Showing posts with label 'Shame on us doctors. Show all posts

Monday 19 February 2018

He's held down and injected

Requests for a medical cannabis licence to help a boy whose rare form of epilepsy improved after taking the drug have been denied by the Home Office.

Six-year-old Alfie Dingley, from Kenilworth in Warwickshire, suffers up to 30 violent seizures a day.

His parents want to treat him with medical cannabis oil, which is illegal in the UK.

The Home Office said the drug "cannot be practically prescribed, administered or supplied to the public".

A spokesperson added that it can only be used for research.

Alfie's mother, Hannah Deacon, said "you've got to fight for your kids, I want to know that I've done everything I can".

Members of the all-party parliamentary group (APPG) on drug policy reform is calling on the government to assist with Alfie's plight.

Alfie Dingley — Image captionMs Deacon said Alfie's cannabis dose was "very small", just three drops of the oil

Ms Deacon said Alfie went to the Netherlands to take a cannabis-based medication in September.

She said that while there, the medication, prescribed by a paediatric neurologist, saw his seizures reduce in number, duration and severity.

At one point while in the UK, Alfie had 3,000 seizures and 48 hospital visits in a year, but while abroad he went 24 days without a single attack.

"It's very rare and very aggressive, there's only nine boys in the world with Alfie's condition," Ms Deacon said.

"We never imagined how well it would work. He's just a six-year-old boy, he deserves a happy life. We've found something that makes him happy and now we've got to take that away."

Ms Deacon said his cannabis dose was "very small" and he was taking three drops of the oil, which is made using whole plant cannabis.

Alfie's mother said the steroids he currently takes in hospital could eventually cause his organs to fail if he keeps taking them at the rate he is.

"He doesn't know any different, he's had a very traumatic life. He's held down and injected," she said.

With the Dutch cannabis medication, it is estimated Alfie would have about 20 seizures a year.

He stayed with his parents in a holiday camp in the Netherlands to receive the treatment, but without medical insurance in the country they had to return home in January.

The APPG wants Home Secretary Amber Rudd to issue a licence for him to continue taking the medication.

Group co-chair, Conservative MP Crispin Blunt said: "It would be heartless and cruel not to allow Alfie to access the medication.

"Parliament really must look at reforming our laws to allow access to cannabis for medical purposes, which has huge public support."

Image captionMPs have called for Home Secretary Amber Rudd to issue a medical cannabis licence

The Home Office said it recognised that people with chronic pain and debilitating illnesses are "looking to alleviate their symptoms".

A spokesperson added: "However, it is important that medicines are thoroughly tested to ensure they meet rigorous standards before being placed on the market, so that doctors and patients are assured of their efficacy, quality and safety.

"Cannabis is listed as a Schedule 1 drug, as in its raw form it is not recognised in the UK as having any medicinal benefit and is therefore subject to strict control restrictions.

"This means it cannot be practically prescribed, administered, or supplied to the public in the UK, and can only be used for research under a Home Office licence.

"The Home Office would not issue a licence to enable the personal consumption of a Schedule 1 drug."

Thursday 29 October 2015

EU doctor suspended from UK work for 'poor English test'

Image copyrightpsphotograph

An Italian doctor has been suspended from practising medicine in the UK after failing English language tests.

Dr Alessandro Teppa is one of the first EU doctors to face disciplinary action over language skills following a change in the law in 2014.

His suspension will last at least nine months, the Medical Practitioners Tribunal Service (MPTS) has ruled.

Another medic - a Polish doctor who failed language tests three times - has been allowed to work under supervision.

Dr Teppa qualified in 1998 in Italy and was granted a licence to practise in the UK in 2012.

He failed an English assessment two years later and was put under an interim suspension order that year.

Repeated tests

In a document, the tribunal panel said the standard of his English was currently "insufficient to support safe and effective medical practice in this country".

He told the panel he had since been taking English language lessons at his home in Italy.

He must return for a further hearing in the next nine months.

The medical regulator for the UK - the General Medical Council (GMC) - agreed with the decision.

Niall Dickson, chief executive of the GMC, added: "This doctor should not be able to practise in the UK again until he can demonstrate he is able to communicate effectively."

A separate case involved a second doctor, Dr Tomasz Fryzlewicz, who qualified in Poland and has held a licence to practise in the UK for the last nine years.

He failed English language assessments in October 2014, December 2014 and again in February 2015.

The panel ruled he must only work under direct supervision for the next year and must pass an English language assessment within 12 months.

But the chief executive of the GMC said there should have been tougher sanctions.

Mr Dickson added: "We are disappointed that the MPTS panel did not suspend Dr Fryzlewicz as we had requested but we are satisfied that the panel has placed sufficient conditions on his clinical practice to make sure that patients will be protected."

