Sunday 29 July 2012

Whooping cough


Whooping cough outbreak spreads to very young babies

baby being vaccinatedBabies are offered a whooping cough vaccine at two, three and four months of age
The outbreak of whooping cough in England and Wales has spread to very young babies who are most at risk of severe complications and death, the Health Protection Agency has warned.
There were another 675 cases in June bringing the total to 2,466 for 2012 so far.
At this stage last year there had only been 311 cases.
Increased levels of whooping cough have also been reported in Northern Ireland and Scotland.
The main symptoms are severe coughing fits which are accompanied by a "whoop" sound as children gasp for breath.
Surges in the number of whooping-cough cases are seen every three to four years. This latest outbreak began at the end of 2011.
Before routine vaccination in 1957, whooping cough outbreaks in the UK were on a huge scale. It could affect up to 150,000 people and kill 300 in one year.
'Very concerned'
There have been 186 cases reported in infants under three months this year compared to 72 in the same period last year. Five babies have died from the infection.
Dr Mary Ramsay, the head of immunisation at the Health Protection Agency, said she was "very concerned" with the increase in cases.
She said: "Whooping cough can be a very serious illness, especially in the very young. In older people it can be unpleasant but does not usually lead to serious complications.

Whooping cough

  • It is also known as pertussis and is caused by a species of bacteria, Bordetella pertussis
  • It mostly affects infants, who are at highest risk of complications and even death
  • The earliest signs are similar to a common cold, which then develop into a cough and can even result in pneumonia
  • Babies may turn blue while coughing due to a lack of oxygen
  • The cough tends to come in short bursts followed by desperate gasps for air (the whooping noise)
"Anyone showing signs and symptoms, which include severe coughing fits accompanied by the characteristic 'whoop' sound in young children, but as a prolonged cough in older children and adults, should visit their GP."
In the UK, the whooping cough vaccine is given to babies after two, three and four months. A booster dose is given just before primary school.
Babies are not fully protected until the third jab. It is in the following years that protection is at its peak then it gradually fades. It means you can get whooping cough as an adult even if you had the infection or the jabs as a child.
The Department of Health's Joint Committee of Vaccination and Immunisation is considering ways to tackle the outbreak, such as giving teenagers or pregnant women a booster jab.
Vaccinations for medics working with young babies have already been recommended to protect them and prevent them from spreading the infection.
Figures for the end of March showed 27 confirmed cases in Northern Ireland, compared to 13 in the whole of 2011. At the end of March there had been 150 cases reported in Scotland compared to 22 in the first three months of 2011.
Prof Adam Finn, from University of Bristol, said: "The current vaccination programme has reduced whooping cough in children, but also pushed it back into older age groups.
"Immunity due to vaccine does not last as long as immunity due to infection so as the number of people who have had whooping cough in the past falls, population immunity falls and rates go up.
"This is happening everywhere, not just in the UK."

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Wednesday 25 July 2012

Botox doctor suspended


Leading Harley Street Botox doctor suspended

Dr Mark HarrisonDr Harrison said he had performed more than 50,000 remote consultations since 2005
A Harley street doctor exposed in a BBC London investigation encouraging nurses to order potentially dangerous Botox drugs in one person's name for use on another has been suspended.
Dr Mark Harrison will not be able to practise as a doctor for up 18 months pending a review.
The General Medical Council (GMC) will decide whether he will face a fitness to practise panel.
Botox can normally only be prescribed by doctors or designated professionals.
If Dr Harrison faces a panel he will be assessed by the GMC's Medical Practitioners Tribunal Service.
It comes after the GMC banned doctors remotely prescribing injectable cosmetic medicines, such as Botox, on the phone, fax or online, without a face-to-face consultation.
Niall Dickson, chief executive of the GMC, said: "There are good reasons why these are prescription-only medicines, and we believe doctors should assess any patient in person before issuing a prescription of this kind."
Remote prescribing was common practice at Dr Harrison's company Harley Aesthetics - one of the UK's largest purchasers of the anti-wrinkle drug.
Nurses who have independent prescribing qualifications are able to prescribe any drug, including Botox, without the involvement of a doctor.

