Quality Long Term Care Commission

The cost of childcare could be cut by as much as 28% if the government was to go ahead with stalled plans to raise ratios of children to staff in nurseries.

Government plans are currently stalled due to a disagreement within the coalition between the Liberal Democrats and the Conservatives.

The new calculations released by the Department for Education under a freedom of information request said parent costs could be cut from £4 an hour to £3.49 an hour (a 12% cut) while teacher salaries could go up. Alternatively, if the extra revenue was used solely to reduce costs for parents, this could yield costs savings for parents of up to 28%.

Conservative ministers had been hoping to relax staff-child ratios by September, but Nick Clegg, the deputy prime minister, vetoed the plans saying he thought the proposed ratio changes would lower the quality of childcare. Conservatives are likely to use the figures to show they have been on the side of parents and choice, but are being blocked by the Liberal Democrats.

Department estimates suggest that if legal ratios for under-threes rose from four children for each member of staff to six and increased from a ratio of one to eight to one to 13 for staff looking after over-threes, the number of full-time places could be expanded by 52% to 73.

This increase in places creates a gross additional revenue of around £200,0000 based on the nursery charging £4 an hour. Even assuming the setting required the employment of a graduate, revenue would rise by £166,0000. Distributing this over 73 childcare places for 52 weeks a year and 39 hours a week the nursery could maintain its revenues and reduce its fees from £4 an hour to £2.88 an hour, a reduction of 28%.

The figures are bound to be raised by allies of the education secretary, Michael Gove, and the children’s minister, Liz Truss, to show that parents are being denied a large-scale cut in their childcare costs by Liberal Democrat objections.

It is not yet clear if the plans can be revived, but Gove has acknowledged that his plan to introduce the changes by September are looking hard to implement. He claimed that Clegg had vetoed the plans because he was worried he was about to be challenged for his party leadership by the business secretary, Vince Cable.

The Daycare Trust earlier this year showed nursery costs rising while wages are stagnating: it found average childcare costs were increasing by more than 6% a year (more than double the rate of inflation).

After-school care costs more than a family holiday to Florida and the costliest nurseries are more expensive than top public schools.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/5KnGmBS-mHM/nursery-reforms-cust-childcare-costs

Five men have been arrested over an allegation of a child being sexually assaulted at a day nursery.

West Mercia police said officers detained the men after a very young child told their family about an incident reported to have happened last week.

The incident is said to have taken place at one of the premises of Bright Eyes Nurseries and officers have been searching three branches run by the operator in Bromsgrove, Redditch and Droitwich, all in Worcestershire. Three other properties have also been searched.

Superintendent Kevin Purcell, of West Mercia police, said: “A young child has made a disclosure that we are taking extremely seriously. We are also treating it as sensitively as possible due to the nature of the offence and the very young age of the child involved.

“Our primary concern is their welfare as well as that of the other children who attend the nurseries. We are working with our partner agencies in the Worcestershire Safeguarding Children Board as part of our response.

“The investigation is at its early stages and five men have been arrested as we endeavour to identify the person responsible for the assault. We fully understand how concerning this disclosure will be to those people whose children attend Bright Eyes Nurseries, as well as the wider community.

“All parents and carers who have visited the nurseries today were given a letter explaining, as far as possible, the reasons for our activities, while police staff are available to discuss any immediate worries they may have.”

The five men are in police custody awaiting questioning. Ofsted inspectors rated each of the three nursery premises’ early years provision as good in their most recent visits. Nobody from the nursery was available to comment.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/ATBHFbncLhA/five-arrested-claims-assault-nursery

Main Category: Primary Care / General Practice
Also Included In: Nursing / Midwifery
Article Date: 17 May 2013 – 0:00 PDT

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At a time when the U.S. health system is facing both an increasing demand for primary care services and a worsening shortage of primary care physicians, one broadly recommended strategy has been to increase the number and the responsibilities of nurse practitioners. In 2010 an Institute of Medicine (IOM) committee recommended that “advance practice registered nurses should be able to practice to the full extent of their education and training” and that nurse practitioners should be able to admit patients to hospitals and hospices, lead medical teams and medical homes, and receive reimbursements similar to what physicians receive for providing the same services.

A study published in the New England Journal of Medicine finds, however, that while primary care physicians and nurse practitioners for the most part agreed with the first recommendation, they significantly disagreed about some proposed changes to the scope of nurse practitioners’ responsibilities. Specific points of disagreement revealed in the survey – led by investigators from Massachusetts General Hospital (MGH) and the Institute for Medicine and Public Health at Vanderbilt University Medical Center – include appropriate leadership roles for nurse practitioners, reimbursement levels and the overall quality of services they provide.

“We were surprised by the level of disagreement reported between these two groups of professionals,” says Karen Donelan, ScD, EdM, of the Mongan Institute for Health Policy at MGH, lead author of the report. “We had hypothesized that, since primary care physicians and nurse practitioners had been working together for many years, that collaboration would lead to more common views about their roles in clinical practice. The data reveal disagreements about fundamental questions of professional roles that need to be resolved for teams to function effectively.”

Adds Peter Buerhaus, RN, PhD, director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt and a co-author of the paper, “It is unsettling that primary care physicians and nurse practitioners, who have been practicing together for several decades, seem so far apart in their perceptions of each other’s contributions. I am concerned that these large gaps in perceptions will inhibit efforts to redesign care delivery and to improve the productivity and configuration of the primary care workforce.” Additional co-authors of the paper are Catherine DesRoches, DrPh, Mathematica Policy Research, Cambridge, Mass.; and Robert Dittus MD, MPH, Veterans Administration Tennessee Valley Geriatric Research, Education and Clinical Center and Vanderbilt Institute for Medicine and Public Health.

Although debates on the appropriate roles of health professionals are nothing new, the authors note, little data has been available on the roles played by nurse practitioners in primary care and how they differ from those of primary care physicians. The current study was designed to assess those roles and how expanding them might affect the health care system. The survey was mailed to a national random sample of nearly 2,000 primary care clinicians – evenly divided between physicians and nurse practitioners – and responses were received from 467 nurse practitioners and 505 physicians.

The majority of both groups – 96 percent of nurse practitioners and 76 percent of physicians – agreed with the IOM recommendation that nurse practitioners “be able to practice to the full extent of their education and training,” and 76 percent of nurse practitioners reported they were doing so. Majorities also agreed that increasing the supply of primary care nurse practitioners would improve the timeliness of and access to care, and respondents working in collaborative practices indicated that both professions provide a wide range of services in their practices.

But the survey revealed significant disagreements on specific recommendations:

• 82 percent of nurse practitioners believed they should be able to lead medical homes – practices using a team-based model to deliver coordinated patient care – but only 17 percent of physicians agreed;
• 64 percent of nurse practitioners agreed they should be paid equally for providing the same services, compared with only 4 percent of physicians;
• 60 percent of nurse practitioners in collaborative practices indicated they provided services to complex patients with multiple conditions, but 23 percent of physician in such practices responded that those services were provided by nurse practitioners,
• the two groups disagreed significantly regarding whether an increase in the supply of nurse practitioners would improve patient safety, the effectiveness of care and health costs, with one third of physicians responding that such an increase might have a negative effect on safety and effectiveness.

The investigators note the need for more analysis of the economic implications of expanding nurse practitioner roles and responsibilities, as well as the contribution of nurse practitioners to the care of complex patients. Buerhaus stresses, “At this stage, discussion is critical to finding points of agreement. Several states have workforce commissions that might serve as a forum for primary care physicians, nurse practitioners, payors and even patients to discuss these issues. Our study did not find major differences by states and did not include physician assistants or other allied health professionals, but including everyone in this dialogue will be important.”

Adds Donelan, “Patients need health care teams that work in concert. We need to look at models of successful collaboration and understand how good teams function effectively and efficiently. We also need to consider how to structure nursing, medical and interprofessional education to enhance understanding and appreciation of each others’ professional cultures.”

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Related MedlinePlus Pages

By Kate Kelland

LONDON (Reuters) – Two health workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients in their care – the first evidence of such transmission within a hospital, the World Health Organization said.

The new virus, known as novel coronavirus, or nCoV, is from the same family of viruses as those that cause common colds and the one that caused the deadly outbreak of Severe Acute Respiratory Syndrome (SARS) that emerged in Asia in 2003.

“This is the first time health care workers have been diagnosed with (novel coronavirus) infection after exposure to patients,” the Geneva-based U.N. health agency said in a disease outbreak update late on Wednesday.

The health workers are a 45-year-old man, who became ill on May 2 and is currently in a critical condition, and a 43-year-old woman with a coexisting health condition, who fell ill on May 8 and is in a stable condition, the WHO said.

France has also reported a likely case of transmission within a hospital, but this was from one patient to another patient who shared the same room for two days.

NCoV, like SARS and other similar viruses, can cause coughing, fever and pneumonia.

Scientists are on the alert for any sign that nCoV is mutating to become easily transmissible to multiple recipients, like SARS – a scenario that could trigger a pandemic.

WHO experts visiting Saudi Arabia to consult with the authorities on the outbreak said on Sunday it seemed likely the new virus could be passed between humans, but only after prolonged, close contact.

Initial analysis by scientists at Britain’s Health Protection Agency last year found that nCoV’s closest relatives were most probably bat viruses. Yet further work by a research team in Germany suggests nCoV may have come through an intermediary – possibly goats.

The WHO’s Wednesday update said that, while some health care workers in Jordan had previously contracted nCoV, these Saudi cases were the first clear evidence of the virus passing from infected patients.

“Health care facilities that provide care for patients with suspected nCoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients and health care workers,” it said.

It also advised health care providers to be “vigilant among recent travelers returning from areas affected by the virus” who develop severe acute respiratory infections.

Since nCoV first emerged and was identified in September 2012, the WHO says it has been informed of a total of 40 laboratory-confirmed cases worldwide, including 20 deaths.

Saudi Arabia has had most of the cases – with 30 patients infected, 15 of them fatally – but nCoV cases have also been reported in Jordan, Qatar, Britain, Germany and France.

(Reporting by Kate Kelland; Editing by Kevin Liffey)

Article source: http://www.nlm.nih.gov/medlineplus/news/fullstory_136881.html

Main Category: Palliative Care / Hospice Care
Also Included In: Nursing / Midwifery
Article Date: 16 May 2013 – 1:00 PDT

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Nurses will use extreme measures to save patients and their parents. But they’d prefer less aggressive life-preserving methods for themselves, according to an international survey on nurses’ end-of-life preferences.

Findings from a cross-cultural survey of 1,089 nurses from five countries about their end-of-life (EOL) preferences were reported a recent issue of in the International Nursing Review.

“Globally, nurses chose different EOL treatments for themselves than they do for their patients,” said Joyce Fitzpatrick, PhD, RN, FAAN, from the Frances Payne Bolton School of Nursing at Case Western Reserve University and a lead investigator on the study.

While the study looked at preferences, the researchers asked, if nurses chose this as best personal choice, why isn’t it the one for the patients?

End-of-life preferences among physicians and families have been widely studied, but Fitzpatrick’s research group sought similar attitudes among nurses.

Nurses in Hong Kong, Ireland, Israel, Italy and the United States were given three hypothetical scenarios of dying patients to learn what they would do for the patient, their parents and themselves. The survey was conducted between June 2011 and July 2012.

The respondents were given the scenario of an 84-year-old male Alzheimer’s patient in a nursing home who had gastrointestinal bleeding, was in shock and likely to die without an intervention. Participants had to chose from one of four treatment options: palliative, limited, surgical or intensive care.

The scenario was repeated with the elderly patient as the survey-taker’s father. In the third scenario, they were to imagine themselves as that patient.

Most of the nurses in each country, from 55 percent in Hong Kong to 85 percent in the United States, responded that they would use CPR for patients and parents. But those numbers dropped on use for themselves.

But significant differences arose when asked about the use of feeding tubes. Just 19 percent of respondents in United States to 59 percent in Israel would use this intervention for themselves. But if the patients were their parents, the numbers would be double in some cases (40 percent to 75 percent, respectively).

Respondents globally reported that factors that influenced EOL preferences were: duty of care, lack of knowledge of the patient’s wishes, personal experiences with a dying family member, the patient’s age and lack of contact with the family.

Fitzpatrick said the study contributes important information in developing global policies that provide patients with end-of-life choices.

“Making these decisions is complicated when the patient is unable to speak due to cognitive or medical problems,” said Fitzpatrick, Elizabeth Brooks Ford Professor of Nursing. “Then the hard and emotional decision is left to the family and healthcare professionals.”

The researchers report that end-of-life issues are in the midst of a global social debate, ranging from type of appropriate treatment to whom should make the ultimate decision, especially when differences arise between a doctor and family members.

For years, the decision, when a patient was unable to make it, was left to the doctor. But more countries – the United Kingdom, Australia, Canada, Israel, United States and several other European nations – have adopted the practice of leaving advance legal instructions.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/5CX1VfFv3ow/260553.php

Since the Coalition was formed, they said the number of days lost to “delayed
discharge” was more than one million and an estimated to the NHS of up to
£260m.

Charity officials said that a third of the “days lost” due to
delayed discharge are linked to patients waiting for social care.

“Waiting in hospital needlessly not only wastes NHS resources but it can
also undermine an older person’s recovery and be profoundly upsetting for
them and their families as a result,” said Michelle Mitchell, the Age UK
charity director general.

“We are very worried that the growing crisis in social care is having a
significant impact on the length of time that older people are having to
stay in hospital waiting for social care support to be put in place.”

Over the past two years many local authorities, which provide social care,
have been “struggling” to balance their books because of funding
cuts, she added.

Many authorities have since raised their eligibility criteria so that older
people have to be more frail and disabled to qualify for help.

Cllr Zoe Patrick, chairman of the Local Government Association’s (LGA)
Community Wellbeing Board, said: “Sadly this research highlights the very
real crisis we are facing in providing even the most basic care to the most
vulnerable members of society.

“The current system promotes an inefficient use of taxpayers’ money but
more worryingly it also reduces the quality of care people receive.

“Radical reform of the way adult social care is paid for and delivered in
future [is needed] or things will get much worse.”

The Department of Health (DoH) yesterday announced that health and social care
would be “fully joined up” by 2018

A DoH spokesman said that at present “inadequate co-ordination”
between hospital and social care staff leads to some older patients facing “long
waits” before being discharged.

He said other elderly people are discharged from hospital to homes which are
not adapted to their needs, which leads to them deteriorating or falling and
ending up back in AE.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2be17ecd/l/0L0Stelegraph0O0Chealth0Celderhealth0C10A0A544960CElderly0Epatients0Eface0Elonger0Ehospital0Ewaits0Efor0Ecare0Ehome0Etransfer0Bhtml/story01.htm

An out-of-hours GP service covering 250,000 patients is using senior nurses when doctors cannot be recruited to work the shifts, it is reported.

The private healthcare provider Harmoni regularly employs advanced nurses to work eight-hour overnight shifts covering districts of up to 150 square miles, a whistleblower claims.

In times of extreme staffing shortages, there has been just one advanced nurse practitioner working overnight in North Somerset, the Daily Mail said.

The whistleblower told the newspaper that locum doctors have been flying in on easyJet from Europe, or driving from elsewhere in Britain to perform back-to-back shifts round-the-clock; terminally-ill cancer patients have waited eight hours for a doctor to visit them at home and administer pain relief; and foreign doctors with a poor grasp of English have been used to plug gaps in the rota.

The whistleblower said that working for Harmoni was like “taking a loaded gun and sitting with it because at some point it’s going to become so unsafe it’s going to go off”.

“My personal feeling is that at times it has been unsafe,” the source said.

“It’s a dereliction of duty. Everything is secondary to meeting budget. Patient care is compromised, employee care compromised.

On Sunday evening a spokesman for Harmoni said: “The clinical staff employed by Harmoni are all self-employed GPs or advanced nurse practitioners who work on flexible contracts.

“Harmoni has comprehensive measures in place to ensure team members take sufficient breaks.

“Harmoni has in place some of the most robust interviewing procedures in this field to ensure the communication skills of GPs who work for us are of a high standard.

“On very rare occasions, and only after consultation and agreement with our commissioning colleagues in North Somerset that the service remained clinically safe, we have run an overnight shift with a very experienced advanced nurse practitioner providing the first point of contact, with a GP available on-call to support with any advice needed.

“For Harmoni, and indeed virtually all out-of-hours providers, there are some occasions where filling all the planned GP rota slots is a challenge. Even when this is the case we ensure we are providing a service which is clinically safe and our service is constantly closely monitored by NHS commissioners to ensure this is the case.

“Our performance figures are accurately recorded in line with national guidelines and, again, carefully scrutinised by our commissioning colleagues.”

Harmoni has contracts across the country and asked if this happens elsewhere, it answered: “Highly trained and experienced advanced nurse practitioners are a valued, important and often-used part of our workforce across the country.

“Harmoni imposes strict criteria on our recruitment of advanced nurse practitioners, selecting those with advanced qualifications and additional skill sets suitable for the urgent care environment.

“Advanced nurse practitioners do have certain limitations on the care they can provide such as with very young children and palliative care. Therefore, on the occasions when they are the first point of patient contact, we ensure there is always covering support available from a GP.”

A Department of Health spokesman said: “It is a legal requirement for the NHS to make sure the right, high quality out-of-hours services are in place for patients in their area.

“If this is not happening it is totally unacceptable and we expect the local NHS to take action immediately to improve their services.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/340ejS1l58g/night-gp-service-nurses

“My personal feeling is that at times it has been unsafe,” the source said. “It’s
a dereliction of duty. Everything is secondary to meeting budget.

“Patient care is compromised, employee care compromised. “It’s an edict
from on high.

“They have thinned rotas down to a bare minimum.”

A spokesman for Harmoni said: “The clinical staff employed by Harmoni are all
self-employed GPs or advanced nurse practitioners who work on flexible
contracts.

“Harmoni has in place some of the most robust interviewing procedures in this
field to ensure the communications skills of GPs who work for us are of a
high standard.

“On very rare occasions, and only after consultation and agreement with our
commissioning colleagues in North Somerset that the service remained
clinically safe, we have run an overnight shift with a very experienced
advanced nurse practitioner providing the first point of contact with a GP
available on-call to support with any advice needed GPs available to support
if a home visit was necessary.”

The spokesman added that “there are some occasions where filling all the
planned GP rota slots is a challenge”.

“Even when this is the case we ensure we are providing a service which is
clinically safe and our service is constantly closely monitored by NHS
commissioners to ensure this is the case,” he said.

Harmoni has contracts across the country, and when asked if this happens
elsewhere, the company answered: “Highly trained and experienced advanced
nurse practitioners are a valued, important and often-used part of our
workforce across the country.

“Harmoni imposes strict criteria on our recruitment of advanced nurse
practitioners, selecting those with advanced qualifications and additional
skills sets suitable for the urgent care environment.

“Advanced nurse practitioners do have certain limitations on the care they can
provide such as with very young children and palliative care. Therefore, on
the occasions when they are the first point of patient contact, we ensure
there is always covering support available from a GP.”

A Department of Health spokesman said: “It is a legal requirement for the NHS
to make sure the right, high quality out-of-hours services are in place for
patients in their area.

“If this is not happening it is totally unacceptable and we expect the local
NHS to take action immediately to improve their services.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2bd348fd/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A528950CNight0EGP0Eservice0Euses0Enurses0Eto0Efill0Edoctor0Epositions0Bhtml/story01.htm

The SSA, which includes the Royal College of Nursing, Unison and the Patients
Association, said that nurse staffing levels have been ignored for too long,
the BBC said.

The alliance quoted a survey of almost 3,000 nurses at 31 English hospitals
which found that wards were run with a ration of one nurse for eight
patients about 40% of the time.

In a statement the SSA said: “For the sake of clarity, more than eight
patients per registered nurse is the level considered to be unsafe and
putting patients at risk. It is not a recommended minimum.

“For nurses to provide compassionate care which treats patients with
dignity and respect, higher levels will be needed and these should be
determined by every health care provider.”

The survey by Nursing Standard and the Sunday Mirror also found that almost
half of nurses had seen patients suffer as a result of services being cut.
But 57.5% of nurses said they were still proud to work for the NHS.

Royal College of Nursing general secretary Dr Peter Carter told the newspaper: “What
happened at Mid Staffordshire was a tragedy, and for nurses to say they
predict another scandal is very worrying indeed.

“The issues of unsafe staffing levels, unregulated health care
assistants, and a financially driven culture must be addressed.”

The Government said hospitals were responsible for their own levels of
staffing.

Health Minister Dr Dan Poulter said: “It is for hospitals themselves to
decide how many nurses they employ, and they are best placed to do this.

“Nursing leaders have been clear that hospitals should publish staffing
details and the evidence to show that staff numbers are right for the care
needs of the patients that they look after.

“Overall, the number of clinical staff in the NHS has risen and the
number of admin staff has fallen by 18,000.”

Mr Poulter said a new chief inspector of hospitals would have powers to take
action if hospitals are found to be compromising patient care by not having
the right number of staff on wards.

Professor Elizabeth Robb, chief executive of the Florence Nightingale
Foundation, added: “For the first time ever, nursing’s leadership is
united on this.

“We are coming together to stand up for patient safety and for the
profession.

“We are saying that, with a ratio of one registered nurse to more than
eight patients, there is a significantly increased risk of harm. We hope
that by coming up with a figure we will give directors of nursing the
evidence they need to argue for the staffing levels necessary to provide
good care.

“If Government are saying that staffing levels are a local decision, then
it is more important than ever to set out clear guidance.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2bce5c7b/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A519830CHospital0Estaffing0Elevels0Eunsafe0Esenior0Enurses0Ewarn0Bhtml/story01.htm

A group of senior nurses is warning that staffing levels on many hospital wards in England are unsafe.

The Safe Staffing Alliance (SSA) says wards often have just one registered nurse looking after eight patients.

According to the BBC, he alliance, which was formed last summer, says there is a worry that this ratio could be regarded as the minimum acceptable of staffing when it in fact puts patients at risk.

The SSA says research shows that when nurses are asked to look after more than eight patients there is an increased risk of harm or death.

The warning comes as a poll for the Sunday Mirror and the Nursing Standard journal found that more than three-quarters of nurses believe a scandal similar to that in Mid Staffordshire could happen again.

In the poll of 2,000 nurses, 40% said on their last shift there were not enough staff to provide a safe level of care.

The SSA, which includes the Royal College of Nursing, Unison and the Patients Association, said nurse staffing levels have been ignored for too long.

The alliance quoted a survey of almost 3,000 nurses at 31 English hospitals, which found that wards were run with a ratio of one nurse to eight patients about 40% of the time.

In a statement, the SSA said: “For the sake of clarity, more than eight patients per registered nurse is the level considered to be unsafe and putting patients at risk. It is not a recommended minimum.

“For nurses to provide compassionate care which treats patients with dignity and respect, higher levels will be needed and these should be determined by every healthcare provider.”

The survey also found that almost half of nurses had seen patients suffer as a result of services being cut. But 57.5% of nurses said they were still proud to work for the NHS.

The general secretary of the Royal College of Nursing, Dr Peter Carter, told the Sunday Mirror: “What happened at Mid Staffordshire was a tragedy, and for nurses to say they predict another scandal is very worrying indeed.

“The issues of unsafe staffing levels, unregulated healthcare assistants, and a financially driven culture must be addressed.”

The government said hospitals were responsible for their own levels of staffing.

Health minister Dr Dan Poulter said: “It is for hospitals themselves to decide how many nurses they employ, and they are best placed to do this.

“Nursing leaders have been clear that hospitals should publish staffing details and the evidence to show that staff numbers are right for the care needs of the patients that they look after. Overall, the number of clinical staff in the NHS has risen and the number of admin staff has fallen by 18,000.”

Poulter said a new chief inspector of hospitals would have powers to take action if hospitals were found to be compromising patient care by not having the right number of staff on wards.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/HSUEaEhdKy4/hospital-staffing-levels-nurses

People will be treated more compassionately in hospital, see their care better joined up and be reassured that they will not have to pay astronomical care costs if they need to go into a care home in their old age, thanks to measures set out in the Care Bill, published today in Parliament.

The Care Bill will help drive up quality of care following the findings of the Francis Inquiry into events at Mid-Staffordshire NHS Foundation Trust. It will also include improvements to the care system following an extensive consultation with people and organisations right across the health and care system – from users of services to providers of care. The Bill will create a single modern law that replaces more than a dozen pieces of legislation dating back to the post-war period.

Through the Care Bill, the Government is introducing laws that will:

• Help people get compassionate care in hospital, in a care home or in the community, by introducing Ofsted-style ratings for hospitals and care homes, making quality as important as finance and strengthening training for staff.

• Join up care by enshrining in law that everyone should have a personal care plan, access to a personal budget and that carers, for the first time, will have a right to get support themselves if they are found to have eligible needs. There will also be a national minimum eligibility threshold across the country.

• Reform the funding of care so no one will have to sell their home in their lifetime, or lose everything they’ve worked for, to pay for the costs of living in a care home. And a cap on care costs and financial support for more people will protect people from catastrophic costs and provide important peace of mind.

Health Secretary Jeremy Hunt said:

We have swiftly brought in measures to address the findings of Robert Francis’ report that will improve care and mean that patients will be treated with more compassion and respect. I strongly believe that Ofsted-style ratings, improved training for staff and making quality as important as finance will improve NHS care.

These changes go hand in hand with our epic changes to care legislation that will mean, for the first time, people will not have to fear losing their homes in their lifetime to pay care home fees and everyone with a care plan will be able to have a personal budget to choose how they are cared for.

Importantly, if someone receives care in the south but wants to move to the north to be closer to their family, they will be able to do so without fear of losing their care.

Care Services Minister Norman Lamb said:

For the first time in a generation we are addressing the pressing need to support people when they reach crisis point and need help most. People will finally be able to plan for their later years and not have to fear being saddled with catastrophic costs to pay for care.

This, coupled with the new national eligibility criteria, security that our care is not lost if we move to a different part of the country and giving everyone who is eligible access to a personal budget, will greatly improve the outlook for later life.

Elements of the Bill that respond to the Government’s Caring for our future White Paper last year include:

• A new legal right for everyone with a care and support plan (or support plan) to have a personal budget, which they can receive as a direct payment if they wish to. This gives people more control and the ability to tailor the services they receive to their requirements and preferences.

• No-one’s care and support is interrupted if they move to a different local authority area, for example, if they want to live closer to family or change jobs.

• For the first time, carers will have a right to receive support themselves if they are found to have eligible needs.

• The person will be involved in the assessment process that determines what care and support needs they have, and this process will focus on the needs of the individual and on the outcomes they wish to achieve.

• National eligibility criteria will mean a fairer and clearer system, and help people understand whether they might be eligible for access to ongoing care and support.

• A new focus on people’s wellbeing will see more done to keep people well. This will include a more all-encompassing assessment process that considers a person’s capabilities and what they can achieve themselves, as well as considering what other support might be available from family, friends or in the community. This will help to delay or prevent people from developing serious care and support needs, rather than the current system which often only intervenes in a crisis, and will mean than people’s specific needs at different times in their life will be better supported.

• No-one will have to sell their home in their lifetime, or lose everything they’ve worked for, to pay for the costs of living in a care home later in life. A cap on reasonable care costs and financial support for more people with their costs will protect people from catastrophic costs and provide important peace of mind. As our population ages this is more important.

Elements of the Bill that respond to Robert Francis QC’s report include measures that:

• Underpin the new ratings regime for hospitals. Francis highlighted the need for a single, shared version of the truth about quality. This Bill will give CQC the legal powers it needs to set up, design and get on with the new ratings system, without any political interference.

• Ensure quality is as important as finances. The Bill will give Monitor clear authority to intervene where the Chief Inspector exposes problems with the quality of care. The Care Quality Commission will also be given a power to require Monitor to put a Foundation Trust into administration if it becomes clinically unsustainable (currently Monitor can only do this on financial grounds).

• Give the CQC stronger powers to expose poor care. At the moment, the CQC can only take action where a hospital is failing to comply with one of its set standards. This can be bureaucratic. The Bill will give the Care Quality Commission broader powers to act if it spots poor care that requires significant improvement.

• Introduce a new criminal offence on providers who supply false or misleading information. The Bill will make it a criminal offence for care providers to give false or misleading information. We will limit the offence to providers of NHS secondary care (NHS Trusts, FTs and independent providers of NHS secondary care) and to certain types of information such as mortality rates.

The Bill will also:

• Strengthen training and education. The Bill will set up Health Education England legally as the first ever non-departmental public body responsible for training and education for NHS staff, giving the NHS workforce unprecedented focus and support.

• Strengthen research regulation. The Bill will set up the Health Research Authority legally as a non-departmental public body, so it can act independently to regulate the research sector and protect people who take part in research or are thinking about taking part. This will help build a vibrant research sector that is safe and ethical.

Notes to editors

1. The Bill can be found here.

2. Proposals to grant social workers new rights to enter homes where abuse is suspected will not proceed after a Government consultation resulted in mixed opinions over the case for such a power. The responses did not show a compelling enough case to legislate for a new power of entry. It is a sensitive and complex issue, which is why the Government consulted extensively on it. However Councils and the police already have significant powers of intervention in safeguarding cases.

3. Contact Department of Health press office on 0207 210 5947 for more information.

Article source: https://www.gov.uk/government/news/governments-care-bill-to-give-people-peace-of-mind-in-hospital-care-homes-and-their-own-homes

Main Category: Pediatrics / Children’s Health
Also Included In: Nursing / Midwifery;  Public Health
Article Date: 10 May 2013 – 1:00 PDT

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A new study shows that pediatric nurse staffing ratios are significantly associated with hospital readmission for children with common medical and surgical conditions.

The study, led by a nurse scientist at Cincinnati Children’s Hospital Medical Center, is believed to be the first to examine the extent to which hospital nurse staffing levels are related to pediatric readmissions. Publication of the study comes just weeks after the introduction of federal legislation that would mandate nurse staffing ratios across the country.

The study, published online in the journal BMJ Quality and Safety in Health Care, looked at such common medical and surgical conditions as pneumonia and appendectomy.

“Preventing unnecessary hospital readmissions is an increasingly important focus of large-scale quality improvement initiatives,” says Heather Tubbs-Cooley, PhD, RN, a nurse scientist at Cincinnati Children’s and the study’s main author. “Reducing preventable readmissions is also a high priority for hospitals, particularly as they face the prospect of nonpayment for these services.”

