Thursday 14 November 2013

Birmingham children's services takeover warning

Birmingham children's services takeover warning


Keanu Williams died in January 2011 after being found with 37 injuries

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Children's services at Birmingham City Council could be taken over by the Department for Education before Christmas if standards do not improve.
The takeover will happen if Ofsted inspectors do not see improvements when they return later this month.
The department is the biggest of its kind in England and has been rated as "inadequate" for four years.
Department head Peter Hay said the city council had to be involved in its running but there were no easy answers.

Analysis

The moment of reckoning for Birmingham is near. There has been a clamour for years from some campaigners for Whitehall to do something, but that is far easier said than done.
Earlier this year, Mr Gove announced he was to create an independent trust to run Doncaster's equally-troubled child protection services. But the model has now been watered down amid concerns about accountability and potential legal challenges.
Birmingham is far, far larger and there simply isn't a ready-made solution out there. It would be a brave private company that would approve running services in a city with nearly 2000 children in care and 300,000 young people living here.
Anything can happen at any time. And any contract would need to have a lot of zeros at the end of it, which is money the government probably doesn't have. So while the problems are clear, the solution is anything but.
Earlier this week, Michael Gove signalled a significant shift in direction in the way his government will deal with failing child protection services.
He suggested in a speech that more children's services departments could be taken over - in the same way that Doncaster began the process earlier this year.
Doncaster children's services is set to be taken out of council control, with the services to be run by an independent trust, in the mean time the council is working with a management consultancy firm to improve its services.
There have been a number of high-profile child deaths in Birmingham in recent years, including those of Khyra Ishaq in 2008 and Keanu Williams in 2011.
Rebecca Shuttleworth is serving a life sentence for murdering Keanu after he was found with 37 injuries at his home in Ward End, Birmingham in January 2011. A serious case review concluded last month there were "a number of significant missed opportunities" to save the two-year-old.
Khyra died aged seven in 2008 after being starved at her home in the Handsworth area of the city. Her mother, Angela Gordon, 35, and her ex-partner Junaid Abuhamza, 31, were jailed in 2010 for her manslaughter.

Khyra Ishaq weighed just 2st 9lb (16.5kg) when she was discovered at her home in 2008
'National disgrace'
Birmingham children's services has been rated as inadequate by Ofsted since 2009.
Mr Hay, who took over as head of the department in July, said shortly after starting that improvements had not been made and he could not guarantee the safety of children in the city.

Analysis

Is a government takeover of Birmingham's children's services the best solution for its problems?
Firstly, there is not a fully-tested or functioning model as only a couple of councils have had the control of their children's services taken away.
Even in the case of Doncaster Council, the most advanced case where the government has stepped in, the takeover is more of a half-way house.
An independent management consultancy runs the department but Doncaster retains responsibility for commissioning out services.
This is because a change in the law is required to enable a third party - not the local authority - to issue the life-changing court orders that take a child away from their parents and place them in care.
The education secretary says he is planning more intervention in struggling authoritie, and considering allowing successful authorities to innovate by commissioning outside organisations such as social worker practices.
So perhaps the dawn of fully privately-run children's services is nearer than we thought.
Last month Ofsted chief inspector Sir Michael Wilshaw said the city's failure to protect vulnerable children was a "national disgrace".
A spokesman for the DfE said it had warned the council that unless Ofsted identified signs of improvement in its next inspection in the coming weeks it would have to take further action.
Speaking to BBC Radio 4's Today programme, Mr Hay said the department was "very clear that performance is inadequate" and it had been trying to establish a greater transparency so it could "get governance right of how we improve services".
He said there should be a role for the city council because it could "bring the relationships and the money and the investment".
"But it can't do what it's always done and I absolutely respect that the secretary of state has a very difficult decision," he said.
The key was having "enough social workers to do great social work" but his department currently had vacancy rates for qualified staff of more than a quarter and experienced supervisors of more than a third, he added.
"I've heard people thinking about jobs say that they've been told not to come to Birmingham because it's a blot on their CV. I think that's unacceptable," Mr Hay said.
Computer-generated image showing four injuries to Keanu's headA computer-generated image shows some of the injuries inflicted to Keanu's head
He said social care involved many "risky decisions" and "fine calls".

