Tag Archives: David Cameron

Cameron takes on Pensioners – and loses

Older people sitting on a sofa holding a banner reading "A great place to grow old".

David Cameron finds out

London’s Pensioners are a feisty lot –

Determinded to have their say about the NHS

Continue reading

Jaw Jaw and the Minister

Basic hospital mistakes in England cost the NHS

up to £2.5bn a year, admits Health Minister.desktop

NHS could afford to hire more nurses, if errors were cut out, according to Health Minister Jeremy Hunt’s calculations.  During a speech in Birmingham he admitted costs were incurred through problems like medication errors, avoidable infections after surgery, pressure sores, etc.

And last year the NHS spent £1.3bn on pay-outs on litigation,countering  poor care, etc., and Andrew Lansley’s massive re-organisation of the NHS is estimated to have cost about £10billion. Now there is widespread recognition that this was a massive waste, for no overall benefit – just extended waiting lists, more people forced to go privately, 6 months wait for a pain clinic appointment and so on.

A spokesman for the Royal College of Nursing said mistakes were the result of understaffed wards.  The nurses were doing an excellent job, but no-one listened to them and what was needed.  Now there are even less to point out what needs to be done.  Continue reading

Does NHS make you lose will to live? Follow my example and counter with a little Luxury

Struggling with NHS bureacracy zaps will to live

So reward yourself

Neom – one of my favourite brands, has come up with a lovely Body Oil. Just in time to calm me down after 2 days battling the NHS for check-ups.

And no snotty-nosed friend or nurse neom2can possible object to it – the name says it all:  Lavender, Jasmine and Brazilian Rosewood Body Oil.  So if they say you shouldn’t use perfumed products, tell them Lavender was used as an antiseptic in military hospitals in WWI – so there!

As I smoothed this on after showers, it calmed me down.  And boy, was I simmering.  24 hours spent going round-and-round the NHS system, when I suddently found I hadn’t received recommended annual post-cancer check-ups, had driven me crazy,  NHS England sent me off to PALS, CCGs – and any organisation they could fob me off to. Continue reading

NHS PR loses out big time over Ashya

Public Questions NHS Big Brother approach over little cancer patient

A frightened 5 year old lies in a hospital bed, denied visits from his family, whilst his parents languish in jail waiting to hear what are their bail conditions.

Meantime the clock is ticking down on the 4 months doctors say this little boy has left to live.

When the story of Ashya King first broke,  (he was suffering from a form of cancer in University Hospital, Southampton), at first public opinion seemed to be on the side of NHS.   The Public believed that

In a typical treatment plan for proton therapy...

when a child was suffering, the NHS would be the body to treat them.

But then public opinion, aided by Social media, comments on TV shows such as The Wright Stuff, and unease that seemed to be expressed by the spokesman for police called in by the hospital to search for the little boy after his father had removed him from hospital – swung the other way. Continue reading

Patients DO know best

Now doctors agree

Pulse is THE magazine that goes out to GPs.  A recent issue had a fascinating article about letting patients refer themselves to Physiotherapy.

English: NHS logo

Wikipedia

The article came up with the conclusion that doing this had “slashed care costs by almost a third compared with referral through a GP, a study by one NHS primary care service has found”.

Apparently the sensible folk in Barnsley introduced a self- Continue reading

NHS copies Big Bad Wolf

English: Little Red Riding Hood

Wikipedia

Like Red Riding Hood

I tend to believe people.  I even believed hospital comment websites, that used to list ‘How many Patients would recommend this hospital to their friends?’.  Which would be followed by a high percentage figure.

Until I actually read the comments – and you began to wonder what sort of friends they had, as the comments that followed were generally a litany of complaints about their treatment at this hospital.

With the Mid-Stafford Hosopital enquiry published, one wonders

You have to wonder why it is that really sensible, bright people insist on doing really daft things. Let’s face it Whitehall is full of big brain-boxes and the invisibles in Leeds are no dozers either. Degrees and professional qualifications up to the eyeballs. Number 10; awash with advisors and gurus. They can’t all be stupid can they? Is it them or is it us?