Dr. Tubbs-Cooley and colleagues from the University of Pennsylvania found that each one patient increase in a hospital’s average staffing ratio increased the odds of a medical patient’s readmission within 15-30 days by 11 percent. The odds of readmission for surgical patients increased by 48 percent.

Children treated in hospitals meeting a contemporary staffing benchmark of no more than four patients per nurse were significantly less likely to be readmitted within 15-30 days. Nursing staffing ratios had no effect on readmissions within the first 14 days after discharge.

The study team examined the outcomes of more than 90,000 children in 225 hospitals using survey and discharge data from California, Florida, New Jersey and Pennsylvania, as well as the American Hospital Association Annual Survey from these four states. All hospitals included in the study were non-federal, acute-care facilities with at least 50 pediatric discharges a year.

“Lower patient-to-nurse ratios hold promise for reducing preventable readmissions by allowing for more effective pre-discharge monitoring of patient conditions, improving discharge preparation and through enhanced quality improvement success,” says Dr. Tubbs-Cooley. “Delivering high quality patient care requires nurses’ time and attention, and better staffing conditions likely allow nurses to thoroughly complete the clinical care that children and their families need in order to have a successful discharge.”

Despite the study results, she isn’t ready just yet to endorse mandated staffing ratios. “We have abundant evidence that better nurse staffing levels in hospitals are associated with better patient outcomes, but we lack robust data to guide decision-making regarding optimal staffing levels for a given unit or patient population. Producing that evidence will require different designs and methods than those we have relied on in the past.”

Dr. Tubbs-Cooley plans to test these research designs in further studies.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/sy_FobMMifw/260302.php

Care homes will face prosecution if they do not report concerns that their staff are mistreating patients under social care legislation to be published this month.

The “duty of candour” on social care providers, a recommendation in the Francis report into the Mid Staffs NHS scandal, will be set out by health secretary Jeremy Hunt and would mean industry executives would have to tell health regulators if they thought their employees might be harming or neglecting elderly people.

Ministers will also lay out a new payment system for social care, which the government says will “ensure the elderly do not have to sell their homes to meet their care bills”. This allows elderly and vulnerable people to borrow the cash to pay for residential care from councils – to be repaid when they die and their house is sold. At present councils can offer a deferred payment scheme, though many do not as it is in effect an interest-free loan. The government intends to make this scheme universal and allow local authorities to charge interest.

Experts say this will make the new system more expensive.

The government will also set a national eligibility level, replacing the postcode lottery whereby elderly people receive different levels of state support depending on how councils rate their needs.

Ministers will set a cap on care costs at £72,000 from 2016. However, this system is not designed to underwrite private care homes – and the industry says that only a very narrow band of the elderly who are accepted as “eligible and can find a care home that accepts local authority funding” will not have to pay for care. Such is the complexity of the system that insurers are calling for the government to make regulated financial advice a legal requirement in social care.

“There are a lot of unknowns here,” said Chris Horlick of Partnership Assurance – the last insurer to offer pre-funded care insurance. He said that the government underestimated how big the reforms were and would probably have local trials before rolling them out nationally. “It is what happened in welfare reform. I can see the same thing here.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/eBozVcvXZxw/care-homes-abuse-legislation

Panel chair Maurice Cohen said: “Mr Madziwa displayed verbally and physically
abusive behaviour towards service user A and a sanction is needed to meet
the public interest.

“It was a serious departure from the relevant standards as set out in the
code.

“There is no evidence he has considered the consequences of his actions on
service user A or on the profession.”

Mr Cohen added: “His actions amounted to abuse of his position and power –
this was not an isolated incident but occurred over a protracted period of
time.”

Service user A had suffered from mental health problems including depression,
bulimia and diabetes when she was admitted to the Priory Clinic in
Southgate, north London, in June 2008.

The clinic, which treated the late singer Amy Winehouse, is famed for its
treatment of patients with substance abuse problems and mental health
issues.

Madziwa began emailing Service User A after she was transferred to another
hospital eight months later.

The patient’s mother discovered she had been seeing ‘Trevor from the Priory’
at Christmas 2010 but did not say anything for fear of affecting her
daughter’s condition.

But the relationship took a turn for the worse after Christmas 2011 and
Madziwa violently pinned her down and removed her tights while holding her
captive in his flat.

The teenager eventually managed to escape after kicking Madziwa and grabbing a
knife from the kitchen.

The attack was reported to police, but the woman decided that she did not want
to press charges.

Madziwa later claimed that the woman hacked into his email account to fire off
a series of aggressive messages to herself.

But Mr Cohen dubbed Madziwa’s evidence “implausible” and “contradictory”.

Madziwa had already admitted having a sexual relationship with his former
patient and preventing her from leaving his flat.

He has 28 days to appeal the striking off order. An interim suspension order
of 18 months has been passed to cover the appeal period.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b9c06d5/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A410A870CNurse0Estruck0Eoff0Efor0Eholding0Eformer0Epatient0Ecaptive0Ewhen0Eaffair0Eended0Bhtml/story01.htm

Maja Petersen, 38, a prostitute, could not wait a moment longer for her fix. She had made her way to Copenhagen’s drug consumption room, hoping to inject there, away from public view and within sight of its nurses. But the room – a place where addicts can use class A drugs free of fear of prosecution – doesn’t open its doors to the city’s 8,000 addicts until 8.30am.

At 8am last Wednesday, she sat down on the cobbled street outside and plunged a syringe into her arm, flushing cocaine into her bloodstream. Speaking shortly afterwards, with tears welling in her eyes, she estimated that she would inject herself another 20 times that day with cocaine, methadone, or a mixture of the two – her usual routine. “With cocaine you want more and more and more. If you have it, you take it,” she said. “I hate life. I don’t have a life any more. But I have never taken too much. I have never tried to die.”

Not wanting to die is the reason why Petersen, like the 1,000 regulars at what the Danes call the “fixing room”, make their way to this small health centre in a square that it has made its own, walled off from view, in Copenhagen’s Vesterbro area – the city’s former meat-packing district.

Even the most addled addict is unlikely to die here under the watch of medics and social workers. It is why, back in Britain, Brighton’s public health leaders will meet this summer to “give serious consideration” to establishing a similar facility in the city, where 110 people died drug-related deaths between 2009 and 2012.

Maja Petersen, right, outside the drug consumption room. She says she uses the facility to stay alive. Nurses have dealt with 36 overdoses there, with no fatalities.  Photograph: Mikkel Østergaard/Panos for the Observer

Copenhagen’s drug consumption room is small, but it is the latest incarnation of the idea of a safe haven for addicts and those behind it have learned lessons from about 90 others around the world. Last month’s revelation in the Observer that there is a movement championing a similar facility on the south coast of England drew predictable fire from the rightwing commentariat. If Brighton does go ahead, it may wish to learn from Denmark.

In Copenhagen’s fixing room, eight people at a time, and another four in a van parked up in the courtyard, inject, in the knowledge that they are being watched over by nurses and are taking their drugs in a clean environment using sterile needles, a dose of saline solution, a cotton bud and a pump, all provided by staff.

A large anatomical drawing of a man shows users the location of their main veins and arteries, and there is even a machine addicts can use that illuminates a healthy vein to spike. The atmosphere is tense; drug-takers can be mercurial and outbreaks of violence have been known. But, incongruously, it has the atmosphere of a library, as the addicts crouch in their booths, complete with small desk lamps, offering few words beyond the odd call for hush to those who make a noise. Those who inject cocaine – the favoured drug in this area – become extremely sensitive to noise while high.

It is not a pleasant place, but it is very popular. There have been more than 36,000 injections in the room since it opened in October, with the addicts getting through as many as 350 syringes a day. There have been an additional 13,000 injections in the van, about 40 a day. Most users, about 75%, are male and two thirds are aged 31-50.

Crucially, while nurses in the room have dealt with 36 overdoses in the last seven months, not one has been fatal – as is the pattern in the other drug-consumption rooms around the world. Dealing in drugs is forbidden and the police carefully monitor those hovering outside. They will enter the room and its courtyard if necessary, but they don’t come in for “the sake of it”, said Superintendent Henrik Orye.

The lives of addicts are without doubt being saved. All the evidence, here and internationally, suggests so. But there is much more to it than that, proponents say. When Petersen and the others have finished with their needles, they put them in a sharps bin. Up to 10,000 syringes used to be picked up off the streets of Vesterbro every week before the room opened. Everyone in the area appears able to tell a tale of a child they know who has been spiked, although none of them appears to have been infected. Since the launch of the room, the quantity of drug paraphernalia collected from gutters, playgrounds, stairwells and doorways in the area has halved.

Vesterbro also appears to be a place where the desperate are seemingly becoming a little less desperate. Year on year, burglaries in the wider area are down by about 3%, theft from vehicles and violence down about 5%, and possession of weapons also down. “From the police perspective, I can see the benefits,” said Orye. “It feels calmer.”

Critics say that such rooms make it easier for drug users to abuse themselves and send the wrong message. Only five people using Copenhagen’s room have been put on treatment since October.

Petersen, like many others using the room or floating around the courtyard outside, said that she does not want and would never seek treatment. But every day that she comes here to inject she meets health professionals, social workers and people offering treatment in case she suddenly want to rise from rock bottom, say the room’s staff. Petersen might change her mind one day, said Nanna Gotfredsen, a lawyer who campaigned for the room.

Michael Olsen, a local resident who was a key figure in persuading authorities to accept the idea of a consumption room, said that he felt moved to champion the cause when he found addicts taking drugs in his bins, and women urinating in a phone box because all the toilets in the area had been sealed to stop addicts injecting there. “There is no country that has solved this problem, so surely, until we solve it, we can meet their basic needs – access to food, a toilet, medical help and a safe place to take their drugs,” he said. Ivan Christensen – who runs a nearby hostel for the homeless which, in partnership with the Copenhagen town hall, manages the consumption room – said that ultimately it is about harm reduction rather than treatment. “We don’t do this to get people out [of drugs],” he said. “We are happy when we do, but at first it is helping people in the situation they are in.

“We just intervene when they ask for help because we do not demand that they change, or push them to change. The philosophy is that we can’t change people, people can change themselves and we can be there when they want to change.”

Frank Nealson, 42, who has been using cocaine and heroin, among other drugs, for 27 years, is surprised that anyone could believe consumption rooms encourage use. “The reasons I use drugs, and where and how I use drugs, are two separate things. This place makes sure I don’t do it in the street, don’t pick up diseases from dirty needles, and that is it.”

There is a plan to open a second facility, with a smoking room, further up the road. It will be called The Cloud. But the local authority is struggling to win acceptance from all residents. The high school, which is across the road from the current consumption room, is worried for its students, said Michael Knudsen, the caretaker. “We can’t live with it so close.”

Martin Petersen, 43, who lives on the road where the second room is planned, said that he believed the consumption room had reduced the number of addicts he saw injecting on the street by half. Pointing to the blood splatter on the archway above the door to his flat, caused by an addict injecting in a neck artery, he said: “That used to be normal.”

But Petersen said that he was also concerned about the location. “It is a good idea, but there is a lot you need to get right.” A warning for Brighton then. But experience of the Copenhagen room also offers a great deal of encouragement.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/g9TDotczmbQ/denmark-nurses-addicts-inject

New measures, including financial checks on care providers, will for the first time protect people receiving care if their provider fails, Care and Support Minister Norman Lamb revealed today.
The first ever system of national oversight and co-ordination will give early warnings if a company is in trouble. The Care Quality Commission (CQC) will take on the responsibility of a tough system of checks on the largest care companies – including those that provide care in people’s own home as well as in care homes.

A consultation on this issue ended in March and this plan of action is supported by the majority of the responses received. It will mean that the CQC will have the power to:

• require regular financial and relevant performance information

• require the provider to develop and submit a ‘sustainability plan’ to manage any risk to the organisation’s on-going sustainability

• commission an independent business review to help the provider to return to financial stability

• require information from the provider to enable the CQC to support local authorities to manage a provider failure

A provider in financial trouble can be a predictor of poorer quality care. Identifying these issues at an early stage can play a role, alongside regular inspection and customer feedback, in helping to pick up and stamp out quality failures.

These powers will bring care in line with other services such as hospitals and holiday operators, who already have formal mechanisms for oversight of a company’s financial “health” at a national level, to protect customers.

Care and Support Minister, Norman Lamb said:

Everyone who receives care and support wants to know they will be protected if the company in charge of their care goes bust.

The fear and upset that the Southern Cross collapse caused to care home residents and families was unacceptable. This early warning system will bring reassurance to people in care and will allow action to be taken to ensure care continues if a provider fails.

The plans will produce a system of central oversight for the 50 – 60 largest and most difficult to replace care providers, normally ones which operate nationwide. In the event of a failure by one of these, the effect is felt in many parts of the country and it is unreasonable to expect individual local authorities to manage the situation.

Smaller providers regularly exit the market for various reasons and in those circumstances, local authorities will continue to be required to make sure that people are given the necessary support if they need to arrange alternative care.

CQC Chief Executive David Behan said:

These are important measures that provide early warning of potential failures in care homes. Set alongside our plans for the appointment of a Chief Inspector of Social Care and Support, tougher registration requirements on social care providers and the introduction of a new ratings system, these new measures will strengthen our oversight to help ensure that risks to peoples’ care are identified and acted upon as early as possible.

The new system will be set out in forthcoming legislation and will improve the standards and care given in the care sector.

This is part of wider work to improve standards and quality across the care sector and was first announced in the care and support white paper in July 2012. The Department has progressed a number of further initiatives in the sector to improve quality of care, including a new website bringing together for the first time comparative information about care in local areas, and a Code of Conduct and Minimum Training Standards of care for adult social care workers.

This programme will see a greater standard of care for people in care and will mean a more coordinated system between the NHS and Social care, which will provide people with greater support and choice.

Background information

1. Further information on the Government’s plans to improve care and support can be found here.

2. For more information contact the Department of Health press office on 020 7210 5317.

Article source: https://www.gov.uk/government/news/early-warning-system-to-protect-against-care-home-failure

Officials said the collapse of Southern Cross had underlined the financial
difficulties in the care home sector.

The company was Britain’s biggest care home operator with 750 homes but went
bust because of a drop in income and a £250 million rental bill.

Mr Lamb said: “Everyone who receives care and support wants to know they
will be protected if the company in charge of their care goes bust.

“The fear and upset that the Southern Cross collapse caused to care home
residents and families was unacceptable.

“This early warning system will bring reassurance to people in care and
will allow action to be taken to ensure care continues if a provider fails.”

David Behan, CQC chief executive, suggested that if a company is in financial
difficulty it could be a predictor of poor care.

“Set alongside our plans for the appointment of a Chief Inspector of
Social Care and Support, tougher registration requirements on social care
providers and the introduction of a new ratings system, these new measures
will strengthen our oversight to help ensure that risks to people’s care are
identified and acted upon as early as possible,” he added.

Around £23 billion is spent every year by public bodies and private
individuals looking after older and disabled people.

Under England’s social care system, the Department of Health sets the policy
framework but local councils fund many of the services.

In recent years, smaller care home owners have been swallowed up by large
companies but these have run into trouble as town halls have frozen their
fees and funded fewer residents.

Research suggests that the number of care homes going bust climbed by 12 per
cent last year.

Data from accountancy firm Wilkins Kennedy said the number of care home
insolvencies rose from 60 in 2011 to 67 in 2012.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b7dd967/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A358170CInspectors0Eto0Estudy0Ecare0Ehome0Efinances0Ein0Ebid0Eto0Eprevent0Esudden0Eclosures0Bhtml/story01.htm

Senior nursing and theatre staff told inspectors that they had repeatedly
warned of risks to patients.

Untrained staff were left to care for very sick children, the CQC report said,
with porters put in charge of patients recovering from surgery, and no
medical handover to ensure safety before and after procedures.

“Staff were untrained and had very limited experience of caring for sick and
post operative children. The hospital management team were dismissive of
conenrs and blocked action to improve the situation,” the report said.

The CQC said correspondence between hospital staff and managers “showed that
the hospital management were made aware that the use of untrained staff was
putting patients at risk and contravened all published guidance.”

Consent was not properly sought for operations, including those involving
children. Senior staff did not know where resucitation equipment for
children was kept.

In another case, an adult patient deteriorated and died without being assessed
by doctors, and a decisions was taken not to rescuscitate him without any
discussion with the patient or relatives.

Theatre staff were uanble to locate emergency blood supplies in cases when
patients haemmorhaged, putting those undergoing surgery at risk of
“catastrophic” outcomes, the CQC report said.

Basic equipment, such as a tracheostomy set to allow patients to breathe, was
not available when life-threatening emergencies occurred.

Senior nurses said they were forced to tolerate “totally unacceptable and
intimdating behaviours by consultants” which put patients in danger.

“They said that when they raised valid concerns about serious risks they had
been dismissed,” the report said.

The report describes incidents in which a consultant refused to wear surgical
gloves or wash his hands between operations, instead wearing “long shirt
sleeves with blood on them” as he operated.

On another occasion, when surgery was cancelled because a patient was not well
enough, a surgeon decided to operate regardless – carrying out surgery in an
outpatient setting without giving the patient pain relief or anaestheisa.

Staff said the patient was left “shaky, pallid and uncomfortable” after the
procedure, and the CQC said the surgery should not have gone ahead because
the patient’s condition left them at high risk of contracting an infection.

On repeated occasions, a doctor refused to be chaperoned when carrying out
intimate examinations of women.

The report said: “The documents and reports we saw highlighted very serious
failings. Medical, surgical and some nursing practices at BMI Mount Alveria
hospital were so poor that people were put at significant risk. This risk
was, on some occasions, life-threatening.”

It describes theatre staff and senior nurses becoming upset and distressed
after surgery was carried out despite their warnings about risks to
patients, with difficulties transporting equipment to makeshift operating
theatres which were set up when the regular theatres were unable to open.

Stephen Collier, chief executive of BMI Healthcare, has now written to more
than 3,700 patients treated at the hospital last year to acknowledge the
failings found and to say that action has been taken to address the problems
which were identified.

BMI said the specific incidents described in the report involved less than ten
patients, who have been contacted separately.

Mr Collier said BMI has begun disciplinary procedures against a number of
staff, having replaced the senior management team running the hospital, and
referred concerns about specific doctors and nurses to the General Medical
Council and to the Nursing and Midwifery Council.

Mr Collier said: “Critically, what the CQC has told us is that the hospital’s
senior management team was dismissive of staff concern and that they blocked
actions to improve the situation. That is both disappointing and concerning.
We are taking this really seriously.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b71baf2/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A341310CNurses0Ewarned0Ethat0Echildren0Eat0Eprivate0Ehospital0Ewere0Ebeing0Eput0Eat0Erisk0Bhtml/story01.htm

Main Category: IT / Internet / E-mail
Also Included In: Public Health;  Nursing / Midwifery
Article Date: 01 May 2013 – 0:00 PDT

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Roboticists are currently developing machines that have the potential to help patients with caregiving tasks, such as housework, feeding and walking. But before they reach the care recipients, assistive robots will first have to be accepted by healthcare providers such as nurses and nursing assistants. Based on a Georgia Institute of Technology study, it appears that they may be welcomed with open arms depending on the tasks at hand.

More than half of healthcare providers interviewed said that if they were offered an assistant, they preferred it to be a robotic helper rather than a human. However, they don’t want robots to help with everything. They were very particular about what they wanted a robot to do, and not do. Instrumental activities of daily living (IDALs), such as helping with housework and reminding patients when to take medication, were acceptable. But activities daily living (ADL) tasks, especially those involving direct, physical interactions such as bathing, getting dressed and feeding people, were considered better for human assistants.

The findings are being presented April 27- May 2 at the ACM SIGCHI Conference on Human Factors in Computing Systems in Paris, France.

“One open question was whether healthcare providers would reject the idea of robotic assistants out of fear that the robots would replace them in the workplace,” said Tracy Mitzner, one of the study’s leaders and the associate director of Georgia Tech’s Human Factors and Aging Laboratory. “This doesn’t appear to be a significant concern. In fact, the professional caregivers we interviewed viewed robots as a way to improve their jobs and the care they’re able to give patients.”

For instance, nurses preferred a robot assistant that could help them lift patients from a bed to a chair. They also indicated that robotic assistants could be helpful with some medical tasks such as checking vitals.

“Robots aren’t being designed to eliminate people. Instead, they can help reduce physical demands and workloads,” Mitzner said. “Hopefully, our study helps create guidelines for developers and facilitates deployment into the healthcare industry. It doesn’t make sense to build robots that won’t be accepted by the end user.”

This study complements the lab’s prior research that found older people are generally willing to accept help from robots. Much like the current research, their preferences depended on the task. Participants said they preferred robotic help over human help for chores such as cleaning the kitchen and doing laundry. Getting dressed and suggesting medication were tasks viewed as better suited for human assistants.

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Main Category: IT / Internet / E-mail
Also Included In: Public Health
Article Date: 29 Apr 2013 – 0:00 PDT

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Researchers previously have shown that a depth camera system, such as Kinect, can be combined with a projector to turn almost any surface into a touchscreen. But now researchers at Carnegie Mellon University have demonstrated how these touch-based interfaces can be created almost at will, with the wave of a hand.

CMU’s WorldKit system enables someone to rub the arm of a sofa to “paint” a remote control for her TV or swipe a hand across an office door to post his calendar from which subsequent users can “pull down” an extended version. These ad hoc interfaces can be moved, modified or deleted with similar gestures, making them highly personalized.

Researchers at Carnegie Mellon’s Human-Computer Interaction Institute (HCII) used a ceiling-mounted camera and projector to record room geometries, sense hand gestures and project images on desired surfaces.

But Robert Xiao, an HCII doctoral student, said WorldKit does not require such an elaborate installation. “Depth sensors are getting better and projectors just keep getting smaller,” he said. “We envision an interactive ‘light bulb’ – a miniaturized device that could be screwed into an ordinary light fixture and pointed or moved to wherever an interface is needed.”

The system does not require prior calibration, automatically adjusting its sensing and image projection to the orientation of the chosen surface. Users can summon switches, message boards, indicator lights and a variety of other interface designs from a menu. Ultimately, the WorldKit team anticipates that users will be able to custom design interfaces with gestures.

Xiao developed WorldKit with Scott Hudson, an HCII professor, and Chris Harrison, a Ph.D. student. They will present their findings April 30 at CHI 2013, the Conference on Human Factors in Computing Systems, in Paris.

“People have talked about creating smart environments, where sensors, displays and computers are interwoven,” said Harrison, who will join the HCII faculty this summer. “But usually, that doesn’t amount to much besides mounting a camera up on the ceiling. The room may be smart, but it has no outlet for that smartness. With WorldKit, we say forget touchscreens and go straight to projectors, which can make the room truly interactive.”

Though WorldKit now focuses on interacting with surfaces, the researchers anticipate future work may enable users to interact with the system in free space. Likewise, higher resolution depth cameras may someday enable the system to sense detailed finger gestures. In addition to gestures, the system also could be designed to respond to voice commands.

“We’re only just getting to the point where we’re considering the larger questions,” Harrison said, noting a multitude of applications in the home, office, hospitals, nursing homes and schools have yet to be explored.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/BhbT7GEBiag/259698.php

Parents are joining forces with Britain’s top nursery chains in a revolt against plans to reduce the number of carers required to look after babies and toddlers – amid stark warnings the safety of children would be compromised.

The two leading internet forums for mothers – Mumsnet and Netmums – unite this weekend with top private and voluntary sector nurseries to demand the reforms be abandoned.

Under the government’s plans, announced in January by the childcare minister, Liz Truss, ratios for two-year-olds will rise from four children per adult to six, and for one-year-olds and under from three children per adult to four. Ratios for three-year-olds and over will remain at eight or 13 children per adult, depending on whether a qualified graduate is present.

Truss says the plans will improve care as the higher ratios can only apply where better qualified staff are present. She believes that, as standards rise, operating costs will fall, meaning lower fees for parents. However, the proposals have led to a wave of protests, with experts and nursery operators saying they will create a two-tier service, with nurseries in more deprived areas raising the ratios while those in more affluent areas, where parents can afford to pay more, will keep them the same.

In a serious escalation of the row, the largest membership organisation for nursery schools, the Pre-school Learning Alliance, which is also the biggest voluntary operator of nurseries in deprived areas, accused Truss of conducting a “sham” consultation that has led to a “ridiculous” and dangerous policy.

Writing on the Observer website, Neil Leitch, the alliance’s chief executive, who speaks for 14,000 nursery school operators, says: “At some point the consequences of her [Truss's] actions will come back to haunt us.

“Children will suffer physically and emotionally, and I hope she is as keen to defend her policies then as she is to implement them now – but I doubt it. She says that the government has consulted on these proposals. Rubbish.”

The alliance has launched a government e-petition, www.rewindonratios.com, which, if it gains 100,000 signatures, could force ministers to grant a Commons debate. Backing the petition, Justine Roberts, founder of Mumsnet, said: “When we asked our members about the cost of childcare, only 5% of parents backed ratio relaxation, even if it meant lower costs. We think the government needs to rethink its plans.”

A separate survey of parents for the alliance found that 84% of mothers were against childcare ratio changes, even though they might lead to a cut in their childcare bills.

Pressure on the government to cut the cost of childcare is intense, partly because it has committed itself to providing free care for 130,000 two-year-olds from underprivileged families from this September, and for 130,000 more from September next year. Local authorities, already strapped for cash, have a statutory obligation to find and fund the places and have an interest in seeing charges fall among private and voluntary providers.

However, even some of the government’s own advisers are critical of the route chosen. Professor Eva Lloyd, who co-authored a report commissioned by ministers which has yet to be published – despite being delivered months ago – told the Observer that Truss’s blueprint was “a deplorable document”. She added: “There is absolutely no evidence that changing the ratios will help nurseries become more sustainable or bring greater choice to parents. But there is a real risk of doing harm to vulnerable children.”

None of the biggest five companies that run nurseries in this country is now backing the change in ratios. The managing director of the biggest of all, Busy Bees, Marg Randles, says the company will not change its ratios or do anything that would be detrimental to safety, while the second biggest, Bright Horizons, is seeking a meeting with Truss to address its concerns. However, a Department for Education spokesman said: “All the evidence shows that quality and safety in nurseries and other early-years settings are linked to high-quality staff. Only high-quality providers will be able to take advantage of the flexibility that our reforms on ratios offer – which countries like France and Denmark already use successfully. The OECD has said that staff qualifications are the best predictor of the quality of early childhood education and care.

“Indeed, many of the largest childcare providers in England already operate higher ratios in Ireland and Scotland, but no one is suggesting quality has suffered there as a result. Of course, it will be up to professionals to decide what is best for the children they look after, and up to parents whether they choose settings with better-quality, but fewer, staff.”

Andy Morris, chief executive of Asquith Day Nurseries, the UK’s third biggest private operator, has told parents he will not change the ratios. He said: “To me, this ill-conceived scheme is more about buying the government votes than about properly caring for the nation’s children. Liz Truss talks about the need to improve quality in the sector – but the death of a child will not be a price worth paying for cost savings.”

Claire Burgess, early years consultant for Norland, the early years training college, said that while she backed any move that would improve qualifications for carers, she was against higher ratios.

“Higher qualifications do not mean more pairs of eyes and arms. Such a move could potentially compromise safety and mean a lower quality of care.”

Siobhan Freegard, founder of the UK’s main parenting site Netmums, said: “All the evidence shows young children thrive best on one-on-one care – so to suggest one person, however qualified, can adequately care for four babies or six toddlers at once, as the new ratios will allow, is nonsense.”

Last week Truss caused further controversy when she condemned “chaotic” pre-schools that she said allowed children to do what they want all day long. She said children were “running around with no sense of purpose”.

Answers to parliamentary questions revealed last week that she had conducted official visits to six nurseries, most of which had received glowing Ofsted reports.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/fXnaWKhrmUk/parents-join-nurseries-protest-ratios

Main Category: Cancer / Oncology
Article Date: 27 Apr 2013 – 0:00 PDT

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Certain patients with cancer at risk for malnutrition may improve survival rates, response to treatment and quality of life by receiving nutrition therapy at home, according to information in a Walgreens Infusion Services’(NYSE: WAG) (Nasdaq: WAG) presentation today at the Oncology Nursing Society’s 38th Annual Congress in Washington, D.C.1,2

In patients with cancer, malnutrition may cause more severe treatment side effects, added risk of infection and reduced response to treatment, negatively impacting quality of life and survival rates.3,4 Accordingly, both forms of nutrition therapy – intravenous parenteral nutrition (PN) and tube-delivered enteral nutrition (EN) – are important components of comprehensive care for many cancer patients.

Approximately 40,000 PN patients and 344,000 EN patients each year receive nutrition therapy safely at home and avoid the risk of exposure to hospital-acquired infections5-6; and this patient population includes cancer patients. For example, Walgreens Infusion Services home nutrition data over a six-month period shows that cancer patients comprised 13.1 percent of PN patients and 10.4 percent of adult EN patients.2

“The American Society of Parenteral and Enteral Nutrition recommends care including nutrition screening and frequent assessment for cancer patients, and early initiation of nutrition therapy when deficits are identified,” said Noreen Luszcz, RD, MBA, CNSC, Walgreens Infusion Services nutrition program director. “Nutrition support can be a vital part of a cancer patients’ care plan, and we’re able to provide these services to patients in their homes. Our staff dietitians work closely with each patient’s physician, pharmacist and nurse to evaluateand proactively monitor their therapy and deliver personalized care.”

Research suggests malnourished cancer patients are more likely to benefit if they receive nutrition support before they become severely malnourished.1,3,7,8 A result of severe malnutrition, cachexia (wasting) causes an estimated 20 to 40 percent of cancer deaths.9 By the time they are diagnosed, 80 percent of upper gastrointestinal cancer patients and 60 percent of lung cancer patients have lost a significant amount of weight.10

Multidisciplinary home nutrition support teams, which should include nurses, dietitians and pharmacists, can be effective in optimizing both clinical and financial outcomes for these patients.11 These clinicians implement physician treatment plans designed to help maintain independence and improve quality of life, and are poised to quickly identify therapy complications and intervene to address them with the guidance of the patient’s physician.

