Saturday, 14 September 2013

Sepsis lives can be saved, says ombudsman

Sepsis lives can be saved, says ombudsman

Bacterial infection of the blood causing sepsisSepsis is a potentially fatal condition caused by the body's immune system overreacting to infection

Related Stories

More must be done to save the lives of patients with sepsis, says a report from the Health Service Ombudsman.
It found significant failings in treatment of the condition, which is caused when the body's immune system overreacts to infection.
It focused on 10 patients who were not treated urgently enough and died.
The National Institute for Health and Care Excellence will produce guidance for GPs and clinicians to help them recognise sepsis at an early stage.
Around 37,000 people are estimated to die of sepsis each year, accounting for 100,000 hospital admissions.
The Ombudsman, who investigates complaints from people who have received poor service from the NHS in England, said diagnosing and treatment presented some real problems because the condition was hard to spot and treat.

'Sepsis was taking over his body'

Jem and wife Karen
Jem Abbotts was 37 years old and recovering from a routine operation when he became ill.
He started vomiting and feeling feverish so the GP prescribed antibiotics and he went to bed to recover.
But a few days later he woke up vomiting and was rushed to hospital in a coma, as his organs began to fail.
He had contracted a bacterial infection which had entered his bloodstream, causing a condition known as sepsis.
Sepsis can lead to swelling and blood clotting - and cause internal organs to stop working.
The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
Julie Mellor, the Health Service Ombudsman, said it was time for the NHS to act.
"In the cases in our report, sadly, all patients died. In some of these cases, with better care and treatment, they may have survived.
"We have worked closely with NHS England, NICE, UK Sepsis Trust and Royal Colleges to find solutions to the issues identified in our report. NICE and NHS England have already agreed to take forward the recommendations of our report.

Start Quote

We know it is not easy to spot the early signs of sepsis, but if we learn from these complaints... then lives can be saved ”
Julie MellorHealth Service Ombudsman
"We know it is not easy to spot the early signs of sepsis, but if we learn from these complaints and work to improve diagnosis and provide rapid treatment, then lives can be saved."
The report recommended improving the recognition and treatment of sepsis by providing medical staff with clear clinical guidance.
She also recommended that NHS England launch a public awareness campaign which targets vulnerable groups of patients, such as those who are weak or in hospital.
Clinical staff should attach more importance to listening to the relatives of patients since they can be the first to recognise the patient's deterioration, she said, and more senior doctors should be involved in patient care.
Charles Turton, clinical advisor with the Health Service Ombudsman: "Patients in the early stages can look quite well"
Simple life-savers
Dr Ron Daniels, chairman of the UK Sepsis Trust, said there was a straightforward solution.

Facts about sepsis

  • Sepsis is a more common reason for hospital admission than heart attack - and has a higher mortality.
  • The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
  • The most common signs of sepsis are a high fever, violent shivering, fainting, cold and pale hands, rapid breathing, confusion or delirium.
  • 37,000 people are estimated to die of sepsis each year in the UK.
  • From the time sepsis first takes hold, healthcare workers have just hours to deliver the right care.
"The best hospitals have achieved better outcomes from sepsis by adopting a simple set of life-saving measures, collectively known as the Sepsis 6, and ensuring that a culture of awareness around sepsis has been created.
"We now need to spread this awareness to other health professionals and to the public, and to underpin this with guidance from NHS England and the National Institute for Health and Care Excellence."
He said the recommendations would potentially save 12,500 more lives every year.
Dr Mike Durkin, NHS England's director of patient safety, said the NHS would use the findings to work with GPs and hospitals to reduce deaths from sepsis.
"This report and guidance will help us to build on the work that is already in place to emphasise the importance of education, early detection and prompt treatment.
"We all need in every setting to understand the importance of identifying deterioration in both adults and children, in reducing the admission of full-term babies to neonatal care and identifying problems in vulnerable older people in the first 48 hours of acute illness."
Dr Peter Carter, chief executive of the Royal College of Nursing, said the report showed the tragic consequences of sepsis.
"It is vital that all staff are provided with training and support to enable them to recognise the signs and symptoms of sepsis, and crucially to know how to act quickly when sepsis is diagnosed."

