Tag Archive: NHS


Smoking damages the body in minutes rather than years, according to research in the US. A report, published in Chemical Research in Toxicology, shows that chemicals which cause cancer form rapidly after smoking. Scientists involved in the small-scale study described the results as a stark warning to people considering smoking. Anti-smoking charity Ash described the research as “chilling” and as a warning that it is never too early to quit.

The long term impact of smoking, from heart disease to a range of cancers, is well known. This study suggests the damage begins just moments after the first cigarette is smoked.The researchers looked at the level of chemicals linked with cancer, polycyclic aromatic hydrocarbons (PAH), in 12 patients after smoking. A PAH was added to the subject’s cigarettes, which was then modified by the body and turned into another chemical which damages DNA and has been linked with cancer.

The research shows this process only took between 15 and 30 minutes to take place. Professor Stephen Hecht, from the University of Minnesota, said: “This study is unique, it is the first to investigate human metabolism of a PAH specifically delivered by inhalation in cigarette smoke, without interference by other sources of exposure such as air pollution or the diet. The results reported here should serve as a stark warning to those who are considering starting to smoke cigarettes. Martin Dockrell, director of policy and research at Ash (Action on Smoking and Health), said: “Almost everybody knows that smoking can cause lung cancer.

“The chilling thing about this research is that it shows just how early the very first stages of that process begin – not in 30 years but within 30 minutes of a single cigarette for every subject in the study. “The process starts early but it is never too late to quit and the sooner you quit the sooner you start to reduce the harm.”

Hospitals are fiddling a four-hour A&E wait target by using other wards as dumping grounds, the Conservatives say. Data from 114 NHS trusts in England found many patients faced long waits in assessment units which did not count towards the waiting time. Over a fifth of units reported keeping patients longer than the recommended 24 hours with the average wait being 17. Doctors agreed the system was being abused in places, but the government said the research was “misleading”.

The Conservatives asked hospitals to provide data on their use of these wards under the Freedom of Information Act.We expect assessment units to be used to improve patient care, not as a ‘holding area’ or to avoid breaching the A&E four-hour standard. The units are commonly known as emergency assessment or clinical decision units. They effectively act as a half-way house between A&E and hospital to allow patients to continue to be monitored before a decision is taken to continue treating them or discharge them.

Many are mixed-sex and do not have proper beds, leaving patients to rest on trolleys. Shadow health secretary Andrew Lansley said: “Labour complacently claim that they have abolished long waits for patients being admitted to hospitals, but these figures show that all they have really done is fiddle the figures.

It is not the first time the way the target is being met has been criticised. Both the British Medical Association and academics at London’s City University have raised concerns over the last few years about the use of assessment units. John Heyworth, from the College of Emergency Medicine, said the four-hour target, introduced in 2004, was not working as well as people believed it was. “There is a continuing amount of gaming going on,” he said. “We know these areas are being used frequently purely to admit patients to meet the target and quite often they are not properly equipped or staffed.” He adds doctors would like to see more flexibility in the target to allow them to continue monitoring patients for longer than four hours when appropriate.

Nigel Edwards, policy director of the NHS Confederation, which represents hospital trusts, said it was likely patients were being moved to provide more time for tests, as the four-hour target did not give medical staff “very much leeway”.

Health minister Gillian Merron pointed out before Labour came to power patients were facing long waits. She said the Tory figures were “misleading” as some of the units were observational wards which had been designed and equipped to care for patients for a while. But she added: “We expect assessment units to be used to improve patient care, not as a ‘holding area’ or to avoid breaching the A&E four-hour standard.”

It would seem that the NHS is under so much pressure to change to many things at once, no wonder they are overstretched due to the sheer number of people they have to see when they have a mountain of paperwork to complete. So we shouldn’t blame them for attempting to modify procedure so that they appear to conform to the standards set by the government as they are aware that they risk funding being reduced if they don’t conform.