Key dates in 'failing' social services

  • May 2008: Khyra Ishaq, seven, dies after months of abuse by mother and mother's ex-partner
  • Feb 2009: Council served with improvement notice by government
  • Feb 2010: High Court judge rules Khyra "might still be alive if had not been failed by social services"
  • July 2010: Serious case review says Birmingham social services is still failing to protect vulnerable children
  • Oct 2012: Ofsted inspection shows council's child protection services are "inadequate"
  • Feb 2013: Report reveals 431 children's services staff were on long-term sick leave in 2012
  • Oct 2013: Serious case review finds opportunities missed to save two-year-old Keanu Williams, who was beaten to death by his mother
  • Oct 2013: Ofsted singles out city for criticism for 23 serious case reviews over past seven years
  • Nov 2013: Council says children's services budget to be protected despite £600m cuts from budget over six years
  • Nov 2013: BBC learns council could be taken over if standards do not improve
"We sometimes expect people to have had a crystal ball. All I'm expecting them to have done is to have made a judgement - an analysis of the information - and to live with that risk," he added.
Khalid Mahmood, Labour MP for Birmingham's Perry Barr constituency, said the takeover warning was a "complete and utter political move" by the government.
"If they are going to do it they should just do it instead of making leaks and threats," he told BBC Radio 5 live.
He said the government could instead look at devolving the department to constituency level, as there were some constituencies with more than 100,000 people.
With a population of 1.1 million, Birmingham is the British city with the most residents outside London.
Former Tory MP Tim Loughton said he had visited Birmingham more times than any other authority when he was children's minister and the major problem was "the city was in denial about the extent of the problem".
He said Birmingham had to contend with challenges such as its size and its ethnic diversity, as well the the lack of consistent leadership with four leaders in as many years.

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Listen to The Report, broadcast on BBC Radio 4 on Thursday 14 November at 20:00 GMT
Sue White, a professor of social work at Birmingham University, said the city would "not get better simply by being shamed by Ofsted inspections".
"In my view that process has made the patient sicker. The medicine is killing the patient," she said.
Tony Rabaiotti, of Unison West Midlands, said the idea that the Department for Education "could do a better job than the people on the ground" was "ridiculous" and the move was "purely ideological".
In 2010, Birmingham was ranked 13th in a government list of deprived areas, behind authorities such as Hackney and Tower Hamlets in London.

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Sunday 10 November 2013

NHS spends £700 on negligence cover for every birth

NHS spends £700 on negligence cover for every birth

New mother Amanda McDonald: "People need support when they're in a vulnerable situation"

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The NHS spends nearly £700 on clinical negligence cover for every live birth in England, a report says.
The review by the National Audit Office said last year this cost nearly £500m - almost a fifth of all spending on maternity.
Public Accounts Committee chairwoman Margaret Hodge said the figure was "absolutely scandalous".
The Department of Health said the NHS is one of the safest places in the world to have a baby.
Having a baby is the most common reason for admission to hospital in England.
The number of births has increased by almost a quarter in the last decade, reaching nearly 700,000 live births.
The public spending watchdog said maternity services were generally good for women and babies, but there was still a lot of scope for improvement.
Its report highlighted "wide unexplained variations" between trusts in rates of complications such as readmissions, injuries and infections.
Laura Blackwell, director of health value for money studies at the National Audit Office, told the BBC the number of maternity claims had risen significantly in recent years.
Speaking to BBC Radio 4's Today programme, she said: "There has been an increase in claims and we don't cover exactly why. It is the same across the NHS.
"I think it's a complicated picture... further complicated by the fact it takes an average of four years for a claim to be settled... so it's quite hard to draw conclusions about the current state of care."
Clinical negligence
Dr Daniel Poulter, health minister: "The cost of an individual claim can be very high"
The NAO also pointed to a shortage of midwives and consultants on labour wards. The report concluded that a further 2,300 midwives are required, though their distribution across England varies substantially.
And although it said the level of consultant presence has improved, more than half of units are not meeting the standard recommended by the Royal College of Obstetricians and Gynaecologists.
The report noted that between April and September last year more than a quarter of maternity units were closed to admissions for at least half a day because demand outstripped capacity.
Clinical negligence claims for maternity have risen by 80% in the last five years. The cost of cover last year was £482m, and the average payment per claim was £277,000.
Figures from the NHS Litigation Authority released last year showed the health service in England paid out more than £3bn in compensation claims linked to maternity care between 2000 and 2010.