David Cameron is championing the Friends and Family Test (Killer question; Would you recommend this service to friends and family?),  This is now in operational in most hospitals, but one questions how accurate it is. Everyone who knows anything about sampling and finding out what people think will tell you; the F&F Test is meaningless.

Anyone who has looked after Gran in hospital, knows what when you say you are going to complain on their behalf, she will say “I don’t want to complain”;  petrified that she will be victimised and singled out.

Before the F & F test was rolled out, our local hospital had a meeting of those us who had been discharged recently.  40 of us turned up;  we were given official postcards to fill in, asking us how we had been treated.  Two of weren’t very complimentary, and when we asked questions we were obviously singled out – even though others just nodded their heads and dutifully ticked boxes.

Returning to the room after the meeting was over, I noticed our two postcards sitting forlornly in the middle of our table;  the others had all been collected.  But when I went on the hospital’s website and looked at F & F score for that month, was surprised to see it had received a 92% rating that people would recommend the hospital to their friends.

So why is there this culture of fear allowed in hospitals?

Dr Rachel Reeves, principal research fellow at the School of Health and Social Care, Uni of Greenwich, says ‘…it is not the right test’; lack of rigour in the methodology, opportunities to skew results, bias and just about everything else you don’t need in a sample. Even Bill Morgan, LaLa’s former special advisor, wrote; ‘…(it) … is too narrow and too crude to work as a measure for shared decision-making. Retrofitting a retail-centric measure onto healthcare feels awkward anyway.’

Known in industry as the ‘Net Promoter Score’ it is designed as a measure of brand loyalty and that’s all. As the average NHS patient has little opportunity of switching brands away from the NHS, or even the local Trust, the whole exercise is hollow. In industry the NPS is seen as useless unless accompanied by a good ‘voice of the customer’ programme and the ability to dig into customer experience dynamics. Something the NHS does not have.

Business uses NPS to drive bigger-picture questions; Is increasing recommendation really the best way to achieve success? They may want decrease volumes and increase margins. The NHS can’t do that, it is demand led, can’t cherry pick and aside from fiddling the Tariff and employing serial-fraudster coders, it’s a non-starter. They’ll ask; if I lose 35% of my customer base per year, but most of those who stay would recommend, am I really in good shape? If an NHS service scored ‘35% dissatisfied’ there would already be something seriously gone wrong and the Board should be in jail.

And, there is the mother-of-all problems compounded by the DH’s own F&F guidance. Sec 3.8, Survey Timeframe: “Patients should be surveyed on the day of discharge or within 48 hours of discharge. This will ensure that the answer given reflects the patient’s informed opinion, based on recent experience.”

Wrong!  No!  Couldn’t be worse! It falls foul of the Halo Effect.

In plain English; respondents are aware that the sponsors of the survey are the very people who are providing the service. Or, even simpler; patients are being asked about the NHS experience by the people providing it. Furthermore, questions can be asked whilst the patient is still in the care of the Trust. We know the nearer to the event a survey is carried out, the more likely it is to overstate reaction. Plus, if undertaken whilst the patient is still in hospital, most answers (particularly among older patients) will be positive for fear of retribution or reprisal and the wish not to be critical, face-to-face, for fear of confrontation.

Patients will not be able to judge the experience in its own right and usually unable to make comparisons with other brands (Trusts). The DH Guidance creates a potential 56hr window to ask questions in situ or later, perhaps on the phone. This distorts results because of a lack of consistency in question framing, timing and environment. All hopelessly skewed.

 Like Red Riding Hood,

I tended to believe the Big Bad Wolf.  So, why are the big brains using a sampling system that is flawed? Two reasons. The F&F Test can be relied upon to produce generally positive scores about NHS performance. Gold dust in the run-up to the 2015 elections. Second, by publishing results, ward-by-ward, staff will start to feel proprietorial about performance. Usually that translates into a positive impact on morale and performance.