Gordon Brown has said overpaid public sector workers will be “named and shamed” in efforts to deliver more value for money in public services. Ahead of the pre-Budget report, the PM said “efficiency savings” would help to save £12bn over four years – £3bn more than planned in the Budget. Crime maps and online school reports will be used to cut overheads as Labour tries to halve the Budget deficit.

The Conservatives say the government is not being straight on the cuts needed. The government has delayed its planned comprehensive spending review until after a general election. In the pre-Budget report, Mr Darling is expected to confirm annual borrowing will top £175bn – which the government has promised to halve within four years. In his speech in central London, Mr Brown said ministers had identified £3bn in additional efficiency savings since the Budget in April.

Of that, £1.3bn over four years would be achieved by streamlining central government, he said, indicating that certain programmes would have to be delayed or abandoned. We need to do what households up and down the country do to prioritise the necessities and postpone the things we can do without

Government spending on consultants would be cut by half and communication spending by a quarter – saving £650m – while more Civil Service staff would be relocated from London to “cheaper” premises. Whitehall departments could set up “common spending policies” and share office space, as part of a “third generation of changes in public services”. In its report, Putting The Frontline First, the government points out there are now 4,300 senior civil servants compared with 3,100 in the mid-1990s.

Mr Brown said public sector workers earning an “over-generous” salary would be “named and shamed”, as many had “lost touch” with normality. In future, all new public sector jobs with salaries above £150,000 will have to be approved by the Treasury while the details of civil servants and other public sector managers under direct ministerial control currently earning that amount will be published.

Mr Brown has ordered a review of senior public sector pay by the Senior Salaries Review Body to report by the Spring. He said: “Money which should be spent on health, on schools, on policing and on social services is, in some cases, going on excessive salaries and unjustified bonuses, far beyond the expectation of the majority of workers. This culture of excess must change and will change.” He added that the government would use technological advances to make services more user-friendly and cheaper.

As an example, sending text messages to remind patients about GP appointments could help save up to £600m a year wasted on missed visits. The public needed more “feedback and interaction” when using services, such as crime maps and giving parents online details of children’s progress at school, he added. Mr Brown promised to bring more such details on to the internet by next year. “The proposals we are setting out in this plan – which is just one element of our efforts to reduce the deficit – will go further than we have ever gone before in streamlining central government,” Mr Brown said.

“We have already promised savings of £35bn a year by 2011 on top of the £26.5bn a year already delivered through the Gershon [spending] review. “But by identifying new ways of working – and being prepared to make the tough choices – we can deliver in excess of another £12bn in efficiency savings over the next four years.
“This includes £3bn of new efficiency savings identified since the Budget – of which over £1.3bn will come from streamlining central government.”

The proposals were laid out in Parliament by Liam Byrne, Chief Secretary to the Treasury, who said that saving money should be “everybody’s business”. Chancellor Alistair Darling told BBC One’s Andrew Marr show that public spending would be “a lot tighter than it was in the past” as a result.

He said parts of the troubled £12bn NHS IT system would be delayed as it “isn’t essential to the front line” – a move Health Secretary Andy Burnham told MPs on Monday would save £600m “over the lifetime of the programme”. Mr Darling said the full details of spending cuts would not be revealed until “the first half of next year at some point”.

Meanwhile, as part of plans to tackle the deficit in public finances, the Treasury is working on a possible windfall tax on what it sees as the exceptional profits of banks or the excessive bonuses of bankers.
But the Conservatives say the government is still not revealing the full extent of cuts needed to tackle Britain’s debts.

They say they would protect NHS and international development spending but the rest of Whitehall would face “very difficult choices” if the Tories won power. The party has also called for a moratorium on all government computer projects, claiming Labour has spent £100bn on IT since 1997 and that contracts worth another £70bn are due to be renewed or commissioned in the next two years.

Shadow Treasury minister Philip Hammond told MPs: “Since 2000 they’ve poured billions of pounds of taxpayers’ money into indifferent public services, borrowing and spending like it’s Monopoly money.”
He called Labour’s savings plans a “mish-mash of announcements and stolen clothes, in the dying months of their rule”.

