Thread: UK -Sick urged to stay at home, e-mail doctors rather visit

Hospital wards to shut in secret NHS cuts

Sick urged to stay at home, e-mail doctors rather than visit emergency rooms--London Telegraph

Tens of thousands of NHS workers would be sacked, hospital units closed and patients denied treatments under secret plans for £20 billion of health cuts.

By Jon Swaine and Holly Watt
Published: 10:41PM GMT 26 Mar 2010

Internal NHS documents show cuts are expected to fall on hospital services Photo: GETTY

The sick would be urged to stay at home and email doctors rather than visit surgeries, while procedures such as hip replacements could be scrapped.

The plans have emerged as health chiefs draw up emergency budgets that cast doubt on pledges by Gordon Brown to protect “front line servicesâ€

Number of NHS bureaucrats increases SIX TIMES as fast as number of nurses

By Daniel Martin
Last updated at 8:37 AM on 26th March 2010
Comments 99

The workforce of bureaucrats in the NHS is growing six times as quickly as the number of nurses, according to official figures.

While the number of health service managers went up 12 per cent in one year, the number of nurses increased by less than 2 per cent - and the number of health visitors plummeted.

Since Labour came to power, the number of managers has almost doubled, partly as a result of the need to monitor stringent Whitehall targets on waiting times.

This is despite the fact that Tony Blair's 1997 manifesto promised to 'raise spending in real terms every year - and spend the money on patients not bureaucracy'.

Meanwhile there has been a fall in health visitors, who are vital to ensuring children and the elderly get the best possible care in the community.

Numbers have fallen by a fifth since 1999 - so that there are now four times as many managers as health visitors.
The rise in bureaucrats comes as ministers are urging the NHS to slash management costs by a third - raising the prospect of huge job losses and associated high redundancy costs.
Overall, the number of NHS staff increased to record levels, according to the NHS Information Centre.
There are now more than 1.4million working in the Health Service - more than one in 50 people in the country, making it one of the largest employers in the world behind the likes of the Chinese Army.

The news comes a day after it emerged NHS productivity had fallen by 3 per cent since 2001, largely because too many staff were employed and because they have been given such generous pay increases.
The annual NHS workforce survey reveals that in 2009 there were 1,432,000 workers in the Health Service - up 63,300 (4.6 per cent) on the previous year; and up almost a third on the 1999 total.
There are 375,500 qualified nurses - up 7,080 (1.9 per cent) on 2008 and a quarter higher than in 1999.

And there are 44,660 managers - up 4,750 (11.9 per cent) on 2008 and 84 per cent higher than a decade before.
More...NHS porters and cleaners can snoop on your records

The statistics also show there have been increases in the numbers of junior doctors in hospitals (51,500 - up 4.7 per cent in a year); GPs (40,270 - up 6.8 per cent); and consultants (36,950 - up 5.8 per cent).
The number of midwives has increased by only 650 to 24,310 - despite the fact there is a shortage of at least 3,000 on overstretched maternity wards.
Enlarge However, there has been a fall in the number of nurses working in GP practices, health visitors and nursing assistants.
There are 10,390 health visitors - down 4.1 per cent on last year and down 16.5 per cent on 1999.
Liberal Democrat health spokesman Norman Lamb said: 'The NHS is facing the toughest financial period in its history, yet we're still seeing managers being recruited like there's no tomorrow.
'Many people will be left wondering why so much money is being spent on more NHS bureaucracy when we're in desperate need of frontline staff.

'Labour has poured huge amounts of taxpayers' money into the NHS while failing to ensure we get good value for money.'
A spokesman for the Department of Health said: 'Although there has been a large percentage rise in the number of managers, overall they make up just 3.5 per cent of the NHS workforce.
'Increases in the number of NHS managers in the past have supported the service in meeting challenging priorities, including delivering financial turnaround, record low waiting times, improved access to care and the lowest ever rate of healthcare associated infections.'

http://www.dailymail.co.uk/news/article ... z0jKHlV16N

Ambulance service gets £38 for every patient they don't take to hospital
The Ambulance service is being paid bonuses for not taking patients to hospital in a bid to help the NHS hit controversial targets.

