Tuesday, 18 December 2012

Winter bug cases '83% up on 2011'


Winter bug cases '83% up on 2011'


There have been just over 3,000 lab-confirmed cases.
Norovirus
Latest figures show there has been an increase in cases of norovirus - often known as the winter vomiting bug.
The Health Protection Agency estimates there have been about 880,000 cases in England and Wales since the summer, 83% more than in the same period last year.
But the HPA says these reported cases are the tip of the iceberg and for each one, there will be around 288 that go unreported.
Health Protection Scotland has also reported a rise in cases.
Early increase
The figures also show there were 61 outbreaks of norovirus in hospitals in the fortnight up to December 16 - almost double the number in the same period last year when there were 35.
Norovirus is highly contagious and can be transmitted by contact with an infected person, contaminated surfaces or objects or through consuming contaminated food or water.
It spreads rapidly in closed environments such as hospitals, schools and care homes.
The norovirus "year" - the date from which experts start to count cases - begins in July and runs to the following June.
The increase in norovirus cases is occurring earlier than normal - but experts are unsure why this is happening.
And these figures are a small fraction of the number of confirmed cases seen during the usual peak period of January to March.
However the HPA stresses norovirus is unpredictable, and no two years are the same.
Laboratory confirmed reports represent a small proportion of the actual number of cases because most people do not see a doctor - and therefore their case is not recorded.
'Short-lived'
John Harris, an expert in norovirus at the HPA said: "The number of laboratory confirmed cases has risen again, following the drop in the number we reported last week.
"This is typical of the norovirus season where the number of laboratory reports fluctuates between October and April with the bulk of cases usually occurring between January and March.
"Norovirus is very contagious so we would urge anyone who thinks they may be unwell with norovirus to stay at home and stay away from hospitals and care homes.
"The infection is short-lived although it is very unpleasant while you are unwell.
"Most people will not need to go to see their doctor and will recover in a couple of days. It is important to take plenty of fluids to avoid dehydration."
A Department of Health spokesman said: "The NHS is well prepared for the increase in winter related health problems which are typical at this time of year.
"Our weekly published figures show the number of beds closed across the NHS due to norovirus symptoms is around 2%.
"This compares to 2.9% of beds that were closed during the peak of norovirus cases last winter."
The latest Scottish figures, published on 5 December, showed 2,016 laboratory reports so far this season - up 46% on 2011 figures.

Saturday, 15 December 2012

guilty of killing baby


Grace Adeleye guilty of killing baby in botched circumcision

Grace AdeleyeGrace Adeleye denied causing Goodluck Caubergs' death

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A nurse has been found guilty of manslaughter after causing a baby's death by botching his circumcision.
Grace Adeleye, 67, carried out the procedure on four-week-old Goodluck Caubergs at an address in Chadderton, Oldham, in April 2010.
The boy bled to death before he could reach hospital the following day.
Adeleye was found guilty of manslaughter by gross negligence at Manchester Crown Court.
The nurse, who denied the charge, had told the jury she had done "more than 1,000" circumcision operations without incident.
The court heard that Adeleye and Goodluck's parents were from Nigeria, where the circumcision of newborns is the tradition for Christian families.
Adeleye, of Sarnia Court, Salford, was paid £100 to do the operation.
The jury was told that she carried out the procedure using a pair of scissors, forceps and olive oil and without anaesthetic.
She had claimed there had been "no problem" when she left the infant and that his parents had been pleased with the operation.

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Goodluck Caubergs was a healthy little boy whose tragic death was wholly unnecessary”
Jane WraggCrown Prosecution Service
However, the court heard that when Goodluck's parents had changed his nappy several hours later, they had found a large amount of blood and phoned Adeleye, who had told them to redress the wound.
Goodluck's parents called an ambulance the following morning and he was taken to the Royal Oldham Hospital, where he died a short time later.
A spokesman for NHS Oldham said had the family gone to the hospital and asked for a circumcision, "they would have been advised to go to an approved practitioner who would have charged £100, the same as Grace Adeleye".
Following the guilty verdict, Adeleye was bailed while pre-sentencing reports are prepared.
The Crown Prosecution Service's Jane Wragg said the case "was not about the rights or wrongs of circumcision, but the grossly negligent way in which the procedure was undertaken".
"Goodluck Caubergs was a healthy little boy whose tragic death was wholly unnecessary," she said.
"Goodluck died because the standard of care taken by Grace Adeleye in carrying out the circumcision fell far below the standard that should be applied.
"She also failed to inform his parents of the risks and possible complications, which ultimately led to his tragic death."

