Friday, 11 January 2013

the CQC had still failed to grasp its primary role to ensure patient safety.


Health regulator problems 'persist'

By Nick TriggleHealth correspondent, BBC News
Surgeons operatingThe commission monitors hospitals and care homes

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The health and care regulator for England has yet to win the public's confidence, according to a report by a committee of MPs.
The Care Quality Commission (CQC) was only created in 2009 but has been under fire virtually ever since.
The House of Commons' Health Select Committee said the CQC had still failed to grasp its primary role to ensure patient safety.
Previous reports have found recruitment problems have meant the quantity and quality of inspections have suffered.
Now the new review by the cross-party group said despite some recent improvements it was was not yet back on track.
Eighteen months ago the committee had produced a report which said the CQC had developed a "tick-box culture" and lost sight of its main role - to protect patients.
The report prompted Prime Minister David Cameron to criticise the organisation and this was followed by another attack by the National Audit Office a year ago and an official performance review by the Department of Health.
Its work also came under scrutiny after abuse at the Winterbourne View residential home near Bristol came to light.
Since then the CQC has lost its chief executive, while its chair is due to leave soon.
Public confidence
The MPs acknowledged the organisation was now aware of the changes it had to make, while new inspectors have been taken on.
But the committee said the CQC had not yet successfully defined its core purpose or earned public confidence.

“Start Quote

We will ensure that openness and transparency are at the heart of the way we develop”
David BehanCare Quality Commission
It suggested its inspections needed to be more challenging and that when problems were identified ensure providers of care were addressing them rapidly.
Committee chairman Stephen Dorrell said: "The CQC's primary focus should be to ensure that the public has confidence that its inspections provide an assurance of acceptable standards in care and patient safety.
"We do not believe that the CQC has yet succeeded in this this objective."
David Behan, the CQC's new chief executive, said the regulator had carried out a strategic review and was in the process of making changes.
"We will ensure that openness and transparency are at the heart of the way we develop.
"We are focused on protecting and promoting the health, safety and welfare of people who use health and care services."
Mike Farrar, chief executive of the NHS Confederation, which represents health managers, said feedback from his members showed many did not have confidence the CQC would be fit for purpose this year.
But he said the new leadership at the regulator had brought "strong expertise" for the future.
"It is in everybody's interest to have a strong and respected regulator for health and social care in place," he added.

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Saturday, 5 January 2013

Labour


Consider tougher regulation in obesity fight - Labour


Man eating a hot dogBy Adam BrimelowHealth Correspondent, BBC News
Are legal limits on the fat, salt and sugar content of food needed?

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Labour has urged the government to consider introducing legal limits on sugar, salt and fat-content in food.
The party says the coalition's emphasis on voluntary agreements with industry is not working.
It is starting a consultation on how to tackle obesity.
The Department of Health in England says its Responsibility Deal with food companies shows the voluntary approach can be successful.
At its core this is an argument about how best to reduce levels of fat, sugar and salt in our food - through regulation, or collaboration.
The coalition says working with industry through the Responsibility Dealhas improved food content and labelling.
But Labour argues the government has failed to come up with a convincing plan to tackle rising obesity rates.
Shape the rules
Its consultation paper Children, Food and Obesity says parents are primarily responsible for ensuring their children eat healthily, but it argues that government also has a crucial role.

Which foods should be regulated?

Nutritionist Amanda Ursell highlighted five foods that she says could benefit from regulation:
  • Breakfast cereals: to reduce high sugar content
  • Fruit juice drinks: these are drinks which are not pure fruit juice and can have added sugar - but are confusing to spot among pure fruit juice products
  • Ready meals: regulation would stop some brands adding too much salt
  • Crisps: caps could reduce salt levels
  • Biscuits, cookies and cakes: manufacturers might be encouraged to rethink levels of fat
It says that means "shaping the rules of the system" to help parents who are trying to do the right thing.
The paper cites recent data NHS data indicating that one third of children in England are either overweight or obese by the time they leave primary school. It says this puts them at greater risk than ever before of developing serious problems such as diabetes and cancer.
Shadow health secretary Andy Burnham says the government's response - working with industry through its Responsibility Deal - has been complacent.
"It is clear that the current voluntary approach is not working. We need to open our minds to new approaches in tackling child obesity."
He says it is time for "new thinking" on how to tackle child obesity.
"Labour wants to lead this debate. That is why we are asking the public and experts if new limits for sugar, fats and salts would be the right approach."
The party says measures could include a 30% cap on sugar content in cereals aimed at children - significantly lower than in several well-known brands.
The consultation will also consider tighter restrictions on marketing and improving access to healthy food.
Healthier choices
The Department of Health in England says the Responsibility Deal has succeeded in cutting fat, sugar and salt in foods.
A spokesperson said: "Our successes so far clearly demonstrate that the voluntary approach can work and we now have over 400 partners in the responsibility deal.
"We are working to reduce the amount of salt in food further, cut saturated fat consumption and we are exploring how to promote healthier food choices more widely. We also want more businesses making pledges so we get bigger results ."
The Food and Drink Federation also said collaboration between business and government had been a success.
"Through voluntary commitments, manufacturers have made significant progress in reducing salt, saturated fat and calories in their products. Salt levels have reduced 9% since 2006 and some manufacturers have introduced calorie caps in particular for snacks and soft drinks."
However, former regional director of public health, Professor Gabriel Scally, said the voluntary "collaboration" between food companies and the government was not working.
Speaking to the BBC he said: "I don't anyone in this country actually thinks that the food industry are the right people to decide what we should be eating."
Professor Nick Finer, who co-authored a recent report on obesity by the Royal College of Physicians, said legislative measures had already worked in other European countries.
"In French schools food and drink is controlled and all marketing of foods high in fat, sugar and salt is banned unless they are taxed and marketed with a health warning.
"Studies have shown that following these measures, the number of overweight children in France has dropped from 18.1% in 2000 to 15.5% in 2007."
Nutritionist Amanda Ursell said introducing legal limits on food could be "incredibly useful" if it meant "manufacturers are encouraged to reformulate their products" and market in "a responsible way".
Speaking to BBC News she said: "Children's food up to the age of one is closely regulated - so you know they won't have too much sugar, salt or fat. But at the age of one those regulations disappear.
"It's a slow process and the food industry has done quite well over the years, but this would be an extra incentive to go one stage further."
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Tuesday, 1 January 2013