Start Quote

We are many thousands of midwives short of the number needed to deliver safe, high quality care”
Cathy WarwickRoyal College of Midwives
Ms Hodge said: "I find it absolutely scandalous that one fifth of all funding for maternity services, equivalent to around £700 per birth, is spent on clinical negligence cover."
She said the NAO report had shown an urgent need to improve maternity services.
"The department needs to buck up and take responsibility for this. It needs to review its monitoring and reporting process to ensure that all relevant bodies can work effectively together to deliver maternity services that are value for money and fit for purpose."
James (not his real name), a recipient of medical negligence money, told the Today programme the money had helped give his son a better quality of life.
He and his wife did not claim for negligence until six months after the birth of their son, when they realised the costs involved in his care. Their son had been starved of oxygen during birth and now suffers from quadriplegic cerebral palsy, severe brain damage, visual impairment and epilepsy.
Health Minister Dr Dan Poulter said the health service should always learn from any mistakes to improve patient care in the future.
"The NHS remains one of the safest places in the world to have a baby, but on rare occasions care falls below acceptable standards and unsafe care should never be tolerated."
Jacque Gerrard, Royal College of Midwives: "The system is creaking"
He said the service was making progress.
"This report shows that most women have good outcomes and positive experiences of maternity care. We know 84% of women now say they have good care, which has gone up from 75% six years ago. But we are determined to improve further."
Royal College of Midwives chief executive Cathy Warwick said the report backed up what the college had been saying for a long time.
"We are many thousands of midwives short of the number needed to deliver safe, high quality care. Births are at a 40-year high and other figures out this week show that this is set to continue. As the report states, births are also becoming increasingly complex putting even more demands on midwives and maternity services."
Royal College of Obstetricians and Gynaecologists president Dr David Richmond said the NAO report raised valid concerns.
"Although the UK is generally a safe place for women to give birth, we have known for some time that pressure on maternity services is growing in some areas, particularly inner city conurbations, placing stress on clinicians, managers and patients alike."

More on This Story

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Friday 8 November 2013

NHS spends £700 on negligence cover for every birth

NHS spends £700 on negligence cover for every birth



Baby's handThere are wide unexplained variations between trusts, the report says

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The NHS spends nearly £700 on clinical negligence cover for every live birth in England, a report says.
The review by the National Audit Office said last year this cost nearly £500m - almost a fifth of all spending on maternity.
Public Accounts Committee chairwoman Margaret Hodge said the figure was "absolutely scandalous".
The Department of Health said the NHS is one of the safest places in the world to have a baby.
Having a baby is the most common reason for admission to hospital in England.
The number of births has increased by almost a quarter in the last decade, reaching nearly 700,000 live births.
The public spending watchdog said maternity services were generally good for women and babies, but there was still a lot of scope for improvement.
Its report highlighted "wide unexplained variations" between trusts in rates of complications such as readmissions, injuries and infections.
Laura Blackwell, director of health value for money studies at the National Audit Office, told the BBC the number of maternity claims had risen significantly in recent years.
Speaking to BBC Radio 4's Today programme, she said: "There has been an increase in claims and we don't cover exactly why. It is the same across the NHS.
"I think it's a complicated picture... further complicated by the fact it takes an average of four years for a claim to be settled... so it's quite hard to draw conclusions about the current state of care."
Clinical negligence
The NAO also pointed to a shortage of midwives and consultants on labour wards. The report concluded that a further 2,300 midwives are required, though their distribution across England varies substantially.
And although it said the level of consultant presence has improved, more than half of units are not meeting the standard recommended by the Royal College of Obstetricians and Gynaecologists.
The report noted that between April and September last year more than a quarter of maternity units were closed to admissions for at least half a day because demand outstripped capacity.
Clinical negligence claims for maternity have risen by 80% in the last five years. The cost of cover last year was £482m, and the average payment per claim was £277,000.
Figures from the NHS Litigation Authority released last year showed the health service in England paid out more than £3bn in compensation claims linked to maternity care between 2000 and 2010.