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Friday, 7 December 2012

'Never mind the patient, tick the box'


'Never mind the patient, tick the box'

PaperworkRegulation and inspection are often increased after a crisis
Scandals lead to inquiries and to recommendations - leading to a focus on filling in forms and ticking the right boxes.
But in this week's Scrubbing Up Sue Bailey, president of the Royal College of Psychiatrists, says it's time to listen to those receiving the care.
Why do care standards break down? We've all read heartbreaking stories of elderly people with dementia or patients with learning difficulties being neglected, mistreated and abused.
When things go wrong, inquiries are set up, reports are published and lessons learnt.
Think Winterbourne View; Mid-Staffordshire; childcare in Rochdale, or the Carlisle Report.
At heart, the recommendations boil down to improving communication, listening, learning and acting. It means taking notice of what patients and service users have to say.
Blame culture
But when trying to deliver the right kind of care, the health service often addresses regulation, standard setting, inspection and monitoring.
This approach aims to improve scrutiny and accountability, which most people would agree is a "good thing".

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The present blame culture doesn't help anyone.”
But there is a risk that a constant focus on targets, procedures and performance can lead to a tick box approach to healthcare.
This usually ends up placing more controls on healthcare workers, greater monitoring and prescriptive procedures.
Unfortunately, this is often at the expense of professional judgement, leading to dissatisfied and demoralised staff - with the all important relationship between the patient and healthcare worker forgotten.
I'm not saying that people shouldn't be held to account for their actions, but the present blame culture doesn't help anyone.
Healthcare is, or should be, a moral as well as a practical undertaking.
It deals with uncertainty in which mistakes are inevitable - but this isn't a message anyone wants to hear. Positive change won't happen if we continue to exist in a risk-averse bubble.
As Professor Eileen Munro of the London School of Economics put it recently, defensive care practice doesn't avoid risk, it simply displaces it - usually onto those using the services.
Time sensitive
What is needed is something in very short supply in the health service - time.
It takes time to develop expertise and build relationships based on intelligent kindness, not just technical skills.
It takes time to build critical reasoning skills and provide effective supervision.
It takes time to allow staff doing a difficult and stressful job to reflect, offload and be mentored by those with more experience.
In an era of unprecedented NHS reform, how can we find the time?
I believe we need a greater focus on helping the workforce develop the skills, knowledge and personal qualities required to meet care needs, support new staff more and improve opportunities for career progression
Workforce development takes time and money, but it is an investment that could support safer and better care, and mutual respect between patient and carer or doctor.
Old fashioned?
Don't get me wrong; improved processes can help, too.
We need data in healthcare but what we want and need are useful, practical tools that help learning and improve care.

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Policy makers will have to be brave to think and act in the long term”
This learning should involve ongoing feedback from patients, which is acted on by people like me.
What's the bottom line? A health service in which the treatment and care of people - not systems and processes - are at the heart of what we do.
Does that seem terribly old fashioned?
It sounds an awful lot like what I came into medicine for 40-odd years ago, but which I have seen start to drift away.
I will be accused of being simple minded, but a just culture should replace a blame culture.
This will require a major shift in approach towards positive risk taking and being open and honest with ourselves and with our patients that not everything can be "cured".
It's not too late, but policy makers will have to be brave to think and act in the long term. But is anybody listening?

Sunday, 25 November 2012

wrong patient


Cambridge Hospitals NHS Trust 'operated on wrong patient'

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A health watchdog is taking action against a Cambridgeshire hospital trust which performed eye surgery on the wrong person.
Cambridge University Hospitals NHS Foundation Trust performed four botched operations, including leaving instruments inside two people.
Surgeons also operated on the wrong part of the body of a patient, Monitor said.
The trust said it was "determined to improve".
It has been ordered to look at the effectiveness of its services and improve the quality and organisation of healthcare for its patients.
The trust also has to report to Monitor every month.
The regulator said that since September 2011, eight "never events" - instances which are never supposed to happen - had happened at the trust, including four between September and October last year.
Wrong lens
Monitor said that the "wrong person surgery" related to a patient who had the wrong surgical lens fitted.
Several patients were attending the hospital for similar operations at the same time, a trust spokeswoman said.
The wrong lens was fitted to the wrong patient and then quickly removed.
The patient did not suffer any ill effects, the spokeswoman said.