More on This Story

Related Stories

Wednesday, 21 August 2013

Measles jab claims by Children's Immunisation Centre 'irresponsible

Measles jab claims by Children's Immunisation Centre 'irresponsible'

Measles vaccinationSome 75,868 unscheduled vaccinations were given to people in Wales to control the measles epidemic

Related Stories

A clinic selling separate measles, mumps and rubella vaccines has been told to remove "misleading" claims from its website implying a link between the MMR jab and autism.
Complaints were made about the Cheshire-based Children's Immunisation Centre during the measles outbreak centred on Swansea.
The Advertising Standards Authority (ASA) decided the clinic's language "could have caused fear and distress".
The centre said it had now complied.
One person died and a total of 1,219 measles cases were diagnosed during the Swansea area measles epidemic, which was officially declared over in July.
As part of the response from public health officials, almost 76,000 unscheduled MMR vaccinations were given to people around Wales who had not been immunised in a bid to bring the epidemic under control.
The Children's Immunisation Centre offered single vaccines to parents, running a clinic in Swansea and others in England.

Start Quote

We told Children's Immunisation Centre not to promote prescription-only medicines and to remove claims not supported by objective scientific evidence”
ASA report
In its response to the ASA, the centre said it offered a safe alternative for parents who needed to have their children protected from childhood diseases but did not wish to undergo government or NHS programmes such as the MMR vaccine.
It also argued its website information did not constitute advertising.
But the ASA said because the centre "promoted non-government recommended vaccination and because the overall context of the website focused on their claim that a single MMR vaccination was linked with autism, we considered the language used could have caused fear and distress without justifiable reason and we concluded the website was irresponsible".
Three complainants, including a GP, challenged whether the centre's 100% safety claim could be substantiated, while two said the advert was irresponsible and could cause fear and distress because it appeared during the measles outbreak in south Wales.
The ASA ruled that the website breached regulations because it advertised prescription-only medicines.
The centre told the ASA each of its 20,000 patients had a record card and not one had been hospitalised or had regression, autism or other health issues after vaccination.

SWANSEA MEASLES OUTBREAK

  • Began in November 2012
  • There have been no laboratory-confirmed cases in the affected area since May and the outbreak was cleared over in July
  • Some 75,868 unscheduled vaccinations were given to people around Wales who had not been immunised to control the epidemic
  • In the outbreak area more than 30,000 doses of the MMR vaccine were given
  • GP surgeries administered 16,500 and drop-in clinics have given more than 8,500
  • School and occupational health clinics administered more than 5,300 jabs
But the ASA noted that a sample complaint log supplied by the centre confirmed some children had developed minor and major complications as a result of receiving a vaccination ranging from a rash and high temperature to emergency hospital admission.
The ASA said: "Because Children's Immunisation Centre did not have a 100% safety record, we concluded the claim was misleading."
It added: "We considered the website had probably been live for some time before the outbreak of measles in Wales, during April and May 2013.
"However, we noted two links referenced the Welsh measles outbreak."
The ASA said it had not seen robust evidence that linked a single MMR vaccine with autism, concluding that that website was misleading.
It ruled: "The ad must not appear again in its current form.
"We told Children's Immunisation Centre not to promote prescription-only medicines and to remove claims not supported by objective scientific evidence."
Dr Andrew Wakefield's research linking the MMR jab to autism was published in 1998 has since been entirely discredited.
In a statement to BBC Wales, Zoe Miller from the Children's Immunisation Centre said: "We're now fully ASA compliant, everything that was requested has been taken off the website."

More on This Story

Related Stories

The BBC is not responsible for the content of external Internet sites

Saturday, 17 August 2013

Basic rights of mentally ill

Basic rights of mentally ill 'violated'

Woman holding head in her handsThe cross-party group of MPs is urging Parliament to take action

Related Stories

The basic rights of some mental health patients in England are being "violated" because of a shortage of beds in psychiatric units, MPs say.
The Health Select Committee said there was evidence some people are being sectioned unnecessarily to secure hospital treatment.
It also warned safeguards to protect patients who lack capacity are often ignored.
The charity Rethink said the findings were "shocking".
Changes to mental health laws in 2007 were supposed to ease pressure on psychiatric units by extending the treatment available out of hospital.
Legislation provided for Community Treatment Orders so some people previously detained in hospital could be treated - under supervision - in the community.
But compulsory detention has continued to increase.