Start Quote

We are many thousands of midwives short of the number needed to deliver safe, high quality care”
Cathy WarwickRoyal College of Midwives
Ms Hodge said: "I find it absolutely scandalous that one fifth of all funding for maternity services, equivalent to around £700 per birth, is spent on clinical negligence cover."
She said the NAO report had shown an urgent need to improve maternity services.
"The department needs to buck up and take responsibility for this. It needs to review its monitoring and reporting process to ensure that all relevant bodies can work effectively together to deliver maternity services that are value for money and fit for purpose."
James (not his real name), a recipient of medical negligence money, told the Today programme the money had helped give his son a better quality of life.
He and his wife did not claim for negligence until six months after the birth of their son, when they realised the costs involved in his care. Their son had been starved of oxygen during birth and now suffers from quadriplegic cerebral palsy, severe brain damage, visual impairment and epilepsy.
Health Minister Dr Dan Poulter said the health service should always learn from any mistakes to improve patient care in the future.
"The NHS remains one of the safest places in the world to have a baby, but on rare occasions care falls below acceptable standards and unsafe care should never be tolerated."

Jacque Gerrard, Royal College of Midwives: "The system is creaking"
He said the service was making progress.
"This report shows that most women have good outcomes and positive experiences of maternity care. We know 84% of women now say they have good care, which has gone up from 75% six years ago. But we are determined to improve further."
Royal College of Midwives chief executive Cathy Warwick said the report backed up what the college had been saying for a long time.
"We are many thousands of midwives short of the number needed to deliver safe, high quality care. Births are at a 40-year high and other figures out this week show that this is set to continue. As the report states, births are also becoming increasingly complex putting even more demands on midwives and maternity services."
Royal College of Obstetricians and Gynaecologists president Dr David Richmond said the NAO report raised valid concerns.
"Although the UK is generally a safe place for women to give birth, we have known for some time that pressure on maternity services is growing in some areas, particularly inner city conurbations, placing stress on clinicians, managers and patients alike."

More on This Story

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Sunday 3 November 2013

Minority girls less likely to have cervical cancer jab

Minority girls less likely to have cervical cancer jab

Nurses vaccinating a girl with the HPV jabThe HPV vaccine is offered to all 12 to 13-year-old girls

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Girls from black and Asian ethnic minorities are less likely to be vaccinated against cervical cancer, research suggests.
In a survey by University College London of 2,000 teenagers from 13 London schools, unvaccinated girls also said they would be less likely to go for a smear test when adults.
The HPV vaccine is offered to all girls aged 12-13 in schools across the UK.
Girls who are not vaccinated have an increased risk of cervical cancer.
Sara Hiom, Cancer Research UK's director of early diagnosis, said it was important that as many girls as possible were protected.
"It's vital that girls, along with their parents, understand the importance of both these programmes, which are designed to prevent cancer from developing.
"As well as cervical cancer, research has shown that HPV also increases the risk of developing other cancers, such as some types of mouth, head and neck cancers, anal cancer and other genital cancers."
'Knowledge about the disease'
The HPV vaccine was introduced in the UK in 2008, with a national vaccination programme for girls in Year 8 at school. To be fully protected, girls need to receive three doses of the vaccine within six months.
Cervical cancer is largely preventable through vaccination against HPV, the virus that causes it, as well as cervical screening in adulthood, which picks up any problems early.

Start Quote

We need to understand the reasons for ethnic inequalities in uptake, as well as working to ensure that unvaccinated women understand the importance of cervical screening”
Dr Jo WallerUniversity College London lead researcher
In the UCL survey, 85% of white girls said they had received the three doses, compared with 78% of Asian, 74% of "other" ethnicity and 69% of black girls.
The findings, being presented at a National Cancer Research Institute conference in Liverpool, also revealed there was no link between the vaccine status of the girls who were surveyed and their level of sexual activity.
Laura Marlowe, a researcher at UCL, said religious beliefs could have a part to play in the lower uptake figures for Asian girls but they could not explain the figures for the black girls.
Dr Jo Waller, lead researcher at UCL, said more research was needed to find out why there was a difference between ethnic groups.
"We need to understand the reasons for ethnic inequalities in uptake, as well as working to ensure that unvaccinated women understand the importance of cervical screening."
Jo's Cervical Cancer Trust has carried out research into awareness of cervical cancer among ethnic minority groups and charity director Robert Music said its results showed "a clear difference in levels of knowledge about the disease and ways to prevent it".
Pre-cancerous changes
He said: "Less than half of black and minority ethnic women knew the human papillomavirus causes cervical cancer."
The findings also showed that a third more black and minority ethnic than white women said they had never attended a cervical screening appointment.
Around five million women are invited for cervical screening in England each year when a smear test looks for pre-cancerous changes in the cells lining the cervix.
The tests are routinely offered to women aged 25 to 64.
In Scotland, the age at which women are first offered a cervical screening test will be raised from 20 to 25 in 2015.
From September, women in Wales are now being invited for smear tests when they reach 25. This is because research concluded that screening women under 25 was not an effective way of preventing cervical cancer.

