Wednesday, 14 November 2012

overhaul is needed in the system for caring for people


'Catastrophic failings' in schizophrenia care

Nurse and patientAlternative ways of caring for patients with schizophrenia are needed, says the inquiry

Related Stories

An independent inquiry says a major overhaul is needed in the system for caring for people with schizophrenia.
The Schizophrenia Commission, which was set up a year ago, says patients spend too long in "demoralised and dysfunctional" hospital wards.
Its analysis suggests the condition costs society almost £12bn a year - and treatment budgets could be spent more wisely to stop people from getting ill.
The government says mental health is one of its high priorities.
A spokesman said: "We are clear that people with mental health problems should be treated with the same high quality and dignified care as anyone else and we expect the NHS to make this happen."
The commission, which was established by the charity Rethink Mental Illness, says too much is spent on secure care - 19% of the mental health budget in England last year - with many people staying too long in expensive units.
Among the 42 recommendations, the report calls for a better use of "recovery houses" in the community, to provide an alternative to hospital admission.

Start Quote

It is a scandal that in 2012 people with schizophrenia are dying 15-20 years earlier than the general population”
Paul JenkinsRethink Mental Illness
The average cost of a night in a mental health in-patient bed is £321 - meaning a typical admission of 38 days costing more than £12,000.
The commission says early intervention teams, which aim to help people before their hallucinations or delusions become severe, are popular and should be extended. The report claims some teams are being cut or diluted at the moment.
'Madhouse'
Prof Sir Robin Murray from King's College London, which chaired the commission, said: "If you have psychosis and your mind is disturbed, you need a period of respite and calm.
"But especially in inner cities, you get admitted to something like a madhouse. The nurses are often overwhelmed.
"If patients have had a bad experience and then a further relapse, it's more likely they will then have to be admitted by compulsion.
"The system is pervaded by pressure. People are locked up too often and for too long.
"There's a preoccupation with risk, and the idea that this is a madman with an axe. But people with schizophrenia are actually more likely to be attacked themselves.

Recovery

Dan Lowe, 36, began having psychotic symptoms 16 years ago.
He has been admitted to hospital four times, each stay lasting several months.
Dan found the stays in hospital sometimes made his paranoia worse.
He is now taking clozapine, a medicine which has helped him a lot.
Dan lives independently in Surrey, with support from a community psychiatric nurse.
He enjoys taking part in a regular computer course.
"There's no other condition where such an emphasis is put on the risk of an effect on other people."
The report says care of people with schizophrenia and psychosis is falling "catastrophically short".
An economic analysis for the commission highlighted an "exceptionally low" employment rate for people with schizophrenia of 7%, as well as disrupted education - because the illness often develops in young adulthood.
The authors said some of the costs of schizophrenia were unavoidable - but effective interventions, such as family therapy and making a concerted effort to find people jobs, were not being widely used.
Paul Jenkins, head of the charity Rethink Mental Illness, was also a member of the commission.
He said: "It's been over 100 years since the term 'schizophrenia' was first coined, but care and treatment are still nowhere near good enough.
"It is a scandal that in 2012 people with schizophrenia are dying 15-20 years earlier than the general population."
The report said tackling those worse chances of physical ill health would take many years, but made economic sense.
And it highlighted poor prescribing practice as another problem faced by people with schizophrenia, saying patients were not always receiving the most effective medication.
The report - titled The Abandoned Illness - concludes patients can be given hope and support, with the aim of stability or recovery.

Sunday, 4 November 2012

Liverpool Care Pathway: Relatives 'must be informed


Liverpool Care Pathway: Relatives 'must be informed'Elderly man's hands

There will be a 12-week consultation on the proposed changes to the NHS constitution

