Tuesday, 16 April 2013

Stafford Hospital trust to go into administration


Stafford Hospital trust to go into administration

Monitor administratorsThe administrators have 145 days to to produce a plan for the future of hospital trust services

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The trust which runs Stafford Hospital is to be put into administration by the health regulator Monitor.
Mid Staffordshire NHS Foundation Trust will be run by two specially appointed administrators to "safeguard the future of health services" currently provided.
Dr Hugo Mascie-Taylor and Alan Bloom of Ernst and Young will take over the running of the trust on Tuesday.
It will become the first foundation trust to go into administration.
A report for Monitor, written by a panel including Dr Mascie-Taylor in February, said services at the trust were "unsustainable".
It recommended the closure of its maternity unit, intensive care unit and accident and emergency department.
It said services could instead be provided at neighbouring trusts including the University Hospital of North Staffordshire, the Royal Wolverhampton or Walsall Healthcare NHS Trust.
Monitor said the administrators were appointed after it was concluded the trust, which also runs Cannock Chase hospital, was "neither clinically nor financially sustainable in its current form".
The trust "was likely to become unable to pay its debts", it said.
Last year, the trust reported a drop in annual income of about £4m and received a £20m bailout from the government.
'Starting again'
Monitor said the administrators would have 145 days to work with commissioners and other local healthcare organisations to produce a plan for patients that was "sustainable in the long term".
The plan would be subject to a public consultation, it said.

Analysis

Adam BrimelowHealth Correspondent, BBC News
Monitor says the decision to put Mid Staffs into special administration had nothing to do with the recent public inquiry - which highlighted appalling neglect, abuse and incompetence in the four years up to 2009.
But although standards of care have improved, the trust remains clinically and financially unsustainable.
It is now on a fast track to reorganisation, with a strong likelihood that some services will be relocated to bigger hospitals in Stoke-on-Trent, Walsall and Wolverhampton.
Monitor insists they will remain accessible within "reasonable journey times", and local people will be consulted.
Despite Stafford Hospital's notoriety, it commands deep loyalty among many in the town, and for them, the fight starts now.
David Bennett, from Monitor, said the current management at the trust would report to the administrators but patients would not see changes to services over the next 145 days.
He said: "It is important that people in Mid Staffordshire know that they can still access services as usual at Stafford and Cannock hospitals while the Trust Special Administration process is on-going."
"We have taken this decision to make sure that patients in the Mid Staffordshire area have the services they need in the future."
Administrator Hugo Mascie-Taylor said recommendations to downgrade some services were not "set in stone" and would be looked at again.
He said: "We will derive a lot of information from the report but we arrive here starting again, looking at the whole health economy, looking at what other hospitals could do, maybe what other services like community trusts could do.
"It's about taking all that into account and asking what could we do in Stafford and Cannock that's safe and sustainable."
'Put patients first'
The Support Stafford campaign group said it would be holding a march in the town centre on Saturday against the current proposals.
Cheryl Porter from the group said: "We haven't been listened to yet, and these plans are unacceptable.
"I do hope that the administrators listen to what the people need for safety reasons because to take all our acute services away is leaving us very vulnerable in a very dangerous position."
She said more than 15,000 people had signed a petition against the proposals.
The Conservative MP for Stafford, Jeremy Lefroy said he hoped the administrators would "put patients first".
He said: "There is a vital need to retain acute services in Stafford and Cannock because the capacity elsewhere is simply not there.
"They also need to consider the huge disadvantage to local people who would have to travel much longer distances for their treatment but also for hospital visitors who would have to do the same."
The trust's chief executive, Lyn Hill-Tout, said: "We would like to reassure local people and GPs that we are continuing to provide all our usual services at both hospitals and patients should turn up as usual for any appointments they have."
"We would like to thank our local community for their continued support, which means a great deal to staff."
The Mid Staffordshire trust was at the centre of a three-year public inquiry into "appalling standards" of care at Stafford Hospital, following concerns over high death rates.
The concluding Francis Report, published in February, highlighted the "unnecessary suffering of hundreds of people" between 2005 and 2009.

