Showing posts with label NHS focus on elderly. Show all posts
Showing posts with label NHS focus on elderly. Show all posts

Monday, 16 September 2013

NHS patients 'should not face constant moves'

NHS patients 'should not face constant moves'

Hospital wardPatients often face multiple moves around hospital

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The era of NHS patients being shunted around hospitals needs to end, an expert group says.
The Future Hospital Commission - set up by the Royal College of Physicians - said a radical revamp in structures was needed to bring care to the patient.
This was particularly true for frail people with complex needs, who often faced multiple moves once admitted to hospital, the report said.
It also recommended closer working with teams in the community.
The commission said this could involve doctors and nurses running clinics in the community and even visiting people in their own homes - as is already happening in a few places.
'Bold and refreshing'
It also called for an end to the concept of hospitals discharging patients.
Sir Mike Rawlins: "Hospital shouldn't stop at the walls of the building"
Instead, it argued that many of those seen in hospitals in the 21st Century needed ongoing care that did not end when they left hospital.
So the report recommended that planning for post-hospital care should happen as soon as someone is admitted.
Key to that will be a new hub that should be created in every hospital, called a clinical co-ordination centre, which would act as a central control room, helping to ensure information about patients is shared and their care planned properly.
Once in hospital, patients should not move beds unless their care demanded it, the report said.
That contrasts with the multiple moves many patients with complex conditions often find themselves facing as they are passed from specialism to specialism.
It said this would require a greater emphasis on general wards with specialists visiting patients rather than the other way round.

Case study

The longest Suzie Hughes, who has the auto-immune condition Lupus, has spent in hospital is 21 days.
During her stay, she was moved five times for non-clinical reasons.
"I would find myself being wheeled down the corridor with my flowers and chocolates. Nurses would be with me and I kept thinking, 'What a waste of their time.'
"And each time I arrived on a new ward I had to explain my condition again. The information does not get passed on and it results in delays."
The authors - drawn from across the NHS and social-care spectrum - also called for an end to the two-tier weekday and weekend service in many facilities.
They even said it would be preferable to work at 80% capacity across the seven days if extra resources were not available in the short-term.
Commission chairman Sir Michael Rawlins said it was about providing the care patients "deserved".
Alzheimer's Society chief executive Jeremy Hughes said too often hospitals were stressful places with patients being moved "from pillar to post".
"We need nothing less than a revolution... in order to ensure our NHS is fit for the future," he added.
Health Secretary Jeremy Hunt said the report was "bold and refreshing".
"I agree completely that we must make services more patient-centred both inside and outside hospital."
Shadow health secretary Andy Burnham said: "We must turn this system around and help support people where they want to be - at home with their family around them."

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Wednesday, 20 February 2013

Jeremy Hunt


Jeremy Hunt warns NHS trusts over 'defensive culture'

Gary WalkerGary Walker broke an NHS gagging clause when he spoke to the BBC

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Health Secretary Jeremy Hunt has warned NHS bosses against allowing a culture that is "legalistic and defensive" in dealing with staff who raise concerns over patient care.
In a letter to all English NHS trusts, Mr Hunt highlighted fears that "gagging" clauses were being used to "frustrate" such whistleblowing.
A climate of "openness and transparency" is essential, he said.
It comes after one former NHS trust boss broke a gag to talk to the BBC.
Gary Walker, former chief executive of United Lincolnshire Hospitals Trust (ULHT), said he had been forced out of his job and gagged from speaking out about his concerns over patient safety.
'Positive move'