Related Stories

Relatives of terminally-ill patients would have to be consulted before a decision to withdraw food or water is taken, under new government proposals.
It comes after some patients were placed on the Liverpool Care Pathway - designed to relieve suffering - without their relatives' knowledge.
The government wants to ensure families are told of life and death decisions.
The instruction will be included in a number of proposed changes to the NHS Constitution to be unveiled on Monday.
The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.
Supporters say it can make the end of a patient's life as comfortable as possible and the method is also widely backed by doctors and many health charities.
However, critics argue it can be inhumane.
The government has now said that the rules needed to be stricter, meaning relatives of patients are always consulted before the technique is applied.
'New right'
A Department of Health (DoH) spokesman said the proposed changes would set out a "new right" under the NHS Constitution, which was established by the Health Act 2009, but he stopped short of describing the move as a "legal requirement".
However, the spokesman added: "Anybody providing NHS services is required by law to take account of it [the NHS constitution] in their decisions and actions."
Some reports suggested health trusts that failed to involve patients and families in decisions could be sued, while doctors could face being struck off.
The DoH spokesman said it was unlikely policy had been developed on this as the proposal was still at an early stage.
Health Secretary Jeremy Hunt will launch a 12-week consultation on the proposed changes to the constitution - the formal statement of patients' rights - on Monday.
Health minister Norman Lamb said this week that it was "completely wrong" for terminally-ill patients to be put on a "pathway" to death without relatives being consulted.
Mr Lamb has called a meeting of doctors and patients to discuss worries about the pathway.
Meanwhile, Conservative peer Baroness Knight called for an inquiry into claims some people might have survived had they not received this treatment.

More on This Story

Related Stories

110th birthday


Sunday, 4 November 2012

Britain's oldest man marks 110th birthday

 

Britain's oldest man marks 110th birthday

Reg Dean 2012Reg Dean said he felt "a year older" than 109

Related Stories

Britain's oldest man is celebrating his 110th birthday.
A public concert was held on Saturday night for former church minister Reg Dean, from Wirksworth, Derbyshire, although he was unable to attend.
The Dalesmen Male Voice Choir, which he set up, will sing for him later.
Mr Dean, who was born in Tunstall, Staffordshire, on 4 November 1902, says the secret of his longevity is being lazy, but his family says it may be down to a potion he drank in India.
Having been unwell, Mr Dean was presented with his cake in bed.
Asked how he felt, he said: "A year older than when I was 109! It has been a long year but I feel much better now.
Reg DeanMr Dean served as an army chaplain during World War II
"I can't say enough (about the birthday celebrations), it's all very kind and I did not expect it and of course I shall have another one when I am 130."
Mr Dean, who has lived in Derbyshire since 1947, has lived through two world wars and 24 British prime ministers.
Indian elixir
Stationed in Burma as an army chaplain during World War II, Mr Dean continued to work as a minister until his retirement at the age of 80.
He also spent 10 years working as a teacher and has been married three times.
His son, Christopher said the family had its own theory about his long life.
"When he was out in India, just before World War I, he was given an elixir by a local there.
"He did a favour for one of the locals and this guy said, 'drink this and you'll live til at least 100'.
"And he said being naive 'I just drank it' - this muddy mixture and here he is now - no one can argue with that now."
Mr Dean became Britain's oldest man after the death of 110-year-old Stanley Lucas, from Cornwall, in June 2010.
The current world record holder is 115-year-old Jiroemon Kimura from Japan.

More on This Story

Related Stories

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

Liverpool Care Pathway: Minister will listen to concerns


Liverpool Care Pathway: Minister will listen to concerns

Elderly patient waiting to be seen

Related Stories

It is "completely wrong" for terminally ill patients to be put on a "pathway" to death without relatives being consulted, a health minister has said.
Norman Lamb has called a meeting of doctors and patients to discuss worries about the Liverpool Care Pathway - which can see water and food withdrawn.
A Conservative peer has called for an inquiry amid claims some people treated in this way could have survived.
Mr Lamb also defended the practice of paying hospitals for using the pathway.
He was reacting to reports in the Daily Telegraph that two third of NHS Trusts in England using the Liverpool Care Pathway regime have been paid sums totalling millions of pounds for reaching targets related to their use.
Relieving suffering
Responses to a Freedom of Information request by the paper have suggested that at least £12.4m has been paid out to trusts in the past three years.
The pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.

