complained of a sore throat and feeling ‘a bit bunged up’ and then instead of just struggling on regardless announced she was going to take the day off work and endlessly complain about how ill she was to her partner. It was at this point that government scientists confirmed Andrea was suffering from Man Flu.

‘I’ve had colds before and in many ways this very feels similar,’ said Andrea. ‘But since I realised it was Man Flu I’ve struggled to do anything more strenuous than lying on the sofa watching Match of the Day DVDs and reruns of Top Gear on Dave. It’s been awful.’ Concerned that she might actually be dying caused Andrea to visit to the doctor who gave her a patronizing chuckle and informed her that she just has a bit of a virus and advised her to take paracetamol and drink plenty of fluids. Scientists say that a rare mutation has caused the Man Flu virus to spread to women for the first time, although there have already been instances of Man Flu being passed to birds. In the Far East, millions of chickens were destroyed when farmers noticed them lying in bed all day, showing signs of headaches, dry mouths and other symptoms quite similar to those of a hang-over.

For more similar stories see http://www.newsbiscuit.com/2008/11/09/pandemic-fear-after-woman-catches-man-flu-401/

Get the NHS out of the clutches of the politicians

BMA campaigns to “look after our NHS”

I can’t quite work out if we should be jumping up and down with joy, but suddenly cancer patients seem to be flavour of the month.

Instead of looking for a baby to kiss – remember those days?  all parties are keen to woo us.  Today thanks to PC etc. cancer patients have taken their place.

So why am I suspicious? As a patient in the middle of what is brewing up to be a political storm, I want to shout “I AM THE PATIENT – YOU SHOULD BE WORRYING ABOUT ME – NOT WHAT IS VOTE CATCHING!”

As the political football to be kicked about whichever way the main parties want to show off their credentials, and hung out to show the ‘caring’ side of whichever party is on that day’s platform, when the election is over we, and our problems, will be kicked into a corner and forgotten.

Now, the latest organisation to set out to woo us is the British Medical Association (BMA).  Its  “Look after our NHS” campaign has existed since last year, but was aimed at medical professionals. Now organisers are taking their campaign public and asking us to support them.

However, instead of asking US what WE want – “Look after our NHS” opposes private sector involvement in the NHS.

The BMA argue that the focus of private companies will always be profits and dividends for their shareholders, rather than reinvesting the money in better care, treatments, or research and development.

The campaign argues that if budget cuts are inevitable, given the state of the UK’s public finances then the brunt of these cuts should focus on the cost of private sector involvement in the NHS. The NHS should be publicly funded and its services should be publicly provided.

Have they actually looked at the cost of private treatment?  Seen how private hospitals are running their theatres more efficiently – and in some cases seven days a week?  Friday afternoon/evening and Saturday morning is often the busiest time of the week in private hospitals;  that is when the Consultants operate in private hospitals as their NHS hospitals’ theatres are shut from Friday mid-day.

Just before he resigned, Lord Darzi spoke in a key-note speech on how French people, who pay a combination of taxes and private insurance for their medical care, actually pay less per head than we do in taxes to fund the NHS.

I am reminded of asking the head of a 500-bed German hospital “where is the Administration block?”  In her hospital the doctors seemed to be running things – where were the Administrators?  Her reply, “if I had as many administrators as you have in British hospitals, the Insurance companies would be asking why I was wasting their money”.

So involving the private sector can cut down on over-spend.

Instead of banging away on the old, old platform hitting at the ‘rich’, shouldn’t the BMA be campaigning for the NHS to be taken away from the political arena and run by those most closely involved – with input from patients?  How can we have an efficient health service if it answers to whichever political party is in power?  We have had to many changes at the top in recent years, and not one was any use – John Reid, Patricia Hewitt, now Andy Burnham – did any one of those politically-appointed Ministers do anything for our benefit?  No – is the answer.  All their stupid initiatives and changes were politically- led, led to massive over-spend and have led to patients being unable to get through to book an appointment – so administrators boast they have cut down waiting lists, political quangos have refused funding for drugs which are regularly prescribed to patients in Europe, etc.

The BMA should be campaigning to get control of the NHS back into the medical sector – take it away from politicians – then work out if some services might be handled more efficiently by the private sector, and what the NHS could copy from them.  For the patients’ benefit.

The BMA campaign plans to distribute leaflets and posters to GP practices through its members.   www.lookafterournhs.org.uk.

It might be worthwhile leaving a comment – letting them know what PATIENTS want.

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NHS ignores phone costs

PHS Japan 1997-2003 (Willcom, NTT DoCoMo, ASTEL)
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WILL  SOMEONE PLEASE TELL THE NHS HOW MUCH A MOBILE PHONE COSTS TO RUN

After the fiasco when thousands signed a petition on No. 10’s website protesting about NHS using 0870 numbers (they had to climb down and promise to change, but so far no signs) , it seems arrogant NHS Executives still haven’t learn their lesson.

The newest NHS dept – dealing with an investigation into Generic drugs – has opened an office.  In fact, as is their wont, it has several offices to spread the jobs around the UK.  And each one of  these offices only has a mobile phone number for us to contact.