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Tuesday, 2 April 2013

Health correspondent
Doctor's equipment, a sphygmomanometer and stethoscopeThe changes have proved extremely controversial

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Government reforms of the NHS in England have come into force and health leaders warn of a tough year ahead.
Monday marks the first day of the new structures.
GP-led groups have taken control of local budgets and a new board, NHS England, has started overseeing the day-to-day running of services.
The NHS Confederation said the reforms represented a big opportunity but should not be seen as a "silver bullet" for the challenges ahead.
Mike Farrar, chief executive of the confederation, which represents health managers, said the squeeze on finances and the need to rebuild public confidence after the Stafford Hospital scandal meant the NHS was facing a critical period.
He said the reforms would bring clinical expertise to the fore of decision making, which would be a "huge asset".

“Start Quote

Because GPs have face-to-face contact with patients every day... they are really well-placed to be able to make decisions about how healthcare should be delivered best”
GP Catherine Briggs
But he warned: "We need to recognise the huge challenges facing the health service. New structures alone won't enable us to tackle these challenges, and we should not see them as a silver bullet.
"Those doing the day-job face major pressures in trying to keep the NHS's head above water, while focusing on making the new world work."
The start of the new system comes nearly three years since the changes were put forward.
The publication of the plans in the summer of 2010 sparked a long and, at times, damaging battle for the government to push through with its changes.
Ministers even had to take the unprecedented step of halting the progress of the bill through Parliament amid criticism from medical bodies, academics and unions.
In particular, concerns have been expressed about what many believe is a greater role for the private sector.
'Compassionate care'
Some have also questioned whether introducing such major changes - they have been dubbed the most radical overhaul since the NHS was created - at a time when money is so tight makes sense.

“Start Quote

Far from letting 'doctors decide', ministers are forcing the medical profession to open up all NHS services to the market”
Andy BurnhamShadow health secretary
But as the new bodies take up control - and the old organisations, including 152 primary care trusts, are scrapped - the government maintained the changes would put the NHS on a firm footing for the 21st century.
Health Minister Anna Soubry said: "The health service will improve, work smarter and, importantly, build an NHS that delivers high quality, compassionate care for patients."
But shadow health secretary Andy Burnham predicted the changes would have the opposite effect.
"Far from letting 'doctors decide', ministers are forcing the medical profession to open up all NHS services to the market.
"Hundreds of new private companies now risk fragmenting patient care when more integration is needed."
GP Catherine Briggs said she would welcome more control over how budgets are spent.
"Because GPs have face-to-face contact with patients every day and because they know their patients and their communities really well," she said.
"That means they are really well-placed to be able to make decisions about how healthcare should be delivered best."
But GP John Hughes said he had reservations.
"The GPs aren't really free to do what they like with the money as a lot of people seem to think," he said.
"Most of the directions as to what happens to that money and what should be bought or commissioned locally is coming from the Department of Health.
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Friday, 29 March 2013

the ageist BBC says


Are the patients the problem?

COMMENTS (126)
PatientTwo thirds of hospital admissions are people over the age of 65

More from Nick

On unveiling the package of measures in the government's response to the Stafford Hospital public inquiry, Health Secretary Jeremy Hunt said he was confident the changes would ensure problems on such a scale would not slip under the radar again.
A clearer system of rating hospitals and better regulation of managers and healthcare assistants, he argued, would ensure greater accountability, while better training for nurses could create a culture of compassionate care.
But in some ways the changes ignored the elephant in the room: the changing nature of the patient population.
It is an open secret that hospitals in the 21st Century are full of patients that should not be there.
A combination of the ageing population and advances in medicine have meant that there is a growing number of frail, elderly people who need intensive care and support.
But all too often that is not available in the community, and so they end up in hospital as an emergency case.
Two-thirds of hospital admissions are people over the age of 65. Many have multiple chronic conditions, such as heart disease and dementia.
In fact, the change in the patient population has been so acute that aKing's Fund study has put the average age of a patient at over 80.
That is presenting problems for staff that no amount of training and resources can counter.
'Wrong place'
As one nurse, who has worked in the NHS for over 30 years, told me: "The patients we are seeing in hospital are completely different from the ones that were being admitted when I started out.
"These patients need a complex package of care and support.
"They need help washing, dressing and eating round-the-clock. It requires a lot more personal care than the hospital environment is designed for."
However, it need not be like this. The evidence suggests as many as a third of hospital admissions could be prevented with better systems in place in the community.
But instead of going down the numbers being admitted as emergencies is actually on the rise - it is up by nearly 40% in the past decade - and that is having a damaging impact on hospital wards.
The Royal College of Physicians has warned hospitals are "on the brink" with a mindset developing among staff that many patients are simply in the "wrong place".
Its report, Hospitals on the edge?, cautioned staff against such defeatism, but it was also clear for that to change there needed to be progress on keeping people out of hospital.
To be fair, it was a point acknowledged on Tuesday by Care Services Minister Norman Lamb.
During the government press conference to announce the response to the public inquiry, he said it had to be a "top priority", conceding "a lot of hospitals have large numbers of frail elderly that perhaps with better care would not have ended up there".
Improving the culture, accountability and transparency is clearly important, but the defining challenge for the health service over the next decade and beyond could prove to be something completely different
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Wednesday, 27 March 2013