Start Quote

Payments have been made to encourage and ensure that patients and their loved ones are involved in the critical discussions that take place at the end of life”
Norman LambHealth minister
Mr Lamb said any payments made in connection with the pathway happened at a local level, without the government's involvement.
"Payments should only be made to encourage better care for people at the end of life," he told BBC Radio 4's World at One.
"Payments have been made to encourage and ensure that patients and their loved ones are involved in the critical discussions that take place at the end of life. If that is the result of the system, then that seems to me to be a good outcome."
The Lib Dem minister, responsible for social care, said his "sole interest" was making the final days of someone's life as comfortable and dignified as possible whether they chose to be in hospital, a hospice or at home.
"This (the pathway) is an approach improving the experience at the end of life. This is an approach supported by Macmillan and Marie Curie. Would those organisations really advocate a programme that denied dignity to people at the end of life."
'Right to complain'
Mr Lamb said he wanted to hear about cases where patients or their families had not been properly involved in, or informed about, how they were being treated and had convened a "roundtable" of clinicians and patients groups later this month to discuss the issue.
"Families are right to complain when that happens and it is that sort of approach which has to be challenged," he added. "I am absolutely determined myself to ensure we do challenge that."
"I want to hear where things have gone wrong. I want to ensure we address that absolutely, but a lot of good things have happened in recent years to improve the experience at the end of life."
Conservative peer Baroness Knight, who is calling for an inquiry into suggestions the Liverpool Care Pathway had accelerated some people's deaths, said she had heard of cases where people were deprived of water without their consent.
"One man actually rang the police and asked 'let me get some water'," she told BBC Breakfast. "That cannot be right. To die needing water is not a pleasant experience."
"What I think has happened is that a good idea at the beginning has translated into some very heartbroken people who have seen their relative die when actually they could have saved them."
But Dr David Nicholl, a consultant neurologist, told the BBC he was not aware of any financial targets connected to the pathway and that he believed hospitals were only concerned with getting more resources for good quality palliative care
"It is quite explicit that patients, where possible, should be fully consulted and their families consulted.
"Where there have been problems, I would say it has not been with the pathway but due to a lack of communication."

More on This Story

Related Stories

Monday, 29 October 2012

Winterbourne View: Care workers jailed for abuseWorkers from


Winterbourne View: Care workers jailed for abuseWorkers from Winterbourne View were filmed pinning down and hitting patients

Related Stories

Six out of 11 care workers who admitted a total of 38 charges of neglect or abuse of patients at a private hospital have been jailed.
Five other workers from Winterbourne View near Bristol were given suspended sentences after the acts of abuse were uncovered by BBC Panorama.
Ringleader Wayne Rogers, 32, who admitted nine counts of ill-treating patients, was jailed for two years.
Judge Neil Ford QC said there was a "culture of cruelty" at the care home.
'Vile and inexcusable'