You see; they’re not so stupid after all!

Calls for NHS Chief David Nicholson to resign

So he counters with Video

 

 “Everyone Counts”

 

Sir David Nicholson

Sir David Nicholson (Photo credit: NHS avid Confederation)

The calls for the NHS’s supremo, David Nicholson, to resign are mounting.

He was in charge for some of the time when patients were being abused in Mid-Staffordshire hospital – but although Dr. Max Pemberton of Daily Telegraph, Julie Bailey of Cure the NHS and many others are calling for his resignation – and even to go to prison – he counters with a rambling video about the NHS.

He can’t even dress properly to be filmed – perhaps he considers it isn’t worth getting properly dressed when sending out his message to the NHS – or is this all he thinks the NHS is worth?

 

Watch the video on http://www.commissioningboard.nhs.uk/everyonecounts/everyone-counts-intro/

 

Who is it?

No – it’s not the Plumber – actually the video focusses on SIR David Nicholson – perhaps he can’t afford a tie on his vast salary

It’s entitled “Everyone Counts”  – one of the buzz phrases thought up by the expensve Consultant hangers-on employed by the NHS.  Problem is , they think up these phrases, but no-one actually thinks they should carry the idea on, and Plumber Nicholdson doesn’t seem to know either.

So don’t hold your breath – we STILL won’t be listened to. But it rather shows us, in a week when the Francis Report shocked the Nation, that patients still will have to fight their own battles;  NHS big-wigs still only pay lip service to consulting Patients.   Am still puzzling over why I can’t be sent a copy of the report from my recent MRI scan:  was told I couldn’t have it “due to patient confidentiality’!

And David Nicholson is still hanging on to his job, even after all the calls for his resignation post the Francis Report.

So whatever Francis Report said, it is still down to us to make a fuss if we don’t get what we are entitled to.

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What's going to happen to NHS after Francis Report?

Five hospitals to be investigated

 

But is anyone naive enough to think things are going to

change?

 

Two days after the report came out, the headlines have disappeared from the BBC website, showing the lack of interest shown by the general public.

Don’t get me wrong – Possibly 1,200 patients may have died earlier or even needlessly.  But their relatives won’t get much comfort from the report;  no-one’s head is to roll – no-one is accountable.  All Robert Francis has done is set up a massive industry for Consultant and Conference organisers to milk for the next decade.

But as nhsManagers.net says:

Hours before the Francis report was published Number 10 had decided that its 290 recommendations were not enough. One more was needed. The Prime Minister announced he alone had the solution; an Inspector of Hospitals. If that is the solution I suspect Francis would have said so. Why didn’t he? Because he knows what we know; it is bureaucracy that got us into this mess. More bureaucracy is the last thing we need. Daft idea but the lad has to look busy so he’s had his two-penny-worth. That’s the trouble; everyone will want to have their two-penny-worth. Two hundred and ninety one recommendations will become 291 headings, 500 sub-sets, 1,500 reports and three thousand complications, report-backs, work-groups, committees and a shed-load of costs.

The massive Francis report will be the NHS’ F-word for quite a while. What is missing from his report are a few more ‘F’ words;

But ‘Dave’ in No. 10 has a solution!

In response to the findings of the Francis Report into the failings at Mid-Stafford hospital, David Cameron announced that five other hospitals with persistently high death rates would be investigated. All the hospitals named have had high rates for two years.  Yet the Dept. Health has waited until now to act.

The hospitals are:

  • Colchester Hospital University NHS Foundation Trust
  • Tameside Hospital NHS Foundation Trust
  • Blackpool Teaching Hospitals NHS Foundation Trust
  • Basildon and Thurrock University Hospitals NHS Foundation Trust
  • East Lancashire Hospitals NHS Trust.

Death rates are calculated by looking at the number of people that would be expected to die when taking into account the age and disease profile of the local population.

High death rates were one of the factors that triggered the original investigation into Stafford Hospital. While not necessarily proof there is a problem, they are a “smoke alarm” suggesting there could be.