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Main Category: Medical Students / Training
Also Included In: Nursing / Midwifery
Article Date: 26 Apr 2013 – 0:00 PDT

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An article published today on bmj.com argues that forcing nurses to undergo work experience before their studies will not improve nursing standards.

Following a suggestion from the Francis report that nurses should undergo paid work as healthcare assistants prior to study, Elaine Maxwell says that there is no reason to think it makes them better practitioners.

She argues that it plays to the popular conception that nursing is purely about caring: without recognising the cognitive skills required.

Although there is no evidence to support the idea that work experience will improve the understanding of diagnostic skills, there is strong evidence to suggest the positive association between the educational attainments of nurses and clinical outcomes.

Maxwell gives an example from Jarman and colleagues who found that higher hospital death ratios in the UK were associated with a greater proportion of healthcare assistants in the nursing workforce. Plus, a further study found that for every 10% increase in the number of degree educated nurses in the US there was a 4% drop in patient mortality.

She also points out that as nursing forms the largest part of the healthcare workforce this has a significant overlap with medicine and any deficit in skills will have a significant knock-on effect on medical staff.

Maxwell also worries that as the workforce demographic changes, the bright enthusiastic school-leavers that the nursing world is trying to attract will find it a less attractive option if they have to delay their start to university.

There is also a danger of this changing the shape of the existing workforce and Maxwell asks if the thousands of healthcare assistants will have to give up their jobs for potential nursing students.

Maxwell concludes that the route to improved nursing standards is not to “return to a theory-lite apprenticeship model” but to improve practice environment and supporting the existing workforce to practice high standards.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/bww7CcdhDHU/259672.php

Yet, apart from a new criminal offence to prevent the fiddling of waiting
times and death rates, NHS managers seem to have ’scaped whipping for that
entire tragedy. Not to mention He Who Cannot Be Sacked, NHS chief executive
Sir David Nicholson. So who was responsible for a tick-box culture that
ranked the completion of “tasks” above spending time with a person in pain?
Who decided that tasks that needed doing on a ward should be split into
“essential and non-essential” and “medical or non-medical”? Who cut staffing
to dangerous levels? Who was it that spent millions of pounds of public
money silencing whistleblowers who were only trying to protect the public?
It wasn’t nurses, that’s for sure.

As the Telegraph revealed on Monday, more than 8,000 NHS managers are being
paid stonking six-figure salaries. This pampered breed skulk in their
offices with luxuriant pot plants while nurses are dispensing complex
medication, answering phone calls from vexed relatives, bleeping doctors who
are too busy to reply, and trying to prevent a confused patient climbing out
of bed – all of which means they can’t answer the call bell rung by another
patient who needs a bedpan. Oh, and then there’s filling in the paperwork to
prove that they have, in fact, done all of the above. And people wonder why
compassion is in short supply.

I’d like to see an NHS manager try to tend to a 22-bed ward (three bays of six
patients, four isolation rooms) staffed by two very tired nurses and one
care assistant with uncertain English.

According to a poll this week, two in three nurses think patients in their own
hospitals are at risk of neglect. The vast majority believes that managers
put financial targets ahead of patient care. Jeremy Hunt says he is keen for
NHS whistleblowers to be treated fairly – but, in the same breath, rubbishes
RCN claims that staff shortages are jeopardising patients. Perhaps the
nurses are blowing the wrong kind of whistle.

This is not to say that the RCN doesn’t need to be honest about the failings
of some of its own members. Making nursing a degree-entry profession was a
disaster. It was like decreeing that motherhood should be for graduates
only. You automatically excluded many of the best and gentlest candidates.
If degrees gave nurses more status, they also, quite understandably, made
them less inclined to carry out “non-medical” tasks. It was about
timesheets, not clean sheets. Too often, basic care became something you
studied in training and didn’t do once you were qualified. That explains why
a 92-year-old gentleman has no one coaxing him to eat.

Forcing student nurses to do a year as healthcare assistants isn’t going to
help Claire’s father. Not if staffing levels remain the same. Changing a
target culture that rates simple kindness and feeding an old person as
“non-essential” might be a good start. So would sacking some of the massed
battalions of NHS managers and using their large salaries to employ more
nurses on the frontline. A good heart is essential for a compassionate NHS.
So are many hands.

WHY WE MUST NOW FEAR FOR OUR DAUGHTERS

Look at her pictures on Facebook. How did she learn to pose like that? She
regards the camera with a sultry moue or a mouth slightly open in a
come-hither, porn-star “O”. Her cheeks are sucked in to make her look
thinner, and so is her stomach. Though she is slender, she is conscious of
her tummy and believes she is fat. Her look is sophisticated, provocative,
sexy, brazen, knowing. She is a siren, she is available, she is Beyoncé, she
is Rihanna. She is 14. She is your daughter.

What effect does taking and seeing thousands of photographs of herself have on
a teenage girl? I have often wondered about that, as I compare the library
of images my daughter has of herself compared to the few awkward, blinky,
Kodak snapshots of me at the same age. Teenage girls have never much liked
what they see in the mirror, but there’s no avoiding it now when the whole
world has become a giant looking-glass.

Even girls as beautiful as Sarah Houston are dissatisfied. The 23-year-old
medical student, who had struggled with anorexia since her teens, died after
taking a banned slimming pill along with Prozac. Sarah’s mother said: “It’s
not all about food. It’s about self-image, about control. Sarah was a
perfectionist. They put themselves on a pedestal and compare themselves to
everybody else and they are never good enough.”

How many mothers does that ring alarm bells with? I spoke to a teacher the
other day who believes that such pressures, combined with the stress of
endless exams, are causing depression to reach “epidemic levels” among
girls.

Now Katharine Welby, the 26-year-old daughter of the Archbishop of Canterbury,
has spoken out courageously about her “unbearable” bouts of depression. I
don’t know if Katharine’s depression stems from low self-esteem caused by a
world that reflects a young woman’s image back to her in a thousand
unforgiving ways, or whether it’s hereditary. I do know that she is far from
alone, and that we must fear for our daughters who don’t believe they are
good enough. Tell her she is pretty all you like, she won’t hear you. It’s
how she looks to herself on Facebook that counts.

N0 SEX, PLEASE, WE’RE PANDAS

Well, they did all they could to help the pandas get it on. Soft lighting.
Barry White’s Greatest Hits. An indoor “love tunnel”, whatever that is.
There were even rumours of a saucy film screening to help poor Yang Guang
get the hang of it. PG rating: Panda Guidance.

It was like one of those romantic mini-breaks exhausted couples take in an
attempt to inject a little passion back into their relationship.

But this was Edinburgh Zoo, under Scottish skies, and Tian Tian, the female,
just wasn’t interested. Pandas seldom are. They prefer to munch their own
bodyweight in bamboo, which has almost no nutritional value, and hang around
in a daze making big eyes at people and wondering why everyone is staring
back at them.

What everyone is thinking, of course, is: “If evolution means the survival of
the fittest, why do these creatures still exist? They’re about as fit as a
Fatboy beanbag.”

Undaunted, Edinburgh has spent seven million quid on its pandas over the past
decade, hoping for the “mating window” to swing open. This sounds like a
novelty feature from Grand Designs, and I don’t quite see how it can be
made flush with the love tunnel – but what it means, apparently, is that
Tian Tian gets the hots for 36 hours a year, and not a minute more.

Now, in a final act of desperation, the zoo has tried artificial insemination.
This puts pandas in the same position as married lawyers or investment
bankers, who never take time off and leave conception too late. Please. Why
not admit defeat? Pandas are soft toys that came to life by mistake. They
should be allowed to fade away, as Nature intended, like the dodo and
debutante.

OLIVIA LORDS IT OVER BROADCHURCH

Broadchurch, which came to a climax on Monday night, finally broke the
stranglehold of all those Scandinavian crime dramas. Oh, the pride of
homegrown gloom!

Ahead of time, apparently, only 29 cast and crew members knew whodunit.
Correction: only 29 people and nine million of us staring at the telly. I
worked it out the week before, when detective Ellie Miller interrogated
shady Susan (Pauline Quirke), whose husband had abused their son. “How could
you not know what was going on in your own home?” marvelled a disbelieving
Ellie. Poor woman, she was just about to find out.

Olivia Colman was so good as Ellie that they should save time and put the
Bafta in the post. It is hard enough to make goodness interesting, but this
superb actress made it engrossing.

Hers was by far the third-best performance in the show. Second came the Dorset
coastline, now being invaded by murder-thirsty coach parties. And the winner
was Pauline Quirke’s chocolate Labrador, who gave a searing performance as
himself.

Look out Denmark, Dorset is coming!

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b20906a/l/0L0Stelegraph0O0Chealth0C10A0A15350A0CNurses0Eshouldnt0Ecarry0Ethe0Ebedpan0Efor0Ethe0ENHS0Ecrisis0Bhtml/story01.htm

“It feels like [Mr Hunt] plucked an idea out of the air,” he said.

The criticism came as the RCN published a survey of 8,200 members showing that
69 per cent of nurses believe problems from poor care could happen on their
wards due to low staffing levels.

A second survey of senior nurses found that almost three quarters fear the
number of staff on wards and in the community has reached unsafe levels.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b00e034/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A0A94910CHunts0Enurse0Etraining0Eplan0Eis0Ereally0Estupid0Esays0Eunion0Eleader0Bhtml/story01.htm

However, Andrea Spyropoulos, the president of the RCN, has described those
plans as a “stupid idea” which will “take nursing back a hundred years”.

Peter Carter, general secretary of the RCN, said it was “bizarre”
that the Government had focused on a plan which was not included among the
report’s 290 official recommendations, many of which have not yet been
implemented.

“It feels like [Mr Hunt] plucked an idea out of the air,” he said.

A furious Mr Hunt said he had in fact “plucked it out of the Francis report on
Mid Staffs”.

He went on to say that the union had “very serious” questions to answer over
its conduct as the Mid Staffs scandal developed.

He added: “Let me say this, I think the Royal College of Nursing have got to
be very, very careful. They missed what happened at Mid Staffs. The Francis
report levelled some very serious criticisms about it. It said that they
basically allowed their trade union responsibilities to trump their
responsibilities as a royal college to raise professional standards and that
they have a conflict of interest.

“I think that before they start criticising the Government for accepting
recommendations that are going to improve compassionate care throughout the
NHS, they need to answer those very, very serious criticisms themselves.”

Julie Bailey, founder of the Cure the NHS campaign, whose mother Bella died at
Stafford hospital, earlier this year called for Dr Carted to step down over
the scandal because the union had told a whistleblowing nurse there to “keep
her head down”.

Dr Carter in February said that calls for him to step down were “unfortunate
and unfounded”.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b02d4ef/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A0A99740CJeremy0EHunt0ENursing0Eunion0Ehas0Equestions0Eto0Eanswer0Eover0EMid0EStaffs0Bhtml/story01.htm

The RCN has described the plan – which was not among the 290 official
recommendations of the Francis inquiry – as “stupid” and “plucked
out of thin air”.

Mr Hunt told Sky News: “I think the RCN have got to be very, very
careful. They missed what happened at Mid Staffs. The Francis report
levelled some very serious criticisms about it.”

Dr Peter Carter, RCN chief executive and general secretary, replied: “I
think it’s easy to take a slug at us and overstate our role [in Mid
Staffordshire] because of what we’ve been saying.

“We genuinely think this recommendation that to be a nurse you have to
work as an HCA for a year – we think that’s fundamentally wrong.”

David Cameron pledged to push on with the plan regardless of the opposition
from nurses.

The Prime Minister told a PM Direct event in Derby: “It is going to be
controversial, but in the end the sort of health service we want is not just
about making sure we have the facts and the figures, and the money spent
well, it’s about the level of care, so when our elderly relatives go in
there we know they are going to get a really good quality of care.”

Mr Hunt highlighted criticisms in the Francis report of the RCN’s dual role,
suggesting its activities as a union had prevented it from putting patients
first.

The Francis report also noted that Dr Carter had visited Mid Stafforshire in
2008 and written a “paean of praise” of it in the local press.

Mr Hunt said: “It said that they basically allowed their trade union
responsibilities to trump their responsibilities as a royal college to raise
professional standards and that they have a conflict of interest.

“I think that before they start criticising the Government for accepting
recommendations that are going to improve compassionate care throughout the
NHS, they need to answer those very, very serious criticisms themselves.”

Dr Carter admitted the RCN had been guilty of local failings at Mid
Staffordshire but denied that the union had a conflict of interest and said
it was regulators, not the RCN, which should have spotted the scandal.

Speaking at the RCN congress in Liverpool today, he said: “The idea that
the Secretary of State is saying the RCN missed Mid Staffs – that isn’t our
role.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b0c1745/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A112170CNursing0Eleaders0Emissed0EMid0EStaffs0Esays0EJeremy0EHunt0Bhtml/story01.htm

The RCN has described the plan – which was not among the 290 official
recommendations of the Francis inquiry – as “stupid” and “plucked
out of thin air”.

Mr Hunt told Sky News: “I think the RCN have got to be very, very
careful. They missed what happened at Mid Staffs. The Francis report
levelled some very serious criticisms about it.”

Dr Peter Carter, RCN chief executive and general secretary, replied: “I
think it’s easy to take a slug at us and overstate our role [in Mid
Staffordshire] because of what we’ve been saying.

“We genuinely think this recommendation that to be a nurse you have to
work as an HCA for a year – we think that’s fundamentally wrong.”

David Cameron yesterday pledged to push on with the plan regardless of the
opposition from nurses.

The Prime Minister told a PM Direct event in Derby: “It is going to be
controversial, but in the end the sort of health service we want is not just
about making sure we have the facts and the figures, and the money spent
well, it’s about the level of care, so when our elderly relatives go in
there we know they are going to get a really good quality of care.”

Mr Hunt highlighted criticisms in the Francis report of the RCN’s dual role,
suggesting its activities as a union had prevented it from putting patients
first.

The Francis report also noted that Dr Carter had visited Mid Stafforshire in
2008 and written a “paean of praise” of it in the local press.

Mr Hunt said: “It said that they basically allowed their trade union
responsibilities to trump their responsibilities as a royal college to raise
professional standards and that they have a conflict of interest.

“I think that before they start criticising the Government for accepting
recommendations that are going to improve compassionate care throughout the
NHS, they need to answer those very, very serious criticisms themselves.”

Dr Carter admitted the RCN had been guilty of local failings at Mid
Staffordshire but denied that the union had a conflict of interest and said
it was regulators, not the RCN, which should have spotted the scandal.

Speaking at the RCN congress in Liverpool today, he said: “The idea that
the Secretary of State is saying the RCN missed Mid Staffs – that isn’t our
role.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b094573/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A112170CNursing0Eleaders0Emissed0EMid0EStaffs0Esays0EHunt0Bhtml/story01.htm

Two-thirds of nurses have raised concerns about patients receiving inadequate care, but a quarter have been told not to pursue them because of an NHS “culture of fear and intimidation”, according to a report published on Tuesday.

The findings, from a survey of 8,262 nurses conducted by the Royal College of Nursing (RCN), cast doubt on the NHS’s attitude to staff whistleblowing about poor care and its ability to respond to the official report into the Mid Staffordshire hospital care scandal.

Robert Francis QC’s official report into the scandal identified staff keeping silent and complaints being ignored as a key factor in the poor care at Stafford hospital, where 400-1,200 patients died unnecessarily in 2005-09. NHS staff should be able to speak out when they believe patient safety is at risk without fear of suffering as a result, he said.

In all, 5,277 (64%) of the 8,262 nurses surveyed by pollsters ICM for the RCN had raised a concern, mostly about unsafe staffing (48%) or patient safety (21%). But 24% said they were discouraged or warned off taking any further action by managers or colleagues.

Almost half (45%) of those who had voiced disquiet said their employer took no action as a result, while 44% said fears about being victimised or suffering reprisals had made them think twice about speaking out again in case they were seen as troublemakers.

Fear among staff about highlighting inadequate care was worrying because it “is putting patient safety at risk”, said Dr Peter Carter, the RCN’s chief executive and general secretary.

“Nurses have told us about occasions when they have been bullied, ostracised or belittled when they have tried to raise concerns on behalf of their patients,” added Carter. “The stakes are simply too high for this to be allowed to continue. Trusts which don’t encourage an open culture from the very top will only continue to make mistakes, sometimes with devastating consequences.”

One nurse who made a written report of her worries that there were too few staff to look after patients properly said that, as a result, “I was lambasted by my manager for putting in an incident form as it would lead to them being questioned by their manager.”

Carter told the RCN’s annual conference in Liverpool on Monday that: “If you see poor care you should be able to tell someone without fear. If a manager stops you from raising the concern, it should be them who is punished, not you for having the guts to stand up and speak out.”

Headlines from the conference were dominated by government plans to force all would-be nurses to spend a year working as healthcare assistants – helping to feed, wash and turn patients. The union’s president, Andrea Spyropoulos, dismissed the plan as “a really stupid idea” that “will take nursing back a hundred years”.

That prompted David Cameron to defend the plan, describing it as “an important reform” that built on a suggestion Francis made in his report in February. “I think most people in the country, and indeed most nurses in the country, will think that it’s right that when we train people to be nurses they spend some time doing hands-on care in hospitals, in care homes, in places where people need care”, said the prime minister. The RCN has raised a series of questions about how the plan might work in practice. Pilots of the scheme are currently being planned.

But Jeremy Hunt, the health secretary, hit back much more sharply, accusing the RCN of having “missed” the Mid Staffs scandal because of an inherent conflict of interest it faces as both a trade union and professional body.

“I think the Royal College of Nurses [sic] has to be very, very careful. They missed what happened at Mid Staffs,” Hunt told Sky News. “The Francis report levelled some very serious criticisms at that. It said that they basically allowed their trade union responsibilities to trump their responsibilities as a royal college to raise professional standards.”

Dr Dan Poulter, the health minister, said the Department of Health had funded a national helpline for whistleblowers and enhanced protections in NHS staff contracts for those wishing to raise concerns, and planned to put NHS organisations under a new legal “duty of candour” to be open when mistakes are made.

“NHS staff who have the courage and integrity to speak out in the interests of patient safety must be protected and listened to. We have been clear that the era of NHS staff not being able to raise their real worries about patient care must come to an end”, said Poulter.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/cokFf9mAEh0/nhs-culture-fear-stops-nurses

“If the staff start saying ‘I wouldn’t have my family treated here’, you
know you’ve got a problem,” he said.

Source: ITN / PA

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b063bdb/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A10A3140CDavid0ECameron0Edefends0Eplans0Eto0Ereform0Enurse0Etraining0Bhtml/story01.htm

Peter Carter, general secretary of the RCN, said it was “bizarre”
that the Government had focused on a plan which was not included among the
report’s 290 official recommendations, many of which have not yet been
implemented.

Speaking in Derby, Mr Cameron said the reforms would ensure nurses focus on
the “caring and quality” demanded in Robert Francis’ report into the
failings at Mid Staffs.

“We have said in the light of that report that nurses should spend some time
when they are training as health care assistants in the hospital really
making sure that they are focused on the caring and the quality and some of
the quite mundane tasks that are absolutely vital to get right in hospital,”
the Prime Minister said.

“And that is going to be controversial but in the end the sort of health
service we want is not just about making sure we have got the facts and the
figures and the money and everything else spent well, it’s the level of care.”

It comes as Jeremy Hunt, the Health Secretary, launched a blistering attack on
the RCN, saying that the organisation “missed” the Mid Staffordshire
hospital scandal.

Mr Hunt used an interview with Sky News to escalate his growing row with the
union over the Government’s response to the failures at Mid Staffs.

Responding to the RCN’s criticism of the Government’s nursing plans, Mr Hunt
said that the union had “very serious” questions to answer over its conduct
as the Mid Staffs scandal developed.

He said: “Let me say this, I think the Royal College of Nursing have got to be
very, very careful. They missed what happened at Mid Staffs. The Francis
report levelled some very serious criticisms about it. It said that they
basically allowed their trade union responsibilities to trump their
responsibilities as a royal college to raise professional standards and that
they have a conflict of interest.

“I think that before they start criticising the Government for accepting
recommendations that are going to improve compassionate care throughout the
NHS, they need to answer those very, very serious criticisms themselves.”

Julie Bailey, founder of the Cure the NHS campaign, whose mother Bella died at
Stafford hospital, earlier this year called for Dr Carted to step down over
the scandal because the union had told a whistleblowing nurse there to “keep
her head down”.

Dr Carter in February said that calls for him to step down were “unfortunate
and unfounded”.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2b063bd8/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A10A6760CDavid0ECameron0Edefends0Econtroversial0Enursing0Eplans0Bhtml/story01.htm

“These figures prove what a shocking amount of a nurse’s time is being wasted
on unnecessary paperwork and bureaucracy,” said Dr Peter Carter, chief
executive and general secretary of the RCN.

“Yes, some paperwork is essential and nurses will continue to do this, but
patients want their nurses by their bedside, not ticking boxes.

“We are encouraged that the Government has acknowledged this issue, and the
ongoing review by the NHS Confederation is a step in the right direction,
but urgent action is needed now.”

Labour’s shadow health minister Andrew Gwynne said: “David Cameron is cutting
the NHS front line and wasting billions on a chaotic reorganisation, leaving
hospitals to operate without enough staff. Now form-filling is taking nurses
away from their patients for longer and longer.

“Under this Government, close to 5,000 nursing posts have been axed, with over
800 going in the last month alone.

“On understaffed wards, a nurse’s time becomes increasingly precious – they
must be free to care for patients. Ministers must stop the job losses and
ensure all hospitals have enough staff to provide safe care.”

Health minister Dr Dan Poulter said the coalition Government has significantly
cut the amount of red tape in the NHS and is examining how to reduce
bureaucracy further.

He added: “NHS staff need to be free to do what we were trained to do – look
after patients, so patients not paperwork must be our NHS’s priority.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2af9125a/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A0A0A83920CNurses0Eswamped0Eby0Epaperwork0Bhtml/story01.htm

“Mrs Foster’s training and leadership was not up to standard,” said
Barnaby Hone, for the NMC.

“She wasn’t just a member of staff, she was the leader and through her
leadership her patients on Richard Wing fundamentally suffered.

“Dementia patients are particularly vulnerable because they wouldn’t be
able to know what medication they need taken.”

When concerns were raised about patients’ weight loss, Mrs Foster claimed she
could not contact their GPs or families because she was going on holiday the
next day.

Staff were instructed and encouraged to put patients to bed at 6pm rather than
8pm to make life easier for those working the night shift.

And Foster failed to liaise with kitchen staff and instruct her team on
feeding residents – a senior investigator had to even provide food for
patients.

Patient records were kept in a “generic” fashion and not updated by
staff.

Mr Hone said: “There was a lack of individuality on Richard Wing,
treating people as though they were in an institution rather than in care.

“Dementia care is a very difficult area but it doesn’t allow the
administration of drugs without consent.

“Is Mrs Foster suitable to remain on the register without restrictions?
We simply say no.”

The home was owned by Southern Cross, one of the country’s biggest provider of
residential care homes until the firm collapsed last year.

Susan Lowe, a service quality inspector at the firm, led an investigation into
standards at Victoria House after concerns were raised in 2009.

Mrs Lowe said she had qualified as a nurse in 1976, before laws to improve
mental health care were passed.

“For me, walking onto the wing was like going back to that period,”
she said.

“None of the improvements in mental health care up to 2010 had reached
Richard Wing.

“Medication had been administered covertly without the necessary
processes being followed.

“Jam sandwiches with medication in were given to patients without it
being explained to patients what was happening and if they understood.”

She said she had to instruct Foster on how to address patients’ weight loss
before handing her an action plan – yet Foster told another investigating
officer she did not have the time to go through it.

She was dismissed from the home in Bath Lane, Stockton-on-Tees in March 2010
after a later inspection revealed continuing problems on her ward.

Foster denied a catalogue of charge, including failing to ensure patient
medication records were adequately maintained by staff and failing to
prevent residents from losing weight.

She also denied failing to make adequate referrals to GPs and dietitians for
residents losing too much weight and encouraging staff to carry out
showering of residents only on allocated days.

The nurse further denied instructing staff to administer medication to
residents covertly in their meals and sweets, but admitted not reporting a
fight between two residents and instructing day staff to administer night
medicine at the end of their shifts.

Charges that she had instructed staff to ban patients from attending a concert
at the home and that she told them only to shower residents on certain days
were found not proved.

The panel said there was insufficient evidence to support allegations Foster
had laced jelly babies with drugs.

Foster is not attending the hearing and has not sent a representative.

The hearing continues.

Edited at Telegraph.co.uk by Richard Holt

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2aeae035/l/0L0Stelegraph0O0Chealth0Celderhealth0C10A0A0A620A20CNurse0Eran0E1970As0Estyle0Eward0Eand0Eserved0Ecustard0Elaced0Ewith0Emedication0Bhtml/story01.htm

Thousands of nurseries and pre-schools in England could be closed as part of a government shakeup of care for babies and toddlers.

Sir Michael Wilshaw, the chief inspector of schools and children‘s services, said more than a fifth of carers of children under four were “satisfactory” or worse.

From this September, nurseries, childminders and pre-schools previously deemed to be satisfactory will be branded “requiring improvement”.

If they have not improved after four years, Ofsted inspectors will label them “inadequate” and they will face closure if they do not dramatically improve at their next inspection.

Wilshaw called for carers of under-fours to have A-levels or degrees. He said it was “absolute nonsense” that adults who worked with animals as veterinary assistants needed better qualifications than those working with young children.

“One of our biggest problems is that too many of the workforce are underqualified and there is far too much regional variation,” he said. “We demand more from those who work with animals – they need at least five good GCSEs. There isn’t the same insistence for early years providers.”

Wilshaw said care in poorer areas was particularly patchy, despite the millions spent by the Labour government on Sure Start centres.

“We need to address this problem urgently. We all know from the research that children’s early years are a period of rapid development and vital for building a secure foundation for future personal and academic success.”

In January, Elizabeth Truss, the early years minister, announced that nurseries and childminders would be able to take on more pre-school children.

Childminders are currently restricted to looking after three children per staff member between the ages of one and five. In future, they will be able to look after four children, two of which can be aged under one.

Wilshaw added that he wanted to stop failing nurseries from renaming themselves and reopening.

Professor Andy Goodwyn, head of the University of Reading’s institute of education, said early years workers did not need a tougher inspection regime, but a period of stability to build on their skills.

“It needs to become an attractive and high-status sector that can attract graduates who can see a real career path … The last thing it needs is more threats.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/_p2Ai0sOMQo/nurseries-preschool-england-closed-shakeup

Main Category: Public Health
Also Included In: Nursing / Midwifery
Article Date: 19 Apr 2013 – 0:00 PDT

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Lower mortality and other improved patient outcomes achieved at designated “Magnet hospitals” are explained partly – but not completely – by better nurse staffing, education, and work environment, reports a study in the May issue of Medical Care. The journal is published by Lippincott Williams Wilkins, a part of Wolters Kluwer Health.

“Magnet hospitals have lower mortality because of investments in nursing,” comments Matthew D. McHugh, PhD, JD, MPH, RN, of University of Pennsylvania School of Nursing, Philadelphia, lead author of the new report. He adds, “Magnet recognition likely stimulates positive organizational behavior that improves patient outcomes.”

Magnet Hospitals Have Better Patient Outcomes

The researchers compared patient outcomes at Magnet hospitals versus non-Magnet hospitals in California, Florida, Pennsylvania, and New Jersey in 2006-07. Magnet hospitals are recognized for quality patient care, nursing excellence and innovations in professional nursing practice. The Magnet Recognition Program® is a voluntary recognition/certification program administered by the American Nurses Credentialing Center (ANCC), an arm of the American Nurses Association.

Dr McHugh and colleagues linked patient, nurse, and hospital data on 56 Magnet hospitals and 508 non-Magnet hospitals. The goal was to see if Magnet hospitals achieved better patient outcomes, and to identify characteristics of Magnet hospitals that led to improved outcomes.

The results showed important differences in nursing at Magnet hospitals. “Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor’s degrees and specialty certification,” the researchers write. Magnet hospitals also had higher nurse-to-patient staffing ratios.

Key patient outcomes were also better at Magnet hospitals. On analysis of more than 600,000 surgical patients, mortality rates were 20 percent lower at Magnet hospitals, after accounting for clinical factors. Magnet hospitals also had better performance on “failure to rescue” – that is, mortality rate among patients with recognized complications.

Magnet Designation Process Promotes Investment in Nursing and ‘Culture of Excellence’

Nurse staffing, education, and work environment explained much of the superior patient outcomes at Magnet hospitals. In addition, there was a residual mortality advantage attributable to the ongoing process of maintaining Magnet recognition status. “Even controlling for differences in nursing, hospital, and patient characteristics, surgical patients in Magnet hospitals had 14 percent lower odds of inpatient death within 30 days and 12 percent lower odds of failure-to-rescue compared to patients cared for in non-Magnet hospitals,” Dr McHugh and coauthors write.

Nursing services are a vital part of hospital care. A pivotal 1994 paper by the same research team – also published in Medical Care – found that hospitals with reputations for excellence in the management of nursing services had lower mortality rates. That study, among others, led to the development of the Magnet hospital designation. However, few studies since then have been done to confirm that Magnet hospitals achieve better patient outcomes.

The updated analysis provides new evidence that patients treated at Magnet hospitals have better outcomes, and that more favorable nurse staffing, more nurses with bachelor’s degrees, and better work environments are important contributing factors. However, the mortality advantage of Magnet hospitals also seems related to their membership in a network of institutions where innovation is encouraged through the ongoing process of Magnet redesignation. Dr McHugh notes, “This is the first study to suggest that the Magnet application process itself is an intervention that promotes better quality of care.”

Dr Jeroan Allison, Editor-in-Chief of Medical Care, comments, “This large study makes an important contribution to an emerging literature attempting to understand what makes some hospitals superior in terms of patient outcomes they obtain, how to best manage hospitals, and whether or not the Magnet designation process as it now exists truly designates institutions where patients fare better.”

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/5U5wINmsR6k/259237.php

School nurses will play a bigger and more important role in improving the health of children and young people, according to plans announced today by the children’s Health Minister, Dr Dan Poulter.

England’s 1,200 school nurses and their teams will lead a new, strengthened and more tailored school nursing service which means better care and support for children, including those with disabilities and complex emotional needs.