Analysis

The row over secret gagging clauses has focused attention on the man at the top of the English NHS, Sir David Nicholson.
His position was already being questioned in the wake of a highly critical report on the Mid Staffordshire Hospitals scandal, where hundreds of patients may have died from neglect and abuse.
However Sir David escaped personal censure from inquiry chairman, Robert Francis QC.
Following the report, another 14 NHS trusts have been placed under investigation.
What makes the gagging row potentially so toxic for Sir David is one of those trusts, the United Lincolnshire Hospitals Trust, has been trying to enforce Gary Walker's gagging clauses with the threat of legal action.
Since Mr Walker broke cover, more people are asking whether Sir David and other senior NHS civil servants can bring about the cultural change and openness Jeremy Hunt and many others consider essential.
In his letter, Mr Hunt called for the NHS to "recognise and celebrate" staff who had "the courage and professional integrity to raise concerns over care".
The health secretary insisted that "fostering a culture of openness and transparency" was essential in creating a climate "where it is easy for staff, present and former, to come forward with any concerns they have relating to patient safety".
Mr Hunt also warned NHS bosses against the "institutional self-defence that prevents honest acknowledgement of failure".
"I would ask you to pay very serious heed to the warning from Mid Staffordshire that a culture which is legalistic and defensive in responding to reasonable challenges and concerns can all too easily permit the persistence of poor and unacceptable care," he said.
Mr Walker, who was sacked in 2010 for gross professional misconduct for allegedly swearing in a meeting, told the BBC he had no choice but to sign an agreement linked to a confidentiality clause in April 2011.
He said he was gagged by the NHS from speaking out about his dismissal and his concerns over the quality of care at the trust.
After breaking the order, lawyers for the trust then warned him he would have to repay £500,000.
Speaking to BBC Radio 4's Today programme on Saturday, Mr Walker applauded Mr Hunt for "clearly taking a personal interest" in his case and the issue of gagging orders.
"I think that's a very positive move."
"I don't think it's simply about the Lincolnshire Trust," he added, calling for Mr Hunt to investigate the "chain of command" that led to the gagging, which he said included the Department of Health, the East Midlands Strategic Health Authority (SHA) and the Lincolnshire Trust.
"I don't think Mr Hunt can investigate his own department so I think he should be looking for someone exceptionally independent from all of this."
'Suppressed and bullied'
BBC Radio 4 Today programme reporter Andy Hosken said Mr Hunt's letter could spell the end of the National Health Service gag if the NHS trusts' chairmen to whom he wrote actually followed the advice and guidance contained within the letter.
Our correspondent said the letter was certainly a warning shot across the bows of the trusts. It appeared the use of these gagging clauses was widespread in the NHS, he added.
Meanwhile, Dr Phil Hammond, chief medical correspondent at Private Eye magazine joined calls for NHS chief executive Sir David Nicholson to stand down.
He told BBC News: "We need to change the culture, we have to change the people at the top. David Nicholson has to go and that's the one constructive thing that Jeremy Hunt could do.
"Unless you have accountability at the top, you won't get it at the bottom."
Health Minister Lord Howe: "It is the right and the duty of any NHS employee to raise concerns"
A spokesman for the East Midlands SHA said it had always acted "appropriately and properly" in the "interest of patients".
And ULHT has said the allegations that they had tried to stifle debate about patient safety issues were "incorrect".
ULHT is one of 14 trusts in England currently being investigated for high death rates, in the wake of the Stafford hospital scandal, where hundreds are believed to have died after receiving poor care.
It emerged on Friday that police and prosecutors are now studying a damning report into failures at Stafford to see whether any criminal charges should be brought against staff.

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Saturday, 9 February 2013

Stafford Hospital scandal: Jeremy Hunt calls for police inquiry


Stafford Hospital scandal: Jeremy Hunt calls for police inquiry

Jeremy HuntJeremy Hunt said the police and the General Medical Council should review the evidence
The deaths of patients at Stafford Hospital should be investigated by the police, the Health Secretary has said.
In an interview with the Daily Telegraph, Jeremy Hunt said it was "absolutely outrageous" that nobody had been "brought to book".
Staffordshire Police said it was currently "studying the report's full contents."
It said it had previously investigated two cases at the hospital but found no evidence to bring prosecutions.
"This was a public inquiry that was designed to help us understand why the system didn't pick up what went wrong but I think it is absolutely disgraceful with all those things happening, whether it is doctors, nurses or managers, nobody has been held to account," Mr Hunt told the newspaper.
'Duty of care'
He said that it was not for politicians to decide whether people should be prosecuted but that evidence should be reviewed.
The findings of the public inquiry into failings at Stafford Hospital were published on Wednesday.
Helene DonnellyNurse Helene Donnelly left the hospital trust in 2008
The 12-month inquiry, which cost £13m, came after a higher-than-expected number of deaths at Stafford hospital between 2005 and 2008.
The report by Robert Francis QC strongly criticised hospital managers and the Department of Health.
Helene Donnelly worked as a staff nurse in the casualty department at Stafford Hospital and raised concerns about patient care about 100 times in six years.
She said there had been a culture of neglect at the hospital and that she was in favour of the evidence being looked at.
"As a nurse who went through it and saw some terrible things, I think there does need to be some accountability certainly with some of the nurses I spoke out against," she said.
Staffordshire Police said two cases of misdiagnosis had been formally investigated following patient deaths but no evidence was found to suggest the hospital had been negligent in its care.

