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15.01.10                                                                                 How can you help the PA? Click here

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This week the Patients Association featured on Radio 4 You and Yours as the issue of dignity in care for elderly people was discussed to coincide with the publication of Dignity Ambassador Sir Michael Parkinson's report into the issue.      

After a year in the post touring the country Sir Michael took part in a discussion that featured interviews with participants from the Patients Association report Patients not Numbers, People not Statistics. To listen to the discussion and an interview with the Patients Association that was featured the day before click on the links below:

You and Yours phone in
http://www.bbc.co.uk/programmes/b00pqbsl

Interview on You and Yours discussing Patients not Numbers, People not Statistics
http://www.bbc.co.uk/programmes/b00pqbvl
Listen from 45 minutes 30 seconds

Alongside Sir Michael's report the National Audit Office published a report into the current progress of plans to improve dementia care.

This week attention once again focused on the issue of out of hours care as the inquest into the death of David Gray started and Newsnight published research into the quality of care being provided across England.

We are still recruiting for a West Midlands focus group, click the link below to find out more.

 This week...

1. Out of hours death inquest begin

2. Dementia services not being given sufficient priority

3. Apology for Thalidomide survivors

4. Regulation of Healthcare Assitants being considered

5. Cancer survival variation concerns raised again

Opportunity to take part in West Midlands Focus Groups

1. Out of hours death inquest begins

David Gray, 70, from Manea in Cambridgeshire died in February 2008 after being given ten times the recommended maximum dose of the pain killer diamorphine by a German out-of-hours doctor on his first ever shift in the UK. Dr Daniel Ubani, 66, later admitted that he had no knowledge of the diamorphine because it was not routinely prescribed in Germany.

This tragic death highlights the need for greater regulation concerning the use of European doctors and the need to make the out-of-hours medical service safer. The Head of the General Medical Council has said “Within the EU there is an assumption that there is an equivalence across the European Union and we are not able to challenge for example whether a particular country’s regulator is working effectively or not.”

Newsnight screened a special investigation into the issue which can be viewed by clicking the link below:

http://news.bbc.co.uk/1/hi/programmes/newsnight/8455231.stm

 Last year an interim report by the Care Quality Commission (CQC) said that the 5 Primary Care Trusts who use the care provider, Take Care Now, that employed Dr Ubani should monitor quality of care as well as just response times. The story also bears similarities to the death of Penny Campbell, 41, in 2005. A coroner’s report in 2006 blamed systemic failures in the out-of-hours service.

Steve Field, President of the Royal College of General Practitioners stated that “In this case, it appears it was a multiple systems failure. The whole thing was appalling and we need to learn lessons from that, and I believe we are doing now.”

Inez Brown the solicitor representing the Gray's family has commented that “This case has unearthed concerning aspects about the use of overseas doctors to deliver out-of-hours medical care in the UK. Of particular concern is the process for vetting the doctors beforehand, their level of training in comparison to the NHS, and the information and training given to ensure the safe use of medicines and controlled drugs like diamorphine.”

Katherine Murphy, director of the Patients Association, said “why do NHS managers need to be told that they should ensure out of hours care is safe? It is such a vital service, sometimes dealing with very vulnerable and unwell patients. It’s frightening to think it is not being properly monitored. There have been other cases where patients died when they received poor care from out of hours services. Penny Campbell died in 2005 and the coroner ruled the out of hours doctors contributed to her death. How many alarm bells need to ring before action is taken?”

Any readers who have had a poor experience of out of hours care can tell the Patients Association by emailing our Helpline on helpline@patients-association.com

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2. Dementia services not being given sufficient priority

On Tuesday Michael Parkinson published a report into his year as National Dignity Ambassador.In response to the report PA Director Katherine Murphy said “We absolutely applaud those people doing a fantastic job-there are so many people out there who are dedicated and provide wonderful care. But, we receive the same ‘mountain’ of letters that Sir Michael Parkinson has received; we read the same distressing stories. We have hundreds of letters that describe what Sir Michael recognises as the ‘ugly – the inexcusable and the downright unacceptable.’

 To find out more about the report and to read the full PA response click the link below:

http://www.patients-association.org.uk/News/324

 Also this week on Thursday the National Audit Office released an interim report on dementia treatment in England. It argues that although the government made dementia care a national priority alongside heart disease and cancer, this has not been backed up with a genuine commitment.

Although the dementia strategy was described as ‘comprehensive and ambitious’, the fact that it has not been included in the NHS Operating Framework has caused concerns. The NHS Operating Framework sets out the main areas of focus for the NHS a year in advance.

It is also unclear how the £150 million allocated to NHS Trusts for the strategy has been spent. Karen Taylor, director of Health Value for Money at the NAO said that without proper oversight of the implementation of the strategy, Trusts “won’t be giving it the priority or the urgency that both ourselves and the Public Accounts Committee were led to expect dementia would get when we reported on it in 2007”.