For the first time ever, children who are carers will themselves train school nurses in how to provide the best support for young carers. As part of the plans, school nurses will:

• Get more training to make sure their skills are constantly improved and updated so they can support children with more complex health needs;

• Become local leaders in children’s health and be given the expertise to improve what school nurses offer to children. This could mean being available outside of school hours; and

• Be champions for children who care for others to make sure they get the right support. Young carers themselves will train school nurses so they know exactly what support to provide.

The best school nurses will also be rewarded for their work through a new, national school nurse award.

Children’s Health Minister Dr Dan Poulter who is responsible for the Government’s programme for improving children’s health said:

School nurses play a crucial role in improving health and supporting young people. I want them to have an even bigger role and provide even better support for more young people with different health needs and conditions.

Young carers are often under incredible pressure both at home and at school. School nurses can do a lot to give young carers a voice and help ease that pressure. Our plans will help them do just that.

We continue to lead work with the NHS, Royal College of Paediatrics and Child Health and local authorities to do everything possible to improve children’s health and to give each and every child the very best start in life.

There are as many as 700,000 young carers in the UK, and their caring responsibilities – which could be as intense as 50 hours a week – are often a hidden cause of health problems, bullying, truancy and not doing well at school. School staff can sometimes be unaware that children are carers, and school nurses are in a perfect position to provide the right support that young carers need to help them be happier and do better at school.

Dr Moira Fraser, Director of Policy and Research at Carers Trust:

Over 60 per cent of young carers are bullied in schools while nearly 30 per cent miss school or experience educational difficulties – often due to their caring responsibilities. Many don’t feel able to tell staff members at their school that they are a young carer.

These are worrying numbers and so we are heartened at the government’s plans to strengthen the role of school nurses in supporting young carers.

School nurses are ideally positioned to play a pivotal role in the lives of young people. They are well placed to identify young carers earlier and implement preventative support while reducing the negative impact on the health and wellbeing of young carers by initiating support for the whole family. We are pleased that young carers themselves will shape the work of school nurses by training them in how to provide the best support.

Today’s announcement builds on last year’s School Nursing Vision, which promised to make it easier to contact school nurses – including texting to make appointments. We continue to work with nursing bodies – including the School and Public Health Nurses’ Association – on the implementation of the vision.

Edward Timpson, Minister for Children and Families said:

Young carers have told us time and time again that they want their teachers and schools to be more ‘carer aware’, which is why we are determined to ensure that they are provided with the best support possible.
“We know that some schools already have excellent systems in place to identify and respond to young carers needs. Unfortunately these pockets of excellence are too few and far between, leaving many vulnerable young people without the support they need to thrive.

Today’s announcement will mean that young carers across the country are being given a voice to help shape their own services – truly empowering these dedicated children and young people whose daily lives are dramatically affected by caring for family members.

Three hundred young people who have offered to become ‘school nurse champions’ and help shape the way the School Nursing Vision is implemented have also been trained and are beginning their work.

Notes to editors

• For more information, please contact the Department of Health press office on 020 7210 5703.

Article source: https://www.gov.uk/government/news/school-nurses-to-play-a-bigger-role-in-improving-childrens-health

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MONDAY, April 15 (HealthDay News) — Regular exercise slows disability and prevents falls in patients with Alzheimer’s disease without increasing overall costs, a new study from Finland says.

The findings suggest that exercise, particularly when tailored to an individual’s needs and performed at home, may help Alzheimer’s patients maintain their independence and delay the move to a nursing home.

“This is an important study,” said Dr. Kostos Lyketsos, director of the Johns Hopkins Memory and Alzheimer’s Treatment Center, in Baltimore. “If we could ever deliver exercise for people with dementia in their homes, I think we could accomplish very substantial benefits for patients and reduce costs, which is a very big deal … in health care these days.” Lyketsos was not involved in the new research.

Mental changes are the first wrenching signs of Alzheimer’s disease, and they often are the symptoms that get the most attention. But physical declines are also a part the disease. Over time, muscles become stiff and uncoordinated, or may start to tremor. Alzheimer’s patients may lose the ability to brush their teeth, climb stairs, and dress, feed and bathe themselves.

“These people are at very high risk of disability. That’s one of the reasons they end up in institutional care,” said study author Dr. Kaisu Pitkala, a general practitioner at the University of Helsinki. “They need so much help that their caregivers often get very tired, and after a few years they will end up in institutional care, which is very expensive and often not the wish of the patients nor the caregivers.”

For the study, published online April 15 in the journal JAMA Internal Medicine, the researchers chose more than 200 patients with moderate to severe Alzheimer’s disease who were living at home with a caregiver and showing signs of physical decline. The patients were randomly assigned to one of three groups: home exercise, group exercise at a day care center, or a control group that got usual care through the Finnish national health care system.

Those in the home-exercise group got visits from a physical therapist for one hour twice a week. The physical therapists specialized in dementia care, and they tailored these sessions to each patient’s problems with function and mobility.

Patients in the group-exercise classes traveled to an adult care center twice a week, where two physical therapists guided them through exercises to improve endurance, balance, strength and mental function.

The patients in the usual-care group were followed by the study nurses and were given advice on nutrition and exercise.

After one year, all the groups saw declines in physical function, but the groups that exercised regularly fared better than those who got usual care. Those in the home-exercise group did the best. Their physical function declined about half as much as that of the control group. Importantly, they also had half as many falls as those who got usual care.

Group exercisers showed some signs of better health — their strength improved over the course of the year — but those results were not statistically significant. And although the study found an association between exercise and better health among Alzheimer’s patients, it didn’t prove a cause-and-effect relationship.

The researchers think one reason the group exercisers didn’t see bigger benefits was because they were more likely to skip their sessions than those who exercised at home.

“When the taxi came to the person’s home to take them to the group-based exercise, they could say often, ‘Today I’m tired; I’m not coming,’” Pitkala said. “When there’s a person coming to your home and telling you, ‘Let’s do a little bit today,’ it’s much easier to say yes than it is to go outside your home.”

During the year they exercised, patients in the home group had fewer hospital admissions and about half as many falls as those in the control group. The money they saved on medical bills more than offset the cost of regular private sessions with a physical therapist. The average annual cost of caring for a patient in the home-exercise group was about $25,000, but it was about $34,000 for patients who received only usual care. The annual cost for group-exercise patients was even lower, at about $22,000.

Another expert who was not involved in the study praised the research and said it offered a practical blueprint to improve the lives of patients and families affected by Alzheimer’s disease.

“If you can do something that can improve their physical functioning and mobility and help them stay home and not actually cost anything — or be cost neutral — I think you can make a huge potential impact on a family’s quality of life,” said Dr. James Galvin, a professor of neurology and psychiatry at NYU Langone School of Medicine, in New York City.

Article source: http://www.nlm.nih.gov/medlineplus/news/fullstory_135921.html

NHS Continuing Healthcare and NHS Funded Nursing Care: Public Information Leaflet

A guide for people who may be in need of ongoing care and support from health and social care professionals.

PDF, 104KB, 16 pages

This file may not be suitable for users of assistive technology.
Request a different format.

To request this document in an alternative format such as braille, audio
or a different file type please email
publications@dh.gsi.gov.uk
quoting your address, telephone number along with the title of the
publication (“NHS Continuing Healthcare and NHS Funded Nursing Care: Public Information Leaflet”).

Article source: https://www.gov.uk/government/publications/nhs-continuing-healthcare-and-nhs-funded-nursing-care-public-information-leaflet

The national framework for NHS continuing healthcare and NHS funded nursing care sets out the principles and processes for determining eligibility.  It has been revised to reflect the new NHS framework and structures created by the Health and Social Act 2012, effective from 1 April 2013. The associated tools (a checklist, decision support tool and fast track pathway tool), which are designed to assist clinicians and practitioners with the decision making process, have also been revised accordingly.

NHS continuing healthcare is an ongoing package of health and social care that is arranged and funded solely by the NHS where an individual is found to have a ‘primary health need’. Such care is provided to an individual aged 18 or over, to meet needs that have arisen as a result of disability, accident or illness.

These documents are intended for use by clinical commissioning groups from 1 April 2013.

The documents are provided in word format for use by those involved in the assessment process for NHS continuing healthcare.

Article source: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

The Food Standards Agency (FSA) has published a new information sheet on preventing listeriosis in hospitals, nursing homes and care homes.

Listeriosis is a rare but potentially life-threatening illness caused by the bacterium Listeria monocytogenes. The following groups are at increased risk of listeriosis:

•    people with weakened immunity due to illness, disease, medication or treatment
•    pregnant women
•    people of advanced age with a weakened immune system

Hospitals, nursing homes and care homes are classed as food businesses because they provide food on a regular basis to people in their care, so they are legally responsible for ensuring that the food they supply is safe.

The FSA information sheet, Preventing listeriosis in hospitals and nursing/care homes, gives practical advice for catering and ward staff on storing and serving food.

The FSA is currently developing more comprehensive advice and guidance for hospitals and healthcare professionals on reducing the risk of listeriosis for people in the most vulnerable groups. This is expected to be published later in 2013.

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Article source: http://www.dh.gov.uk/health/2013/02/fsa-info-listeriosis/

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Also Included In: Nursing / Midwifery
Article Date: 04 Feb 2013 – 0:00 PST

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In hospitals, poor floor design, storage closet clutter and crowded corridors can contribute to nurse and medical staff fatigue. These distractions can hurt patient care quality and result in higher medical costs.

Now, a new Cornell University study offers a spatial solution.

Rana Zadeh, Cornell assistant professor of design and environmental analysis in the College of Human Ecology, analyzed the floor plans and work patterns within five medical-surgical units at U.S. hospitals and found numerous opportunities to boost nurses’ efficiency through better design. Zadeh’s research, “Rethinking Efficiency in Acute Care Nursing Units: Analyzing Nursing Unit Layout for Improved Spatial Flow,” is published in the current issue of Health Environments Research and Design Journal (6:1).

In some hospital wards, important spaces such as nourishment rooms are located far away from a nurse’s typical path. Jammed patient-care corridors create excessive noise, and high foot traffic raises the potential for interruptions. Supplies are stocked in various rooms, leading nurses to “hunt and gather” to find materials.

Experts say some nurses walk up to five miles during a typical shift. Even seemingly minor changes to improve the alignment of a facility layout for better caregiver workflow can have significant benefits.

“Imagine if a pilot was flying an airplane and trusted with keeping passengers safe, but instead of located in the cockpit, the necessary tools and controls were spread around the cabin of the plane,” Zadeh says. “New medical practices and technology have emerged during the past decade, and facility design should adapt to these changing practices so that caregivers can perform better on their critical tasks.”

Data confirms the average hospital has an infrastructure that is roughly 30 to 40 years old, says Zadeh. “They can be designed innovatively and smartly for today’s fast pace of care. We hope this tool offers planners, designers and managers doing a facility renovation or addition a way to spot the missing links in their floor plans and to make work processes more efficient through research-based design.”

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/2_q4KSp3cgM/255701.php

“If you’re running flat-out, really really busy, the first thing that is
probably going to stop happening is that you’re not going to be able to stop
and have a talk with the patient, have those regular contacts; it’s going to
be very much doing the basics.

It’s the compassion that is probably going to be the victim of the being busy,
perhaps”, said Mr Ford.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/282f24fc/l/0L0Stelegraph0O0Chealth0Chealthnews0C98453550CNurses0Evoice0Econcerns0Eover0Eunderstaffing0Eof0Ewards0Bhtml/story01.htm

Editorial: “Relevance of Genomics to Healthcare and Nursing Practice.” ,
Kathleen A. Calzone, Jean Jenkins, Nick Nicol, Heather Skirton, W. Gregory Feero and Eric D. Green.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/j.1547-5069.2012.01464.x).

”Integration of Genomics in Cancer Care.”,
Erika Maria Monteiro Santos, Quannetta T. Edwards, Milena Floria-Santos, Silvia Regina Rogatto, Maria Isabel Waddigton Achatz and Deborah J. MacDonald.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/j.1547-5069.2012.01465.x).

“Genomics and Autism Spectrum Disorder.”,
Norah L. Johnson, Ellen Giarelli, Celine Lewis and Catherine E. Rice.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/j.1547-5069.2012.01483.x).

“Current and Emerging Technology Approaches in Genomics.”,
Yvette P. Conley, Leslie G. Biesecker, Stephen Gonsalves, Carrie J. Merkle, Maggie Kirk and Bradley E. Aouizerat.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12001).

“An Overview of the Genomics of Metabolic Syndrome.”,
Jacquelyn Y. Taylor, Aldi T. Kraja, Lisa de las Fuentes, Ansley Grimes Stanfill, Ashley Clark and Ann Cashion.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/j.1547-5069.2012.01484.x).

“Ethical, Legal, and Social Issues in the Translation of Genomics into Healthcare.”,
Laurie Badzek, Mark Henaghan, Martha Turner and Rita Monsen.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12000).

“An Update of Childhood Genetic Disorders.” ,
Cynthia A. Prows, Robert J. Hopkin, Sivia Barnoy and Marcia Van Riper.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12003).

“Physical, Psychological and Ethical issues in Caring for Individuals with Genetic Skin Disease.”,
Diane C. Seibert and Thomas N. Darling.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12004).

“Cardiovascular Genomics.”,
Shu-Fen Wung, Kathleen T. Hickey, Jacquelyn Taylor and Matthew J. Gallek.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12002).

“Implications of Newborn Screening for Nurses.”
Jane DeLuca, Karen L. Zanni, Natasha Bonhomme and Alex R. Kemper.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12005).

“The Implications of Genomics on the Nursing Care of Adults with Neuropsychiatric Conditions.”,
Debra L. Schutte, Marilyn A. Davies and Emilie Dykstra Goris.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12006).

“A Blueprint for Genomic Nursing Science.”,
Genomic Nursing State of the Science Advisory Panel: Kathleen A. Calzone, Jean Jenkins, Alexis D. Bakos, Ann Cashion, Nancy Donaldson, Greg Feero, Suzanne Feetham, Patricia A. Grady, Ada Sue Hinshaw, Ann R. Knebel, Nellie Robinson, Mary E. Ropka, Diane Seibert, Kathleen R. Stevens, Lois A. Tully and Jo Ann Webb.
Journal of Nursing Scholarship; Published Online: February 1, 2013 (DOI: 10.1111/jnu.12007).

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Main Category: Lung Cancer
Article Date: 29 Jan 2013 – 2:00 PST

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There are not enough specialist nurses to cope with the demands of the UK’s biggest cancer killer, according to a new report.

More than 40,000 people are diagnosed with lung cancer every year with fewer than one in 10 likely to survive beyond five years.

However, despite the poor outcomes for the disease, experts fear that specialist nurse posts may be cut as part of NHS cutbacks.

The report, from the Roy Castle Lung Cancer Foundation and the National Lung Cancer Forum for Nurses, calls for current posts to be protected and increased in number in order to help improve survival rates.

Dr Jesme Fox, Medical Director of the Roy Castle Lung Cancer Foundation, said: “Lung cancer nurse specialists are vital if we are to start improving survival rates for the UK’s biggest cancer killer.

“Research shows us that patients who have a specialist nurse are twice as likely to receive treatment as those who don’t.

“Yet our report shows that some patients are not being seen by a specialist nurse at all and that nurses are struggling to cope with their increasing workloads.

“NHS commissioners must ensure there are sufficient numbers of these specialists in place and that all patients have equitable access to these nurses, regardless of where they live.”

John White, Chair of the National Lung Cancer Forum for Nurses, added: “Specialist nursing posts are often placed under threat during times of financial austerity, despite evidence that patients value the services provided by specialist nurses greatly.

“With the ongoing financial pressures in the NHS, we are concerned that these posts may be threatened.

“As this report illustrates, specialist nurses are essential to the delivery of high quality care and improved outcomes for patients.

“Posts must be maintained and, where possible, the numbers increased so all patients with lung cancer have access to a specialist nurse.”

According to the report, only 80% of lung cancer patients are seen by a specialist nurse.

In England, there is only one lung cancer nurse specialist per 161 patients and in Scotland this figure rises to 200.

The report found that increasing caseloads and paperwork were affecting nurses’ ability to provide high quality care for their patients.

It also recommended that;

• Patients should be able to access a specialist nurses at all stages, from pre-diagnosis to end of life care
• National clinical guidelines should reflect the important role played by lung cancer nurse specialists
• Specialist nurses should be recognised as the patient’s advocate at multi-disciplinary team meetings
• Resources should be provided for nurse-led clinics and to help smokers to quit
• More research should be carried out into why those patients who see specialist nurses are more likely to receive treatment
• Nurse-led follow up after treatment should be offered to all patients
• Lung cancer nurse specialists should be recognized as the patient’s advocate at multi-disciplinary team meetings

The Understanding The Value Of Lung Cancer Nurse Specialists report is available to download here.

Lung Cancer Facts

• Lung cancer is the most common cause of cancer death in the Uki
• Each year, around 41,500 people are diagnosed with lung cancer in the UKii
• Only around a third will survive for three years after diagnosis and fewer than one in ten survive beyond five yearsiii
• More than two thirds of patients are diagnosed at a stage when treatment which could cure them is no longer an optioniv
• Although it is more common in smokers, around one in eight people with lung cancer has never smokedv

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The Australian radio show behind the prank call to the Duchess of Cambridge‘s hospital last December has been replaced on air by its Sydney-based broadcaster, 2Day FM. A new programme, hosted by a different DJ, will fill its nightly slot.

The Hot 30 programme, hosted by DJs Michael Christian and Mel Grieg, was taken off air following the death of the nurse Jacintha Saldana, who had forwarded the pair’s prank call to the Duchess’s room at the King Edward VII hospital in central London early last month. Three days later, Saldanha, 46, was found hanged in her apartment in the nurse’s quarters.

During the call, in which the DJs pretended to be the Queen and Prince Charles, the nurse caring for Kate Middleton revealed personal information about the Duchess’s condition relating to a severe form of morning sickness.

The prank call sparked international outrage against the radio station, which had not gained consent from the nurses involved for their voices to be broadcast before putting the prank call to air.

Southern Cross Austereo, which owns 2Day FM, said while Christian and Greig’s time slot had been replaced with a new show, the pair remained employed by the station and were on leave.

“We look forward to Mel (Greig) and MC (Christian) returning to work when the time is right, in roles that make full use of their talents – we will discuss future roles with them when they are ready,” said Southern Cross Austereo chief executive Rhys Holleran.

Since the programme was taken off air in December, a music-based show without a host DJ has been playing in its timeslot.

In December the Metropolitan police submitted a file to the Crown Prosecution service to decide whether any criminal offence had been committed in connection with the death of Saldanha.

The Australian Communications and Media Authority (ACMA), which regulates commercial radio stations, launched its own investigation into whether 2Day FM had breached the Commercial Radio Code of Practice. ACMA has the power to revoke the station’s licence or to impose conditions on how it operates.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/to83VcwgjAw/royal-hoax-djs-show-cancelled

Main Category: Nursing / Midwifery
Article Date: 24 Jan 2013 – 0:00 PST

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The Nurse Practitioner marks 25th Annual Legislative Update

The most comprehensive review of new legal and regulatory issues affecting advanced nursing practice across the United States is now available in the “25th Annual Legislative Update,” presented exclusively by The Nurse Practitioner: The American Journal of Primary Healthcare. The Nurse Practitioner is published by Lippincott Williams Wilkins, a part of Wolters Kluwer Health.

Compiled by Susanne J. Phillips, MSN, FNP-BC, the annual supplement presents a comprehensive review of the legislative proceedings, bills, and laws pertaining to advanced practice registered nursing (APRN) practice in every state. The 25th Annual Legislative Update is now freely available on the journal website.

Progress in Evidence-Based Reforms Improving Access to APRN Care

The 25th Annual Legislative Update incorporates current information provided by state nursing boards and APRN associations about the “hot topics” affecting APRN practice in their states. “Despite attempts by medical boards to limit current practice authority, APRNs succeeded in improving access to APRN care in several states,” writes Phillips.

The special edition provides an essential update on recent legislative and regulatory activity promoting access to APRN care, prompted by decades of peer-reviewed research demonstrating the quality and safety of APRN practice. Efforts are ongoing to standardize laws and regulations governing APRN practice across states, and to establish effective consumer protections.

Yet legislation continues to be “vehemently opposed” in many states, according to Phillips. She discusses steps APRNs can take to “empower legislators to move beyond the outdated, evidence-lacking arguments that APRNs are not educated enough, safe enough, or credentialed enough to care for the nation’s residents.”

This year’s update presents a rundown of the latest developments in the areas of legal authority, reimbursement, and prescriptive authority for all 50 states. It also includes a table summarizing practice authority for nurse practitioners in every state and the District of Columbia, along with updated statistics and the total number of APRNs reported by state boards of nursing.

Nurses Encouraged to Work Together to Meet Challenges

The past year has seen several important improvements in legal authorization of APRN practice, including passage of legislation and promulgation of regulations in 17 states. In addition, eight states reported statutory or regulatory activity leading to improvements in prescriptive authority.

But challenges remain, including reports of defeated bills and unsuccessful regulatory reform efforts in five states. In addition, two states – Kentucky and Missouri – passed legislation limiting APRN practice in specific ways. Phillips urges APRNs and others interested in ensuring access to evidence-based healthcare to support state APRN organizations.

Nurses are also encouraged to check out the Future of Nursing Campaign for Action, supported by the Robert Wood Johnson Foundation and AARP, to see what steps are being taken and participate in efforts to improve nursing practice. Phillips adds, “This is a great way for all of the APRN organizations to work together to implement the recommendations and improve practice in your state.”

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The study, published in the International Journal of Nursing Research, also
considered data on the numbers of doctors and nurses on all wards.

It found that patients were 9% more likely to die if there were fewer doctors
than average, and 8% more likely to die if there were fewer nurses.

It also showed that patients on wards where there were more untrained workers
such as healthcare assistants were 10% more likely to die.

Professor Peter Griffiths, who led the research, said that while some very
frail patients would have died regardless of the standard of treatment, a
high proportion were probably due to poor care.

He said: “The suspicion is that poor care is a very plausible explanation in a
lot of these cases. If a hospital responds with the best possible care, the
consequences of that complication should be less. If you do not have enough
staff, they cannot provide good care.”

The results will cause concern because many debt-laden hospital trusts have
been axing nursing posts or imposing recruitment freezes, with thousands cut
in the last two years.

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She said: “This patient was allocated to Ms Biju, but she delegated the task
of observations to a student nurse.

“Ms Biju went on her break at 3am, and reported to Staff Nurse Morris that
there were no issues with the patient.

“But when Staff Nurse Morris went to check on patient A, she was unresponsive.”

Efforts were made to revive patient A, but she died shortly afterwards.

Ms Hamilton continued: “’MEWS had not been completed since 1.25am, and it is
clear that shortly before that time her respiration had accelerated and her
oxygen saturation was unstable.

“Observations had not been done and Staff Nurse Morris had not been alerted to
any deterioration in patient A’s condition.”

Ms Hamilton said there were signs that patient A’s health was failing at 10pm
the previous night, but the alarm was not raised.

Between 400 and 1,200 patients are thought to have died due to substandard
care at the two hospitals run by Mid Staffordshire NHS Foundation Trust from
2005 to 2008.

Robert Francis QC, who has just chaired a public inquiry into failings there,
is expected to hand his report to Jeremy Hunt, the Health Secretary, at the
end of the month.

Biju, who has admitted failing to monitor Patient A after 1.25am, was allowed
to keep her job but ran into difficulties again on a night shift on June 2,
2010, it is alleged.

Patient B was transferred to the nurse’s ward after suffering a stroke, and
soon started to develop breathing problems.

Ms Hamilton said another staff nurse, Sarah Benn, had to “bypass Ms Biju” and
speak to another colleague to get assistance for the patient.

“Ms Biju appeared to be more concerned that the patient had not passed urine,
so she was not getting her priorities in the right order,” she said.

“Patient B was confused and wanting his family. It was left to Ms Morris to
increase patient B’s oxygen levels and change the face mask.”

When patient B’s family arrived on the ward, it is alleged Biju failed to tell
them his condition was deteriorating.

Biju is also accused of ill-treating an elderly patient on June 10, 2010, when
she asked for help going to the toilet.

“Patient D complained about Ms Biju, saying she pressed her patient bell but
Ms Biju came to her aid and merely turned off the bell and left,” said Ms
Hamilton.

“She buzzed again because she needed help to go out to the toilet.

“Ms Biju came again but didn’t give any assistance, merely passing patient D
her walking aid but without assisting her to the lavatory.”

Biju, who is attending the hearing in central London, denies that her fitness
to continue practicing as a nurse is impaired by misconduct.

The hearing continues.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/27c8bd25/l/0L0Stelegraph0O0Chealth0Chealthnews0C98186660CStafford0Enurse0Eleft0Ein0Ejob0Efor0Etwo0Eyears0Edespite0Eblunders0Bhtml/story01.htm

Main Category: Abortion
Also Included In: Nursing / Midwifery
Article Date: 22 Jan 2013 – 0:00 PST

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First trimester abortions are just as safe when performed by trained nurse practitioners, physician assistants and certified nurse midwives as when conducted by physicians, according to a new six-year study led by UCSF.

The study posted online in the American Journal of Public Health in advance of the print edition.

The publication comes a week before the 40th anniversary of the Roe vs. Wade, the landmark Supreme Court decision that made abortion legal in the United States.

Currently in the United States, a patchwork of state regulations determines who can provide abortions, with several states specifically prohibiting non-physician clinicians from performing the procedure.

The new study was designed to evaluate the safety of early aspiration abortions when performed by nurse practitioners, physician assistants and certified nurse midwives trained in the procedure. The study was conducted under a legal waiver from the Health Workforce Pilot Projects Program, a division of the California Office of Statewide Health Planning and Development. California law requires a legal clarification about who can perform aspiration abortions.

The researchers report in their study that the results show the pool of abortion providers could be safely expanded beyond physicians to include other trained health care professionals. They found that:

Nurse practitioners, certified nurse midwives and physician assistants can provide early abortion care that is clinically as safe as physicians;

Outpatient abortion is very safe, whether it is provided by physicians or by nurse practitioners, certified nurse midwives or physician assistants.

Nationally, 92 percent of abortions take place in the first trimester but studies find that black, uninsured and low-income women continue to have less access to this care, according to the researchers.

In California, 13 percent of women using state Medicaid insurance obtain abortions after the first trimester. Because the average cost of a second trimester abortion is substantially higher than a first trimester procedure and abortion complications increase as the pregnancy advances, shifting the population distribution of abortions to earlier gestations may result in safer, less costly care, according to the research team.

“Increasing the types of health care professionals who can provide early aspiration abortion care is one way to reduce this health care disparity,” said lead author Tracy Weitz, PhD, MPA, a UCSF associate professor and director of Advancing New Standards in Reproductive Health at the UCSF Bixby Center for Global Reproductive Health. “Policy makers can now feel confident that expanding access to care in this way is evidence-based and will promote women’s health.”

Currently, non-physicians are allowed to perform aspiration abortions in four states: Montana, Oregon, New Hampshire and Vermont. In other states, non-physician clinicians are permitted to perform medication but not aspiration abortions. In recent years, in an effort to limit abortion availability, several states have put laws on the books to prohibit non-physician clinicians from performing abortions.

In the study, 40 nurse practitioners, certified nurse midwives and physician assistants from four Planned Parenthood affiliates and from Kaiser Permanente of Northern California were trained to perform aspiration abortions. They were compared to a group of nearly 100 physicians, who had a mean of 14 years of experience providing abortions.

Altogether, 5,675 abortions were performed in the study by nurse practitioners, certified nurse midwives and physician assistants, compared to 5,812 abortions by physicians. The abortions were performed between August 2007 and August 2011 at 22 clinical facilities in California.

The researchers found that both groups of abortion providers had few complications — less than 2 percent, including incomplete abortions, minor infection and pain. Statistically, according to the researchers, the complication rates were not different between the two groups of providers.

“The value of this study extends beyond the question of who can safely perform aspiration abortion services in California because it provides an example of how research can be used to answer relevant health care policy issues,” said study co-author Diana Taylor, PhD, RNP, professor emeritus in the UCSF School of Nursing. “As the U.S. demand for cost-effective health care increases, workforce development has become a key component of health care reform. All qualified health professionals should perform clinical care to the fullest extent of their education and competency.”

University of California – San Francisco

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MONDAY, Jan. 21 (HealthDay News) — Finding private, quiet places to pump breast milk can be difficult for mothers with babies in neonatal intensive care units, a new study says.

This can cause mothers to miss feedings or be too shy to pump breast milk, which can pose a health risk for low-weight premature babies. Breast milk includes antibodies that help protect infants against infections and gastrointestinal problems, the Case Western Reserve University nursing school researchers explained.

Their study included 15 new mothers in multiple-bed neonatal intensive care unit (NICU) rooms and 25 in single-family NICU rooms. The researchers expected that mothers in the single-family rooms would be less likely to have problems, but that wasn’t the case.

Most of the mothers in both types of rooms said they had privacy and comfort concerns and would rather pump breast milk at home, according to the study recently published in the journal Advances in Neonatal Care.

In some cases, the possibility of interruptions kept mothers from starting pumping breast milk because they feared they would miss updates about their baby’s progress delivered during a doctor’s rounds. Missing that opportunity might mean they would have to wait hours before being able to meet with the doctor again.

Some of the women also said they felt uncomfortable pumping breast milk in front of doctors making their rounds.

“The meaning of privacy might differ for mothers and the hospital. This calls for new ways to create privacy for these mothers who want to breast-feed,” study lead researcher Donna Dowling said in a university news release.

Of the 40 mothers in the study, 75 percent said before giving birth that they planned to breast-feed. However, only 45 percent were breast-feeding exclusively when their babies were discharged from the NICU.

Interruptions and privacy weren’t the only issues. Many mothers found it difficult to breast-feed exclusively because of family, home and work responsibilities, the researchers said.

More information

The U.S. Office on Women’s Health has more about breast-feeding.

SOURCE: Case Western Reserve University, news release, Jan. 16, 2013

Article source: http://healthyliving.msn.com/pregnancy-parenting/kids-health/privacy-an-issue-for-nursing-moms-in-neonatal-icus

The nurses do not receive all the money, with agencies taking a fee of at
least 20 per cent of the total.