By Laura Donnelly and Alastair Jamieson
Published: 9:00PM GMT 27 Mar 2010

Patients' groups expressed horror at the "sick experiment" in which NHS managers have agreed to pay £38 for every casualty that ambulance staff "keep out of Accident and Emergency" (A&E) departments after a 999 call has been made.

The tactic is part of an attempt to manage increasing demand for emergency care amid failings in the GP out-of-hours system.

Documents seen by The Sunday Telegraph disclose that staff at Britain's largest ambulance service have been encouraged to maximise the organisation's income, by securing payments for diverting patients to telephone helplines.

The bonuses are among dozens of schemes being tried out by ambulance trusts across the country as they attempt to improve their emergency response times and help A&E departments meet controversial targets to treat all patients within four hours of arrival.

Another plan uncovered would see thousands of 999 calls currently classed as urgent downgraded so that callers receive telephone advice instead of an ambulance response.

The changes were due to be introduced across the country this week, but the Government committee governing ambulances has delayed its decision amid safety concerns.

Last week, an investigation was launched at the ambulance trust piloting the scheme following the death on Thursday of a man whose case was referred for telephone advice when an ambulance should have been immediately dispatched.

Katherine Murphy, from the Patients' Association, expressed horror at the potential risks being taken to ensure Government targets are met.

She said: "This is a sick experiment being played out on the public, at a cost to people's lives. These incentives are not just deeply unethical, but clearly dangerous. The patient has been forgotten."

Conservative health spokesman Mike Penning described the bonus payments as a "desperate" attempt to tackle a crisis in the emergency care system, which had been caused by Labour's policies.

He said the combination of rigid targets in A&E departments, and difficulties accessing GPs at weekends and evenings, meant "the system is falling apart".

The Sunday Telegraph has discovered that dozens of Primary Care Trusts in London are now paying the capital's ambulance service a £38 bonus for each patient crews do not send to hospital.

While the maximum amount of money the ambulance service can make from the scheme is "capped," board papers suggest increasing the number of patients diverted from hospital by 20 per cent a year "in order to reach the maximum level of funding available".

In the current financial year, London Ambulance Service has made £850,000 through the scheme.

Earlier this month, ambulance services in Berkshire, Buckinghamshire, Hampshire and Oxfordshire abandoned plans to reward crews with shopping vouchers if they sent patients to a GP, instead of taking them to hospital.

South Central Ambulance Service had offered paramedics raffle tickets to win £200 of store coupons if they used the GP referral scheme, but dropped the plans following fury from crews.

Jonathan Fox, from the Association of Professional Ambulance Personnel said the use of financial inducements for individuals or organisations was too dangerous.

The paramedic said: "Trusts simply shouldn't put finances ahead of the clinical need of the patient; it is too risky and puts too much pressure on staff.

"Time and time again we come across incidents where red flags that a patient's situation is life-threatening are missed.

"Not every patient sent to hospital needs to be there, but paramedics need to take decisions based on what is best for the person they are treating, not the finances of their trust."

London introduced the bonus payments ahead of a pilot scheme to downgrade more than a dozen categories of calls currently classed as urgent and requiring a "blue light ambulance".

Since October, calls – including those involving stab victims and people suffering breathing difficulties – have been downgraded by London Ambulance Service.

More than a dozen types of medical crisis currently designated as urgent, and requiring a blue light ambulance within 19 minutes are instead either passed to telephone advisers or phoned back within 15 minutes of dialling 999.

The changes had been due to be introduced nationally, from this week.

However, concerns about the safety of the scheme have caused a delay, with a decision by a Government advisory committee now put back until next month.

On Thursday, there were furious clashes at the headquarters of London's ambulance service when it emerged that a 999 call about a dying man had been passed to the telephone helpline.

By the time advisers realised that the symptoms suffered by David Fisher, 76, from East London, were life-threatening, and sent an ambulance, the retired teacher could not be saved.

His partner Antony Croot dialled 999 just before 1am on Thursday, after Mr Fisher, who had a history of heart problems, collapsed at home.

When the call handler categorising the call chose between two responses, both of which had previously generated an urgent ambulance response, the screen did not warn them that one selection had been downgraded.

In selecting an option relating to Mr Fisher's struggle to breathe, rather than his history of heart problems, the call was diverted to telephone advisers.