Liberal Democrat Treasury spokesman Vince Cable said: “If the government knew there was inefficiency, why hasn’t the government already dealt with it?” We have now reached the point where the investment gap which we inherited…in 1997 has been fixed.

He added that more had to be done to improve the level of independence local government has from Whitehall, in an effort to increase accountability. Jonathan Baume, general secretary of the First Division Association, which represents senior civil servants, called the government’s proposals on public sector workers “irresponsible”. He added that “this announcement looks more like crude electioneering than a sober assessment of the implications for central government of the fiscal crisis”.

In businesses where there are groups of people working it is important that they’re able to work together. If they are not able to work together, it results in conflict and low productivity. In some cases it can result in major mistakes being made.

Ideally all members of the group should share the same ideas and goals. However in reality often the goals are shared within the team but the ideas about how to achieve that sometimes differ. This can be a good thing as long as there is good clear communication and the ability to compromise in order to get things done.

The team dynamic usually consists of degree of hierarchy, where each person is assigned a role. In a medical setting you can see this within individual departments which are smaller teams within a larger team, that is the hospital, which is a smaller team with a particular trust and so on until you get to the largest team of all the NHS.

Now we’ve all seen the stories on the news about the NHS failing, this is because their are parts of this team that are not working effectively. If you think about it logically each department is essentially a business if it does not work effectively then it loses customers this can then impact on the hospital as a whole because if you have a bad experience in one department then you are not likely to go back or at the very least reluctant to go to the hospital where you had the bad experience fearing that if you do the same thing may happen again.

There are a number of options that can be applied to rectify the situation:

  • Change the Team
  • Alter the hierarchy
  • Take Courses in team management and effectiveness

If you decided to take the 3rd option then your next question is who/where can i find these courses. Well there is a company called Medicology Ltd. This company offers a diverse range of tools to help you make your team the best it can be.

Experts are warning that poor communication between hospital staff and with their patients is far too common and deeply damaging. According to the findings of a confidential review patients left out of the loop and staff clocking on and off without a handover was commonplace. Change in the hospital team structure over recent years has seen individual clinicians become “transient acquaintances during a patient’s illness rather than having responsibility for continuity of care”, says the NCEPOD report. It found a co-ordinated handover of patients between night and day staff only occurred in a quarter of the teams. In 13.5% of cases lack of communication compromised continuity of patient care.

In just over half (53%) of cases there was an apparent lack of input from senior doctors “leading to delays in giving patients timely and appropriate care”, report author and surgeon Ian Martin said. And 30% of the patients were not seen by a consultant within the recommended 12 hours after admission. In a fifth of patients who were not expected to survive on admission there was no evidence of any discussion between the health care team and either the patient or relatives on treatment limitation. Many “do not attempt resuscitation” orders were signed by very junior trainee doctors. NCEPOD chairman Professor Tom Treasure said the report vividly revealed the challenge medical teams face in making the transition between saving life and allowing natural death. “It should be ensured that patients achieve the best quality of life until they die. Effective team working and communication with patients, relatives and carers are fundamental to getting this right.”

Director of the Patients Association, Katherine Murphy, said: “These findings run the risk of undermining basic confidence in the NHS. Some of the examples are shocking. “NCEPOD is the nearest the NHS has to airline ‘near miss reporting’. Its findings must be acted upon, or problems will continue to plague vulnerable patients and their families.” John Black, president of the Royal College of Surgeons, said doctors had long been concerned that the loss of team working in hospitals had fuelled the risk of poor communication, and sub-standard patient care. He said the implementation of a 48-hour working week under the European Working Time Directive almost certainly meant that the problem had got worse since the latest study was carried out. Professor Black said the only way to address the problem was to opt out of the directive.

A Department of Health spokesperson said measures had been introduced to improve care – including an end of life strategy – since the report’s survey was carried out. “We are putting in place an extensive programme of health and social care training to support end of life care provision, including pilot projects to support the development of communication skills. He added that evidence from hospitals already implementing a 48-hour week showed a drop in mortality and no evidence of harm to patients. “Working together with the local NHS and the Royal Colleges we have set up a rigorous quality assurance process to give us an accurate picture of how EWTD is being implemented and so we can provide support where it is needed.”