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Friday, 12 October 2012

Conservative conference: Jeremy Hunt puts NHS focus on elderly


 Jeremy Hunt puts NHS focus on elderly

NHS staff must become the "best in the world" at looking after the elderly, Health Secretary Jeremy Hunt has told the Conservative Party conference.
In his first major speech since taking on the role in the recent reshuffle, he said it was time to change the culture of the organisation.
Mr Hunt attacked Labour, saying no party had a "monopoly on compassion".
He also praised doctors and nurses as "unsung heroes", but added that the NHS should be "honest about failure".
Mr Hunt, who said his father had worked as an NHS manager and his mother as an A&E nurse and midwife, replaced Andrew Lansley in the cabinet reshuffle last month.
This followed the passing of the Health and Social Care Act, which will give GPs greater power over care budgets via clinical commissioning groups, after abolishing strategic health authorities and primary care trusts.
In his speech, Mr Hunt paid tribute to his predecessor, saying: "If Andrew is the health secretary who helped give us the structures for a modern NHS, I want to be the health secretary who helped transform the culture of the system - to make it the best in the world at looking after older people."
'Common decency'
He added: "Since it was set up in 1948 the NHS has come to symbolise a deeply held belief about what it means to be British: a country fit for heroes where everyone should have a roof over their heads, a school for their children and proper treatment for their family when they're sick.

Analysis

The speech was short. In fact, it was barely 20 minutes long, which is a sharp contrast with the lengthy, policy-heavy speeches made regularly by his predecessor Andrew Lansley.
That in itself is telling about what sort of secretary of state Mr Hunt is likely to be. It is clear Mr Hunt has been brought in to establish a clear and concise message about the government's position on the NHS.
Again and again he talked about improving patient care. His speech was peppered with references to the issue. He mentioned past scandals, such as Mid Staffordshire and Winterbourne View. He talked about making managers accountable for care as well as finances.
He also recognised the wider challenge the NHS faces from an ageing population and the need for better solutions to dementia and social care.
Beyond that there was little detail about how he plans to proceed. But after a health secretary that went after the structure of the NHS, Mr Hunt has his eyes firmly set on its culture.
"That was under the Attlee government. But the NHS does not belong to Labour any more than victory in the second world war belongs to the Conservatives. No party has a monopoly on compassion and it is an insult to common decency for any party to claim it."
Ministers are looking at introducing a cap on the amount for which people are liable when funding their care in old age.
Mr Hunt said: "Last month I visited St Thomas', the hospital where I was born. I met a nurse who had been caring for a dying man who had lost touch with his family 20 years earlier. She searched out the family on Google, found them in Ireland, arranged to fly him back there so he was able to spend his last two weeks reunited with his family.
"So much of the NHS is like that. Unsung heroes who represent the very best of our values.
"But as we celebrate excellence, we must be honest about failure. I'm going to name names now because I don't want anything to be swept under the carpet.
"The shocking failures of care at Mid Staffs where a patient with C-diff was left to lie naked in their own excrement.
"The bullying of a man with Parkinsons at East Surrey hospital. The kicking of disabled residents at Winterbourne View care home. The slapping of an older woman with dementia at Ash Court care home."
Mr Hunt added: "Last month the Royal College of Physicians published a report about the way older people are looked after in our hospitals. It said 'the system continues to treat older patients as a surprise, at best, or unwelcome at worst'. Strong words.
"We have many committed managers in hospitals and care homes. But I need to say this to all managers: you will be held responsible for the care in your establishments. You wouldn't expect to keep your job if you lost control of your finances. Well don't expect to keep it if you lose control of your care."
The conference continues until Wednesday.

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