Public health minister Anne Milton: "We're too fat and we need to do something about it"

Global governments 'must get tough on obesity'
They said changes in society meant it was getting harder for people to live healthy lives.Tougher action - including taxing junk food - is needed by all governments if the obesity crisis is going to be tackled, experts say.
Body fat being measured using callipers.The international group of researchers, who have published a series of articles in The Lancet, said no country had yet got to grips with the problem.
Obesity-related problems, such as diabetes, were now accounting for between 2% and 6% of health care costs in most countries.
Rising spending
But as one of the articles showed, this is likely to get worse if current trends continue.
Researchers made projections for the US and the UK - two of the developed countries with the worst rates of obesity.
They predicted obesity rates would rise from a quarter in the UK to about 40% by 2030.
Such a scenario would cost the NHS an extra £2bn a year - the equivalent of 2% of health spending.
The rise in costs would be even greater in the US, where obesity rates would rise from one in three to about one in two.
The researchers accepted that the whole of society - from the individual to industry - had a role to play in tackling the problem.
But they said governments needed to take a lead by using legislation and direct intervention to create a better environment.
They said many measures - including taxes on unhealthy food, restrictions on junk food advertising, traffic light labelling and school-based education programmes - would save money as well as benefit health.

OBESITY MEASURES

CategorySaves moneyMinor costHigher cost
SOURCE: THE LANCET
FOOD
  • Tax junk food
  • Limit junk food ads
  • Traffic light labelling
  • Cost benefit category
LIFESTYLE
  • Discourage kids from TV
  • Exercise and healthy eating at school
  • Work with obese children
  • Help families with overweight children
  • School walking trains
TREATMENT
  • Surgery for obese teenagers and adults
  • Weight loss drugs
Others, such as providing obesity surgery and health programmes aimed at families with overweight children, would come with a minor cost although should still be looked at.
Oxford University expert Professor Klim McPherson, who was one of the lead researchers, said: "It is about changing the environment in which people live so they can make healthier choices."


But he said too many countries shied away from taking the right action and urged a forthcoming UN summit on health in September to "show leadership" by putting pressure on governments to act.
In particular, he criticised the government in England, which has been focusing on voluntary agreements with industry rather than legislation.
He said ministers were "enfeebled by their ideology" and too worried about accusations of the nanny state.
"They have this idea that government action in this sphere would not be a good idea," he added.
Professor Boyd Swinburn, who is based in Australia and works for the World Health Organization, agreed governments had been too slow to act on the "obesity crisis".
"There is more willingness to invest in drugs and surgery than dealing with the underlying causes."
He also compared the tactics of the food industry - in terms of getting people addicted to their products and in blocking attempts to discourage consumption - to those of tobacco firms in previous decades.Dr Frank Atherton, president of the Association of Directors of Public Health, also said he was in favour of the interventions being suggested: "Of course we have to work with industry, but there is a feeling that the emphasis of this government has turned too far away from legislation."
However, Terry Jones, of the Food and Drink Federation, said the industry had been taking positive steps.
"The Lancet fails to recognise the lengths to which the UK food and drink industry has gone to help improve the health of the nation, particularly in relation to rising obesity levels," said Mr Jones.
Public health minister Anne Milton said the government believed the best way to achieve results was through a "collective voluntary effort".
She said this was achieving results, citing the pledge by industry to put calorie information on menus.


"We have no current plans to impose a 'fat tax', but we are working with food companies to reduce fat, sugar and salt and ensure healthier options are available.
"We also want to see businesses use more consistent and informative front-of-pack nutrition labelling than has been achieved in the past," she added.
"We recognise the significant threat that obesity poses to society and have taken a proactive part in improving health."