'Understanding instructions'

Dr Fryzlewicz was previously employed as a heart specialist at various hospitals, including the Royal Stoke University Hospital, the Princess Alexandra Hospital in Essex and the Good Hope Hospital in Sutton Coldfield.

Some colleagues who worked with Dr Fryzlewicz said they weren't always sure he understood what they said.

Dr Simon Woldman, clinical director of specialised cardiology at Barts NHS Trust told the tribunal: "When I spoke to Dr Fryzlewicz, I was never really sure that he had understood the instructions he was being given...

"When Dr Fryzlewicz spoke, you had to concentrate quite hard to understand what he was saying."

Other colleagues and patients wrote to the panel in support of the doctor's command of English.

New powers allowing the medical regulator to check doctors' English language skills came into force in June 2014.

Previously only doctors from outside Europe could have their language skills tested by the General Medical Council (GMC).

The risk of a doctor not being fluent in English was highlighted by a lethal mistake made by Dr Daniel Ubani, a German doctor doing an out-of-hours shift who gave a lethal dose of a painkiller to patient David Gray in 2008.

As a German citizen the doctor was able to register to work in the UK without passing a language test.

auto → cy

Meddyg UE hatal o'r DU yn gweithio ar gyfer 'mhrawf Saesneg wael'

Wednesday 20 May 2015

let down by poor end-of-life care

Thousands of dying patients are being let down by poor end-of-life care provision, the organisation that makes final decisions about NHS complaints in England has said.

The health ombudsman's report detailed "tragic" cases where people's suffering could have been avoided or lessened.

In one instance, a patient had suffered 14 painful attempts to have a drip reinserted during his final hours.

The government said improving end-of-life care was a priority.

The Parliamentary and Health Service Ombudsman has investigated 265 complaints about end-of-life care in the past four years, upholding just over half of them.

Catalogue of failings

Its Dying Without Dignity report said it had found too many instances of poor communication, along with poor pain management and inadequate out-of-hours services.

One mother told the ombudsman how she had had to call an A&E doctor to come and give her son more pain relief because staff on the palliative care ward he had been on had failed to respond to their requests.

In another case, a 67-year-old man's family learned of his terminal cancer diagnosis through a hospital note - before he knew himself. This "failed every principle of established good practice in breaking bad news", the report said.

"There was an avoidable delay in making a diagnosis," it added. "An earlier diagnosis would have meant opportunities for better palliative care."

Ombudsman Julie Mellor told Radio 4's Today the report made "very harrowing reading".

She also urged the NHS to learn lessons from the report, adding: "Our casework shows that too many people are dying without dignity.

"Our investigations have found that patients have spent their last days in unnecessary pain, people have wrongly been denied their wish to die at home, and that poor communication between NHS staff and families has meant that people were unable to say goodbye to their loved ones."

'Appalling cases'

Macmillan Cancer Support chief executive Lynda Thomas said: "The report cites heartbreaking examples of a lack of choice at the end of life that are totally unacceptable.

"If we are to improve the current situation, we will have to see a dramatic improvement in co-ordination of care, and greater integration of health and social care."

The chief inspector of hospitals at the Care Quality Commission, Prof Sir Mike Richards, said the organisation had seen examples of excellent end-of-life care, but also instances where it had not been given enough priority.

He said the CQC would continue to highlight those services that were failing.

A Department of Health spokesman said: "These are appalling cases - everyone deserves good quality care at the end of their lives.

"The five priorities for end-of-life care we brought in emphasise that doctors and nurses must involve patients and their families in decisions about their care, regularly review their treatment and share patients' choices to make sure their wishes are respected.

"NHS England is working on making these priorities a reality for everyone who needs end-of-life care."

Saturday 6 December 2014

GP 'disgust' at watchdog errors

By Sarah BlochHealth reporter, BBC News

GPs have told the BBC their reputations have been "tarnished by incompetence" from the health watchdog.

The Care Quality Commission has been forced to apologise to hundreds of GPs for giving incorrect patient safety risk assessments.

A BBC investigation found serious errors in the calculations used by the CQC.

The British Medical Association is calling for the whole banding system to be withdrawn.

Around 60 practices have been taken out of the highest risk categories and four low-risk surgeries need early inspection.

John Flather, a GP in Hadleigh, Suffolk, said his practice had been incorrectly banded as high risk.

He said he was "totally disgusted by the process" and that a formal complaint had been made.

He told the BBC: "Our reputation, which has been built over many years, has been tarnished by incompetence that they purport to eradicate.

"If they had only given us a chance to view their ratings we could have pointed out their errors and avoided this mess."

Dr Chris Cullen, from Ipswich, said: "My practice was rated for highest risk despite being one of the very high achieving practices in the country.

"The CQC claim we gave flu jabs to 24% of our patients, in fact it was over 96%.

"Our true rating should be for lowest risk, but the CQC aren't interested and have not returned our calls."