Start Quote

It would be naive to believe that this monstrous behaviour had not been continuing for a very long time”
Victims' families
Judge Ford said no attempt was made to provide a caring environment and if the abuse had not been uncovered by the BBC, it would have continued.
He told the sentencing hearing the home had been "run with a scandalous lack of regard to patients and staff".
"What happened was a gross breach of trust," he said.
Alison Dove, 25, of Kingswood, was jailed for 20 months as was Graham Doyle, 26, of Patchway. Both pleaded guilty to seven charges of abuse.
Addressing Dove, Judge Ford said: "You suggested it was born of boredom during long shifts and that you had viewed patients as playthings."
He also referred to a letter Doyle wrote to him, in which the defendant had described his own behaviour as "disgusting, vile and inexcusable".
'Bite face off'
Judge Ford then told Doyle: "You are considered genuinely remorseful and haunted by guilt.
Ch Supt Louisa Rolfe: "These vulnerable people were subjected to the most extreme and persistent abuse."
"But your treatment of Simone Blake was often cruel, callous and degrading. It was always wholly unjustified."
Prosecutor Kerry Barker QC, said care watchdogs failed to act on repeated warnings of "inhumane, cruel and hate-fuelled treatment" of patients.
"The so-called restraint techniques were used to inflict pain, humiliate patients and bully them into compliance with the demands of their carers," he said.
Abuse of five residents at the home featured in footage played to the court during a week of sentencing hearings.
Among the hours of graphic footage, support worker Rogers is shown slapping patient Simon Tovey across the cheek before telling him: "Do you want a scrap? Do you want a fight? Go on and I will bite your bloody face off."
In a statement read outside court after the hearing, families of the abused patients said seeing the footage had been "distressing and extremely harrowing".
support worker and patient at Winterbourne ViewSecret filming caught patients being dragged and slapped by support workers
"The guilty parties were only charged with offences shown on the Panorama programme and it would be naive to believe that this monstrous behaviour had not been continuing for a very long time," they said.
Lawyers representing 17 families say they are now pursuing compensation in a civil action against Castlebeck, who owned Winterbourne View.
Defendant Jason Gardiner, who received a suspended jail term after admitting two charges of abuse, said he wanted to apologise for his actions.
"I take full responsibility for everything I have done," he said outside the court.
'Major flaws'
"It was a very difficult place to work, a tough place to work. We were under-staffed and working 12-hour days without a break.
"All I can do is apologise to everybody for what happened."
Sentencing Gardiner, Judge Ford had said he had heard he was "barely coping" with his remorse and regret.
James Welch, legal director of human rights campaign group Liberty, said he was "disappointed" with some of the sentences but thought the judge had been fair.
Jason Gardiner Gardiner was given a four-month suspended sentence for abuse
The home's owners, Castlebeck, said there had been "extensive changes in board and management" and new measures introduced to ensure it could not happen again.
The Care Quality Commission, which was heavily criticised after it ignored attempts by whistleblower Terry Bryan to inform them of the abuse that was happening at the home, said the responsibility for the abuse rested with the home's owners Castlebeck and individual employees.
Outgoing chair of the CQC, Dame Jo Williams said: "We are committed to do all we can to protect people whose circumstances make them vulnerable - and since the abuse at Winterbourne View was uncovered we have made changes to ensure that we are better placed to prevent abuse."
Care and Support minister Norman Lamb said: "This terrible case has revealed the criminal and inhuman acts some so-called care workers are capable of.
"It has also shone a light on major flaws in the system which we will address. We will publish our final recommendations very soon."
Court artist image of the Winterbourne View former care workersSix of the 11 former care workers were sent to jail
Sentences of all those found guilty are detailed below:
  • Wayne Rogers, 32, of Kingswood, jailed for two years after admitting nine charges of ill-treatment.
  • Alison Dove, 25, of Kingswood, was jailed for 20 months for seven counts of abuse;
  • Graham Doyle, 26, of Patchway, was jailed for 20 months for seven counts of abuse;
  • Nurse Sookalingum Appoo, 59, of Downend jailed for six months for wilfully neglecting patients;
  • Nurse Kelvin Fore, 33, from Middlesbrough, also jailed for six months for wilfully neglecting patients;
  • Holly Laura Draper, 24, of Mangotsfield, pleaded guilty to two charges of abuse and was jailed for 12 months;
  • Daniel Brake, 27, of Downend, pleaded guilty to two charges of abuse and was given a six month jail sentence suspended for two years and ordered to carry out 200 hours of unpaid work;
  • Charlotte Justine Cotterell, 22, from Yate, pleaded guilty to one charge of abuse and was given a four-month jail term suspended for two years. Cotterell was ordered to do 150 hours of unpaid work and complete 12 months supervision;
  • Michael Ezenagu, 29, from Shepherds Bush, west London, admitted two counts of abuse and was given a six month jail sentence suspended for two years and ordered to carry out 200 hours of unpaid work;
  • Neil Ferguson, 28, of Emerson Green, admitted one count of abuse and was given a six month jail term was suspended for two years and ordered to carry out 200 hours of unpaid work;
  • Jason Gardiner, 43, of Hartcliffe, who admitted two charges of abuse, was given a four month jail term was suspended for two years and ordered to carry out 200 hours of unpaid work.

More on This Story

Related Stories

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...