Our investigation found:

• The total bill for temporary nurses is set to reach £450 million by the end
of this financial year – a 21 per cent rise on 2011/12;

• Mid Staffordshire Hospitals Foundation trust paid £1,794 for a specialist
nurse to work 13.5 hours in Accident Emergency (AE) unit in
December 2011 – the equivalent to an annual salary of £230,000. The NHS pays
between £25,528 and £34,189 for the same role;

• University Hospital Southampton Foundation trust paid £1,591 for a 12 hour AE
shift the previous December;

• In April 2011, a 12-hour nursing shift cost North Lincolnshire and Goole
trust £1,572;

• Derby Hospitals Foundation trust spent £1,489 on an 11-hour shift in AE
in January 2011;

Research from 106 NHS trusts – two thirds of those in England – shows that in
2011/12, they spent £238 million on temporary nurses.

The same trusts are facing a bill of £287m by the end of the current financial
year – equivalent to £450 million, when extrapolated to all NHS trusts.

Just 15 organisations agreed to supply figures about the highest rate paid for
a shift. Of those, several admitted to paying rates of more than £1,000 a
day for short-term staff.

In most cases, nurses were provided by private agencies, which normally take a
commission of at least 20 per cent.

Such agencies usually pay nurses rates of between £25 and £40 an hour, but pay
more for bank holidays, specialist nurses and to meet surges in demand.

All hospitals rely on some temporary staff, to cover sickness absence.
However, experts are concerned by the scale of spending identified in our
investigation, and the sharp rise in it, indicating that agency nurses are
increasingly being used routinely, to fill gaps in the permanent workforce.

The Royal College of Nursing (RCN) says the firms have been able to vastly
increase their rates – and the percentage they take in commission – because
many hospitals are desperately short of nurses after cutting thousands of
frontline posts.

Official figures show there are 6,000 fewer nurses working in the NHS since
May 2010.

The payment by Mid Staffordshire Hospitals Foundation trust for £1,794 shift
was made to Thornbury Nursing Services, one of the largest agencies in the
UK.

The firm pays specialist nurses up to £93.25 an hour to work bank holidays –
which is £1,119 for a 12-hour shift.

In its marketing materials, potential recruits that they can earn twice as
much as a full-time NHS nurse if they can take on shifts at short notice.

The firm was founded by former nurse Moira Sloss and her husband John in 1983,
and became part of Independent Clinical Services Limited which they sold for
£66 million in 2002.

The couple personally made £45 million on the deal.

The company, which declared pre-tax profits of £7.5 million on a turnover of
£36.6 million in its latest accounts, is now owned by US private equity
giant Blackstone, which owns a string of businesses, including Hilton Hotels
and tourist attractions such as Madame Tussauds.

There are now more than 60 private firms providing nursing and medical staff
to NHS trusts in the UK.

Other major companies include Medacs Healthcare, which advertises 300 shifts
for nurses every day, and declared an operating profit of £5.9 million on an
annual turnover of £172 million in its latest accounts.

Guy’s and St Thomas’ Foundation trust had the highest total bill, and is on
course to spend £19 million by the end of March.

Dr Peter Carter, General Secretary of the RCN said: “We frankly despair
about what we are seeing going on across the country.

Even the most hard-nosed accountant would think it is bizarre that the NHS
should lose thousands of frontline posts, and then end up at the mercy of
agencies, who can charge hospitals what they like.”

He said that when NHS managers became desperate to fill shifts, agencies were
able to increase the percentage of commission they took, as well as the
overall rate paid.

Last week The Sunday Telegraph disclosed that 17
hospitals have been warned of dangerously low staffing levels
following their latest inspections from regulators Care Quality Commission.

Ten of the trusts who received the warning responded to this newspaper’s FOI
request about agency spending and at nine, bills for temporary workers are
soaring amid the staffing crises.

Although the NHS has been protected from cuts by being guaranteed a rise in
annual spending in line with inflation, the service is attempting to save
£20 billion by 2015, to ensure there are sufficient funds to cope with the
rising demands of an ageing population.

Experts said the disclosures reflected their concern that too many cuts had
been made on over-stretched wards, instead of in the bureaucracy running the
health service.

Colin Ovington, Director of Nursing Midwifery at Mid Staffordshire
Foundation Trust said the trust sometimes had to employ agency staff, and
that on such occasions patient safety was given a higher priority than cost.

He said: “This means that we have to pay the going rate for those staff
who are available to cover, sometimes at short notice – these costs are
often extremely high, due to the agencies’ fees.”

He said the two payments identified were for specialist nurses working on a
bank holiday weekend, and included travel expenses.

Guy’s and St Thomas’ Foundation trust said it was one of the largest and
busiest trusts in the country and that the rise in staff was primarily a
result of the organisation taking over community services.

A spokesman for the Department of Health said hospitals should publish their
staffing levels twice a year.

He said agency staff should be used to cover sickness if necessary, but that
hospitals which saved money did so by cutting back on such spending, and
instead filling their permanent posts.

The most costly nursing shifts:

• Mid Staffordshire Hospitals, 13.5 hours, AE, £1,794, December
  2011

• University Hospital Southampton, 12 hours, AE, £1,591,
  December 2010

• North Lincolnshire and Goole, 12 hours, speciality unknown, £1,572,
  April 2011

• Derby Hospitals, 11 hours, AE, £1,489, January 2011

• Mid Staffordshire Hospitals, 13.5 hours, AE, £1,475, December
  2011

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“She was made to feel by staff that she was being a nuisance if she asked
for anything.”

Her comments come after David Cameron called for greater compassion in
healthcare and Health Secretary Jeremy Hunt warned of the “normalisation of
cruelty” in hospitals.

Writing in the Nursing Times, Dr Quallington, said: “In my experience,
nurses enter the profession because they want to care. How have hospitals
become an environment where nurses cannot provide the kind of personal care
that they would wish to give and where a patient feels like a burden?”

She said: “A key step to developing compassionate, expert nurses who can cope
in difficult circumstances is by changing the way trainees are selected.”

University of Worcester provides the top rated nursing degree course in the
country and uses panels of nurse academics, patient representatives and
clinicians to agree that every potential student has the potential to be a
caring nurse before they are accepted.

She added: “Having selected the right trainees, we must ensure they
receive the right kind of high-quality training and mentoring.

“Student nurses in England spend at least half of their time in the workplace,
including hospitals, GP surgeries and treatment centres, and are strongly
influenced by the cultures that exist in practice.”

Dr Quallington said that patient needs are becoming more complex, with an
increasing number suffering from dementia alongside their physical illness,
which means staff are more under pressure than ever before.

She wrote: “It is vital that students are equipped to question practice and
are supported to challenge the substandard.”

Dr Quallington says that it is equally important for nurses to deliver high
standards of patient care as it is for them to be properly qualified.

“Patients should be confident that every hospital worker, be they doctors,
nurses or other allied professionals, has the right attitude towards care,
as well as appropriate knowledge and skills based on the most up-to-date
medical and scientific knowledge,” she said.

Dr Quallington added: “Nurses today face more challenges than ever
before, and the level of knowledge and expertise they must acquire is
growing.

“But as the first Francis report showed, things can go tragically wrong
if compassion and the fundamental principles of patient care are missing.

“Everyone involved in the training and selection of nurses has a
responsibility to ensure that these elements are at the core of practice
among the professional workforce in all of our hospitals.”

In December Jane Cummings, the chief nursing officer for England, launched the
Compassion in Practice document, outlining a three-year nursing strategy, to
focus on values such as compassion, communication and commitment.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/27a054b7/l/0L0Stelegraph0O0Chealth0Chealthnews0C980A88770CTrainee0Enurses0Eshould0Ebe0Eselected0Eon0Ecompassion0Eto0Eavoid0Erepeat0Eof0EMid0EStaffs0Escandal0Eexpert0Bhtml/story01.htm

This issue: Jane Cummings salutes nursing colleagues recognised in the Queen’s New Year Honours List, we reveal three triumphant winners from the NHS Leadership Recognition Awards 2012, preview plans to introduce a dedicated epilepsy ‘super nurse’ and lift the lid on the latest Be Clear on Cancer campaigns. All this and another invitation to take our very quick survey!

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Article source: http://www.dh.gov.uk/health/2013/01/chief-nursing-officer-bulletin-january-2013/

“I feel that it would have been in the family’s best interest that there
should have been an independent element of the inquiry.

“Despite the fact that the family have sent a list of 40 questions to the
hospital they still seem unwilling to answer them.”

The Australian radio station’s parent company, Southern Cross Austereo, also
received a list of questions from Ms Saldanha’s family.

Mr Vaz added: “As far as the radio station is concerned, I am disappointed
that they have still not written directly to the family and apologised.
However, I am glad that they are co-operating fully with the Australian
regulatory body’s inquiry.”

In a letter to Mr Vaz, hospital chief executive John Lofthouse said he wanted
to reiterate that “no disciplinary action was being contemplated” against Ms
Saldanha.

“We regarded her as the victim of a cruel hoax,” he added.

Greig and Christian spoke of their grief on Australian television soon after
the nurse’s death.

They said their prank had prompted “a tragic turn of events no-one could have
predicted or expected”.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/27786668/l/0L0Stelegraph0O0Cnews0Cuknews0Ckate0Emiddleton0C97984950CDuchess0Eof0ECambridges0Enurse0Eno0Ereply0Eto0Efamilys0E40A0Equestions0Bhtml/story01.htm

Andy Burnham, the shadow health secretary, said: “The public has a right to
know if their local hospital is taking risks with staffing levels.”

The inspections were carried out by staff from the CQC at each hospital,
although not every ward was visited. Each hospital was told it had failed to
employ enough staff “to keep people safe”.

There is no universal ratio of staff to patients. The inspections took place
as recently as November.

The warning may affect only part of the hospitals concerned, but patients’
groups said any lack of staff was a grave concern.

The 17 hospitals were named on a list of 26 “health providers” found to have
inadequate staffing levels. The data has never before been made public.

The hospitals named were: Scarborough Hospital; Milton Keynes Hospital; Royal
Cornwall Hospital; Walton Centre NHS Foundation Trust in Liverpool; Queen’s
Hospital, Romford; Stamford Rutland Hospital; Southampton General
Hospital; Croydon University Hospital; Bodmin Hospital, Cornwall;
Northampton General Hospital; St Peter’s Hospital, Maldon; Queen Mary’s
Hospital, London; Chase Farm Hospital, London; Westmorland General Hospital;
Pilgrim Hospital, Leicestershire; St Anne’s House, East Sussex; and Princess
Royal Hospital, West Sussex.

London Ambulance Service and eight mental health units were also warned about
dangerous staffing levels.

They were: Ainslie and Highams Inpatient Facility, London; The Campbell
Centre, Bedford; Forston Clinic, Dorset; The Cavell Centre, Peterborough;
The Bradgate Mental Health Unit, Leicestershire; Avon and Wiltshire NHS
Mental Health Trust; Blackberry Hill Hospital, Bristol; and Park House,
Manchester.

At Milton Keynes, patients with dementia were left unable to reach call bells,
tables, drinks and warm clothing.

Inspectors said those who were unable to communicate their needs were forced
to do without, and that while staff were busy, some did not even seem to
notice that some patients were uncomfortable.

At Queen’s Hospital in Romford, Essex, women in labour were exposed to
unnecessary risk because there were not enough staff.

Some midwives could not perform basic skills. Previous reports described a
“culture of abuse” at the hospital’s maternity unit.

Mr Hunt has promised a renewed drive to protect patient care ahead of what is
expected to be a damning report into the Stafford scandal by Robert Francis
QC.

Poor staffing levels, particularly involving nurses, were a factor behind the
problems at Stafford Hospital, where up to 1,200 patients died needlessly
while managers slashed their budgets in pursuit of NHS foundation trust
status.

Mr Hunt said: “Where CQC inspections find NHS and social care providers
failing in their legal duties to provide enough staff or appropriate care,
we expect swift action to be taken.

“There can be no excuse for not providing appropriate staff levels when across
the NHS generally there are now more clinical staff working than there were
in May 2010 — including nearly 5,000 more doctors and almost 900 extra
midwives.”

Mr Burnham said: “One by one, David Cameron has broken all the promises he
made on the NHS. It is now struggling with his toxic medicine of spending
cuts and reorganisation.

“Almost 7,000 nursing posts have been lost since David Cameron entered Downing
Street. The public has a right to know if their local hospital is taking
risks with staffing levels.”

Katherine Murphy, the chief executive of the Patients Association said: “It is
a deeply worrying picture: these are just the parts of the hospital that the
inspectors have seen and there is no reason to think it will be any safer on
the wards they have not visited.”

Concern over the quality of care was highlighted last night as it was
disclosed that a whistle-blowers’ line for doctors and nurses to report
concerns about risks to patients was receiving more than 700 calls a month.

Figures show that in the past three months, almost 2,200 calls have been
received from those too frightened to raise their concerns with their
bosses, or whose attempts to do so had fallen on deaf ears.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/277567d7/l/0L0Stelegraph0O0Chealth0Cheal0Eour0Ehospitals0C97978390CSeventeen0ENHS0Ehospitals0Ehave0Edangerously0Elow0Enumbers0Eof0Enurses0Bhtml/story01.htm

Just over a year ago, three-year-old Thomas Hall would not speak. He would not play with other children or follow adults’ instructions. Now he can’t stop chattering. At Christmas his parents watched with tears in their eyes as their previously ungovernable child stood proudly alongside his classmates, dressed as an angel.

It was, says Thomas’s father, Charles, a heart-wrenching moment. “If Thomas had carried on along the path he was heading, by the time he got to school his behaviour might have become too embedded to change,” he says. “I can envisage him being written off as the naughty boy at the back of the classroom.”

Charles attributes the change to the work of staff and specialist practitioners at the Northend nursery in Erith, Kent, a charitable organisation managed by the Pre-School Learning Alliance. “It’s the sheer amount of skilled, one-on-one attention he’s received that’s done it.

“But the nursery didn’t just focus on Thomas: they spent many hours with his mother and me too, teaching us what we can do. Now, because our home is a happier, calmer place, we can start paying proper attention to Thomas’s little brother. The nursery hasn’t just transformed the life of one little boy, it’s changed the lives of a whole family.”

Next week the government is expected to make announcements that could revolutionise childcare. Everyone agrees it is not before time. Childcare in the UK is among the most expensive in the world, costing an average of 27% of parental income, compared with 13% in Europe and 5% in Sweden.

Despite the expense, British childcare fails where it is most needed. Three-quarters of providers are rated by Ofsted as good or outstanding, but it is children in the poorest areas of the country who receive the worst care.

According to the Sutton Trust, an educational charity, the UK has one of the biggest gaps in “school readiness” between the richest and poorest four- and five-year-olds, based on the top and bottom 10%. Children from the poorest homes are, on average, nearly 19 months behind children from the richest homes in vocabulary tests. (That compares with 14.5 months in Australia and 10.6 months in Canada, countries that have similar levels of inequality to the UK but greater social mobility.)

Early years providers and experts are waiting on tenterhooks for the announcements. There are two pending: the government response to Professor Cathy Nutbrown’s official review of early education and childcare qualifications in England; and the deliberations of David Cameron’s commission on childcare, tasked with devising a way to reduce the cost.

Nutbrown’s report, Foundations for Quality, called for all nursery staff to have A-level-standard professional qualifications and better maths and literacy skills. It was widely welcomed by an industry in which 14% of the workforce is educated to graduate level, and which struggles to attract and retain high-quality workers.

Nutbrown was not asked to price her 19 recommendations and, according to figures obtained this week by Labour through freedom of information requests, finances are moving in the other direction. There have been substantial cuts, Labour discovered, to the funding available to train childcare staff.

Figures for 136 local authorities show that money available was slashed by 40% in a year, from £93m in 2010/11 to £56m in 2011/12. In four areas – Redcar and Cleveland, Enfield, Solihull and Lewisham – there is no money for councils to provide nursery staff training.

Causing more angst are hints dropped this week by the Conservative MP Elizabeth Truss about the conclusions of the childcare commission she has led with Steve Webb, the Lib Dem pensions minister, including possibly changing staff-to-children ratios in childcare settings, cutting red tape and creating wrap-around care from 6am to 6pm, as happens in Germany.

Talk of changing ratios is controversial. Under current legislation there is one carer to every three children up to two, 1:4 for toddlers aged two to three, and 1:6 for three- to four-year-olds.

In a piece for the ConservativeHome website, Truss wrote: “We need to think about the balance between the number and quality of staff in our system. It is no coincidence that we have the most restrictive adult-child ratios for young children of comparable European countries as well as the lowest staff salaries.”

Truss has praised the French écoles maternelles system that offers traditional nursery-style teaching in large groups of three- and four-year-olds, with each staff member responsible for up to eight toddlers.

For struggling nurseries, being able to reduce staff numbers should be welcome. Staff salaries account for around 70% of nurseries’ costs. But the reaction from providers has been anything but positive. In a survey by the Pre-school Learning Alliance, 94% of respondents said they did not believe they would be able to maintain their current quality of service if staffing levels were reduced.

Respondents also said having fewer staff would not necessarily reduce the financial burden on parents. “Very few respondents indicated that they would adjust their charges accordingly, arguing that the additional revenue would go part‑way to addressing the historic inadequacy of funding,” said Neil Leitch, chief executive of the alliance.

A yet-to-be-published report by the National Childminding Association, seen by the Guardian, says almost two-thirds of childminders agree that looser ratios would compromise the safety of children in their care.

A closer look at the foreign systems that Truss lauds is revealing. According to an independent report from the Economist Intelligence Unit last year, the quality of childcare was worse in France than the UK, and costs were higher.

At the Northend nursery, when asked to imagine the consequences of new staff-child ratios, the manager, Josie Lait, shakes her head. “The current ratio makes it hard enough already to give children quality one-on-one attention,” she says. “Around half our children have been referred to us by the health authority, which means they have behavioural problems, but the other half deserve individual attention too.”

“If the ratio is loosened, we would find it very hard to give children like Thomas the time they need. I have to admit that if the ratios are loosened, I would be tempted to defy them.”

Truss has hinted she wants to deliver money to frontline services. Currently, the government ploughs about £5bn a year into childcare and early years provision. The Department for Education says the average profit for a nursery is £13,600, but many are doing far worse, with dozens on the brink. Lait says Northend has not made a profit for two years.

Where the money goes is a mystery the government cannot answer. It’s not going on wages: nursery staff take home a salary that barely hovers above minimum wage and even a graduate early years professional takes home only half what a qualified teacher does.

Part of the problem is that the cash allocated for free entitlement to 15 hours of childcare for three- to four-years-olds is passed by central government down to local authorities without being ringfenced. The result in 2006/7, according to a 2008 report by Manchester Business School, was a shortfall of £912m – or 24.7% of the £3.6bn budget – by the time the money reached providers. Amid cuts to local authority funding, this could get worse.

Another reason providers are struggling is that these cuts are being implemented at the same time as local authorities are being asked to do more, such as extend free childcare entitlement to all two-year-olds. This year in the London borough of Bexley, early years settings have been told to expect a 15% cut to their funding.

It seems unlikely that Truss will opt for directly funded services, as in France. At the Daycare Trust conference she voiced her support for a “name and shame” approach towards councils. “I’m urging local authorities to make sure this funding is passed on to providers,” she said. “We’ll be publishing the actual amount every local authority has passed on, on the department’s website next year, so parents and providers will be able to compare rates across the country and hold authorities to account.”

Next week – probably – announcements will be made and the uncertainty will be swept away.

In Kent, however, it will be too late for 28-year-old Katie Hawkins, the lead practitioner who helped Lait set up Northend nursery.

Hawkins has a three-year degree and early years practitioner status. She says she has been passionate about working with children since she was a child. But now she is leaving. “I earn half of what my friends earn as teachers, even though I have the same levels of qualification as them,” she says. “I still live with my parents, because I can’t afford to move out. I don’t feel my work is respected or understood: my friends, and even some parents here, just assume we spend our days playing with babies, and treat us accordingly.”

She adds: “It’s incredibly depressing because I love what I do. But I owe it to my future to take a break and take stock. I need to find something that pays me a living wage and that I know is respected. Doing what I do now, I’m never going to be able to move on with my life.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/ZL_jeGA1bas/childcare-reform-nurseries

The senior Tory MP Stephen Dorrell has been cleared by a sleaze investigation into whether he should have declared financial links with care home owners.

It emerged in November that the health select committee chairman had sold his London home to friends at a reported £70,000 profit – and was using Commons expenses to rent it back from them.

His new landlords run a chain of care homes and his committee has been carrying out an inquiry into social care.

But parliamentary standards commissioner John Lyon has rejected claims that Dorrell broke rules by failing to declare the deal.

In a letter to Labour MP John Mann, who made the complaint, Lyon said: “I have concluded that the nature of Mr Dorrell’s connection to his friends was not such as to require him to declare it as a personal interest and so to stand aside from the committee’s inquiry.

“Mr Dorrell’s evidence is that the relationship is long-standing and is not based on their business interests.

“And I accept his evidence that he did not discuss with his friends in terms the health committee’s inquiry on social care.

“But I am sure it was helpful that, following your challenge, Mr Dorrell did declare to members of the committee his relationship with his friends, although, in all the circumstances, I do not believe he was required by the rules to do so.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/ZNqrFrZs14w/stephen-dorrell-cleared-care-homes

According to a report last July by the London Audit Consortium, an NHS body,
82 per cent of overpayment across the capital were due to “late
notification” that staff had left or changed their hours.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/273e5855/l/0L0Stelegraph0O0Chealth0Chealthnews0C97837480CNursing0Echief0Eanger0Eat0ENHS0Etrust0Estaff0Eoverpayment0Efiasco0Bhtml/story01.htm

Half a million soldiers, nurses and teachers will have their income slashed under the coalition’s benefits crackdown, according to a new report. The chancellor’s sub-inflation rise in benefits and tax credits over the next three years will hit a whole range of the country’s most trusted professionals.

Up to 40,000 soldiers, 300,000 nurses and 150,000 primary and nursery school teachers will lose cash, in some cases many hundreds of pounds, according to the Children’s Society. The revelation appears to contradict the government’s stated intention to target shirkers and scroungers, and will raise the temperature of the Commons debate and vote on the plan on Tuesday.

The analysis, which is set to be at the centre of Labour’s attack on the coalition in the Commons, when Ed Miliband‘s party will vote against the policy, reveals for the first time the range of professions that will be hit. By 2015 a second lieutenant in the army who has three children, who earns £470 per week and whose wife does not work will lose £552 a year; a lone-parent nurse with two children, earning the profession’s average of £530 a week, will lose £424 a year; and a couple with two children where the sole earner is a primary school teacher, earning £600 a week, will lose £424.

The coalition’s welfare up-rating bill caps a whole range of benefits at 1% until 2015, including child benefit, tax credits, statutory maternity pay and jobseeker’s allowance.

The Children’s Society analysis prompted shadow work and pensions secretary Liam Byrne to brand his counterpart in the government a liar on Saturday in a significant escalation in the political row over the government’s welfare plans. Iain Duncan Smith claimed last week that it was unfair that working families had been tightening their belts after years of pay restraint while watching benefits rise.

But Byrne said the analysis illustrated how those in work who have been suffering in the recession are now facing a double blow in the form of the coalition’s squeeze on the full range of benefits. “Iain Duncan Smith is going to come to the House of Commons this week and say this bill is all about punishing Britain’s shirkers and scroungers, when that is a big lie,” said Byrne. “This is about an attack on Britain’s working families.”

The row is now in danger of overshadowing the attempt on Monday to renew the coalition, with a joint appearance by David Cameron and Nick Clegg in Downing Street to launch a mid-term review. They will attempt to dispel claims that the coalition is solely focused on deficit reduction by highlighting their attempt to make welfare fairer.

The prime minister will claim that the coalition reforms are protecting and targeting support on people in real need, as well as stopping benefits going to those who don’t need them, making work always pay more than benefits.

But in a letter published in the Observer, 27 organisations, including Barnardo’s, Women’s Aid, Citizens Advice and the Royal National Institute for the Blind, condemn the coalition’s plans, which they claim will hurt working families.

The letter says: “This Tuesday, MPs will debate the introduction of a 1% cap on benefit and tax credit increases under the welfare benefits up-rating bill. If introduced, this hardship penalty will hurt millions of families across the country. Families already struggling to pay for food, fuel, rent and other basics will see their budgets further squeezed.

“Many thousands have turned to food banks for help. Nearly half of teachers say they often see children going hungry. And, shockingly, six million households are struggling to afford to heat their homes. As the cost of fuel, food and housing rise again, we can expect to see these problems become even more severe and widespread.”

Matthew Reed, chief executive of the Children’s Society, which also signed the letter, said: “The government needs to urgently reconsider this bill and make sure that increases in benefit rates at the very least reflect rises in cost of living.”

A Department for Work and Pensions spokesman said: “In difficult economic times we’ve protected the benefits of disabled people and pensioners who have little means to increase their income. We’ve also committed to helping people who claim working age benefits and tax credits and will increase this support by 1%. This was a tough decision, but it will ensure that the welfare budget is sustainable over the longer term and will continue to help the people who need it most.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/wQRziIwl7g4/soldiers-nurses-teachers-benefit-curbs

A new vision and service model for district nursing has been published today.

This vision builds on ‘Compassion in Practice’, the national vision for nurses midwives and care staff. It was developed by a strategic partnership of the Department of Health, NHS Commissioning Board Authority, The Queen’s Nursing Institute, and with the district nurse leaders and practitioners. The vision recognises the unique and specialist contribution of district nurses and their teams.

It sets out the strong foundations of district nursing services:

• 6Cs – enduring values underpinning the service and delivery
• trust – which starts with therapeutic relationships between patients and carers
• partnerships across GP and other services – collaborative working across agencies to support care
• supporting transition of care – working with partners to provide seamless support including discharge planning, transition to residential or hospice care
• supporting patient choice – working with patients and carers to encourage active participation in care and decision making
• managing risk – reducing social isolation through supportive care co-ordination, supporting the needs of carers and safeguarding vulnerable patients.

It also outlines the developments and innovations that ensure services can meet current and future needs including:

• making every contact count – providing opportunistic public health interventions and supporting the health and wellbeing of carers
• maximising efficiency – use of productive community services and innovation to enhance care
• integrated working with health and social care – developing strengthened ways of working with partners to maximise resources
• delivering complex care – supporting care in community settings e.g. administering chemotherapy at home, reducing avoidable hospital admissions and promotion of early discharge
• new technology to enhance care – the use of tele-health and mobile technology to support complex care in the home.

The district nursing service model outlines the district nurse-led team contribution to providing care and support in the community, including peoples’ homes. The three core elements include:

Population and case load management: Caseload management and providing population interventions to improve community health and wellbeing. Surveillance of caseload and local population needs. Working with partners for health protection and improvement for adults and their carers, at home and in other community settings.

Support and care for patients who are unwell, recovering at home and at end of life: Responding when specific expert health intervention is needed e.g. with short-term health issues, or sudden health crises or when patients are discharged from hospital, or have a sudden deterioration in a health condition. Providing interventions within the home including chemotherapy and intravenous therapy. Working with community specialist nurses including community matrons, to deliver specialist care including palliative and end of life care.

Support and care for independence: Leading and prioritising supportive care to help wellbeing and independence including advice on ‘assistive technology’ such as telehealth and telecare, working with patients and their families to help them care for themselves. Leading and co-ordinating care in partnership with health and social care, other agencies and specialist services. Working together with patients to deal with more complex issues over a period of time.

Viv Bennett, Director of Nursing DH/PHE said:

“In order to meet the needs of our ageing population we have to change the way we work and provide more care in the community. People are living longer and we need services that support people to be as well and as independent as they can for as long as possible. District nurses have the professional expertise and knowledge to lead and provide these services.”

The vision aims to be a resource for those designing and providing local community health services including nurse leaders, health and wellbeing boards, clinical commissioning groups, and others with an interest in developing integrated care for older people.

Read Care in local communities: A new vision and model for district nursing

See also: Compassion in Practice vision for nurses

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Article source: http://www.dh.gov.uk/health/2013/01/vision-district-nursing/

• Juleth McKenzie didn’t know difference between milligrams and micrograms
• Eleven allegations of errors were either admitted or found proved
• She worked at Bradford Teaching Hospitals NHS Foundation Trust

By
Leon Watson

PUBLISHED:

06:39 EST, 4 January 2013

|

UPDATED:

11:11 EST, 4 January 2013

A nurse trained to grade five standard of care was so incompetent she couldn’t even calculate a patient’s heart rate, a disciplinary hearing heard.

Juleth McKenzie was hauled in front of the Nursing and Midwifery Council after she gave a dialysis patient a drink of Lucozade instead of a glucose drip.

The nurse, who worked at Bradford Teaching Hospitals NHS Foundation Trust, didn’t know the difference between milligrams and micrograms and checked a patient’s temperature instead of blood pressure – despite having qualified eight years ago.

Juleth Deborah Mckenzie was hauled in front of The Nursing and Midwivery Council after she gave a dialysis patient a drink of Lucozade instead of a glucose drip

Eleven allegations of incompetent errors against McKenzie were either admitted or found proved against the nurse.

Following an NMC hearing in November last year, at which McKenzie was not present or represented at, her fitness to practise was found impaired by lack of competence.

She was handed a 12 month suspension order, according to the findings of the hearing which have now been released.

The allegations heard by an NMC conduct and competence panel included giving medication to patients she was not authorised to do so, prioritising getting personal details of a patient over stemming bleeding and assessing a patient with Parkinson’s disease as being independent and needing no care or support.

She was also accused of attempting to give drugs which had already been given, preparing drugs for oral administration for a patient who was nil by mouth, being unfamiliar with equipment on a resuscitation trolley, making four errors in relation to giving Heparin, giving prescription eye drops when not authorised and giving them to the wrong patient, failing to register patients and putting the wrong hospital number on a patient’s wristband and not being aware of the difference between milligrams and micrograms and checking a patient’s temperature instead of blood pressure.

McKenzie worked at Bradford Teaching Hospitals NHS Foundation Trust and was found to not know the difference between milligrams and micrograms

McKenzie was placed on the Trust’s poor performance plan and was diagnosed with dyslexia and poor short-term visual memory

Miss McKenzie’s patients on the renal ward and senior colleagues described how she ‘places patients at risk every time she put them on dialysis’.