Bad data

Practices were judged on 38 indicators of performance, ranging from how easily patients managed to get appointments to how good doctors were at picking up conditions such as dementia.

Practices were graded in six bands, with Band 1 being the highest concern, and Band 6 the least risky.

The majority were of low concern, but 11% were rated in the highest risk band.

The BBC discovered that for one indicator, whether patients were able to get an appointment with a GP or nurse the last time they tried, the calculations were so flawed that the CQC has been forced to remove the indicator altogether.

A further four indicators had to be refined based on revisions to data provided to the CQC by NHS England.

Hundreds of practices will now be assigned a different band.

In its initial register, published two weeks ago, the health watchdog ranked 7,276 practices out of the total 7,661 in England, and placed 864 practices in the "highest concern" category.

Original rankings

As a result of the recalculations, around 60 practices will be lifted out of the two "highest concern" categories, and four that were previously deemed low-risk have been found to be in need of early inspection.

The CQC says 519 practices will move bands, but most were between the lowest risk bands.

The CQC register was set up to help target inspections, and the watchdog said it did not necessarily indicate poor GP surgery performance.

Sir Mike Richards, chief inspector of hospitals for the CQC, told the BBC: "We will make them a big apology. This only became apparent when we ran the data on the thousands of practices rather than just the hundreds that we tested them on."

He defended the publication of the risk bands in the interest of transparency.

He said: "We are using the data to help us know where we might go first. Our judgement comes from a combination of data and inspection. The main thing that is going to matter is that we are going to be inspecting every practice."

Poor data

Measures removed

Whether patients were able to get an appointment with a doctor or nurse last time they tried

Measures recalculated

Coronary heart disease incidence
Chronic obstructive pulmonary disease (COPD) incidence
Unnecessary A&E admissions
Dementia diagnosis rates

The British Medical Association said mistakes by the CQC risked "doing serious harm" to the reputation of good surgeries.

Its GP committee chair, Dr Chaand Nagpaul, said: "The banding system as a whole needs to be withdrawn.

We warned at the time that simplistic targets would fail to take into account the enormous pressures GP practices are facing, and that skewed and limited information does not tell us about the quality of care.

"These failings have the potential to seriously undermine the trust in the system and patients' confidence in their GP and it is only right that all of those practices affected are now contacted and receive a full apology."

Monday 3 November 2014

NHS screening advice 'must improve'

By James GallagherHealth editor, BBC News website

The NHS needs to get better at highlighting the dangers of screening for diseases such as cancer, say MPs.

Screening picks up diseases early to improve the odds of survival or improve quality of life.

But the practice also leads to "overdiagnosis" and people having treatment for conditions which would never have caused harm.

The Science and Technology Committee accused the NHS of "poor communication" on the issue.

Breast-cancer screening became hugely controversial in 2012. An independent review was set up to settle a fierce debate about whether the measure did more harm than good.

It showed that for every life saved, three women had treatment for a cancer that would never have proved fatal.

As a result the leaflets given to women offered a mammogram included more information to give them an "informed choice".

'Unnecessary treatment'

However, the Science and Technology Committee argues the lessons have not been learned by those overseeing other screening programmes.

Andrew Miller, the committee chairman, said: "While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment.

"More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them."

Conditions screened for include:

Abdominal aortic aneurysm
Diabetic retinopathy
Breast cancer
Cervical cancer
Bowel cancer

There are also newborn screening programmes, including hearing checks, as well as Down's syndrome and foetal anomaly screens during pregnancy.

Breast-cancer screening guidelines were changed to ensure patients had an informed choice

Mr Miller continued: "Producing accurate, concise and accessible public information on screening will always be challenging, but the UK National Screening Committee must ensure there is standard process across the NHS for achieving this and facilitating informed choice."

There are hopes that screening could be extended to other diseases such as ovarian cancer and eventually prostate cancer.

However, the committee said the barriers to new screening programmes "should remain high" due to the delicate balance of risk and benefits.

'Vitally important'

Prof Kevin Fenton,, director of health and wellbeing at Public Health England, which oversees the NHS screening programmes. said: "We welcome the findings of the Science and Technology Committee's report, which has identified a number of recommendations.

"We will now consider these recommendations in full."

The British Medical Association's Dr Richard Vautrey said: "Many GPs will share the Science and Technology Committee's concerns about health screening. As the BMA has repeatedly warned, it is vitally important that people being invited for screening fully understand the pros and cons of the procedure.

"Patients must also be aware that there is a risk that false positive results could lead to unnecessary and potentially harmful further investigations."

Cancer Research UK was involved in the independent review of breast-cancer screening.

Jessica Kirby, from the charity, said: "It's vitally important that all screening programmes are based on the best possible evidence so people can be confident that screening is only offered where the benefits outweigh the harms.