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Of course we have to work with industry, but there is a feeling that the emphasis of this government has turned too far away from legislation”
Dr Frank AthertonAssociation of Directors of Public Health
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hospitals in particular had "poorly developed" systems in place.


Obesity: NHS approach 'extremely patchy'

By Nick TriggleHealth correspondent, BBC News
obese manThe NHS has a "poorly developed" approach to tackling obesity, the college said

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Obesity services across the UK are "extremely patchy" and valuable opportunities to help obese patients are often lost, doctors say.
The Royal College of Physicians said hospitals in particular had "poorly developed" systems in place.
Its report said the problems meant services were often just dealing with the symptoms, such as heart disease or diabetes, rather than the cause.
There needed to be a rethink over how to approach the problem, it added.
The UK is now among the most obese nations in the world.
One in four adults are obese - a figure which is predicted to more than double by 2050.
Wide variations
The report recognised that attempts were being made to stem the tide of obesity through health promotion campaigns.
But it said that should not detract from the fact the NHS had to do more to deal with those patients who were already obese.

“Start Quote

The only way we will ever tackle the problems caused by obesity is by everyone working together”
Professor Lindsey DaviesFaculty of Public Health
The report pointed out there were wide variations in the way obesity was treated across the UK - particularly in the frequency with which obesity surgery is performed.
It said there needed to be a much more "joined up" approach between hospitals and community services.
To help hospitals should also appoint a doctor to lead on obesity, it added.
Prof John Wass, from the RCP, said: "'Britain is getting bigger and whilst we try to prevent the increase in obesity, we must also prepare the NHS for the influx of patients presenting with severe complex obesity.
"A patient may arrive at my hospital with coronary heart disease, but if the root cause of their condition is obesity, we must be equipped to deal with that root cause."
Working together
Prof Lindsey Davies, president of the Faculty of Public Health, welcomed the recommendations and said she agreed greater coordination was needed.
"The only way we will ever tackle the problems caused by obesity is by everyone working together," she added.
But she also urged the government to be more proactive by addressing some of the wider determinants of obesity.
"Obesity is not only caused by how much we each eat or drink: if tackling it were as simple as telling people to eat less and move more, we would have solved it by now.
"Our chances of being obese are also affected by factors like whether we have easy access to affordable fruit, veg and other healthy foods, and if it safe to let our kids play outside."
A Department of Health spokesman acknowledged the medical profession had a "key role to play".
He added: "We are committed to tackling obesity and are taking action to help people keep a healthy weight and prevent them needing hospital care for obesity related conditions."

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Monday, 31 December 2012

Bristol heart surgery


Mother holds heart babies protest in Bristol

Marie EdwardsMarie Edwards founded the Fragile Angels group to raise awareness of safe children's heart surgery

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A mother whose baby died during the Bristol heart surgery scandal in the 1990s has staged a peaceful protest.
Marie Edwards has marked what would have been her daughter Jazmine's 20th birthday with a demonstration outside Bristol's children's hospital.
She is calling for improvements at the hospital after a damning report from the Care Quality Commission in October.
The NHS Trust said it had "responded immediately" to the CQC inspection and awaited results from a further visit.
The CQC report found the trust had failed to meet safety standards for staffing levels, training and support, and patient welfare.
Following the inspection the trust announced it was to reduce the number of heart operations carried out at the children's hospital.
'Fears'
This has added to the concerns of Miss Edwards, from Rimpton in Somerset, who believes that tighter checks on the results of child heart surgery in Bristol and at other specialist units, are needed.
Her daughter Jazmine died in June 1993 five-and-a half-months after heart surgery at the Bristol Royal Infirmary.
Ten years later a report concluded that between 30 and 35 children who underwent heart surgery at the hospital between 1991 and 1995 died unnecessarily as a result of sub-standard care.
baby Jazmine EdwardsJazmine Edwards died in June 1993, five-and-a half-months after heart surgery
Miss Edwards went on to found the group Fragile Angels which aims to raise awareness about children's heart surgery.
"The reason that I am campaigning on this day, at this location, is due to my fears that this hospital is still losing too many lives," she said.
"We need real time audits whereby death and survival data should be processed and made public to ensure a safety net and flag up any units which have had a high death rate to ensure needless life is not being lost.
"My choice hasn't been an easy one to undertake on this day, I'm not here to criticise this hospital lightly, my wishes are for this hospital to correct their failings and regain their trust with the public."
'Among the best'
The University Hospitals Bristol NHS Trust responded saying it had had remained in communication with families and was seeking to address their concerns "to the best of its ability".
Chief executive Robert Woolley said: "All paediatric cardiac surgery carries with it significant risk and these risks are explained to parents.
"Despite these risks and the complex needs of the children we care for, we have results among the best in England.
"Since 2009, a national review of children's congenital heart services has taken place which rigorously assessed the quality of care in existing centres.
"In July of this year, it was announced that the Bristol children's hospital will be designated as one of seven specialist surgical centres in England."

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