Phil Hope MP, minister for Care Services, said that “we are in the first year of our ambitious five year National Dementia Strategy – change will not happen immediately.”

The report also criticised the lack of “basic training for healthcare professionals to understand and work with people with dementia” as well as the absence of strong leadership in local NHS and social care delivery organisations.

Mr Amyan Morse, head of the National Audit Office, said that although the dementia strategy announced in February last year was welcomed, “the action has so far not matched the rhetoric in terms of urgency. At the moment this strategy lacks the mechanisms needed to bring about large scale improvements”.

For an in-depth BBC analysis of the regional variations in dementia care click the link below:

http://www.bbc.co.uk/blogs/thereporters/markeaston/2010/01/map_of_the_week_dementia.html

To download the NAO report click the link below:

http://www.nao.org.uk/publications/0910/improving_dementia_services.aspx

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 3. Apology for Thalidomide survivors

4. Regulation of Healthcare Assitants being considered

The Nursing and Midwifery Council (NMC) are considering possible new regulations for healthcare assistants including a national register or a mandatory minimum level of training.

The NMC say that they currently receive calls every day from people wanting to report misconduct by healthcare assistants but is unable to act under current regulations. While healthcare workers can be punished by individual employers, they cannot be ‘struck off’, leaving them free to get a similar job with another employer.
Proposals could see the NMC’s role greatly enhanced to become a regulator or the formation of a new body. Prof Dickon Weir-Hughes, NMC Chief Executive, said that “if there is someone who is abusive to patients or who steals from patients, apart from dismissing them and giving them a bad reference, or reporting them to police, there is very little that can be done”. This problem is worse for care homes. Weir-Hughes said “In hospitals staff are well supervised in the main. In care homes there is less supervision and a greater potential for risk.”

One possibility is a similar system to that used to regulate nurses and is backed by the Chief Nursing Officers and the Royal College of Nursing. The first findings are expected within the next few months but changing the regulations could take much longer.

The Patients Association has campaigned for many years on patient safety. Director Katherine Murphy said:

 “Healthcare assistants are relied upon more and more to do what was traditionally done by nurses. We would welcome a consultation on this issue so that patients and the public can put forward their views. People are often confused about the difference between nurses and HCAs and I think many people would be surprised to know staff so intimately involved in the care of patients and not subject to a professional code of conduct”.

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5. Cancer survival variation concerns raised again

 A study by a team at University College London has discovered that there are still wide variations in how early victims of cancer are diagnosed, with the poor, women and the elderly more likely to have a late diagnosis.

The study looked at figures from 2000 to 2006 and reported no improvement in the number of cases admitted as emergencies for colorectal cancer and an actual deterioration in the rates for lung cancer. The number of breast cancer cases admitted as emergencies were shown to be improving.

People from less affluent areas were also less likely to go through vital surgical procedures for these types of cancer.

The study looked at the years around the implementation of the NHS Cancer Plan from 2000-2003 which was backed up by £570 million.

Professor Rosalind Raine, who led the study, said that although waiting times and survival rates had improved, a significant number did not benefit from this because their cancer was not diagnosed early enough.

The Department of Health said that the 2007 Cancer Reform Strategy and National Cancer Equality Initiative are designed to address these inequalities and that the Initiative would be publishing “a practical guide to reducing cancer inequalities early in 2010”.

Opportunity to take part in Focus Groups

The Patients Association would like to hold some focus groups this year in the West Midlands region. Anyone interest in taking part should be emailed to events@patients-association.com. Any questions should also be sent to the events@patients-association.com email address.

We currently expect this event to place at a central Birmingham location on the morning of Thursday 4th February.

The Patients Association always strongly encourages patients and the public to take up any opportunity to put forward your views on issues affecting all users of the NHS. Running focus groups also help us generate income vital for supporting the charity.

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How can you help?

The Patients Association is only able to work hard speaking up for patients with the support of our members. Our free E-membership is incredibly important as it allows us to keep you informed about our work and campaigns.  Your continued support is crucial for us to be able to continue our work.  

Please forward this email to your friends, family and colleagues and encourage them to join as a free E-member at http://www.patients-association.org.uk/Join-Us.  

Full membership and donations provide direct support for our work. If you also wish to become a full member for only £10 a year you can now sign-up online at http://patients-association.org.uk/Membership-Subscription or email mailbox@patients-association.com for details. You can make a donation here http://www.patients-association.org.uk/Support-the-PA

You can also show us your support by leaving your comments on our new Twitter page:  

http://twitter.com/PatientsAssoc

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 If you have been forwarded this email and would like to receive your own copy in future sign up for free as a Patients Association E-Member on the website:

www.patients-association.com/Join-Us