"The report highlights the importance of ensuring people get the best possible information so they can make the decisions that are right for them."

Wednesday 25 June 2014

Right-to-die

Right-to-die Supreme Court judgement due

Paul Lamb won an earlier legal battle to join Tony Nicklinson's court challenge

Campaigners for the right to die are to receive judgement from the Supreme Court in the latest round of their legal battle.

It involves family of the late Tony Nicklinson, of Wiltshire, who had locked-in syndrome, and Paul Lamb, of Leeds, who was paralysed in a road crash.
They want the law changed to allow doctors to assist patients to die.
Judgement is likely to be issued on Wednesday.
The court has had to decide if the law prohibiting assisted suicide is incompatible with the European Convention on Human Rights because it denies Mr Lamb, and others like him, the right to choose the timing of their death.

Analysis

Clive Coleman Legal correspondent, BBC News

The Supreme Court judgement is seen as perhaps the most ambitious attempt yet to change the law on the right to die.
Paul Lamb took up the legal challenge brought by the late Tony Nicklinson, who suffered from locked-in syndrome.
At a hearing at the Supreme Court last year his lawyers argued the current prohibition on assisting suicides interfered with his right to a private and family life, because it prevented the most severely disabled from getting medical assistance to end their lives at a time of their choosing.
Any doctor who helped someone to kill themselves would be guilty of assisting a suicide, a criminal offence that carries a maximum prison sentence of 14 years.
Subject to strict safeguards, including the medical assistance being sanctioned by a court, Paul Lamb wants any doctor who does assist a suicide of someone in his position, to have a defence in law.
The defence would be that of "necessity". However, many fear any change to the law on assisted suicide which would make the position of the sick, the infirm and the elderly, more vulnerable.
The fear is that members of these groups could easily feel themselves to be, or be persuaded that they are, a burden to others and decide to end their lives as a result.
A second man, known only as Martin, wants clarification of the director of public prosecutions's guidance on the position of health professionals who assist a suicide.
The existing guidance is unclear on whether they would be prosecuted.

There are nine judges on the panel, rather than the normal five.

'Unanimously dismissed' Paul Lamb, 57, has been almost completely paralysed from the neck down since a car accident more than 20 years ago and says he is in constant pain.
He has called for the law to be changed so any doctor who helped him die would have a defence against the charge of murder.
Tony Nicklinson was paralysed from the neck down after suffering a stroke while on a business trip to Athens in 2005.
After losing his High Court battle last year, he refused food and died naturally, aged 58, a week later at his home in Wiltshire. His widow, Jane, is continuing his legal battle.
Earlier last year, Mr Lamb joined forces with Mr Nicklinson's family to fight a joint legal case.
In their Appeal Court case, the decision centred on whether the High Court was right to rule Parliament, not judges, should decide whether the law on assisted dying should change.
The three Court of Appeal judges unanimously dismissed the Nicklinson and Lamb challenge.
In the judgement, the Lord Chief Justice Lord Judge said Parliament represented "the conscience of the nation" when it came to addressing life and death issues, such as abortions and the death penalty.
"Judges, however eminent, do not - our responsibility is to discover the relevant legal principles, and apply the law as we find it," he said.
At the same hearing a third paralysed man won his case seeking clearer prosecution guidance from the director of public prosecutions (DPP) for health workers who help others die.

Tony Nicklinson suffered from locked-in syndrome

The man, known only as Martin, wants it to be lawful for a doctor or nurse to help him travel abroad to die with the help of a suicide organisation in Switzerland. His wife and other family want no involvement in his suicide.
The Supreme Court will also deal with the DPP's appeal against the Court of Appeal's ruling in Martin's favour.

mengele plus

Monday 19 February 2018

He's held down and injected

Thursday 29 October 2015

EU doctor suspended from UK work for 'poor English test'

EU doctor suspended from UK work for 'poor English test'

Repeated tests

'Understanding instructions'

Wednesday 20 May 2015

let down by poor end-of-life care

Catalogue of failings

'Appalling cases'

Saturday 6 December 2014

GP 'disgust' at watchdog errors

GP 'disgust' at watchdog errors

Monday 3 November 2014

NHS screening advice 'must improve'

NHS screening advice 'must improve'

Wednesday 25 June 2014

Right-to-die

Right-to-die Supreme Court judgement due

Analysis

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More patients in Scotland given antidepressants

Monday 19 February 2018

Thursday 29 October 2015

EU doctor suspended from UK work for 'poor English test'

Repeated tests

'Understanding instructions'

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Wednesday 20 May 2015

Catalogue of failings

'Appalling cases'

Saturday 6 December 2014

GP 'disgust' at watchdog errors

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Monday 3 November 2014

NHS screening advice 'must improve'

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Wednesday 25 June 2014

Right-to-die Supreme Court judgement due

Analysis

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