Start Quote

It's absolutely shocking that people are being sectioned unnecessarily, just so they can get access to the treatment they are entitled to”
Paul JenkinsRethink
The report said in 2008-09 there were 42,208 detentions in England. By 2011-12 the figure had risen to 44,894.
'Ticket to a bed'
Many wards are at over-capacity. The MPs were told it has become hard to be admitted voluntarily.
One witness said "being detained is the ticket to getting a bed".
Their report said compulsory detention when it was not clinically necessary would be a "serious violation" of civil rights.
It called for an urgent investigation by the Department of Health to establish the prevalence of the practice.
The inquiry also examined safeguards to protect people detained under the Mental Capacity Act. These are often patients in care homes with dementia or severe learning difficulties.
The safeguards include provisions to provide a representative, to offer a right of challenge, and for a regular review of their deprivation of liberty.
The MPs concluded there was "extreme variation in their use" - a situation they describe as "profoundly depressing".
They called for an urgent review of Deprivation of Liberty Safeguards (DOLS) together with an action plan for improvement to be presented to Parliament within 12 months.
Paul Jenkins, from the charity Rethink, said: "It's absolutely shocking that people are being sectioned unnecessarily, just so they can get access to the treatment they are entitled to. Being sectioned, although sometimes necessary, can be extremely distressing and should only be used as a last resort.
"Treatment is much less likely to work if it is imposed on patients against their wishes. Health professionals should be aiming to build a trusting partnership with their patients and to take away their liberty unnecessarily like this, completely undermines that trust."
Dr Julie Chalmers, the Royal College of Psychiatrists' lead for mental health law, said: "We share the committee's concerns over the severe pressure on beds, and believe this is an issue that needs to be urgently addressed.
"However it is also important to ensure that there are a range of effective community services to support people who are in crisis before the need to consider hospital admission arises.

More on This Story

Related Stories

The BBC is not responsible for the content of external Internet sites

Friday, 14 June 2013

multiple failings in the home care

CCTV footage reveals domestic care neglect

Muriel Price and her grandsonMuriel's grandson says he feel guilty for employing the company

Related Stories

The BBC has obtained footage showing multiple failings in the home care provided by a company to one woman - as ministers warn the next abuse scandal may come in the sector.
The videos, recorded by the family of Muriel Price, 83, show carers failing to turn up for visits or turning up late, causing Mrs Price great distress.
The company involved say they were never informed the family had concerns.
They say the care of patients is of paramount importance to them.
Care minister Norman Lamb is hosting a summit with domiciliary care providers and carers on Thursday in an attempt to improve standards within the industry.
Mrs Price's grandson installed two CCTV cameras in her house in Blackpool, Lancashire, to monitor her movements and to provide help should she fall when she was home alone.
'Absolutely disgusting'
Instead they recorded carers failing to turn up when they should and behaving inappropriately on occasions.
One scene shows Mrs Price in great distress prior to her carer arriving. The grandmother, who is incontinent, had been in bed for 13 hours as her carer was nearly one hour late. She had tried and failed to contact her care company, carers, family and neighbours for help.
"Disgusting this is, absolutely disgusting," she is heard to cry out. "It's not good enough, I can't put up with it much longer."
One piece of video shows Mrs Price becoming increasingly distressed as she waits for her carer to arrive
She then quietly sobs before crying out for Les, her husband of 63 years. He was her primary carer prior to his death.
"I'll be here till 12 o'clock until the next one comes along, I bet. It's always the same."
Eventually a carer does appear, 55 minutes late.