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I take my professional and moral obligations to both the patients who have treatments and the nurses who use the service extremely seriously”
Dr Mark Harrison
And nurses without this qualification are legally allowed to inject the drug under a doctor's direction, but risk being struck off for doing this remotely, unless in an emergency.
Dr Mark Harrison, the director of Harley Aesthetics, had built up a network of hundreds of nurses who phoned him on his mobile from across the UK to receive authorisation to inject patients immediately with Botox.
They paid Dr Harrison £30 for each conversation.
After concerns were raised to the BBC, an undercover researcher secretly recorded one of Dr Harrison's training days and joined his team of nurses.
Dr Harrison was secretly recorded explaining how prescriptions for Botox could be obtained in the names of friends and family and the stock of drugs could be used on walk-in patients.
If nurses were unable to reach him on his mobile at any time when they had a patient expecting immediate treatment, he encouraged them to inject their patients anyway and he would phone the patient later.
'Little bit naughty'
"If you can't get a signal, what you might do is do the treatment and then you ring through with the details and the phone number and we guarantee we'll always ring the client after the event," Dr Harrison was secretly recorded saying.
"That may be after the event, which is a little bit naughty."
The BBC then phoned him to see if this would really happen, claiming a new patient had already been injected.
Dr Harrison left a message on the voicemail of the "patient" and later sent a prescription.
BotoxBotox is a potentially dangerous medicine and should usually only be prescribed by a doctor
Senior doctors have said this amounts to a potential safety risk and would mean the nurse was breaking the law by injecting Botox without a prescription.
In a statement, Dr Harrison said he had performed more than 50,000 remote consultations since 2005, with no adverse affects on patient health.
He said the use of prescriptions in one person's name for the treatment of others was "common, almost universal practice throughout the aesthetics industry" and had "no consequence for patient safety".
Dr Harrison said the practice of a doctor phoning a patient after an injection "would never be encouraged and would never be acceptable for a new patient".
He added: "The decision to treat has been taken by the nurse and the doctor informed retrospectively."
Dr Harrison went on: "I can confirm that I take my professional and moral obligations to both the patients who have treatments and the nurses who use the service extremely seriously."
Dr Nigel Mercer, a leading cosmetic surgeon and former president of the British Association of Aesthetic Plastic Surgeons, was shocked by the BBC's findings.
He said: "This is a wake-up call. It's not an appropriate way for providing a medical service."

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Thursday 5 July 2012

mengele: Elderly denied NHS care

mengele: Elderly denied NHS care

Probe into 25 deaths after trust admits 'poor records'


Probe into 25 deaths after trust admits 'poor records'

Imperial College Healthcare NHS Trust signThe trust said it had been open and transparent about the matter

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The deaths of 25 patients are under review by one of the UK's biggest NHS trusts, after it admitted "poor record keeping".
Westminster and two other London local authorities have expressed "extreme concern" about lost data on referrals at Imperial College Healthcare.
BBC News understands Imperial is still unaware of the outcomes of 86 patients who were referred for cancer tests.
The trust says it does not believe any patient has come to serious harm.
Imperial, which runs four big hospitals in London, has however admitted that patients may have faced "discomfort, worry and possible deterioration as a result of a delay".
In an unprecedented move, the trust was allowed to suspend the reporting of its waiting times for planned operations and diagnostic tests to the government for the first six months of this year.
Waiting longer
The trust has been unable to make contact with 86 people who were referred for a possible cancer diagnosis.
It made efforts to trace 87 patients, through GPs and by sending letters by recorded delivery to the last available address.
Seven letters were returned undelivered and just one patient contacted the hospital to be seen directly.

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The safety of our patients is an absolute priority”
Sir Richard SykesImperial College Healthcare chairman
And at the height of the problems in February, around 3,500 patients were waiting longer than the 18-week NHS target for treatment or operations. Currently the figure stands at 1,600.
Some of these patients - and some of the suspected cancer cases - were recorded as having been on the waiting list since 2009.
So far, 74 deaths have come under the spotlight. A review group is satisfied that 49 were unrelated to any problems caused by delayed treatment.
In a joint letter, Westminster, Hammersmith and Fulham, and Kensington and Chelsea Councils complained to the trust about its handling of the problem.
The letter said: "It seems to us there could be a possibility of clinical harm as a result of delays in the diagnosis and commencement of treatment arising from the trust's failings.
"We are unhappy that the trust appears to have responded to the scrutiny function of local authorities with a lack of openness and transparency."
Westminster Council's scrutiny committee will question Imperial's interim chief executive, Mark Davies, at a meeting on Thursday night.
An NHS source described the discovery of such long-waiting patients as "dynamite" and "appalling".
The source said: "I would be surprised if there were not similar scandals waiting to be uncovered at other London hospitals.
"London has problems because that is where so many of the long-waiters and financial problems are."
'Extremely sorry'
Imperial has blamed issues arising from multiple computer and record-keeping systems.
A spokeswoman said: "To date we have found no evidence that these patients have come to clinical harm as a result of our poor record keeping.
"We are extremely sorry that this situation was not identified and resolved earlier."
In a letter responding to the councils, the trust's chairman, Sir Richard Sykes, said: "The safety of our patients is an absolute priority.
"We have been handling this in an open and transparent manner. We did not want to raise undue concerns for people when the issue was actually with our data collection."
In a statement, the Care Quality Commission said it would continue to monitor the trust closely "to make sure that it complies with the essential standards of treatment and care that people are legally entitled to expect".

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