No more covering up errors, NHS told


No more covering up errors, NHS told

By Nick TriggleHealth correspondent, BBC News
Health Secretary Jeremy Hunt: "Stafford Hospital to be ''a catalyst for change''

Staffordshire NHS scandal

The NHS will have a legal duty to be honest about mistakes as part of an overhaul of the system in the wake of the Stafford Hospital scandal.
The move is part of a package of measures in England to put patients at the heart of the NHS, ministers said.
There will also be a new ratings system for hospitals and care homes, while changes to nurse training will be piloted.
It comes after the public inquiry claimed patients had been "betrayed".
The harrowing neglect and abuse at the hospital between 2005 to 2008 which led to needless deaths has already been well documented.
Statistics at the time showed there were between 400 and 1,200 more deaths than would be expected.
The £13m inquiry, published at the start of February, focused on why the problems were not picked up sooner.
It accused the NHS of putting corporate self-interest ahead of patients, concluding the failings went from the top to the bottom of the system.
'Fundamental change'
In total, the report made 290 recommendations.
Ministers have not responded individually to each one.
But Health Secretary Jeremy Hunt said the response on Tuesday marked the start of a "fundamental change to the system".

Government response at a glance

  • Duty of candour to be placed on NHS boards to be honest about mistakes.
  • Consideration being given to making individual doctors and nurses criminally responsible for covering up errors.
  • New ratings system for hospitals and care homes based on Ofsted scheme used in schools.
  • Posts of chief inspector of hospitals and care homes to be created.
  • Nurses to spend up to a year working as a healthcare assistant so they get experience providing basic care such as washing and dressing in pilot schemes.
  • Managers who fail in their jobs to be barred from holding such positions in the future.
  • Code of conduct and minimum training standards for healthcare assistants, but not full registration scheme as recommended by inquiry.
  • Tough rules to be drawn up to allow trusts to be put into administration when basic standards are not met unless problems can be resolved quickly.
  • Department of Health civil servants to be forced to spend time on the front line of the NHS.
"We cannot merely tinker around the edges - we need a radical overhaul with high quality care and compassion at its heart."
He said he wanted to create a culture of "zero harm" through the changes.
Key to this will be the new post of chief inspector of hospitals - announced immediately after the publication of the public inquiry - and the statutory duty of the NHS to be honest about mistakes, known as a duty of candour.
But the government said it would wait before deciding whether to make individual doctors and nurses criminally accountable for hiding mistakes as recommended by the inquiry as it was concerned about creating a "culture of fear".
The government has also stopped short of the inquiry's demand for a registration system for health care assistants.
Instead, it confirmed it will push ahead with a code of conduct and minimum training standards.
On training for nurses, ministers said there would be a pilot programme whereby nurses will have to work for up to a year as a healthcare assistant before getting NHS funding for their degree.
Meanwhile, managers who fail in their jobs will be barred from holding such positions in the future.
Heather Wilhelms describes how her husband had to resort to drinking from a vase while in hospital
The ratings system, which will start being rolled out later this year, will be based on the Ofsted system used in schools.
Hospital and care homes will be given an outstanding, good, requiring improvement or poor rating.
However, in hospitals individual departments will be given their own rating as well to reflect the increased complexity of the organisations.
But shadow health secretary Andy Burnham said the culture of the NHS would not be changed unless staffing problems were resolved first.
"We will never get the right culture on our wards if they are understaffed and overstretched," Mr Burnham said.
Royal College of Nursing general secretary Peter Carter agreed staffing was an issue and said he was disappointed there would not be a registration system for healthcare assistants.
He also said he had concerns about the measures on nurse training, but added the the union was still "committed" to working with government to ensure a "patient-centred NHS becomes a reality".
But Don Redding, policy director of the patient group National Voices, felt the changes would make a difference, particularly the duty of candour.
"In cases where patients have been harmed or worse, both senior managers and their legal advisers have generally decided their first duty is to the interests of the trust. This new legal duty will rebalance that."
Mike Farrar, chief executive of the NHS Confederation, which represents health trusts, said: "The government has used this time to produce an overarching response rather than a something which tries to tick all the boxes.
"The response finds the right balance between external assurance measures and internal changes focused on transforming the NHS culture."
Robert Francis QC, who chaired the public inquiry, added: "Even though it is clear that it does not accept all my recommendations, the government's statement indicates its determination to make positive changes to the culture of the NHS."