Start Quote

Mosaic go above and beyond their legal requirements when employing carers to ensure all staff are capable of delivering quality care to their clients. The care of patients is of paramount importance to Mosaic.”
Mosaic Community Care
In the footage seen by the BBC, which covers a period of nearly a month, carers turn up late or not at all on at least 12 occasions. Several other visits are much shorter than the one hour the carers are contracted for.
While some carers were professional, the footage shows examples of others who clearly were not.
The footage shows one carer sticking her fingers in food to check its temperature, another changes incontinence pads in full view of the street.
'No dignity'
And though Mrs Price is an insulin dependent diabetic with special dietary requirements, one carers admits to not being able to cook. "I can't fry an egg. I am really that rubbish at cooking. Why they send me to people at dinner time; it's beyond me," she can be heard saying.
"The way they treat old people is wrong, just wrong," says Mrs Price, looking back on her experience. "You'd be waiting for your tea and you didn't get any tea cause they never turned up, they never bothered. And you'd ring them up and they'd say we'll be sending someone along but they never did."
Her grandson, Darryl Price, who arranged for the care company to look after Mrs Price, looks back with regret.
"To see someone in your family treated with no respect, no dignity, you question yourself and in a way you feel guilty. You're the one who's put that home care company in there, you've trusted this company to look after them."
Another clip captures examples of poor care - including this carer, who was later disciplined by the company, who 'mooned' at the camera
The BBC showed the footage to Norman Lamb ahead of his meeting with domiciliary care providers and carers. He said the current system resulted too often in poor care, low wages and neglect.
"It's just shocking and depressing because this is neglect in your own home," said Mr Lamb in reaction to the videos.
Talking about the wider domiciliary care sector, he went on: "We know this is not an isolated case. There is some very good care, and we should celebrate that, but where poor care exists we should not tolerate it."
He later told BBC News: "In a way you're almost at your most vulnerable when it's behind a closed door, it's you and a care worker and potentially poor things, dreadful things can happen in those circumstances."
He said a number of companies were failing to provide a complete service and all too often councils were taking part in a "race to the bottom", choosing the cheapest bid when awarding contracts.
Norman Lamb: "I want to shine a spotlight on this whole sector"
The company who provided Mrs Price's care is Mosaic Community Care, based in Preston. The family say they repeatedly contacted the company with their concerns and have provided phone records to the BBC which indicate that calls were made.
But in a statement, Mosaic said it was an award-winning care provider.
It went on: "At no time were any issues raised with Mosaic by the family. Any concerns would have been dealt with via the appropriate channels.
"Mosaic go above and beyond their legal requirements when employing carers to ensure all staff are capable of delivering quality care to their clients. The care of patients is of paramount importance to Mosaic."
Referring to the telephone records, it says: "The length of a call does not provide conclusive evidence as to the content of the call."
Muriel Price is now happily living in a care home. "I'm lucky I have a family to look after me," she says. "Those that haven't got a family, God help them, poor devils."

More on This Story

Related Stories

Thursday, 6 June 2013

Minister Anna Soubry backtracks on women GPs 'burden'

Minister Anna Soubry backtracks on women GPs 'burden'

Female doctorAre women a "burden" on the NHS?

Related Stories

There are "unintended consequences" for the NHS of training and employing women as GPs, Health Minister Anna Soubry has said in Parliament.
She was responding to a question about the "burden" of female doctors marrying and starting families.
The head of the Royal College of GPs said it was wrong to blame women doctors for problems in the NHS.
Ms Soubry later said her comments were not meant to be "derogatory" and the answer was to hire more GPs.
During a debate in Westminster Hall, Conservative MP Anne McIntosh, said: "It's a controversial thing to say, but perhaps I as a woman can say this - 70% of medical students currently are women and they are very well educated and very well qualified.
"When they go into practice and then in the normal course of events will marry and have children, they often want to go part-time and it is obviously a tremendous burden training what effectively might be two GPs working part-time where they are ladies.
"And I think that is something that is going to put a huge burden on the health service."
In response, Ms Soubry said: "You make a very important point when you talk about, rightly, the good number of women who are training to be doctors, but the unintended consequences."
Dr Clare Gerada, the chair of the Royal College of General Practitioners, took to Twitter to say: "I cannot believe that women doctors are being blamed for problems in NHS."
In a statement later, Anna Soubry clarified her remarks saying she had "not intended to be derogatory" and was responding to a point made by another MP during the debate.
"The solution is that we need to increase the number of GPs and we are doing that.
"This government supports good working practices such as flexible working, job-sharing and part-time working which help retain female doctors.

Featured post

More patients in Scotland given antidepressants

More patients in Scotland given antidepressants 13 October 2015   From the section Scotland Image copyright Thinkstock Image ca...