While others said she was a very caring person who wanted to deliver good practice, she was ‘out of her depth and lacking in ability’ and was described as ‘getting muddled and panicked’.

Patients on the dialysis ward had even gone as far as to ask to not be treated by Miss McKenzie.

The panel heard how the job on the renal ward was Miss McKenzie’s first substantive post after qualifying in 2005.

She was required to complete a new starters programme which most nurses complete within three months, but after six months concerns remained about her ability as a registered nurse.

By December 2006, she had been placed on the Trust’s poor performance plan and was diagnosed with dyslexia and poor short-term visual memory.

McKenzie was redeployed to a less acute area on ward 18 but she continued to make fundamental errors.

She became a healthcare assistant but even in this capacity concern was expressed about her competence and she left the Trust on November 30, 2008.

The Royal College of Nursing’s career framework outlines nine levels of nursing. McKenzie was a level 5 nurse, qualified to ‘provide general nursing services to defined groups’.

No evidence was given to the panel which gave it any concern that the hospital had acted in appropriately or unsympathetically towards Miss McKenzie.

A spokesman for the Foundation Trust, which runs Bradford Royal Infirmary and St Luke’s Hospital, said: ‘The Trust took appropriate action to safeguard patients and Miss McKenzie managed in accordance with the Trust’s capability procedures and was provided with extensive supervision and support.’

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Article source: http://www.dailymail.co.uk/news/article-2257082/Nurse-incompetent-gave-dialysis-patient-Lucozade-instead-glucose-drip-pulse.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

David Cameron will say that “completely unacceptable care” was blighting
patient treatment in some hospitals and care homes.

The Prime Minister and the Health Secretary Jeremy Hunt will outline a series
of measures designed to improve standards of care in the NHS.

Details of the new minimum training standards will be announced “in the coming
weeks”.

Mr Cameron will say: “A year ago, I said the whole approach to caring in this
country needed to be reset.

“Since then we have done a lot with more training and better support.

“And nurses are now checking on patients hour by hour in nine out of 10
hospitals.

“We still have a long way to go to raise standards across the NHS and get rid
of those cases of poor and completely unacceptable care that blight some
hospitals and homes.

“We know what an incredible job nurses do – and how much we ask of them. So we
are giving nurses more support to deliver these changes but also help for
all NHS staff, health care assistants and carers. Good quality care must be
everyone’s business.

“It is crucial that we continue to rebuild confidence in the quality of care
in our country – and I hope this effort will help us to do that.”

Mr Hunt is concerned that “in many places quality of care is not valued as
highly as quality of treatment”.

One of the Government’s flagship initiatives is for hospitals to face a
“friend and families test” from patients.

People will be asked whether they would recommend the services and treatment
they received to others and the results will be used to rank hospitals.

Ministers will announce today that the scheme will also be extended to GP
surgeries and district nursing.

Last year, an independent commission warned that the use of well-meaning but
“unreliable” nursing assistants raised “serious concerns about public
protection”.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/272e6eaa/l/0L0Stelegraph0O0Chealth0Chealthnews0C97794550CLessons0Ein0Ecaring0Efor0ENHS0Estaff0Bhtml/story01.htm

The report is expected to make wide-ranging recommendations which will
effectively mean that NHS workers dealing with patients should be regulated.

Currently, only doctors and nurses are subject to official controls. There is
growing concern that untrained assistants are responsible for basic nursing
tasks which would previously have been conducted by trained nurses.

David Cameron will say that “completely unacceptable care” was blighting
patient treatment in some hospitals and care homes.

The Prime Minister and the Health Secretary Jeremy Hunt will later today
outline a series of measures designed to improve standards of care in the
NHS.

Details of the new minimum training standards will be announced “in the coming
weeks”.

Mr Cameron will say: “A year ago, I said the whole approach to caring in this
country needed to be reset.

“Since then we have done a lot with more training and better support.

“And nurses are now checking on patients hour by hour in nine out of 10
hospitals.

“We still have a long way to go to raise standards across the NHS and get rid
of those cases of poor and completely unacceptable care that blight some
hospitals and homes.

“We know what an incredible job nurses do – and how much we ask of them. So we
are giving nurses more support to deliver these changes but also help for
all NHS staff, health care assistants and carers. Good quality care must be
everyone’s business.

“It is crucial that we continue to rebuild confidence in the quality of care
in our country – and I hope this effort will help us to do that.”

Mr Hunt is concerned that “in many places quality of care is not valued as
highly as quality of treatment”.

One of the Government’s flagship initiatives is for hospitals to face a
“friend and families test” from patients.

People will be asked whether they would recommend the services and treatment
they received to others and the results will be used to rank hospitals.

Mr Cameron told BBC Radio Five Live the system can act “as a flashing light”
for problems such as those seen in Mid-Staffordshire.

Ministers will announce today that the scheme will also be extended to GP
surgeries and district nursing.

Last year, an independent commission warned that the use of well-meaning but
“unreliable” nursing assistants raised “serious concerns about public
protection”.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/272f8d36/l/0L0Stelegraph0O0Chealth0Chealthnews0C97798190CDementia0Epatients0Eputting0Estrain0Eon0Enurses0ECameron0Esays0Bhtml/story01.htm

• Student Jennie Cosh says she was left fitting after being ignored by nurses just metres away
• Alleges elderly patients on the same ward left to soil themselves
• Doctors have still not been able to
  pinpoint exactly what caused her stroke

PUBLISHED:

12:27 EST, 2 January 2013

|

UPDATED:

12:49 EST, 2 January 2013

A student who suffered a stroke has condemned the hospital where she was treated as a ‘disgrace’.

Furious Jennie Cosh, 20, claims she was left fitting after nurses at Gloucestershire Royal Hospital ignored her calls – despite one standing at the bed next to her.

She says staff on the hospital’s stroke ward were stretched beyond their limits, meaning they were not able to respond to patients’ needs properly.

Stroke victim Jennie Cosh, 20, says her treatment at Gloucestershire Royal Hospital was a ‘disgrace’

Jennie alleges that elderly patients were forced to soil themselves when there was no response to them repeatedly pressing the buzzer and loudly wailing for help.

The journalism student, who is now recovering at home in Cheltenham, Gloucestershire, said she wanted to raise awareness of conditions in the hospital to help others.

She said: ‘I was shocked at how poor the standard of care was at Gloucestershire Royal Hospital.

‘I was lying in a hospital bed, having a fit, and a nurse just two metres away ignored my cries for help.

‘It is supposed to be a “centre for excellence” for stroke victims but that wasn’t my experience at all.

‘I was put on a big ward in an open bay with very little privacy – and I was the youngest patient by about 60 years. Staff hardly paid any attention to me.

‘I felt totally isolated and alone and it was worse for some of the elderly patients around me who were constantly buzzing for assistance and being ignored.

She claims the staff on the hospital’s stroke ward were stretched beyond their limits, meaning they were not able to respond to patients’ needs properly

‘One poor lady was buzzing repeatedly and, as there was no answer, she ended up soiling herself.

‘Another threw up over herself. It was a disgrace.’

Jennie was suffering from a splitting headache, dizziness, blurred vision and a high temperature on June 26 last year while eating dinner with parents.

She went outside to cool down where she struggled with her right leg before taking a combined aspirin pain killer tablet.

Furious Jennie claims she was ignored by nurses even after calling out for help

Her worried parents took her to the doctor after her symptoms persisted and she was given the shock news that she had suffered a stroke.

Doctors have still not been able to pinpoint exactly what caused her stroke. Jennie describes herself as ‘perfectly healthy’ and does not smoke, drink or take drugs.

Jennie was admitted to Gloucestershire Royal Hospital hours after visiting the doctor and remained there until July 2.

She added: ‘I remember at one point I started to feel faint and buzzed for a nurse. There was no response and I started fitting.

‘Although there was a nurse on the very bed next to me, she didn’t even acknowledge me for nearly 10 minutes.

‘I couldn’t believe how bad it was, but I was only there for a short time. But what about the elderly people who are in for weeks on end?’

Jennie has been left with limited feeling down her right side from the ordeal, but has been working hard to regain full fitness.

A spokesman for Gloucestershire Royal Hospitals NHS Foundation Trust, which runs the hospital, said it would need more details for a full investigation.

He said: ‘Gloucestershire Hospitals is committed to providing high quality and safe care for our patients and we take complaints seriously.

‘We are disappointed to hear that Jennie Cosh was unhappy with the care provided. We would like to invite her to speak to us about her concerns.’

Paralympic athlete Mel Nicholls suffered three strokes before the age of 30, while pop star Jessie J had a stroke at 18.

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Article source: http://www.dailymail.co.uk/health/article-2256107/Student-suffered-stroke-claims-ignored-hospital-nurses-stretched-limits-busy-ward.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

“That might be because they are afraid, or because of the culture, that
if you whistle-blow you will be in trouble, or it might be that they just
don’t want the hassle.”

He went on: “I think that most people who come in to this line of work –
whether it is nursing, social care, or in care homes – want to care but
somehow it gets knocked out of them.

“They end up in systems and structures that make them feel anxious or nervous,
it might be the pressure of work or the culture of the organisation just
setting inappropriate targets where you can measure the measurable but not
the qualities of what it feels like.”

He said that part of the problem was the growth of “daft” and irrelevant
targets and a “blame game” over whether they are met.

“A lot of the leadership development through the whole sector is based on
a business school type ideology, because we haven’t got a clear leadership
development framework based on social work or social care principles,” he
said.

“Instead of being taught how to care for people, they are being taught how
to meet targets.”

He added: “Of course you are going to get the odd rogue but the million
people involved in social care came in to it for good reasons, we need to
switch that back on again.

“We need to stop it being knocked out of them or crushed so that they don’t
exercise it any more.

“Experience is crushing it but maybe training should give then resilience
to stop them being crushed.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/271a0048/l/0L0Stelegraph0O0Chealth0Chealthnews0C97579680CTargets0Eand0Ejargon0Eprevent0Egeneration0Eof0Enurses0Estopping0Eabuse0Bhtml/story01.htm

• Fat NHS staff lose their credibility when giving health advice to patients
• Doctors and nurses should be offered to have their stomachs stapled as well as dietary advice on the NHS

By
Sara Malm

PUBLISHED:

13:14 EST, 30 December 2012

|

UPDATED:

02:48 EST, 31 December 2012

Doctors and nurses who suffer from weight problems should be offered gastric surgery in order to retain credibility with patients on weight loss treatments, a report will say.

Overweight NHS staff ought to be given dietary advice and counselling as well as stomach stapling operations as they are setting a bad example for patients, the Royal College of Physicians said.

Over half of medical staff within NHS organisations are likely to be overweight, in accordance with statistics for the British population.

Gastric help: NHS staff who are overweight or obese should be offered stomach stapling surgery as they set a bad example for patients suffering from weight problems (file photo)

The report by the Royal College of Physicians, set to be published next week, will focus on the lack of treatment for weight problems and obesity within the NHS.

It is also set to conclude that work needs to be done to reduce weight problems for medical staff as they lose credibility in giving overweight and obese patients advice on a healthy lifestyle.

Hypocrisy: If the NHS staff advising overweight people are overweight themselves, they lose their credibility (file photo)

‘We want to make sure that people who work in the hospital health service are exposed to having the ability to get help where they need it,’ John Wass, author of the report told The Sunday Times, adding that ‘a lot of’ NHS medical staff are overweight.

The report will urge NHS
organisations to focus on the health of their staff as well as their
patients an ensure there is healthy food on offer for doctors and nurses
and not ‘sell Coca-Cola all over the place’, John Wass added.

Stomach stapling, also known as vertical banded gastroplasty, is a type of gastric surgery which uses
both a gastric band and staples to reduce the size of the stomach,
effectively restricting food intake.

A private stomach stapling surgery costs between £5,000 and £8,000.

The NHS offers weight-loss surgery
only as a ‘last resort to treat people who are dangerously obese’
meaning a person with a body mass index above 40.

It is also offered to people with a
BMI of 35 and above if they also suffer health conditions which could be
improved through weight loss, such as diabetes type 2.  

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Article source: http://www.dailymail.co.uk/health/article-2254929/Overweight-doctors-nurses-given-stomach-stapling-surgery-bad-example-patients.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

But staff there failed to carry out an assessment or treatment of the surgical
wound on Mrs Marshall’s hip during a 15-day period and it became infected.
Her nightdress was soaked with pus weeping from the infected wound and she
was dehydrated but the condition was not noted by nursing staff.

She developed diarrhoea on the evening of December 29 and other patients
suffered similar symptoms amid an outbreak of Norovirus.

While at Monument House, Mrs Marshall also developed a pressure sore – an
additional condition that went untreated. She was also suffering from poor
nutrition.

Mrs Marshall’s hip wound broke open on January 14 and she was transferred back
to Pinderfields. She died eight days later.

Recording a narrative verdict at an inquest in Wakefield, Deputy assistant
coroner Mary Burke said: “Despite full support and treatment, Mrs
Marshall’s condition failed to improve and she died as a result of sepsis
which was due to her infected hip wound.

“It is likely that if Mrs Marshall had received full care and support
prior to her re-admission to Pinderfields Hospital, she would have survived.”

She noted too, that at the time of Mrs Marshall’s admission to Monument House “initial
documentary assessments of Mrs Marshall were either not completed or were
not completed correctly”.

Nurse Kirsty Shepherd told the inquest the ward at Monument House was “horrendously
busy” and confirmed patients were not getting 100 per cent care due to
staff shortages.

Ms Burke said: “She (Kirsty Shepherd) confirmed when there was an
outbreak of Norovirus, this placed the unit under more pressure. She
described the situation as an absolute nightmare. She recalls she was crying
down the phone saying she could not manage and cope.”

Orthopaedic surgeon Bern Ketzer told the hearing he would have expected a
review to have been carried out on Mrs Marshall’s surgical wound after
December 31, followed by daily checks.

Ms Burke said: “He indicated that the developing infection would have
been evident and would have expected treatment to be provided while she was
at Monument House. He confirmed it was his view it was likely she would have
survived if the infection had been treated.”

Ms Burke said there was a period of several months when patients were at risk.

The hearing was also told that Mrs Marshall had blood tests on December 20,
before she went to Monument House, which revealed her renal function had
deteriorated. But no review of the test results was carried out and no
treatment was provided.

Helen Thomson, interim chief nurse at The Mid Yorkshire Hospitals NHS Trust,
said: “We carried out a thorough review at the time and we fully
recognised that aspects of care fell below the standard that would be
expected. On behalf of the trust, I would like to sincerely apologise.

“We have put significant improvements in place at Monument House over
recent years. We will also take any further areas of learning from the
inquest and take further action as appropriate.

“I would like to offer my sincere sympathies to Mrs Marshall’s family.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2707c5f6/l/0L0Stelegraph0O0Chealth0Chealthnews0C97699580CPensioner0Edied0Ein0Eshort0Estaffed0Ehospital0Eunit0Eafter0Enurses0Efailed0Eto0Echeck0Ewounds0Efor0Etwo0Eweeks0Bhtml/story01.htm

Main Category: Caregivers / Homecare
Also Included In: Psychology / Psychiatry
Article Date: 29 Dec 2012 – 0:00 PST

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Caring for an adult child with developmental disabilities or mental illness increased by 38 percent the chances that an aging parent would develop disabilities of their own, according to findings of a new study led by Dr. Subharati Ghosh, a post-doctoral research fellow at the Lurie Institute for Disability Policy in the Heller School for Social Policy and Management at Brandeis University.

The study, published in Psychiatric Services, highlights economic and psycho-social challenges faced by parents of adult children with disabilities, compared with parents of children without disabilities.

When either parent becomes disabled, the study found, families’ report lower financial well-being. This being especially true when an aging parent must contend with both the needs of an adult child with mental illness and a spouse who develops an age-related disability.

Not surprisingly, parents are themselves susceptible to developing disabilities and chronic conditions as they age. “By age 60, parents caring for adult children with mental illness were more likely to have a spouse with a disability, than parents of children with developmental disabilities or than those with whose children had no disabilities,” Ghosh said.

When one parent of an adult child with mental illness became disabled, the family reported lower financial well-being than a comparison group that did not have a child with disabilities, she said. Parents of adult children with disabilities often bear the costs of care, as many expenses they incur are not fully covered by insurance.

The findings suggest that targeted policy measures may be needed to better support aging parents of adult children with disabilities. These families are highly vulnerable during retirement not only to the onset of their own disabilities, but also to dire financial consequences.

Ghosh’s co-authors are Dr. Jan Greenberg and Dr. Marsha Seltzer of the Waisman Center and School of Social Work at the University of Wisconsin-Madison. The study drew its data from the Wisconsin Longitudinal Study, which has followed over 10,000 high school graduates and their families since 1957.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/kIW5Dird6TY/254312.php

Growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centres because of rising costs and falling standards in Germany.

The move, which has seen thousands of retired Germans rehoused in homes in eastern Europe and Asia, has been severely criticised by social welfare organisations who have called it “inhumane deportation”.

But with increasing numbers of Germans unable to afford the growing costs of retirement homes, and an ageing and shrinking population, the number expected to be sent abroad in the next few years is only likely to rise. Experts describe it as a “time bomb”.

Germany’s chronic care crisis – the care industry suffers from lack of workers and soaring costs – has for years been mitigated by eastern Europeans migrating to Germany in growing numbers to care for the country’s elderly.

But the transfer of old people to eastern Europe is being seen as a new and desperate departure, indicating that even with imported, cheaper workers, the system is unworkable.

Germany has one of the fastest-ageing populations in the world, and the movement here has implications for other western countries, including Britain, particularly amid fears that austerity measures and rising care costs are potentially undermining standards of residential care.

The Sozialverband Deutschland (VdK), a German socio-political advisory group, said the fact that growing numbers of Germans were unable to afford the costs of a retirement home in their own country sent a huge “alarm signal”. It has called for political intervention.

“We simply cannot let those people who built Germany up to be what it is, who put their backbones into it all their lives, be deported,” said VdK’s president, Ulrike Mascher. “It is inhumane.”

Researchers found an estimated 7,146 German pensioners living in retirement homes in Hungary in 2011. More than 3,000 had been sent to homes in the Czech Republic, and there were more than 600 in Slovakia. There are also unknown numbers in Spain, Greece and Ukraine. Thailand and the Philippines are also attracting increasing numbers.

The Guardian spoke to retired Germans and people needing long-term care living in homes in Hungary, Thailand and Greece, some of whom said that they were there out of choice, because the costs were lower – on average between a third and two-thirds of the price in Germany – and because of what they perceived as better standards of care.

But others were evidently there reluctantly.

The Guardian also found a variety of healthcare providers were in the process of building or just about to open homes overseas dedicated to the care of elderly Germans in what is clearly perceived in the industry to be a growing and highly profitable market.

According to Germany’s federal bureau of statistics, more than 400,000 senior citizens are currently unable to afford a German retirement home, a figure that is growing by around 5% a year.

The reasons are rising care home costs – which average between €2,900 and €3,400 (£2,700) a month, stagnating pensions, and the fact that people are more likely to need care as they get older.

As a result, the Krankenkassen or statutory insurers that make up Germany’s state insurance system are openly discussing how to make care in foreign retirement homes into a long-term workable financial model.

In Asia, and eastern and southern Europe, care workers’ pay and other expenses such as laundry, maintenance and not least land and building costs, are often much lower.

Today, European Union law prevents state insurers from signing contracts directly with overseas homes, but that is likely to change as legislators are forced to find ways to respond to Europe’s ageing population.

The lack of legislation has not stopped retired people or their families from opting for foreign homes if their pensions could cover the costs.

But critics of the move have voiced particular worries about patients with dementia, amid concern that they are being sent abroad on the basis that they will not know the difference.

Sabine Jansen, head of Germany’s Alzheimer Society, said that surroundings and language were often of paramount importance to those with dementia looking to cling to their identity.

“In particular, people with dementia can find it difficult to orientate themselves in a wholly other culture with a completely different language, because they’re very much living in an old world consisting of their earlier memories,” she said.

With Germany’s population expected to shrink from almost 82 million to about 69 million by 2050, one in every 15 – about 4.7 million people – are expected to be in need of care, meaning the problem of provision is only likely to worsen.

Willi Zylajew, an MP with the conservative Christian Democrats and a care service specialist, said it would be increasingly necessary to consider foreign care.

“Considering the imminent crisis, it would be judicious to at least start thinking about alternative forms of care for the elderly,” he said.

Christel Bienstein, a nursing scientist from the University of Witten/Herdecke, said many German care homes had reached breaking point due to lack of staff, and that care standards had dropped as a result.

“On average each patient is given only around 53 minutes of individual care every day, including feeding them,” she said. “Often there are 40 to 60 residents being looked after by just one carer.”

Artur Frank, the owner of Senior Palace, which finds care homes for Germans in Slovakia, said that was why it was wrong to suggest senior citizens were being “deported” abroad, as the VdK described it.

“They are not being deported or expelled,” he said. “Many are here of their own free will, and these are the results of sensible decisions by their families who know they will be better off.”

He said he had seen “plenty of examples of bad care” in German homes among the 50 pensioners for whom he had already found homes in Slovakia.

“There was one woman who had hardly been given anything to eat or drink, and in Slovakia they had to teach her how to swallow again,” he said.

German politicians have shied away from dealing with the subject, largely due to fears of a voter backlash if Germany’s state insurers are seen to be financing care workers abroad to the detriment of the domestic care industry.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/SoGt9RTPVBI/german-elderly-foreign-care-homes

• Finn, 7, underwent 18 months of gruelling cancer treatment
• He was desperate to star in his school’s nativity play but surgery to take out a feeding tube was scheduled for the same day
• The family’s Macmillan cancer nurse Sarah stepped in and had the operation rearranged
• She also went in to speak to Finn’s primary school after his brother was bullied because Finn had lost his hair
• Mother described Sarah as ‘our Christmas miracle’. Finn is now in remission

By
Claire Bates

PUBLISHED:

04:30 EST, 24 December 2012

|

UPDATED:

08:39 EST, 24 December 2012

What a star! Finn prepares for his royal entrance as one of the three wise men

For most seven-year-olds, performing in the school nativity play is something to take for granted.

Not so for cancer patient Finn Middleton from Flixton in Greater Manchester.

He was desperate to follow in his older brother’s footsteps and play one of the three wise men in his school’s Christmas play. He had been too ill to take part last year but was now all set for his starring role.

However, his dream was almost shattered when surgery was scheduled for the day of the performance.

It was only the quick intervention of the child’s Macmillan paediatric nurse, Sarah Murphy that saved the day.

Finn was diagnosed with rhabdomyosarcoma, a rare cancer which develops from muscle tissue, in 2011, when he was five-years-old.

His
mother, Jo Middleton, 41, was helping him to get ready for school in
January 2011 when she noticed that his eye had closed up and that he was
experiencing shooting pains in his face.

Worried that something could be seriously wrong she rushed him straight to hospital. He was immediately sent for tests while doctors tried to establish what was wrong with him.

A
CT scan revealed that he did not have a brain tumour, however, a few
weeks later a second CT scan was carried out and his parents, Jo and
Paul, were given the devastating news that he had rhabdomyosarcoma, a
cancer which affects less than 60 children in the UK each year.

Finn underwent 18 months of gruelling chemotherapy and radiotherapy and had to miss two years of school.

Mrs Middleton told Mail Online: ‘I didn’t think that anything could be tougher than being told my child had cancer. But, trying to explain to my little boy what was happening to him proved to be tougher still.

‘We told him he had nasty germs in his head, and he needed to take “magic medicine” to make it go away.

‘Every day we were forced to watch our little boy in pain and, as the treatment took its toll, it almost broke us.’

Support: Finn with Sarah, the Macmillian paediatric nurse described as ‘our Christmas miracle’ by the Middleton family

Jo and Paul with their sons Finn (left) and Jacob: They are looking forward to a cancer-free Christmas after Finn’s last two scans came back clear

She added: ‘He had eight weeks of radiotherapy which was horrific. He was so good at getting into the hospital but was terrified of the radiotherapy as he has to be screwed to the table by his head.

Rhabdomyosarcoma: A cancer that affects just 60 children a year

A cancerous tumour of the muscles that are attached to the bones.

They can grow in any part of the body but are most common in the head, neck, bladder and testes.

Symptoms of head and neck tumours include swelling of the eye and discharge from the nose.

Symptoms of bladder tumours include blood in the urine and difficulty passing urine.

Treatment depends on the location and size of the tumours but usually include surgery, chemotherapy and radiotherapy.

Regular check-ups are needed once the child is in remission.

The cause is unknown.

‘He used to play hide and seek when he was in the radiotherapy room and would kick his feet, screaming and terrified. He could only move his feet. It was heart breaking.’

Not only was Finn suffering but his brother, Jacob, 10, was also feeling the effects of the cancer.
Jacob became the target of school bullies and was picked on about Finn’s hair failing out.

The family hit rock bottom as Finn underwent treatment and Jacob came home from school in tears each day.

Mrs Middleton said: ‘Then we were introduced to Sarah, a Macmillan nurse, and bit by bit our lives started to get better.

‘Sarah went to speak to the school to encourage them to think that the cancer affected both brothers. The teachers also spoke to their classes about the situation.’

Now, 18 months later, Finn is on the
road to recovery and was delighted to be offered the role of one of the
kings in the nativity play.

However,
disaster almost struck for the budding actor when surgery to remove his
feeding tube was scheduled for the day of the play.

Budding actor: Finn (in blue) wore the same costume his big brother Jacob had worn in a previous year

Recovering: Jo (left) said watching her son Finn in pain almost broke her and her husband

On hearing the news Mrs Middleton immediately called Sarah, who works at the Royal Manchester Children’s Hospital, who was able to rearrange the surgery.

As a result, Finn was able to take part in the play wearing the costume his brother had worn.

His mother said: ‘He was poorly last year so missed being in the play. He was desperate to be in it this year as his brother was in it before and it was still the same costume.

‘He loved it so much he has since joined a drama group and a street dance class.’

Finn has now had two clear scans and there is no evidence of the cancer in his body. He will continue to have scans every three months to make sure the cancer has not returned.

Mrs Middleton said: ‘Watching Finn on that stage for the play was the proudest moment of our lives and without Sarah it wouldn’t have been possible – she really was a Christmas miracle.’

For more information about Macmillan Cancer Support visit www.macmillan.org.uk

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Article source: http://www.dailymail.co.uk/health/article-2252773/Cancer-patient-7-stars-king-school-nativity-nurse-works-Christmas-miracle-surgery-scheduled-day.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

Nurseries infected with the deadly fungus set to wipe out Britain’s 80m ash trees have been removed from the official map of the outbreak the Guardian can reveal, after nursery owners complained that being identified might hurt their business.

Officials said permitting anonymity encourages nursery owners to come forward and report infections, but critics say concealing the identity of infected nurseries means the public and scientists trying to fight the epidemic do not have the full facts.

The owner of one of the nurseries affected by ash dieback said locations should be published. Judy Davey, who runs the Perrie Hale Forest Nursery near Honiton in Devon, said she had publicised the fact that an infected ash plant, bought from another UK nursery, had been discovered.

“We decided to take the bull by the horns,” she said. “We wanted people to know we were controlling this disease.”

Davey has had to destroy 7,000 disease-free saplings grown at her nursery as there is no longer any market for ash trees.

Dr Stephen Woodward of Aberdeen University, one of the UK’s few tree pathologists, said: “You are potentially missing some information. They should be mapped, but I think there may be political difficulties. Nurseries are a bit sensitive and it gets in the way of trade.”

The official data from the Forestry Commission lists 309 infected sites across the UK. But only 292 of these sites are shown on the commission’s map of the spread of the infection. These include 132 sites where infected trees from nurseries were recently planted, while the remaining 160 sites may have been infected by fungal spores being blown across from continental Europe. Seventeen infected nurseries are not shown. Versions of the map published in November briefly showed the location of 13 known infected nurseries, but these have since been removed from the website following complaints from the industry.

A Forestry Commission spokesman said: “We responded to concerns from nurseries that the information on the maps could be used to identify them and had the potential to harm the business of those who have done the responsible thing and reported cases of the disease at those nurseries. The risks posed to the wider environment by infections on commercial premises are very low because of the swift control action taken.”

Earlier in December, the environment secretary, Owen Paterson, said the policy of tracing infected young trees – which has seen more than 100,000 destroyed – was “unlikely to be sustainable in the longer term and there may be benefits from a more targeted approach”.

Professor Ian Boyd, chief scientific adviser at the Department for Environment, Food and Rural Affairs (Defra), said control measures had to be “proportional” to ensure trade could continue and deliver “economic uplift”.

Paterson said in November that the Chalara fraxinea fungus that causes ash dieback would be impossible to eradicate from the UK: in Denmark it has now infected 90% of trees.

“It is vital that scientists and the public have the full facts to tackle the spread of ash dieback,” said Mary Creagh, Labour’s shadow environment secretary.

She said officials had altered key material on ash dieback before, when changes were made to the “scientific facts”, emphasising the role of the wind in spreading the disease over the role of imports from continental Europe.

Creagh said: “Now, nurseries which imported infected plants have been removed from the map. Sadly this is further evidence of the huge ministerial incompetence at the heart of Defra.”

Defra and the Horticultural Trades Association declined to add to the Forestry Commission statement.

Dr Robin Sen, an expert in fungi and trees at Manchester Metropolitan University, said: “We have to be very careful about apportioning blame to nurseries. If information is being kept from the public, I am sympathetic to that worry. But we will need the nurseries as they are going to be very important in restocking woods” if varieties that are resistant to ash dieback become available.

Davey, whose nursery is in its third generation of family ownership, said the overall impact on the business “has not been as bad as we feared”.

She added: “Hopefully, ash dieback will make people realise just how precious and valuable trees are.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/flVfHSxC2AE/ash-dieback-infected-nurseries-map

Main Category: Seniors / Aging
Also Included In: Caregivers / Homecare
Article Date: 18 Dec 2012 – 1:00 PST

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Analysis of media portrayals of nursing homes finds that negative stories outnumber positive stories by five to one, reports a study in the December issue of Medical Care. The journal is published by Lippincott Williams Wilkins, a part of Wolters Kluwer Health.