The figures for the five hospitals were already known about within the NHS and were being monitored

However, will grieving relatives have to wait another two years before a report comes out?  What these hopitals need is to appoint a Matron with the power to RUN the hospital, SACK incompetentS, decide WHERE funding is to go, and then do ward rounds EVERY day to talk to patients and LISTEN to their needs.

Don’t hold your breath – but be prepared for cost-saving measures such as Charing Cross Hospital:  they are throwing out the water fountains.

The Mid Staffs public inquiry

See Francis on this video – it makes sad viewing:

http://www.itv.com/news/2013-02-06/key-recommendations-of-nhs-mid-staffordshire-public-inquiry/

Robert Francis QC delivers his statement, saying: “This is a story of appalling and unnecessary suffering of hundreds of people”

There has been anger from some quarters after nobody lost their jobs as a result of the public inquiry.

James Duff’s wife Doreen died in the hospital. He said: “Not one person has lost their job over this – instead they have been promoted and some people have been moved sideways.

“This has been a disaster yet nobody is accountable.”

  • The public inquiry is the fifth major investigation into what happened
  • It has focused mainly on the commissioning, supervision and regulation of the trust from 2005 to 2009 – something campaigners felt had not been properly covered before
  • It was chaired by Robert Francis QC, who also led the fourth major investigation
  • It sat between November 2011 and December 2012 and cost £13m
  • More than 160 witnesses appeared at the hearings and one million pages of evidence have been sifted through
  • The final report contains 290 recommendations over nearly 1,800 pages.

He has also appointed Ann Clwyd, Welsh MP for Cynon Valley, to lead an investigation – now that’s more iike it.

http://www.bbc.co.uk/news/uk-wales-21357075

in the meantime

The government’s full response to the public inquiry will come next month, however, it has already been announced that a new post of chief inspector of hospitals will be created in the autumn.

Speaking in the House of Commons, David Cameron said he was “truly sorry” for what happened at Stafford Hospital, which was “not just wrong, it was truly dreadful” and the government needed to “purge” a culture of complacency.

Sir David Nicholson (how did he get a knighthood?) has been the focus of anger from families affected by the scandal. He is chief executive of the NHS and was briefly in charge of the Regional Health Authority while death rates were high at Stafford Hospital.

Responding to calls for him to go, he said: “I think it’s perfectly understandable, I understand the anger that they feel, the upset that they feel about the treatment of their loved ones in Mid-Staffordshire hospital.

“I absolutely understand all of that. At the time I apologised and in a sense I apologise again to the people of Stafford for what happened, but apologies are not enough.

“We need action, we need to make things happen.”

Too right – but forgive my cynicism –

I think Patients and their Relatives are still going to

have to take on the collective might of the NHS to get the best

available  treatment.

If you have ideas – send a message to your MP, local hospital

and/or PCT:  let them now your views – and DEMAND an

answer.

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Do you 'get what you pay for' when it comes to cancer care?

Seems the answer is yes

 

 

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Americans may pay more for cancer treatment, but they also live longer after diagnosis — getting a benefit that offsets their higher health expenses.

 

Policy Research at the University of Chicago suggests the answer may be yes, at least when it comes to cancer care.

“We found that the value of the survival gains greatly outweighed the costs, which suggests that the costs of cancer care were indeed “worth it,” wrote University of Chicago public policy researcher Tomas Philipson and colleagues, in a paper published by the journal Health Affairs.

So is it worth it in Britain?

With all the talk in the media about costs of cancer care, isn’t it about time we turned this around, and worked out what benefits are gained by helping people live longer?

Cancer patients are constantly being told that a drug is too expensive to be given to everyone who needs it – but shouldn’t we turn the tables and work out the benefits to family and work in the equation?  That person who has the very expensive drug that prolongs their life – might they not still be raising children and contributing to the profitability of the company they work for?