By the time they realised that the elderly man's symptoms were life threatening, and despatched paramedics, who attempted to save his life, nothing could be done.

His bereaved partner said he could not fault the paramedics, and only hoped the delay sending the crew would not have affected Mr Fisher's treatment.

"It is just too awful to think it would have made a difference," said Mr Croot.

Abnormal breathing can indicate a host of high risk conditions, including heart problems, as it did in the case of Mr Fisher.

Other controversial categories downgraded under the pilot scheme include a puncture wound to a peripheral artery, which could result from a stabbing.

A report by the ambulance trust on the pilot scheme, which was written last July says: "Inevitably utilising telephone triage and advice rather than the dispatch of an ambulance may involve an increased risk".

The paper concludes that the level of danger is acceptable, but says the scheme should be supported by a "communication strategy" to make staff and public aware of the new response to emergency calls, and "remove the potential for disappointment".

But last night the ambulance trust refused to disclose details of the 13 categories downgraded.

A spokesman said that following concerns expressed regarding the management of Thursday's incident, technical changes had been made so that handlers were warned if any decisions involved categories which were part of the trial.

He said the trust's financial incentives were "part of a strategy to help manage overall demand in a clinically more appropriate manner".

The disclosures follow calls for an inquiry into the way ambulance services are run, following this newspaper's investigation earlier this month into risks in the operation of 999 software, which may have caused hundreds of deaths.

The problems were exposed by the death of Bonnie Mason, a nurse from Suffolk, whose response was delayed by failures in the handling of the automated system.

Last year a Sunday Telegraph investigation found that thousands of 999 patients were being left to wait in ambulances in car parks and holding bays, or in hospital corridors – in some cases for more than five hours, before they could even join the queue for hospital treatment.

Experts warned that hospitals were delaying patients in ambulances in order to help them meet the four hour A&E target.

http://www.telegraph.co.uk/health/healt ... pital.html

NHS porters and cleaners can snoop on your medical records
By James Slack

Last updated at 8:11 AM on 26th March 2010
Comments 139

As many as 140,000 non-medical staff, including porters and housekeepers, have access to sensitive NHS patient files, it emerged last night.
The astonishing lack of privacy protection has been revealed by a Freedom of Information survey.
Government guidelines say only staff involved in 'providing and supporting patient care' should have access to confidential information.
But trusts are interpreting the rules so widely that administrators, porters and IT staff are all cleared to potentially delve into a person's medical file.
Last night Tory spokesman Stephen O'Brien said the revelation would 'send a shiver down the spine' of NHS patients.
The Information Commissioner's office said access to records should be strictly controlled and it would study the revelations to see if further action was needed.
Critics say it will become even easier to access medical records when they are stored on a controversial new NHS database, although the Health Department says this will make files more secure.
The survey of NHS trusts was carried out by the privacy campaign group Big Brother Watch.
It asked specifically about the number of staff not directly involved in the treatment of patients who have immediate access to medical records.
Immediate access was defined as being able to see at least a patient's name, date of birth and most recent medical history without needing the consent of the patient or another member of staff.
In the 140 Trusts which responded, 101,272 non-medical staff could potentially access such records - an average of 723 per trust.

When trusts which did not respond are factored in, the total across the country could be as high as 140,000.

Among those who replied, the University Hospital of North Staffordshire NHS Trust said those with access included 107 porters and 105 receptionists.

At Cwm Taf NHS Trust the total included receptionists, housekeepers and domestic staff.
North Staffordshire said porters did not have access to electronic records, but routinely carried paper files between departments as part of their job.
Alex Deane, director of Big Brother Watch, said the Government needed to address the problem as a matter of urgency.

He said: 'The number of non-medical personnel with access to confidential medical records leaves the system wide open to abuse.'
Fears have already been raised over the security of moving records online as part of the Government's National Programme for IT.
Earlier this month the British Medical Association called for the programme to be slowed down, saying pilot schemes had not yet been properly evaluated and not all patients had been given the chance to opt out. Big Brother Watch says patients could challenge the legality of the system.

The European Court of Human Rights, passing judgment on a Finnish case, has said access should be restricted to those directly involved in personal care.
Campaigners say such widespread access is behind the worrying level of data security breaches in the NHS.