Negative news coverage of nursing homes may shape public perceptions and consumer care choices, suggest Edward Alan Miller, PhD, MPA, of University of Massachusetts Boston and Denise A. Tyler, PhD, of Brown University. They write, “Our findings suggest that negative reporting predominates and its impact on public perceptions and government decision making may be reinforced by its prominence and focus on industry interests/behavior.”

News Stories Paint Negative Picture of Nursing Homes

Drs Miller and Tyler performed a database search to identify more than 1,500 articles related to nursing homes, published in four major American newspapers between 1999 and 2008. Using a standardized approach, they categorized the tone of each news story as positive, negative, or neutral. The characteristics of articles in the three categories were analyzed as well.

“Most articles were negative or neutral; comparatively few were positive,” Drs Miller and Tyler write. Overall, 49.2 percent of articles were classified as negative and 10.5 percent as positive. The remaining 40.3 percent were categorized as neutral in tone.

There were some prominent differences in the content of positive versus negative or neutral articles. Positive articles were more likely to discuss the quality of nursing home care, while negative articles were often about cases involving negligence or fraud.

“Negative articles were more likely to focus on the nursing home industry; positive articles on the broader community and residents/families,” Drs Miller and Tyler write. Many of the neutral articles covered financing and business/property issues.

Negative News More Likely to Make the Front Page

Negative articles involving negligence/fraud were more likely to be found on the front page, compared to positive or neutral articles. “Editorial decisions about the placement of such articles make sense from a business perspective to the extent that negative, sensationalistic coverage sells newspapers,” according to the authors.

Other negative stores were related to natural disasters – particularly to several high-profile incidents in which nursing home residents endangered by Gulf Coast hurricanes. Many of the positive stories were related to local quality-improvement initiatives – particularly ongoing “culture change” efforts seeking to make nursing homes more home-like environments.

The results draw attention to the overall negative depictions of nursing homes found in U.S. newspapers. Such negative coverage has had a significant impact on public perceptions of nursing homes and the nursing home industry, Drs Miller and Tyler believe.

They also think that negative media coverage has probably influenced consumer behavior – especially at a time of increasing competition from “alternative care sources with more robust reputations,” such as home- and community-based care and assisted living. Drs Miller and Tyler suggest that nursing homes and the nursing home industry may want to develop “more effective media strategies,” highlighting the culture change movement and other innovations to improve care and quality of life for nursing home residents.

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Article source: http://feedproxy.google.com/~r/mnt/healthnews/~3/ej4n_43X0Zw/254058.php

The body of the British nurse found hanged at London’s King Edward VII hospital arrives at a church in India for burial Link to this video

Hundreds of mourners have gathered in a small town in India for the funeral of the nurse who was found dead after she answered a prank call to the hospital where the Duchess of Cambridge was being treated for morning sickness.

Friends and family paid their respects to Jacintha Saldanha, 46, during a simple ceremony in Shirva, some 30 miles north of Mangalore, on the south-west coast.

Earlier, crowds lined the roads close to the Catholic church to pay their respects while relatives attended a private prayer ceremony at her home.

Saldanha, a mother of two, was found hanged in her quarters at King Edward VII’s hospital in London by a colleague and a security guard on 7 December.

Three days earlier, she transferred a call from two Australian DJs to a colleague, who described in detail the duchess’s condition during her hospital stay. She put the call through in the belief that the callers were the Queen and Prince of Wales.

Her children, Junal, 16, and Lisha, 14, have described the “unfillable void” left in their lives by their mother’s death.

During a mass at Westminster Cathedral on Saturday her husband, Benedict Barboza, fought back tears as he paid an emotional tribute to his wife, telling mourners: “I feel a part of me has been ripped out.”

On Monday, he accompanied a coffin carrying her body into Our Lady of Health church after travelling back to the family’s home town for the funeral.

The authorities in India are understood to have made extensive arrangements, including raising security and setting up barricades, to accommodate crowds of mourners touched by Saldanha’s death.

Father Richard Rego, a Jesuit priest who has worked in the region for over a decade, said the close-knit town was in shock. “The local community were jolted,” he said. “They are now coming together to support the family.”

Barboza is understood to be spending Christmas with his family in Shirva as he comes to terms with his wife’s death.

Standing outside the cathedral last week, he said the family “could not have foreseen the unprecedented tragedy that has unfolded in our lives”, and thanked the Duke and Duchess of Cambridge and the prime minister, David Cameron, for their condolences.

“The events of the last week have shattered our lives,” he said. “We barely have the strength to withstand the grief and sorrow.”

Saldanha left two notes in her room, and had marks on her wrist when her body was discovered, Westminster coroners court in London heard on Thursday.

John Lofthouse, the chief executive at King Edward VII’s hospital, said the nurse had been reassured on a number of occasions by senior management after the hoax call. But she was found dead soon afterwards.

Memorial services have been held at the hospital and in Bristol, where her husband and children live.

The DJs behind the call, Mel Greig and Michael Christian, have also spoken of their grief.

Interviewed on Australian TV networks, the presenters said their prank call to the hospital had prompted “a tragic turn of events no one could have predicted or expected”.

Southern Cross Austereo (SCA), the parent company of 2Day FM, has ended the pair’s Hot 30 show and suspended prank calls across the company.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/83_hmPWOHWE/jacintha-saldanha-prank-call-nurse-funeral

Mr Barboza added that the Duchess and her husband had offered condolences, as
had David Cameron.

Junal said: “In times of difficulty you showed us the way forward to happiness
and success. Your priority for us was a good education and a bright future.

“You worked tirelessly to give us everything that we have today. When we
achieved good grades and merit, your pat on our backs encouraged us more.”

Lisha said: “We will miss your laughter, the loving memories and the good
times we had together. The house is an empty dwelling without your presence.

“We are shattered and there’s an unfillable void in our lives. We love you
mum, sleep in peace and watch over us until me meet again in heaven. We will
always love you and keep you close to our heart.”

The tributes were the first to be made in public by Mrs Saldanha’s family
after her death three days after she transferred a hoax call from two
Australian radio DJs purporting to be the Queen and Prince Charles to a
colleague, who then gave out details of the Duchess’s condition.

Mrs Saldanha from Bristol, was discovered at the nurses’ quarters by a
colleague. Police have recovered three suicide notes, one reported to
contain criticism of hospital staff.

She will be buried on Monday in her home town near Mangalore, south-west
India, where she had trained as a nurse before moving to Britain more than
10 years ago.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26a3df3d/l/0L0Stelegraph0O0Cnews0Cuknews0C97472290CJacintha0ESaldanha0ERoyal0Enurses0Eteenage0Edaughter0Etalks0Eof0Eher0Eloss0Bhtml/story01.htm

By
Anonymous Midwife

PUBLISHED:

17:00 EST, 15 December 2012

|

UPDATED:

17:46 EST, 15 December 2012

With Call The Midwife and One Born Every Minute enjoying huge success, bringing babies into the world has rarely had more attention.

Yet the reality could hardly be more different from the cosy TV image. In fact, maternity care is facing crisis.

Here, one midwife describes for the first time the conditions she and her colleagues endure at a London hospital: the emergencies, the danger, the exhaustion – and the joy. Names, locations and timings have been changed to protect identities. But the episodes are all too real.

Call the midwife: One London midwife reveals the truth about what it is like on a busy shift at a maternity ward in the capital

Code Amber means we’re running out of room; Code Red, and there’s no room at the inn. I’m back on nights at a big London hospital. It’s mid-September and we’re Red. The first thing I look at is the rota. Who else is on? Will they muck in? Are they agency staff, who are expensive and often don’t know where anything is? And the most basic question of all: are there any delivery packs, with swabs, scissors, cord clamps? If not, we’re in trouble.

Tonight, it’s a good team and it needs  to be.

The antenatal ward, my responsibility for the next 12 hours, is packed. Postnatal ward is full. The labour ward is rammed. All the festive alcohol at Christmas and New Year means an annual wave of new babies in the autumn, and the deluge is upon us. We have six women in early labour, most of them already have children and may give birth quickly. They all need beds and, more importantly, one-to-one care.

A woman in her late 20s is hooked up to a fetal heart monitor and we notice that the heart rate is dipping, dipping, dipping. There are no doctors here, so we page. All three theatres are open tonight; no one responds. We may have a bad outcome on our hands – serious brain injury, maybe even death – unless we do something. After 20 minutes, I run downstairs to get a doctor myself.

When I get there, the labour ward is Armageddon. Doctors and midwives running in the corridors, trolleys clattering, emergency buzzers going off.

Then, a Brazilian woman walks in supported by her husband. When she removes her trousers, the baby’s head is visible.

She’s never been to our hospital before – in fact, she’d planned to have her baby elsewhere – but they got on the wrong bus in panic and it just happened to stop outside our hospital.

The baby arrives; mother and baby are fine. I say fine. At this point, we have no idea of her HIV status or blood group. We’re supposed to be on top of all these things. But often we’re not.

Real-life miracle: The reality of the maternity wards in the UK is far away from the image portrayed on television shows like Call The Midwife and One Born Every Minute

I get back up to the antenatal ward at 2am to find Julia, one of our early labourers, is now delivering her baby on the bed, in the middle of a four-bedded bay. I grab one of our two remaining delivery packs and help her as the baby is born noisily, quickly and – thankfully – safely.

Julia sustains a second-degree tear, which will need to be stitched, on the wrong sort of bed (this is not a delivery suite) in barely adequate light. The other women in the bay cope stoically. But the two women pregnant with their first babies are shocked. It’s a  far cry from what they’ve been led  to expect.

At 6.30am, the buzzer goes again. Keren, a young woman who lives near the hospital, is pushing uncontrollably. She is fully dilated, the baby’s head is advancing fast.

A colleague joins me. There’s one delivery pack left. Despite knowing the answer, I phone the labour ward to be told that there are no beds free, so it’s down to us.

Keren is 17 and she’s extremely frightened. Her two friends are by her bed and so are the remains of a recent KFC.

Faced with a girl I’ve barely met, I try to calm her, persuade her to trust us when we tell her not to push, to ‘breathe’ the baby out. It seems to work.

While her friends text furiously on their BlackBerrys – and again, in the middle of a fully occupied four-bedded bay – she gives birth to her first baby.

We shouldn’t be doing this, delivering
babies on wards, with little or no privacy for the mothers, let alone no
one-to-one care in labour – but we are. It’s unavoidable; if a baby’s
going to arrive quickly, there’s not much we can do.

It’s better than delivering a child in the lift, which I’ve done on more than one occasion. Often, there’s simply no room, or too few staff on our labour ward.

The baby’s fine, but now Keren is bleeding. The trickle of blood turns into a gush. We call for help, and I shout to the healthcare assistant to page the doctor. The friends are freaking out. We’re on autopilot now, and within minutes Keren has two intravenous (IV) lines in her hands. A doctor arrives. Keren has fluids, some medication and the bleeding stops.

It’s 7.30am and the traffic is roaring past outside. I started my shift 12 hours ago, and I’ve forgotten to eat, drink or go to the toilet. But there is paperwork to be completed, and lots of it.

I sit with Keren in her room while she breastfeeds her baby and try to write a clear account of events in her notes. My hands are shaking as I drink one, then another cup of coffee. It’s nearly 10am by the time I escape.

The following night, I’m back for more. This time I’m on the postnatal ward, full of exhausted new mothers sleeping in bays of four, cots at their bedside. For once, it’s quiet. I’m looking forward to a rare break. It’s 3.30am. After last night, I need sleep.

Cue the sound of a young first-time mother in bed 19 close to our desk, shouting incoherently at the other babies in the ward to be quiet.

I offer her a cup of tea. But once we’re in the office, she loses it, swearing, shouting that no one understands. She picks up a large folder from the desk and hurls it at the wall. A coffee mug lies in pieces on the floor.

Thirty-five women, now wide awake, peer out from behind their curtains. Some emerge, wheeling their babies in cots, to see what’s going on.

The mother is completely out of control, screaming abuse – and heading straight for her baby. A fellow midwife steps deftly in her way, which is brave of her, and I call security.

We’re trying to raise the psychiatrist, who tells me she’s stuck in AE with a suspected schizophrenic. When she arrives, we get a hasty diagnosis of puerperal psychosis – a severe form of postnatal depression – before her pager goes again and she runs back to AE.

With medication, the mother calms down, but for the rest of the shift we’re running on adrenaline. We don’t know where this poor woman is from.

Under pressure: Medical staff rush a patient to theatre where lack of staff, long hours and underfunded wards add to the stress of midwifery

This is a maternity ward, not a psychiatric unit. She will be a guest of the postnatal ward for another week, with a firm diagnosis of full-on psychosis.

We’ve all seen programmes such as Call The Midwife on BBC1 and Channel 4’s One Born Every Minute. We don’t talk about them much at work because they bear no relation to what we go through.

Call The Midwife makes me smile even if it’s for the wrong reasons: a show where a missing bicycle is a crisis! At least, for all its rose-tinted nostalgia, it depicts a time when midwives knew the women they cared for. The close relationship between midwife and mother produced a level of individual care that policy-makers can only dream of now.

Despite appearances, One Born Every Minute – a popular ‘structured reality’ account of life in an NHS maternity unit – is just as removed from our daily reality.

Seeing the midwives sitting down for a staff-room chat with cakes and steaming mugs of tea, is a far cry from our working lives on the ward, in which we are often on our feet for 12 hours without a break. Or with a snatched 30 minutes at 5pm. Since when was lunch at 5pm?

We often joke that if One Born Every Minute came to our unit, they’d get the shock of their lives. I don’t think the television cameras could move fast enough.

The facts paint an altogether more worrying picture than the moving image on TV. The Royal College Of Midwives (RCM) says we are short of more than 5,000 full-time midwives around the country. One in 20 posts are unfilled. London has particular problems. Recent research shows that more than 100 mothers have died in childbirth in the capital in the past five years, twice the rate of the rest of the country. London’s maternal death rate has doubled since 2005, from 11 deaths in 2005-06 to 29 in 2010-11.

Ministers have promised to spend £25 million on new maternity facilities around the country. They will be needed: England is just at the start of the biggest baby boom in 40 years. This year alone we’re expecting more than 700,000 new lives.

Even as it stands, nine out of ten midwives say they can’t give the care they need. Government figures say that one in four hospital trusts is failing to provide adequate quality or safety of care to mothers and new-born babies. If this carries on, the consequences could be dire.

Last month, Cathy Warwick, chief executive of the RCM, said: ‘NHS maternity services, especially in England, are on a knife-edge. We have carried shortages for years, but with the number of births going up and up and up. I really believe we are at the limit of what maternity services can safely deliver.’

Our managers tell us we’re fully staffed, but even they admit that’s questionable.

So, with high rates of sickness, and staffing often skewed towards newly qualified, we frequently run the ward on a staffing shoestring.

Yet to play any part in this is life affirming, which, for all the difficulties, is why I do the job. There are moments of absolute joy.

Such as meeting Pamela. She was expecting a baby after IVF treatment. She was admitted to the ward at just 22 weeks because the risk of her going into premature labour was high. No one expected a good outcome. When she arrived, she was terrified and determined to follow the ‘bed rest’ advice to the letter.

Special duties: The cast of Call The Midwife, left to right, Helen George, Miranda Hart, Jessica Raine and Bryony Hannah

Each day, we tried to keep her spirits up. Days turned into weeks, and at 28 weeks, she even began to be hopeful that her baby – if delivered now – would have a good chance. At 33 weeks, after ten weeks spent on the antenatal ward but still terribly early, her waters broke. She was distraught.

Yet the baby boy hung on. And after another two agonising weeks, her baby was born safely. I finally discharged her home a week later. It sounds a cliche, but it really had been a privilege to be part of it.

Nights are the worst, for us and for the mothers. No one gets much sleep in wards that must often feel like station waiting rooms, only noisier and more chaotic and, occasionally, rather frightening. The constant racket serves one purpose, at least: few of the mothers want to hang around. Some of our beds take three or four women a day.

If we’re lucky, my colleagues and I will get 30 minutes on a sofa in the staff room. I’ll glug down a Diet Coke before nodding off so there’s plenty of caffeine in me when my phone alarm goes off.

People laughingly call night-time on the health service the ‘graveyard’ shift. It is no joke.

During waking hours, there will  be four midwives, three or four  support staff and countless student midwives.

At night there are just three of us for 35 women and their babies. So that’s more than 24 lives each – including the babies – most of them rather fragile lives.

On any given night there will be three or four social-services cases, the ones waiting for a court to decide if they can keep their child. The risk of them absconding is high. And there will be and one or two with mental-health problems, at least one requiring one-to-one care.

This is usually the job of the least-trained member of staff: the healthcare assistant. Or a registered mental health nurse (RMN). We have frequently found the RMNs sound asleep. They are looking after the most dangerous patients in the ward; how can it happen?

Not that the day shift is easy. In early December, I meet Tina, a new mother, for the first time at 8.30am; by 10.30 I’m in a meeting with her,  a social worker, a drugs worker, a specialist midwife and a psychiatrist and they want my opinion. Should she be allowed to go home with her baby? How should I know?

I’ve had a few minutes to look through her notes before the meeting – all looks to be well, so I fudge, as professionally and as honestly  as possible.

Then there is Sarah, currently waiting to be discharged. She left home when she found out she was pregnant – she says she didn’t get on with her mum – and has been living in a local hostel. It is only after her baby is born that she discloses her cannabis use and her alcohol dependency. She’s been self-harming for the past two years. The father of her baby has been violent towards her in the past, ‘but it’s OK now’, she says.

Suddenly, we’re not simply sending her back to the hostel any more. A bewildering array of agencies and professionals is now involved. It takes a huge amount of time to liaise with them all– time we don’t have on a busy ward – but what choice do we have? I’m on first-name terms with the hospital’s social workers and psychiatric senior house officers.

I’m with Maria, from Albania. She’s an asylum seeker staying in a hostel alone. She’s the victim of rape and the child she’s just brought into the world is the result. She speaks no English. She’s a long stayer – six days already – and we can’t communicate.

On-screen joy: A scene from Channel Four show One Born Every Minute depicting life on a maternity ward

So, day by day, Maria comes into the office, packed with computers, midwives, students, doctors, litter and coffee cups, and sits with her ear glued to a translation service on the phone so that she can have her postnatal checks.

The questions are intimate: about her soreness, her body parts and so on. It is deeply personal stuff. Yet here she is explaining everything with the other phones ringing, the chit-chat, the visitors . . . I don’t know what’s worse, the tawdry circumstances, or the fact that she seems to accept it all as normal.

On any day on the ward, there are several women who speak no English at all. I use the phone translation service when I need to convey something important even though it is expensive.

There are many more with poor English, and sometimes we get by with family members to interpret (far from ideal), or mime. Have you ever tried miming bleeding, or worse? We laugh about it, because we have to, but the potential for things going wrong is huge.

We can only hope to give the most basic care to these women – any conversation about how they’re feeling emotionally is almost impossible.  I once found a doctor just inches away from examining a Chinese woman for piles. All she wanted  to say was that she was feeling a  bit sore.

Doctors and midwives with iPhones often communicate via Google Translate. Hardly what it was designed for, I imagine.

Who are these women who arrive knowing almost nothing of the language? The truth is we don’t really know. Many have no papers. But we have a duty to care for them.

The hospital has something called a ‘foreign visitors’ department and its staff come round our wards regularly. They stress upon the women that there are bills to be paid for the care they’ve received, but mostly they’re far too late. With or without English, the new mothers have left.

When I finally discharge Maria back to her hostel, I look through her notes.

She’s a qualified physiotherapist. She is unusually loving towards the child conceived in such terrible circumstances. It is not uncommon.

August brings new contracts and an influx of new doctors, most of whom have a lot to learn, and fast.  If you’ve been a midwife for more than six months you’ll know  considerably more than any senior house officer.

After a couple of weeks, though, they are just fine; if they don’t come when we call for help, that’s because they can’t come.

Like us, they’re hopelessly overstretched. On a number of occasions, I’ve been driven to walk into the operating theatre mid-caesarean to ask for an opinion on some worrying notes or a cardiotocography (CTG) trace. And they’ve always helped without complaint.

We are under pressure to move our women out of hospital, baby in arms. The ‘conveyor belt’ comparison is compelling. Bear in mind, too, the growing alcohol and social problems, and that an increasing number of mothers have medical complications, often due to obesity.

I’m told one morning that a Vietnamese woman is another dead cert for discharge home, although she doesn’t speak much English. Through a mix of mime and broken English, I discover that her baby hasn’t been fed for ten hours. And, worryingly, there is no sign of said baby.

Gesturing ‘where is the baby?’  to the mother, she smiles and responds by lifting three hospital blankets. There he is, in danger  of suffocating.

Responsibility: ‘On the night shift, three of us each have 24 lives to look after’, out whistleblower reveals

So where do I start? Through a mixture of yet more broken English and arm-waving that in less critical circumstances would be comical, I tell her about basic baby care and postnatal health. Armed with our emergency contact numbers, she goes home that afternoon.

In the next bed, I have Claire, a 38-year-old woman who has been on the ward for six days. She’s already been on the ward far too long. It turns out she’s a lawyer, and no, she can’t possibly leave.

She says she felt frightened and confused by her birth experience, no one had explained what was happening, and she ended up having emergency caesarean section.

She’s physically well, but emotionally shaky. No one has given her the time and attention she needs. She’s angry, upset and wants to complain.

I do what I can, and she goes home with the promise of a referral to our counsellors.

The significant few who need more time and help to come to terms with their birth experience are often bypassed – because we need the  bed space.

Across the country, the middle classes are choosing home birth in ever greater numbers. The ones who come to us often have issues – such as the woman from Afghanistan, currently in bed five. She’s just had her seventh baby and is at a high risk of bleeding.

I’m trying to watch her like a hawk. But I’m juggling an in-tray that would have the chief executive of a multinational breaking into a cold sweat.

It’s common – and heart-breaking – to be with new mothers who have already had children removed by social services, but who somehow hope it will be OK with the third.

Drug-addiction is an ever-present worry, too. A couple of years ago, my colleagues dealt with someone who kept disappearing for a cigarette break.

It took them days to realise she was going down to on to the street to score methadone. When they found out, they prescribed it for her.

The financial rewards are fairly limited in my job, and there can be few occupations that have such  persistent levels of stress.

Yet, a few weeks ago, I bumped into Shelley in Brent Cross shopping centre.

I remembered caring for her after the birth of her first child, and she remembered me. She gave me a warm hug.

My mind flashed back to the three nights I’d spent with her on the postnatal ward, after a long labour.  I thought the care and support I’d given was pretty fragmented – trying to help her as she coped with the difficulties of breastfeeding but being called away to answer the phone, or to care for someone else. Yet she saw it very differently.

‘You helped me so much when  I had my first,’ she said. ‘I couldn’t have got through those early days without you – I ended up breast-feeding him for a year!’

So, perhaps we’re doing something right. Meeting Shelley, who is pregnant for the second time, was a timely reminder that I can’t imagine doing anything else.

Right now, I’m simultaneously tackling paperwork, monitoring a five-time mother awaiting her sixth, and attempting to free up yet another bed on the ward. And the buzzer is going.

But I’m still looking forward to meeting Shelley’s new baby this Christmas.

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Article source: http://www.dailymail.co.uk/news/article-2248592/The-secret-midwife-Psychotic-mothers-exhausted-doctors-nurses-asleep-job-A-whistleblower-reveals-the.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

Mr Barboza added that the Duchess and her husband had offered condolences, as
had David Cameron.

Junal said: “In times of difficulty you showed us the way forward to happiness
and success. Your priority for us was a good education and a bright future.

“You worked tirelessly to give us everything that we have today. When we
achieved good grades and merit, your pat on our backs encouraged us more.”

Lisha said: “We will miss your laughter, the loving memories and the good
times we had together. The house is an empty dwelling without your presence.

“We are shattered and there’s an unfillable void in our lives. We love you
mum, sleep in peace and watch over us until me meet again in heaven. We will
always love you and keep you close to our heart.”

The tributes were the first to be made in public by Mrs Saldanha’s family
after her death three days after she transferred a hoax call from two
Australian radio DJs purporting to be the Queen and Prince Charles to a
colleague, who then gave out details of the Duchess’s condition.

Mrs Saldanha from Bristol, was discovered at the nurses’ quarters by a
colleague. Police have recovered three suicide notes, one reported to
contain criticism of hospital staff.

She will be buried on Monday in her home town near Mangalore, south-west
India, where she had trained as a nurse before moving to Britain more than
10 years ago.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26a21caa/l/0L0Stelegraph0O0Cnews0Cuknews0C97472290CJacintha0ESaldanha0ERoyal0Enursess0Eteenage0Edaughter0Etalks0Eof0Eher0Eloss0Bhtml/story01.htm

The family of Jacintha Saldanha have described the “unfillable void” left in their lives after a mass was held for her at Westminster Cathedral on Saturday.

Saldanha, 46, was found hanged in her nurses’ quarters at King Edward VII hospital by a colleague and a security guard on 7 December.

The nurse took a hoax call from an Australian radio station, where two DJs were pretending to be the Queen and Prince of Wales. They were transferred to a colleague who described in detail the Duchess of Cambridge’s condition during her hospital stay for severe pregnancy sickness.

The mass was held “for the repose of the soul of Jacintha and her grieving family”, a spokesman for the cathedral said.

Following the service, Saldanha’s widower, Benedict Barboza, and two children, Junal and Lisha, described her as a “kind-hearted, generous and well-respected woman”.

He thanked the Duke and Duchess of Cambridge and the prime minister, David Cameron, for their condolences.

Fighting back tears, Barboza said: “My wife, you were the light in my darkness, who always showed me the way forward. From the day we met, you always stood by me in times of hardship and happiness. I feel a part of me has been ripped out.

“Without your beautiful smile and sparkling personality, the house is an empty place to live. Nineteen years of togetherness with a strong bond of affection and understanding will be cherished forever in my life. Your loss is a very painful one and nobody can take that place in my life ever again. I love you and miss you forever.”

On Friday, after a private memorial service for Saldanha at the hospital, its chief executive, John Lofthouse, said senior management had repeatedly reassured the nurse that she was not to blame.

Writing in reply to Keith Vaz MP, who said Saldanha’s family needed to know the “full facts” of what happened, Lofthouse said: “Jacintha believed that the call was genuine and she felt it appropriate to put the call through. We stand by her judgment.

“Following the hoax call, Jacintha was reassured on a number of occasions by senior management that no blame was attached to her actions and that there were no disciplinary issues involved, because she had been the victim of a cruel trick.”

Lofthouse said Saldanha had been offered a range of support, including time off, but decided to continue working. “Jacintha said that she would prefer to continue working. Neither ourselves, her friends or family noticed anything to give cause for concern,” she said.

At Westminster Cathedral, Junal said: “Our mother, kind-hearted, generous and a well-respected woman in both of our lives. You were the core of the family who kept us together. In times of difficulty you showed us the way forward to happiness and success.

“Your priority for us was a good education and a bright future. You taught us right from wrong which we appreciate. You worked tirelessly to give us everything that we have today. When we achieved good grades and merit, your pat on our backs encouraged us more.”

Her funeral will take place in Karnataka, India, on Monday, her family said.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/XL6fFpYH4bU/jacintha-saldanha-family-nurse

However, if their health is so bad that they would otherwise have to be in
hospital, the NHS should pick up the tab.

Mr Farley said many people only found this out after a parent had died.

“Some elderly people have had to sell their homes to pay for their own care,
when they should not have needed to,” said the solicitor, whose firm is
acting for about 250 families.

“We estimate the Government had earmarked at least £10m for the relatives of
victims but we believe they are quietly satisfied at the relatively slow
take up thanks to a strategy of making it more complex than it needs to be
to make a claim.”

He continued: “It is scandalous that families are being bullied and given
an unenforceable and illegal deadline of just 28 days to gather all the
evidence they need.

“It’s an impossible task without external help and I feel this deadline is put
in place to put people off claiming.”

One family was claiming £250,000, he said, while the firm had successfully
claimed £45,000 for another.

“When you are talking about care home fees of up to £600 to £1,000 a day, it
soon mounts up,” he said.

The Department of Health has introduced new guidelines stating that
‘eligibility’ reviews regarding recent care must be completed within three
months of receipt of the request. Under these guidelines, it is up to PCTs
to inform individuals of “the process and timescales which apply”.

Jo Webber, interim policy director at the NHS Confederation, which represents
PCTs, said: “It is obviously good practice to make the review paperwork as
simple to complete as possible and trusts should ensure that their forms are
understandable and people are signposted to where they can get help with the
process if needed.

“PCTs have a responsibility to see that individuals and families who request
reviews get clear, easy-to-understand information about the process and
contact details for someone at the PCT with whom they can discuss any
queries.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/269ceae4/l/0L0Stelegraph0O0Chealth0Chealthnews0C97461380CNHS0Eowes0Efamilies0Ethousands0Eover0Ecare0Ehome0Ecosts0Bhtml/story01.htm

“The ACMA will be examining whether the licensee has complied with its
broadcasting obligations.”

The family of the nurse are set to receive more than £300,000 from Southern
Cross Austereo, the parent company of Sydney station 2Day FM, whose
presenters were behind the prank call.

A Scotland Yard spokesman said yesterday that the post- mortem examination
result “would be announced tomorrow at the inquest”.

The death is not being treated as suspicious and the inquest is expected to be
opened and adjourned as inquiries continue.

The hearing comes on the day that Southern Cross Austereo (SCA) is to resume
advertising on 2Day FM. All profits from the adverts until the end of the
year will be donated to a memorial fund established in aid of Ms Saldanha’s
husband and teenage children.

A minimum contribution of £320,000 will be made, the company said.

SCA chief executive Rhys Holleran said on Tuesday that he hoped to help
provide the Saldanha family with support “at this very difficult time.”

Labour MP Keith Vaz has been campaigning on behalf of the nurse’s husband
Benedict Barboza, daughter Lisha, 14, and son Junal, 16, and has called on
King Edward VII’s Hospital, where she worked, to hold a full inquiry and
offer further support to her family.

It has been reported that the family did not know about the hoax call until
after Ms Saldanha’s death.

The Labour MP has said: “They want the facts to be established so that they
can effectively grieve.

“What is needed, clearly, is an inquiry by the hospital into how this tragic
case happened.”