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Friday, 22 March 2013

Ageism


Ageism in politics is 'pathetic' says Cable

William Gladstone aged 71William Gladstone became prime minister aged 82 in 1892
Vince Cable has criticised ageism in modern-day politics, pointing out that Churchill and Gladstone served as prime minister in their 70s and 80s.
The Lib Dem business secretary, who is 69, said he would stand for election again in two years time and had "bags of energy and stamina" left.
Questioning politicians' ability to do the job because of their age was "pathetic", he told the House magazine.
He suggested Deng Xiaoping, who ruled China in his 80s, was a role model.
Mr Cable briefly served as Lib Dem leader after Sir Menzies Campbell quit in 2007 and has not ruled out the possibility of standing for the top job in future should a vacancy arise.
During his 18-month stint as leader, Sir Menzies faced questions about his age and ability to cope with the demands of the 24-hour news cycle.
'Bags of energy'
Mr Cable said his colleague had been "very unfairly treated" at the time.
"It was as bad as attacking people for their colour, for their gender. Pathetic actually, it demeaned the people who did it."
Mr Cable confirmed that he would stand to be an MP again in the next election, scheduled for 2015, and had no "inhibitions" about doing so.
"I take the view that as long as you have got bags of stamina and capacity to do the job and I do have a lot of energy and stamina, I'm perfectly fit and healthy."
Asked about role models, he said Lord Heseltine was still active in politics and business in his late 70s while two of the country's greatest leaders had remained in No 10 long after conventional retirement age.
"Gladstone became prime minister when he was over 80, didn't he? I think Churchill was over 70, wasn't he?"
He added: "Talking of role models, Deng Xiaoping totally transformed China in the last century. I think he was 80 when he took over. And he survived the Long March."
Mr Cable - who was a Labour activist and councillor before joining the SDP in the 1980s, said he had a "sensible working relationship" with Labour but his party would adopt a policy of "equidistance" between them and their Conservative coalition partners at the next election.
"That will be the word Paddy Ashdown invented once upon a time and it will be the case next time," he added.
"It will make the point that in the national interest we are willing to work with other parties on either side."
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Friday, 8 March 2013

Nurse regulator 'not good enough'

Nurse regulator 'not good enough'

By Nick TriggleHealth correspondent, BBC News
Nurses at workIt is illegal to work as a nurse or midwife without being on the NMC register

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The regulator for nurses and midwives is still not doing enough to protect patients properly, MPs are warning.
The Health Select Committee said a huge backlog of cases was hampering the ability of the Nursing and Midwifery Council (NMC) to safeguard standards.
The cross-party group of MPs also highlighted the regulator's poor record of having decisions overturned on appeal.
But the NMC said it was working hard to put things right.
The regulator, which is in charge of registering and regulating the 670,000 nurses and midwives in the UK, has been dogged by problems for some time.
Last year year an independent report by the Council for Healthcare Regulatory Excellence said the NMC was failing at "every level".
This report recognised progress was being made by the new management team, but that there was a "serious gap between current performance and acceptable standards".
It noted the NMC had a backlog of cases dating back more than two years that topped 570.
It said this needed to be cleared by June.
It also expressed disappointment that the rollout of revalidation - regular checks on nurses - was being delayed by 2015. It has already started for doctors.
Challenges ahead
And the MPs said much more needed to be done to tackle two of the major underlying causes of the problems - IT and staff turnover.
It also urged the regulator to be more ambitious in its plans for dealing with cases.
Its current proposal is that the average should take no longer than 18 months, but MPs said it should be half this.
Committee chairman Stephen Dorrell said: "The NMC's job is to protect patient safety by registering nurses and midwives and by enforcing acceptable standards of practice.
"The simple fact is that in recent years it has fallen down on that task."
NMC chief executive Jackie Smith said: "We welcome the report, which recognises the genuine progress we are making, and challenges us to do better.
"We don't underestimate the challenges ahead."

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