We are being asked what we think about the possibility of taking generic drugs;  there is evidence to suggest that possibly these possibly could produce some of the nasty side effects we encounter – but if we phone to give our side of things it is going to cost us several pounds to get this over.

In case you have indulgent parents, or a boss who doesn’t query phone bills, the cost of calling a mobile phone might shock you.  My wonderful IT guru Alun comes up with  following costings:

There’s a 9.2p connection charge, so a 1 minute (or 1 second!) call on average mobile  will cost 12.5p + 9.2p = 21.7p.

2 minutes will be 2 x 12.5p + 9.2p connection charge = 34.2pence.

So if you are a patient calling in, and paying your own phone bills, an average ten minute call is costing you quite a hefty slice of your disability allowance – or beer money.

However, if the NHS lived in the real world, and used BT Option 3 or similar packages provided by other telephone land line companies, the same call to an 01, 02, 03, 0845 or 0870 on option 3 is FREE –  so long as the call lasts less than one hour.

And this office say that executivers are going to work from home.  Well, I always thought it was a simple process to re-route incoming calls – it just needs a little bit of nous.

Alun’s comments:  “Are they really running mobile numbers – beginning “07?  Wow!”

And we thought that GPs offering 0870 numbers were a rip off!!!

http://www.productsandservices.bt.com/consumerProducts/displayTopic.do?topicId=25501

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More good news on Chocolate!

Chocolate-lovers – rejoice!

Amongst all the doom and gloom, a news item this week announced that scientists have found that eating chocolate might prevent some strokes.

Next week the American Academy of Neurology will listen to a paper at its annual meeting, in which author Sarah Sahib will tell the delegates that a study of nearly 50,000 people found that those eating chocolate were 22% less likely to suffer a stroke if they ate a small amount regularly.

As Sarah herself admits, “more reseasrch is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate”.

But in the meantime I can dig into a box with a slightly eased conscience!

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Number of Managers in NHS has doubled in decade

The British Medical Association's logo
British Medical Association  Wikipedia

In the last decade doctors and nurses have increased their numbers by 35% – so one wonders how the old-fashioned half an hour appointment has now  condensed down to ten minutes – did someone shrink the timetable?

Or, is it as the BMA (British Medical Association) says, down to “a fixation” with extra red tape?

But what is more shocking is the number of Senior Managers has doubled in the same time.  Now it is said that there are more administrators in the NHS than hospital beds.  No wonder Lord Darzi was doing his utmost to reduce the time we can stay in those beds – and whoever is the current Minister seems to be trying to cut this further.   And if you want further info – Official data shows since 1995 the number of senior managers increased by 91% – but doctors and nurses still only show a 35% increase in that time.

More money is wasted by officials, with no knowledge of business finance, who are let loose to negotiate contract with the private health sector.  Now, anyone running a private hospital is tasked to run that hospital at a reasonable profit;  anyone with a bit of sense will realise this, so one would assume the NHS would leave contracts to be negotiated by someone who has a financial background.   Contracting out to the private sector can make financial and healthy sense – provided this is done by those who know what they are doing.

But according to the BMA ‘market-driven’  and other management-speak policies have wasted around £220 million in the past five years.   After being made to look fools by the doctors, who negotiated very healthy salary increases with the NHS,  the department allows the same people to handle negotiations for private operations with hospitals.  As a consequence only 85% of operations were carried out – leaving another big hole in the budget.

There is an equation which the NHS could do well to ponder:  the taxpayer who funds the NHS expects the service to deliver reasonable care within its budget.  The savvy taxpayer would be quite happy for the NHS to contract out some of those services to the private sector, provided the services provided offer value for money.  But the taxpayer does not expect Administrators with no proper financial training to be let loose to play ducks and drakes with taxpayers’ money.

So lets call a halt to all those ‘market-driven’ initiatives such as GP-led health centres,  Poly-clinics, Patient Choice and other trendy schemes – the public aren’t stupid, and know these disappear into a bureaucratic black hole.  I am all for involving the private sector IF their care proves more effective, but don’t let Admin-babes loose to negotiate contracts of which they have no understanding.

If  common sense is used, public/private funding for our health service could actually save money.  It works in other countries, but they don’t expect financial babes to negotiate contracts.

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Derby Gripe Moles dig up NHS Waste

Situated almost in the middle of Britain, what goes on in the NHS in Derby is  typical of the NHS around Britain.

An army of obliging moles are working diligently digging up stories – here are some of their recent findings.                They are anonymous, and we have promised to protect their identity.  You know what the NHS does to Whistleblowers!

Mole No. 1 reports
A paratrooper shot in the neck by the Taliban contracted MRSA in a British hospital as he fought back from his injuries. Sergeant David ‘Paddy’ Caldwell was diagnosed with the potentially deadly superbug at a Birmingham hospital after being airlifted back from Afghanistan. He had been leading his platoon in an assault on a heavily-defended Taliban compound when he was hit in the throat and neck by machine-gun fire

After first being treated at a field hospital in Afghanistan, Sergeant Caldwell was transferred to the intensive care unit at Selly Oak’s Royal Centre for Defence Medicine.  Sources said Sergeant Caldwell contracted MRSA after three months at the hospital. He is now recovering from the infection.  Bet you the Military Matrons that used to run the Military Hospitals (before the Govt. axed them) wouldn’t have allowed any bug in THEIR establishments.