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This is not the first time we have called the trust in to explain itself”
Stephen HayMonitor
Monitor said it was also stepping in because the trust had failed to give cancer patients treatment in the recommended time and had not treated emergency patients within four hours.
It said the trust was in "significant breach" of the terms of its authorisation and was concerned that the hospital board had not dealt adequately with the range of issues the trust had faced over the years.
Monitor's chief operating officer, Stephen Hay, said: "This is not the first time we have called the trust in to explain itself.
"We are disappointed that the board has not resolved these issues."
Jane Ramsey, who became chair of the trust at the beginning of the month, said: "We are determined to reverse the situation as soon as possible.
"We will be focusing on turning this trust around.
"Our priority remains the care of our patients - they are at the heart of everything we do."
The trust, which runs Addenbrooke's and the Rosie hospital in Cambridge, has been ordered to commission a "governance and effectiveness review".
A board-level "experienced turnaround expert" should also be appointed, Monitor recommended.
Monitor is an independent regulator of NHS hospital trusts, ensuring they have good leadership and are financially robust.

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Friday, 23 November 2012

kicked 99-year-old patient


Hemel Hempstead nurse kicked 99-year-old patient

A Hertfordshire nurse who called a 99-year-old patient "evil", kicked him and told him she would spit in his face has been suspended.
Christina Gavigan, a sister, tried to drag another patient along the floor by her feet at Hemel Hempstead Hospital.
The Nursing and Midwifery Council (NMC) found 21 of 25 accusations proved and suspended Ms Gavigan for 12 months.
She did not attend and was not represented at the four-day Conduct and Competence Committee hearing in London.
It heard "serious concerns" were raised during one Saturday shift at the accident and emergency department in October 2008.
Ms Gavigan, a nurse for 28 years, was the leader of the shift when a "very challenging, aggressive, uncooperative and confused" man was in the unit.
The NMC heard the man was calling out "help me" but Ms Gavigan said "just leave him" and later got up close to him and called him "evil" and a "horrible man".
'Waste of space'
He was overheard to say he would spit in her face, to which she replied she would "spit in your face".
Ms Gavigan was also seen to kick him and then say "oops, I just kicked you" and told him, when he asked for a cup of tea, that he did not deserve one.
The committee found she also called a "distressed" patient a "waste of space", shouted at her and told her to shut up.
The woman had been placed on a mattress on the floor to reduce the risk of a fall, but had tried to crawl out of the cubicle.
The NMC found it proved Ms Gavigan pushed the patient along the ground with her foot, nudged her head with her foot and tried to drag her back into the cubicle by her feet.
She also slammed a door when the woman was about one metre away and was crawling along the floor.
Another sister who queried why Ms Gavigan was shouting at the patient was then verbally abused, the committee found.
She also spoke loudly to a third patient's son about his mother's condition when the patient had not been told of the situation.
The NMC concluded a suspension for 12 months, the maximum period available, sent out a clear message that Ms Gavigan's conduct was unacceptable.

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Second coronavirus death reported


Friday, 23 November 2012

coronavirus

Second coronavirus death reported

CoronavirusThe source of the virus is uncertain

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A second person has died from a new respiratory illness similar to the Sars virus, according to the World Health Organization.
The WHO said three fresh cases had also been reported bringing the total to six.
All are linked to either Saudi Arabia or Qatar. However, one man has been transferred to the UK for treatment.
Doctors say the virus does not appear to readily spread from person to person.
Both reported deaths were in Saudi Arabia.
Coronaviruses are a group of viruses ranging from the common cold to the Sars (severe acute respiratory syndrome) virus. They infect a wide range of animals.
In 2002 an outbreak of the Sars coronavirus killed about 800 people after it spread from Hong Kong to more than 30 countries around the world.
The WHO is still trying to work our where the infection came from. Studies show that the virus it is closely related to one found in some species of bats.
It said in a statement: "Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases."

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