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Saturday 2 November 2013

Improve your food or close, hospitals told

Improve your food or close, hospitals told

HOSPITALS and care homes will be forced to improve their food under plans to give a new watchdog powers to monitor nutrition.
By Louise Barnett
Consumer Editor

They could even be threatened with closure if found persistently failing to provide decent food.
The move follows the _
Daily Express Respect for the Elderly campaign highlighting the poor quality of hospital food.
DAILY
EXPRESS

CRUSADE

The number of patients discharged from hospital suffering malnutrition has risen dramatically since Labour came to power.

A total of 139,127 were discharged malnourished in 2006-07, an 84 per cent increase on 1997-98.
Now Ministers are consulting on including hospital and care home food under the new Care Quality Commission’s remit.
Health Minister Ben Bradshaw said: “A good, varied diet is all the more important when you are poorly. We want to see more hospitals and care homes emulating the best.”
Last year the Government unveiled plans to tackle malnutrition among elderly patients amid concerns that nurses were failing to help patients to eat. The measures involved nurses being assessed on basic nutrition knowledge as part of their training.    Research shows malnourished patients stay in hospital longer and are three times as likely to have complications in surgery.
Ministers have been impressed with improved recovery rates at hospitals in Cornwall, where local produce is served. London’s Royal Brompton hospital has also been praised for its mainly organic menu.
The Daily Express campaign has found that many patients are too sick to feed themselves and, without help from nurses, do not eat their meals. There are fears that guidelines requiring patients to be monitored for malnutrition are not always followed.
Hospitals spend as little as 50p a head on patients’ meals, less than the average 62p spent on prison meals.

Friday 1 November 2013

Poultry markets in China 'are vast bird flu reservoir'

Poultry markets in China 'are vast bird flu reservoir'

Live poultry market

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Closing live poultry markets in China dramatically curtailed the spread of a novel strain of bird flu this year, according to an analysis.
The report, published in the Lancet, showed shutting the markets cut the number of new cases of H7N9 bird flu by 97%.
It said the future of the markets, a millennia-old culture in China, needed to be reassessed.
Experts said the markets can become a reservoir of viruses.
There have been 137 cases of H7N9 bird flu and 45 deaths, according to the World Health Organization.
However, most were in the months immediately after the virus was found to be moving from infecting animals to people.
'Robust evidence' Live poultry markets rapidly became linked with the outbreak. Nearly 800 markets were then shut across Shanghai, Hangzhou, Huzhou, and Nanjing.
It allowed scientists to analyse the role of the markets in the spread of the virus.
Dr Benjamin Cowling, one of the researchers at the University of Hong Kong, said: "Our findings confirm that live poultry market closure is a highly effective intervention to prevent human disease and protect public health.

“Start Quote

The H7N9 virus has continued to circulate and now has the potential to re-emerge in a new outbreak of human disease this winter”
End Quote Dr Benjamin Cowling University of Hong Kong
"Without this robust evidence, policymakers would struggle to justify further closures of live poultry markets because of the millennia-old culture of trading live birds and the potential huge economic loss on the poultry industry in China."
The Lancet report said the markets should be "rapidly" closed in areas where the bird flu emerged and that discussions on the role of the markets "should be renewed".
Guillaume Fournie and Dirk Pfeiffer, of the Royal Veterinary College in the UK, said: "If birds spend a sufficient amount of time in live poultry markets to become infected and transmit the virus to other susceptible birds, sustained virus circulation in the live poultry markets can occur.
"Live poultry markets can then become a permanent source of infection for poultry flocks and for people who are in loose contact with infected poultry."
Two cases of H7N9 bird flu have been reported in October.
Dr Cowling said: "These are the first laboratory-confirmed cases of H7N9 this autumn, five months after the outbreak earlier in 2013.
"This is of great concern because it reveals that the H7N9 virus has continued to circulate and now has the potential to re-emerge in a new outbreak of human disease this winter."

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