It seems that civilian hospitals aren’t able to protect their patients – no wonder the powers-that-be are desperate to get patients home – it’s safer there.

Yet instead of learning from private medical care (private hospitals were testing for MRSI for newly-admitted patients long before the NHS – but how much does taking a couple of swabs cost?), those who take out private medical care insurance constantly get kicked in the teeth.  Currently, Gordon Brown’s trumpetted ‘nurse for every cancer patient’        plan is fine for NHS, but the scheme will be run on Macmillan ‘lines’, and their nurses still announce they don’t look after  private patients.

Previously, another Mole found that John Reid (he was once a Health Secretary – one of those whom you readily forget) announced he was going to buy all Britain’s 220 private hospitals and turn them into NHS ones. The deal would cost £5 BILLION but would allow an extra 250,000 patients a year to be treated. Private medicine could be killed off by genetic advances that will predict the diseases we are likely to get. Those at risk wouldn’t get insurance cover and with drastically fewer patients, private hospitals would shut. Dr Reid said, “If that’s the case, I’ll buy them out. We’ll take resources which have been the monopoly of the rich and use them for the benefit of all.”   So the only ones getting private care will be the politicians who have to have a private room “for security”.   Those who choose to  forego WAG handbags and long-haul holidays to scrimp and scrape so they can have peace and quiet when ill, won’t have that choice.

Incidentally, London Moles were present at a PR exercise organised by Ken Livingstone (he used to be Mayor of London, until kicked out by blonde-mopped flag-waving Boris Johnston) as a last desperate attempt to woo voters.  He decided cancer was a vote winner, and invited 30 women to ‘discuss’ treatment.  At one point during the evening the Chairman went round the table, asking the carefully-chosen representatives culled from housing estates and deprived areas of the capital, if any of them had ‘gone private’.  As she asked each one of the 30 present, 21 of them said their families had paid for private treatment – children had mortgaged homes, taken out bank loans, etc, “because we don’t want you suffering, Mum”.    Collapse of that PR exercise.

Another last gasp – this time from Patricia Hewitt – probably the most unpopular Health Secretary in recent times.  Another Mole reported she had announced that The Government wants to cut £400 million each year from the NHS budget by reducing the number of unplanned emergency hospital admissions for chronic illnesses. The plan is still on the table:   patients with conditions such as asthma and heart disease could have better home care with help from community nurses. Ms Hewitt said, “If we could cut these unplanned emergency admissions by 30% patients would have improved lives, hospitals would be able to plan their services better and the NHS could achieve savings of more than £400 million a year.” Wonder how much could be saved each year if a few admin staff jobs were axed?  But when I asked this Mole if he had any idea how patients were to be regimented so they didn’t have ‘unplanned emergency admissions’, he/she/it was sadly silent.

And don’t forget, John, Patricia and all the others could still be re-elected and up for Cabinet Office again – if their party gets in.  Being useless as a Minister is no bar to further high office.  And if they aren’t elected, there is always the House of Lords………

And Mole No. 4 is not only complaining, saying it is more of a ferret (there’s always one!), but looks like being a statistic if it doesn’t cut back on its digging.  With the run-up to the election every political party seems to have ideas of reforming the NHS.  Worrying doctors and nurses, but not the Administrators – they know that whatever is planned, their jobs will be safe – they will just hire more administrators to administer the planned cuts.  Or as NHS jargon describes their job:  Planned Facilitators.

In one  round of NHS re-organisation, the eight Primary Care Trusts (PCTs) in Derbyshire could be combined into one massive countywide trust as part of a major cost-cutting exercise. Just as it was in the 1970s. Similar reductions in PCTs are planned across the country in a move to reduce the amount of money wasted on NHS bureaucracy. The Government’s aim is to save £250m a year and Derbyshire must save £3m, but the initial costs of making senior executives redundant could run into millions of pounds.

And as reported in Cancer News elsewhere, each time a PCT is ‘re-organised’, all 150- something Trusts hare off to their favourite designers and printers, to get a new logo and re-print all those tons of paperwork they love to send through the post.  Well, someone has to keep the postal workers in a job.

N.B.  Moles should watch out.  NHS Choices in Derby offers Mole removal on the NHS, and says “your mole may be removed if it is causing you to be depressed”.

This is unfair to Moles – they are just the messenger – without them we don’t know what’s going on.  So next time you want to copy Jasper Carrot and sit up all night with a gun to protect your lawn – don’t shoot the messenger.

For more of the Moles’ reports: http://www.derbygripe.co.uk/nhs.htm

Their anonymity has been protected so they don’t get accused of being whistleblowers, and cost the poor taxpayer lots of money when they sue.  Well, Moles probably have rights too.

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