Experts are warning that the cost of treating the growing number of people drinking heavily threatens to cripple NHS hospitals. If the trend continues the burden will be unsustainable with a quarter of England’s population consuming hazardous amounts, alcohol addiction already costs the NHS more than £2.7 billion a year.

The report claims that hospital care alone cannot solve the problem, but increasing out-of-hospital provision could be more cost effective. This would include GPs screening and counselling their patients on alcohol misuse. Trials suggest that brief advice from a GP, or practice nurse, leads to one in eight people reducing their drinking to within sensible levels. This, says the report, compares well with smoking cessation, where only one in 20 change their behaviour, changing the way alcohol-related services are delivered could save hospitals 1,000 bed days and Primary Care Trusts up to £650,000 a year, experts estimate.

Professor Ian Gilmore, president of the Royal College of Physicians, said: “The nation’s growing addiction to alcohol is putting an immense strain on health services, especially in hospitals, costing the NHS over £2.7 billion each year.” And this sum has doubled in under five years. “This burden is no longer sustainable,” he said. “The role of the NHS should not just be about treating the consequences of alcohol related-harm but also about active prevention, early intervention, and working in partnership with services in local communities to raise awareness of alcohol-related harm.”

Steve Barnett, the chief executive of the NHS Confederation, said: “We hope this report helps to outline the scale of the problems facing the NHS and acts as a warning that if we carry on drinking in the way that we are currently, the bar bill will be paid in worse health and a health system struggling to cope.”

Two thirds of PCTs have adopted reducing alcohol-related hospital admissions as a local priority for the first time. “The department is providing Primary Care Trusts with the support, tools and incentives to deliver alcohol services in their own areas effectively according to local needs.”

The NHS under the spotlight again! This is because they are being accused of not doing enough to protect staff from a daily barrage of punches, slaps and kicks. In the last 3 years there has ony been a 0.5% increase in sanctions against offenders, this is despite a promise of “zero tolerance” approach.

Some cases that have made it to court got dropped as it was deemed “not to be of public interest”. Surely the medical staff have the same rights as everyone else to go to work and do their job without fear of being attacked. Instead that basic right has been denied. The medical professionals are under enough strain as it is with the potential collapse of the institute that provides them with a job and the fact the NHS is stretched so much that there isn’t enough staff.

More should be done to protect those that provide such a valuable service, saving lives.

Given the current economic climate this is an important and timely conference, designed specifically to help address the challenge facing healthcare teams and organisations as they strive to manage costs in a period of growing financial famine. Whilst commencing with the drivers of financial change, the programme addresses the full breadth of issues surrounding achieving meaningful cost improvement without compromising clinical quality. Cost improvement will only be achieved with the hearts, minds and practical engagement of the clinical workforce itself and so this receives special attention in a practical, hard hitting but positive programme.

Medicology Conferences are designed to enable the widest possible audience to gain insight into and solutions
to the core issues facing healthcare professionals today, by providing a cost-effective and accessible platform for information migration, experience sharing, collaboration and knowledge management. Conference topics are identified utilising the following criteria:

• There is a pressing need to resolve challenges in that area
• A wider audience needs access to important insight
• The topic area warrants wider discussion
• The issue in question has significant impact on healthcare success

We are particularly committed to bringing knowledge, insight, strategies & skills to frontline healthcare
professionals, who often face the challenge of implementing major initiatives or resolving key challenges at the operational coalface. Doctors, Nurses, Allied and Business Professionals at all levels of the organisation need access to the insight brought to Medicology Conferences. Widely Accessible to the Right People
Clinical and other frontline staff often find it difficult to access the insight necessary to succeed and thrive in the modern environment because many healthcare conferences are organised, publicised and priced in a manner that precludes them from attending when in fact it is they who really need access to the insight. Medicology conferences are designed to address this very issue by:
• Carefully managing costs to ensure the lowest possible cost of attendance
• Utilising lower cost but high quality venues to ensure the right capacity at the right price
• Ensuring the widest possible publicity to the right people

To book onto this amazing conference Cost Improvement Conference

In an attempt to transform services and improve value for money a lot of healthcare organisations have turned to Lean as the basis of their improvement efforts. It is not a new concept in fact its origins can be traced back to the 15th Century when the Venetian Navy introduced a ‘flow line’ for the production of war ships. Most people though would trace its history from its implementation within Toyota where is acquired the name of the ‘Toyota Production System’ and this became ‘Lean’ in the book ‘Lean Thinking’ that was published in 1996.