The latest-report by the Information Commissioner revealed 140 incidents reported in the NHS in just four months, more than central and local government put together.
The Department of Health said last night: 'We have made it very clear that it is completely unacceptable for staff with no involvement in providing and supporting patient care to access confidential information. We have set clear standards for NHS organisations.'
The spokesman said the computer modernisation programme would cut the number of staff who could see files.
He said: 'Access to electronic records is controlled by smartcards, which allows all access to be tracked and audited. This means that, unlike with paper files, any abuse can be traced and dealt with'.

The Summary Care Record will make patient files easier to access than ever before. And there are fears that the Government is making it too hard for patients to opt out of having their details added to the NHS computer system.
The system will bring together a short medical history of a patient in a computer file.
But before these records can be uploaded a person must have a written warning, which comes with an opt-out form.
Patients are supposed to have a 12-week window to contact the NHS if they want to opt out. They can also find the form online.
However, the British Medical Association says letters may go missing, meaning a person's details are being added without their knowledge and 'at breakneck speed'.
Almost 1.3million records have already been created and another 8.9million people have received a letter about the programme.

http://www.dailymail.co.uk/news/article ... z0jFO4sgVX

God help us.

We were warned by people from Britain Scotland, and Ireland. But no the politicians never listen to good sense. They believe that like a magician with a wave of their hand they can do anything. That is what happens when you live in a perfect world enviornment. Everything that looks good on paper will work because it, well, it looks good, so it must be right.

Trouble is, there's a great big world out there, and it doesn't bow and come running to the call of DC. And just because they pass a piece of legislation doesn't mean they're going to bend the will of the rest of the country, or the world to it.

This would be good to put up on "Newsvine"

Some of this sounds like what is happening in Ontario, Canada. It is bad enough that they are taxed to death for their medical care and then have to be on waiting lists but now they are paying to buy extra insurance due to the waiting lists. For $100 to $200 a month they can buy an insurance policy that covers their healthcare in the United States if the waiting time is over 45 days for a scan or surgery. They say that out of every patient the government pays to come here for treatment there are 10 who pay out of their own pocket for it. The Ontario government does have contracts with some hospitals and clinics on border towns for certain procedures like cancer treatment in Buffalo. It would make me angry to pay all the taxes they do and then pay out of your own pocket for treatment elsewhere. That would be like paying for a car and never being able to drive it.

related: http://www.alipac.us/ftopict-193037-.html

Those of you that wanted Socialized Medicine based on the European System... get ready for a White Nuckle Ride on the ObamaCare / Castrocare Roller Coaster Healthcare Plan

Dying Patient Was Refused A Glass Of Water

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4:00pm UK, Monday March 29, 2010
Steve Davies, Sky News Online

A dying patient had to ring a hospital switchboard on his mobile to ask for a glass of water, after nurses ignored his pleas.


Derek Sauter and his wife Susan on holiday in Portugal in 2007

Officials from the South London NHS Trust have apologised to the family of Derek Sauter, who later died in hospital of pneumonia.

The 60-year-old did not receive a "proper and professional standard of care" when he was admitted with a chest infection in June 2008.

A formal investigation is being conducted into his death, after it was found his oxygen levels went unchecked for 11 hours and were 35% lower than recommended.

Ruth Sauter, the patient's daughter, said she was disgusted by the treatment her father had received.

She told The Daily Mail: "His condition was not life threatening, and nurses had specific instructions to keep close tabs on him.

"'But their appalling lack of care, and cruel behaviour killed my father...It's so much worse knowing that he died alone, thirsty and scared on that ward."

After being admitted in the morning, he was given antibiotics and oxygen, but was later forced to ring his wife to tell her that he was not allowed any more water as he had earlier knocked over a cup.

After ringing the switchboard, a doctor was called to the ward, only for a nurse to tell him that the patient was "overreacting".

The hospital was unable to comment directly on the case, as it is part of the family's legal proceedings.

A spokeswoman said: "South London Healthcare NHS Trust would like to apologise to the Sauter family for the failings in care that Derek Sauter received.

"The trust believes that Mr Sauter did not receive a proper and professional standard of care that he and his family had a right to expect."

http://preview.tinyurl.com/y8aw3po