What happened in the States

To examine whether the higher costs were “worth it,” Philipson and his team mined extensive databases to compare cancer treatment costs and cancer survival data in the U.S. with those in 10 countries that represend 36% of the population of the European Union: Finland, France, Germany, Iceland, Norway, Slovakia, Slovenia and Sweden, as well as Scotland and Wales.

Costs
First, the team examined the costs — and found that Americans spend much more on cancer care than Europeans, with U.S. spending increasing 49%, from $47,000 per case to $70,000 per case (in 2010 dollars,) between 1983 and 1999.  In the European countries, spending grew 16% over the same period, from $38,000 to $44,000.

Then they looked at survival data for patients with types of cancer, including breast, prostate, colorectal and blood cancers, among others.  Comparing length of time from diagnosis to death, as well as differences in survival gains over time, they discovered that among patients diagnosed from 1995 to 1999, average survival in the U.S was 11.1 years and in the European countries studied was 9.3 years.   These statistics might seem old, but when carrying out research to get a broad picture often older statistics have to be used.

Finally, the team used a standard method to put a “conservative” monetary value on the extra longevity of $150,000 per year.  Crunching all the numbers, they found that the extra years Americans enjoyed amounted to $598 billion worth of benefit over the period studied — about $61,000, on average, per patient.

“A key question for policy makers is whether the U.S. survival gains are actually produced by higher U.S. spending on cancer care or by some other factor unrelated to the healthcare delivery system,” the team wrote, cautioning that the analysis does not prove that all treatments are cost-effective.   

However, as David Cameron and Andrew Lansley are always reminding us, UK cancer survival rates lag behind those in France – so would seem they agree with Philipson.

One influencing factor might be the faster adoption of new technologies in the U.S., the authors wrote. Their paper was accompanied by several more articles exploring the costs and benefits of U.S. cancer care.  This would find favour with medical guru Lord Darzi, who has been heard to ask “what good is NICE?”

So next time some politician or NHS administrator tries to refuse use of a drug – get them to work out the long-term benefits;  these might add weight to what can be an emotive subject.

 

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Cameron and the 'F' word

Cameron talks about F-F-F-F

British Mark III tank in ditch, 1917.

G M F U

 

Cameron has been stuttering away trying to make up a sound bite for the cameras (he should realise that after past master Tony Blair, no-one else comes near), and all he could come up with was ‘The Four Fs’.

Whitehall Wags’ emails were red hot with suggestions as to what the ‘Fs’ stood for (most printable was ‘feeble’).

But all he did was to remind me of an old Army saying;  when anything goes wrong it is described as a ‘Grand Military F-Up’.

Apart from laughing at the ditches he and LaLa are digging, what about US?  To use another military phrase, who cares about the PBI (poor bxxxxy infantry) i.e. Patients?

Around the Country patients are gleefully or morosely sending in the latest from the health front line.  Some of the ways of getting NHS treatment are inventive and deserve a wider audience – so I am going to put up the best ideas on this page.  Watch this space!

Idea No 1

Cancer patient was taken ill in middle of Chelsea (as one is).  Kindly shopkeepers called an Ambulance, which parked up in quiet street whilst two very competent Ambulance Crew got on with doing their jobs -superbly as usual.  They installed patient in a comfortable position, and got on with ECGs, evaluations, monitoring, BP, etc. etc.

As things went on, her Blood pressure dropped, she began to feel more alive, and found herself the centre of a very caring team effort.  After about an hour or so, one of the Ambulance crew said they were going to take her to A & E.

This was not such welcome news.  She had been there before;  it isn’t exactly known for TLC, and she had glanced at the Junior Doctors TV programme filmed there, which had filled her with dread.  Pleading with the Ambulance crew, she asked to be taken home.  They asked her searching questions about her home circumstances – then decided that provided she would accept a visit from her local GP, they would take her there.

They accompanied her into her flat;  made sure she was warm and had everything to hand, then departed.

Shortly after they phoned to say they had contacted her GP, and the GP would be coming round to see her.

Only thing wrong with this scenario – the GP is already well entrenched in the new Health Reforms, so phoned to say she was too busy to come.

 

 

 

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