However, whilst the history of Lean in manufacturing is well established, it has only been over the last five or so years that Lean has found its way into the healthcare sector. The initial focus of Lean in healthcare was very ‘point’ focused, such as fixing low level problems in a pathology lab or dealing with theatre capacity. When organisations realised that such a low level approach was unlikely to lead to changes that lasted, the focus changed to ‘end to end’ clinical pathways, but in the early days this meant from the start point till the end point for a patient within a single organisation.
Amnis Courses

As Lean has matured, more people have started to experiment with pan-health economy Lean and this is where Lean moves from being a tactical tool to a strategic approach. It is still early days for the larger projects but there are already signs of success that significantly outweigh the many problems any form of transformation activity within the healthcare sector will experience.

In particular, because Lean consultants generally use a lot of jargon and even today use a lot of manufacturing related examples, it can be very off-putting for front-line healthcare staff. Even more damaging though is when Lean is used as a punishment because a team are under-performing or where the leadership team have hidden motives.

Lean can also experience problems after implementation if the focus is not on turning the changes in the process that have been achieved (such as new referral process) into a change in behaviour (which is achieved when people no longer realise that the process is ‘new’). With a lot of the early adopters of Lean focusing on the exciting parts of Lean, such as ‘Rapid Improvement Events’, the aspects of successful programmes that really make the difference have been forgotten, such as making sure that the Lean programme aligns with the organisational objectives, engaging frontline staff and dealing with any problems that arise along the way through some form of ‘Continuous Improvement’ process.

Healthcare organisations are already experiencing many of the problems that manufacturers have had to deal with for several decades, namely how to turn great ‘brown paper’ plans into real changes and then how to make those changes stick. It may not be surprising to realise that up to 75% of Lean programmes will never deliver long-term change, instead consisting of a series of exciting (yet ultimately wasteful) Rapid Improvement Events, and that is the same in healthcare as it is in manufacturing.

The choices for healthcare organisations going Lean is either to do it properly and ensure that the changes stick, which can be very demanding of management time, or trying a few isolated projects where the benefits ultimately drift away.

The key to success is to ensure that you adopt an approach to Lean that is flexible for your organisation and not rigidly imposed by a management consultancy to suit them and also to develop the internal capability of your staff as quickly as possible so that they can take the reins for your improvement programme. Ensuring all of this works is where the leadership team need to ensure that the targets they set for their Lean projects will deliver the organisational objectives and that everyone, from the boardroom to the wards, understands what needs to be done, why and by when.

This article was taken from Training Bulletin and is run by a company called amnis if you wish to get more details on this follow this link Accelerated Lean Skills Programme.

American researchers have found that children can be taught to use their imagination to tackle frequent bouts of abdominal pain. It is thought that the technique works particularly well due to their fertile imaginations. The research suggests that 1 in 5 children suffer with frquent abdominal pain with no identifiable cause. There were 30 children aged between 6 and 15 in the study half had 20 minute sessions of “guided imagery” this is where the patient is prompted to imagine things which will reduce their discomfort. The other half had the mainstream care.

It is thought that the treatment is very positive because it is inexpensive and is able to be self administered, which potentially opens the door for easily enhancing treatment outcomes for a lot of children sufering from frequent stomach aches.

This technique is an amazing breakthrough because this means that children can be treated by other means instead of drugs which is definately a positive. Also it means that more children can be treated without massive waiting lists which can be a definate plus for the NHS and the parents of the children who are suffering from abdominal pain and there is nothing they can do