In response to Mr Vaz’s criticism, the hospital said its chief executive, John
Lofthouse, spoke to the nurse’s husband by phone on Friday and offered to
meet him whenever he wanted.

The hospital has also established a memorial fund in Ms Saldanha’s name to
provide financial support for her family, and made the first donation to the
fund.

Mr Vaz has written to Mr Holleran, claiming that his company has yet to make
any direct contact with Ms Saldanha’s family.

The MP, who is chairman of the House of Commons Home Affairs Committee,
conceded there had been a public apology for the incident and its
consequences through the media.

During the hoax call, the nurse transferred the DJs, believing they were the
Queen and Prince of Wales, to a colleague who described in detail the
condition of the Duchess of Cambridge during her hospital treatment for
severe pregnancy sickness.

Ms Saldanha, 46, from Bristol, would have been devastated by her unwitting
role in last Tuesday’s scam, her brother has said. She was found dead three
days later in a block of nurses’ flats close to the hospital.

It is understood the family are making arrangements to return Ms Saldanha’s
body to her native India.

The two Australian DJs behind the hoax call – Mel Greig and Michael Christian
– have given an emotional account of their reaction to Ms Saldanha’s death.

Interviewed on Australian TV networks, the 2Day FM presenters said their prank
call to the hospital prompted “a tragic turn of events no one could have
predicted or expected”.

David Cameron paid tribute to Ms Saldanha and said MPs’ sympathies and
condolences would be with her family.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/268e6b6f/l/0L0Stelegraph0O0Cnews0Cuknews0Ckate0Emiddleton0C9741780A0CDuchess0Ehospital0Enurse0Einquest0Eopens0Etoday0Bhtml/story01.htm

“At this time there are no suspicious circumstances apparent to me in
relation to this death.”

Detectives are talking to witnesses, friends, colleagues and Mrs Saldanha’s
telephone contacts, DCI Harman said, in order to establish the circumstances
that may have led to and contributed to her death.

Referring to the two Australian radio presenters who made the prank call, he
added: “You will be aware of the wider circumstances in this case and I
can expect in the very near future we will be in contact with colleagues in
New South Wales to establish the best means of putting the evidence before
you.”

Coroner’s officer Lynda Martindill said Mrs Saldanha’s husband Ben Barboza had
identified her body.

The coroner opened and adjourned the inquest, with a full hearing listed for
March 26 next year.

None of Mrs Saldanha’s family attended the hearing, but one of her colleagues
was there, and the coroner said: “Can I express my sympathy to you and
to the family.”

Mrs Saldanha was a nurse at King Edward VII hospital, West London, where the
Duchess of Cambridge was being treated for morning sickness.

Keith Vaz, the Labour MP who is helping the family, said a memorial service
would be held in Bristol tomorrow, followed by one in Westminster Cathedral
on Saturday.

He did not attend the hearing but said: “I have been asked to come here
by the family. I have just spoken to the family on the telephone and I have
repeated the brief statement given in court.

“The family is very grateful to the coroner’s court for the way they
have dealt with the matter and they are extremely grateful to the
Metropolitan Police.

“They are grieving in their homes, they are comforting each other and
the community is comforting them, that is why they have not come, it would
have been a very long journey for a very short statement.”

Last night, it emerged the broadcasters responsible for airing the call are to
be officially investigated by the Australian Communications and Media
Authority, which regulates radio broadcasting.

A spokesman said the station’s licensee, Today FM Sydney Pty Ltd, will be
investigated in line with the Commercial Radio Codes of Practice

Chris Chapman, Chairman of the ACMA, said: “The ACMA’s formal regulatory
relationship is always with the relevant licensee (and not the presenters of
any broadcast in question).

“The ACMA will be examining whether the licensee has complied with its
broadcasting obligations.”

The family of the nurse are set to receive more than £300,000 from southern
Cross Austereo, the parent company of Sydney station 2 Day FM, whose
presenters were behind the prank call.

The hearing comes on the day that Southern Cross Austereo (SCA) is to resume
advertising on 2 Day FM. All profits from the adverts until the end of the
year will be donated to a memorial fund established in aid of Ms Saldanha’s
husband and teenage children.

A minimum contribution of £320,000 will be made, the company said.

SCA chief executive Rhys Holleran said on Tuesday that he hoped to help
provide the Saldanha family with support “at this very difficult time.”

Labour MP Keith Vaz has been campaigning on behalf of the nurse’s husband
Benedict Barboza, daughter Lisha, 14, and son Junal, 16, and has called on
King Edward VII’s Hospital, where she worked, to hold a full inquiry and
offer further support to her family.

It has been reported that the family did not know about the hoax call until
after Ms Saldanha’s death.

The Labour MP has said: “They want the facts to be established so that
they can effectively grieve.

“What is needed, clearly, is an inquiry by the hospital into how this
tragic case happened.”

In response to Mr Vaz’s criticism, the hospital said its chief executive, John
Lofthouse, spoke to the nurse’s husband by phone on Friday and offered to
meet him whenever he wanted.

The hospital has also established a memorial fund in Ms Saldanha’s name to
provide financial support for her family, and made the first donation to the
fund.

Mr Vaz has written to Mr Holleran, claiming that his company has yet to make
any direct contact with Ms Saldanha’s family.

The MP, who is chairman of the House of Commons Home Affairs Committee,
conceded there had been a public apology for the incident and its
consequences through the media.

During the hoax call, the nurse transferred the DJs, believing they were the
Queen and Prince of Wales, to a colleague who described in detail the
condition of the Duchess of Cambridge during her hospital treatment for
severe pregnancy sickness.

Ms Saldanha, 46, from Bristol, would have been devastated by her unwitting
role in last Tuesday’s scam, her brother has said. She was found dead three
days later in a block of nurses’ flats close to the hospital.

It is understood the family is making arrangements to return Ms Saldanha’s
body to her native India.

The two Australian DJs behind the hoax call – Mel Greig and Michael Christian
– have given an emotional account of their reaction to Ms Saldanha’s death.

Interviewed on Australian TV networks, the 2 Day FM presenters said their
prank call to the hospital prompted “a tragic turn of events no one
could have predicted or expected”.

David Cameron paid tribute to Ms Saldanha and said MPs’ sympathies and
condolences would be with her family.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/268f42cc/l/0L0Stelegraph0O0Cnews0Cuknews0Ckate0Emiddleton0C97419270CDuchesss0Ehospital0Enurse0Ewas0Efound0Ehanging0Bhtml/story01.htm

“At this time there are no suspicious circumstances apparent to me in
relation to this death.”

Detectives are talking to witnesses, friends, colleagues and Mrs Saldanha’s
telephone contacts, DCI Harman said, in order to establish the circumstances
that may have led to and contributed to her death.

Referring to the two Australian radio presenters who made the prank call, he
added: “You will be aware of the wider circumstances in this case and I
can expect in the very near future we will be in contact with colleagues in
New South Wales to establish the best means of putting the evidence before
you.”

Coroner’s officer Lynda Martindill said Mrs Saldanha’s husband Ben Barboza had
identified her body.

The coroner opened and adjourned the inquest, with a full hearing listed for
March 26 next year.

None of Mrs Saldanha’s family attended the hearing, but one of her colleagues
was there, and the coroner said: “Can I express my sympathy to you and
to the family.”

Mrs Saldanha was a nurse at King Edward VII hospital, West London, where the
Duchess of Cambridge was being treated for morning sickness.

Keith Vaz, the Labour MP who is helping the family, said a memorial service
would be held in Bristol tomorrow, followed by one in Westminster Cathedral
on Saturday.

He did not attend the hearing but said: “I have been asked to come here
by the family. I have just spoken to the family on the telephone and I have
repeated the brief statement given in court.

“The family is very grateful to the coroner’s court for the way they
have dealt with the matter and they are extremely grateful to the
Metropolitan Police.

“They are grieving in their homes, they are comforting each other and
the community is comforting them, that is why they have not come, it would
have been a very long journey for a very short statement.”

Last night, it emerged the broadcasters responsible for airing the call are to
be officially investigated by the Australian Communications and Media
Authority, which regulates radio broadcasting.

A spokesman said the station’s licensee, Today FM Sydney Pty Ltd, will be
investigated in line with the Commercial Radio Codes of Practice

Chris Chapman, Chairman of the ACMA, said: “The ACMA’s formal regulatory
relationship is always with the relevant licensee (and not the presenters of
any broadcast in question).

“The ACMA will be examining whether the licensee has complied with its
broadcasting obligations.”

The family of the nurse are set to receive more than £300,000 from southern
Cross Austereo, the parent company of Sydney station 2 Day FM, whose
presenters were behind the prank call.

The hearing comes on the day that Southern Cross Austereo (SCA) is to resume
advertising on 2 Day FM. All profits from the adverts until the end of the
year will be donated to a memorial fund established in aid of Ms Saldanha’s
husband and teenage children.

A minimum contribution of £320,000 will be made, the company said.

SCA chief executive Rhys Holleran said on Tuesday that he hoped to help
provide the Saldanha family with support “at this very difficult time.”

Labour MP Keith Vaz has been campaigning on behalf of the nurse’s husband
Benedict Barboza, daughter Lisha, 14, and son Junal, 16, and has called on
King Edward VII’s Hospital, where she worked, to hold a full inquiry and
offer further support to her family.

It has been reported that the family did not know about the hoax call until
after Ms Saldanha’s death.

The Labour MP has said: “They want the facts to be established so that
they can effectively grieve.

“What is needed, clearly, is an inquiry by the hospital into how this
tragic case happened.”

In response to Mr Vaz’s criticism, the hospital said its chief executive, John
Lofthouse, spoke to the nurse’s husband by phone on Friday and offered to
meet him whenever he wanted.

The hospital has also established a memorial fund in Ms Saldanha’s name to
provide financial support for her family, and made the first donation to the
fund.

Mr Vaz has written to Mr Holleran, claiming that his company has yet to make
any direct contact with Ms Saldanha’s family.

The MP, who is chairman of the House of Commons Home Affairs Committee,
conceded there had been a public apology for the incident and its
consequences through the media.

During the hoax call, the nurse transferred the DJs, believing they were the
Queen and Prince of Wales, to a colleague who described in detail the
condition of the Duchess of Cambridge during her hospital treatment for
severe pregnancy sickness.

Ms Saldanha, 46, from Bristol, would have been devastated by her unwitting
role in last Tuesday’s scam, her brother has said. She was found dead three
days later in a block of nurses’ flats close to the hospital.

It is understood the family is making arrangements to return Ms Saldanha’s
body to her native India.

The two Australian DJs behind the hoax call – Mel Greig and Michael Christian
– have given an emotional account of their reaction to Ms Saldanha’s death.

Interviewed on Australian TV networks, the 2 Day FM presenters said their
prank call to the hospital prompted “a tragic turn of events no one
could have predicted or expected”.

David Cameron paid tribute to Ms Saldanha and said MPs’ sympathies and
condolences would be with her family.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26913b8a/l/0L0Stelegraph0O0Cnews0Cuknews0Ckate0Emiddleton0C97419270CKate0EMiddletons0Ehospital0Enurse0Ewas0Efound0Ehanging0Bhtml/story01.htm

The nurse found dead after a hoax call to the hospital treating the pregnant Duchess of Cambridge was found hanged, the Guardian understands.

Jacintha Saldanha, 46, a mother of two from Bristol, was discovered unconscious at her nurses’ flat near the private King Edward VII hospital in central London on Friday morning.

A postmortem has been carried out, with the results expected to be officially announced at the opening of the inquest into her death on Thursday morning at Westminster coroners court.

The Guardian confirmed a report on Sky News that she had been found hanged. Scotland Yard would not comment on the reports.

Saldanha was the nurse who answered a hoax call to the hospital from two Australian radio DJs in the early hours of Tuesday last week, just hours after the Duchess of Cambridge was admitted for acute morning sickness.

The nurse, who had worked at the hospital for more than four years, was discovered at around 9.30am on Friday morning. Reports that she left a suicide note have not been confirmed.

The death is not being treated as suspicious, and the inquest is expected to be opened and adjourned on Thursday as inquiries continue.

The family of the nurse are set to receive more than £350,000 from Southern Cross Austereo, the parent company of the Sydney station 2Day FM, whose presenters rang the hospital inquiring about the duchess’s medical condition and posing as the Queen and Prince of Wales.

Saldanha is understood to be the nurse who answered the call, then, believing she was talking to members of the royal family, transferred it to a duty nurse on the duchess’s ward.

The DJs, Mel Greig and Michael Christian, have spoken of their devastation over the “unforeseen consequences” of the call. Both are off air at the moment. The station has cancelled its Christmas party, and pledged to donate profits from advertising until the end of the year to a fund to help Saldanha’s family.

The hospital has set up a memorial fund to help support her husband and two teenage children.

A Scotland Yard spokesman said on Wednesday the postmortem result “would be announced tomorrow at the inquest”.

• For confidential support call the Samaritans on 08457 90 90 90

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/KxjeGo_JtkU/nurse-prank-call-found-hanged

“The residents are allowed to be individuals – they have respect for each
other, and there is respect between the staff and them. The residents find
love, achieve things, try not to give in to infirmity, help each other,
share a sense of community, and, above all, they celebrate life. They aren’t
just left on their own, sitting in chairs, staring out of windows.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2679b37b/l/0L0Stelegraph0O0Cculture0Cfilm0Cfilm0Enews0C97350A930CQuartet0Eis0Ea0Etemplate0Efor0Ecare0Ehomes0Esays0ESir0ERonald0EHarwood0Bhtml/story01.htm

2Day FM presenters Michael Christian and Mel Greig being interviewed on Channel Nine Network show A Current Affair. Link to this video

The two DJs at the centre of a prank call to the hospital where the Duchess of Cambridge was staying have spoken for the first time since the death of nurse Jacintha Saldanha.

Mel Greig and Michael Christian told of their distress upon hearing about Saldanha’s death.

“[It was] the worst phone call I’ve ever had in my life,” Greig told the Nine network’s A Current Affair programme.

“There’s not a minute that goes by that I don’t think about what that family [of nurse Jacintha Saldanha] is going through and the thought that we may have contributed to it is gut-wrenching,” she said.

Asked if she had a message for Saldanha’s family, Greig said she’d thought about it “a million times in my head and have wanted to reach out to them and just give them a big hug. I hope they’re OK, I really do”.

“Our deepest sympathies go out to the family,” said Michael Christian. “We just hope that her family and friends are being as good as they can be and are giving [them] the love and support they need. We are shattered.”

The two DJs were speaking for the first time since they went into hiding on Saturday when news broke of the the death. They gave interviews to both Channel Nine and Channel Seven’s main evening current affairs programmes.

Asked by Channel 9 whose idea the prank call was, the DJs said it had come up at a team meeting before the show, but did not say who suggested it.

“We had the idea for a simple harmless call. A call that would go for 30 seconds that we thought we would be hung up on,” said Christian. Neither expected their call to be put through to the Duchess of Cambridge’s room.

Christian and Greig said they thought the joke was on them and their poor accents rather than on the nurses.

“Every other media outlet wanted to touch on it. Our angle was having those silly accents,” said Grieg.

They reiterated that no one could have expected or foreseen what happened after the call. “At every single point it was innocent on our behalf. It was something that was funny and lighthearted and a tragic turn of events that I don’t think could have predicted,” said Christian.

Both DJs said they had not participated in the vetting of the interview. They said it was standard practice for them to record an item then hand it over to be assessed by others. Both said they did not know what the vetting process included.

The segment was subject to an internal review, including with 2Day FM’s lawyers, before it went to air.

The DJs pulled out of a third interview they were scheduled to do for The Project, on the Ten network, because they were unwell, according to a spokesman for the TV channel.

The host of the Nine programme, Tracey Grimshaw, earlier tweeted that the interview had not been paid for. It was “neither asked nor offered”, she said.

Grimshaw told Fairfax Media the prerecorded interview was “very intense” with a lot of people in the room including radio station staff and supporters. She said she felt sympathy for the DJs.

“They’re at a certain point on the food chain. There are other people who made the decision to put it to air. It wasn’t live to air. There was a decision made after that prank call was recorded to put it to air, and virtually all the focus has been on them,” Grimshaw said.

Rhys Holleran, CEO of Southern Cross Austereo, which owns 2Day FM, said the station attempted to contact King Edward VII hospital “no less than five times” before broadcasting the pre-recorded material.

“It is absolutely true to say that we actually did attempt to contact those people on multiple occasions,” Holleran told Fairfax Media. “We rang them to discuss what we had recorded,” he said, adding that this was done before the recorded prank went to air. “Absolutely. We attempted to contact them on no less than five occasions. We wanted to speak to them about it.”

Holleran reiterated that he was “deeply saddened” by the tragic events that had unfolded since the call but again said no one could have reasonably foreseen the circumstances. He said the station was happy to co-operate with any investigation into the incident.

In a statement, the radio station’s owner, Southern Cross Austero Media, said it had suspended advertising on 2Day FM until further notice, ended Greig and Christian’s Hot 30 show and suspended prank calls across the company.

“The company does not consider that the broadcast of the segment has breached any relevant law, regulation or code. The company will fully co-operate with any investigations,” the statement said.

The industry-drawn-up Commercial Radio Codes of Practice and Guidelines state that a station must not broadcast the words of an identifiable person unless they have been informed in advance that the recording may go to air. If someone is unaware they are being recorded, the interviewee must grant consent for it to be played, prior to anything being broadcast.

This is not the first time the radio station 2Day FM has been in trouble. It has had two licence conditions imposed on it in the past three years by the statutory regulator, the Australian Communications and Media Authority (ACMA).

The first followed an on-air incident in 2009 in which a 14-year-old girl was strapped to a lie detector, and was questioned by her mother about whether she was sexually active. The mother volunteered to quiz her daughter despite apparently already knowing she had been sexually assaulted.

When she said that she had been raped at age 12, 2Day FM’s ‘shock jock’, Kyle Sandilands, who presented the show with DJ Jackie O’Neil, then asked: “Right, and is that the only sexual experience you’ve had?” The interview ended after O’Neil stepped in and she and Sandilands apologised.

ACMA found that the station had breached standards of decency and ordered the it to implement staff training programmes.

In 2012 another licence condition was imposed after Sandilands insulted a female journalist for reporting the low ratings of a TV show that he and O’Neil had presented.

“Some fat slag on [the media website] news.com.au has already branded it a disaster,” he said. “You can tell by reading the article that she just hates us and has always hated us. What a fat, bitter thing you are. You’re deputy editor of an online thing. You’ve got a nothing job anyway. You’re a piece of shit.”

ACMA made the Code’s decency requirement (which says “programme content must not offend generally accepted standards of decency”) a condition of the 2Day FM’s licence for a period of five years

Shares in Southern Cross Austereo fell 7.7% in early trading on the Australian stock market before recovering slightly.

• For confidential support call the Samaritans on 08457 90 90 90

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/VnRoOQ4PC8k/royal-hoax-djs-distress-death-nurse

“[It's about] when you talk to a patient, when you’re doing an admission,
when you’re doing their observations, when you’re wanting to know what they
need to rehabilitate to get them back into the community,” she said.

“This takes time and if you’re running against time and constantly
pressurised it does give the impression to patients that you don’t have time
for them.”

Questioning David Cameron in the House of Commons last week, Mrs Clwyd said
there were a growing number of complaints about the level of care provided
by NHS nurses.

She later announced she would lead a campaign for nurses to be more
compassionate and caring, claiming hundreds of people around the country had
written to her about the issue.

One person told her that “the nursing profession is no longer the caring
profession” and another claimed that turning nursing into a degree
course had led to an influx of “snooty-nosed pen pushers” on
wards, Mrs Clwyd said.

Among the major concerns were the way in which budget cuts, higher workloads
and insufficient staff numbers were affecting the standard of care, she
added.

“One of these, of course, I saw for myself: neglect of basic nursing
routines,” she said.

Ms Donnelly said nurses have a duty to report any cases where they believe
colleagues are acting without compassion or are providing a substandard
level of care.

“It’s up to every individual to make sure that when you observe care
which is less than you expect to be giving or receiving then I think you
have a duty of care to report that,” she said.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2674a5bd/l/0L0Stelegraph0O0Chealth0Chealthnews0C97348750CNurses0Etoo0Ebusy0Eto0Ecare0Efor0Epatients0Bhtml/story01.htm

“[It's about] when you talk to a patient, when you’re doing an admission,
when you’re doing their observations, when you’re wanting to know what they
need to rehabilitate to get them back into the community,” she said.

“This takes time and if you’re running against time and constantly
pressurised it does give the impression to patients that you don’t have time
for them.”

Questioning David Cameron in the House of Commons last week, Mrs Clwyd said
there were a growing number of complaints about the level of care provided
by NHS nurses.

She later announced she would lead a campaign for nurses to be more
compassionate and caring, claiming hundreds of people around the country had
written to her about the issue.

One person told her that “the nursing profession is no longer the caring
profession” and another claimed that turning nursing into a degree
course had led to an influx of “snooty-nosed pen pushers” on
wards, Mrs Clwyd said.

Among the major concerns were the way in which budget cuts, higher workloads
and insufficient staff numbers were affecting the standard of care, she
added.

“One of these, of course, I saw for myself: neglect of basic nursing
routines,” she said.

Ms Donnelly said nurses have a duty to report any cases where they believe
colleagues are acting without compassion or are providing a substandard
level of care.

“It’s up to every individual to make sure that when you observe care
which is less than you expect to be giving or receiving then I think you
have a duty of care to report that,” she said.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/2674a5bd/l/0L0Stelegraph0O0Chealth0Chealthnews0C97348750CNurses0Etoo0Ebusy0Eto0Ecare0Efor0Epatients0Bhtml/story01.htm

• The modern career of a nurse has turned the ‘caring profession’ academic

By
Dr Ellie Cannon

PUBLISHED:

17:00 EST, 8 December 2012

|

UPDATED:

17:35 EST, 8 December 2012

Not long ago, a friend of mine, who is in her 40s, was in hospital following a knee operation. She suffered a reaction to the morphine she’d been given and was very sick. And then the drug wore off completely.

At night in her bed, with tears streaming down her face in utter, desperate pain, she later told me she had never felt so alone. And then something miraculous happened. A nurse appeared, and gently held her hand.

My friend recalls: ‘It was almost maternal and I was shocked by the tenderness – I’d not been touched for days, apart from the various functional examinations of my leg.

Pressure: NHS Nurses in Do Not Disturb tabards that caused and outcry

‘She told me, “It’ll be okay .  .  . there, there.”

‘I stopped crying almost instantly. That nurse stayed with me for however long it took for the new painkillers to kick in – it could have been a few minutes or half an hour – and then I fell asleep.

‘I didn’t see her again, but I’ll never forget how much better she made me feel just by offering some comfort.’

I was reminded of her story last week, when I read that Chief Nursing Officer Jane Cummings wanted to see the return of compassion to the curriculum of student nurses, alongside clinical skills.

I felt my heart sink with recognition of a problem I have been fighting against for years.

The return of compassion? It is a phrase that begs the question: How has simple human kindness become so lost from a job once called the caring profession?

Hands-on care: A change in practices at nursing schools with focus on compassion could improve care at hospitals

For, while that nurse who held my friend’s hand undoubtedly understood the power of such a simple gesture, a series of recent reports has revealed the poor care some patients, particularly elderly, receive at the hands of nurses.

Last September it was revealed in this newspaper that nursing staff were to be given red tabards emblazoned with the words Do Not Disturb. Drug Round In Progress. A pilot scheme trialled the tabards on two wards at the Queen Elizabeth The Queen Mother Hospital in Margate, Kent. One nurse at the time said: ‘What we do when interrupted is simply turn round to face the patient and point to the words.’

Due to the public outcry the scheme was withdrawn but, alongside damning assessments by official bodies such as the Care Quality Commission and The Patient Association, these tabards became symbolic of all that was wrong with modern nursing practice.

As a fellow healthcare professional, I welcome what the CNO has said, not just for nurses but for all of us in the NHS.

While many nurses provide an excellent service, it is by no means universal. Nursing was once a vocation for those with a disposition for consideration and support for others. But not any more.

I agree with Jane Cummings. The problem lies in the evolution health care has undergone. In today’s time-pressured, economically drained NHS, holding a hand is no longer a priority. The target-based bureaucracy of the NHS has effectively killed off compassion.

When I look at my own practice nurse, who is both empathetic and caring, the few minutes she could spend talking to a patient after a flu jab is dominated by completing a lengthy computer form. She has to input the data correctly or the practice doesn’t get paid.

Change: The modern career path of a nurse has turned the profession into an academic rather than a compassionate one

Reflecting on my own practice as a GP, it is easy to see in a time-pressured clinic where the kindness can get lost. We get points and therefore practice income for checking a blood pressure, but not for asking about the patient’s Christmas plans.Ticking the points on the computer system is drummed into us and discussed ad infinitum. Compassion is not. The modern career path of a nurse has done little to support the emotional aspect of the profession. Whereas nursing was historically an apprenticeship, it has now become much more academic.

Paradoxically, the more academically able and ambitious nurses will then spend relatively few years nursing before moving into NHS management. This is an incredible waste of skills and training, and perhaps belies a misguided lack of respect for nursing as a career. The more ambitious nurses are tempted out of their vocation by much larger salaries.

I can certainly see the rationale behind adding kindness to the tick-box targets. But I am concerned that it could be almost counter-intuitive to attempt to measure what is essentially a personal characteristic. Of course, bedside manner has always been an acquired skill – tacit knowledge passed on by the more experienced.

As a medical student in my early 20s, it was frightening to be faced with terribly sick, angry or distressed patients – and I’m sure I made a few errors in handling sensitive situations before finding ways to break bad news, or comfort the bereaved.

My worry is that tick-box culture has gone on for so long, there is no one for young nurses to model themselves on.

And I am not convinced genuine warmth, empathy and consideration can even be measured as Cummings hopes. Seeking to quantify compassion could undermine an individual’s inherent compassion by trying to standardise and rationalise it. But I concede we should certainly be trying.

At Birmingham City University, teaching compassion to nurses is already embedded in the curriculum. The students spend half their time in clinical placement and are assessed on their attitudes. Crucially, teachers seek feedback from patients on their perception of caring attributes.

Unfortunately, there is a long way to go to optimise the working environment for nurses so they have ample time to focus on care. Wards are overcrowded and short staffed, patients have complex needs and there is tremendous pressure from management to discharge patients and clear the beds.

The announcement by the Chief Nursing Officer is a very important one but it is a strategy that is going to prove hard, in the current climate, to implement.

twitter.com/Dr_Ellie

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Article source: http://www.dailymail.co.uk/health/article-2245091/How-tick-box-culture-nursing-UNCARING-profession.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

“Next spring we will announce proposals to address the gap in the law on
effective corporate accountability.”

Castlebeck should cover the costs of inquiries into the criminal behaviour of
staff at its Winterbourne View private hospital, Mr Lamb added.

The minister’s remarks were made as the Government unveiled plans to move out
of long stay hospital every person with a learning disability or autism who
does not need to be there.

Under the plans, the cases of all patients in current placements will be
reviewed by June next year with a view to placing anyone being treated
“inappropriately” in hospital into community-based support by June 2014.

There are currently 3,400 people in NHS-funded learning disability inpatient
beds of which around 1,200 are in assessment and treatment units.

“I want this to be seen as a moment when there is a collective view that there
needs to be a substantial culture change in society, that people with
learning disabilities have the same rights as anybody else, and that we
cannot any longer tolerate inappropriate care or treatment for these people
and we have a collective obligation from top to bottom to change this and
that there is a national imperative that we act decisively on that,” Mr Lamb
said.

In October six members of staff – four support workers and two nurses – were
jailed for between six months and two years for their roles in the abuse at
the Winterbourne View Hospital in Hambrook, South Gloucestershire.

Five others were given suspended prison sentences by a judge at Bristol Crown
Court, who condemned the “culture of ill-treatment” and said it had
“corrupted and debased”.

The prosecutions came after the BBC’s Panorama programme exposed the scandal
in June last year when it broadcast undercover journalist Joseph Casey’s
secret footage of the abuse when he was employed at Winterbourne View as a
care worker.

Mr Lamb noted in the report that he felt “shock, anger, dismay and deep
regret” that vulnerable people had been treated in this way.

Journalist Mr Casey got a job at Winterbourne View after whistleblower Terry
Bryan, a former nurse at the home, went to the BBC after his complaints to
care home owners Castlebeck and care watchdogs were ignored.

His shocking footage showed residents being slapped, soaked in water, trapped
under chairs, taunted, sworn at and having their hair pulled, eyes poked and
being illegally restrained.

On one shocking occasion, three support workers forcibly held down a resident
while a nurse forced paracetamol into her mouth.

Barristers representing the 11 defendants apologised on behalf of their
clients but blamed the culture of Castlebeck – calling it a “disease”, a
“cancer” and a “fog” that had engulfed Winterbourne View.

A serious case review published in August criticised the firm for putting
profits before humanity.

The 26-bed hospital opened in 2006 and by 2010 had a turnover of £3.7 million.
The average weekly fee for a patient was £3,500.

The report published today: Transforming Care, a national response to
Winterbourne View Hospital, said Care Quality Commission inspections of
nearly 150 other hospitals and care homes had not found abuse and neglect
like that at Winterbourne View.

But many of the people at Winterbourne View should not have been there in the
first place and in this regard the “story is the same across England”, the
report noted.

“Many people who are in hospital who don’t need to be there and many stay
there for far too long – sometimes for years,” the report said.

Mark Goldring, chief executive of the learning disability charity Mencap, said
the Winterbourne View scandal had “shone a spotlight on a care system that
has failed the most vulnerable people with a learning disability”.

“In today’s report, the Government shows that it has listened to families and
campaigners by committing to a national programme of change,” he said.

“But words are not enough. To achieve this, commissioners in local government
and the health service must take urgent, joint action to develop local
services, provide support to children and families from early on, and ensure
that no-one else is sent away.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26760a32/l/0L0Stelegraph0O0Chealth0Chealthnews0C97357890CWinterbourne0Eabuse0Escandal0Ecriminal0Elaw0Eto0Ehold0Ecare0Ehome0Eowners0Eto0Eaccount0Bhtml/story01.htm

“Next spring we will announce proposals to address the gap in the law on
effective corporate accountability.”

Castlebeck should cover the costs of inquiries into the criminal behaviour of
staff at its Winterbourne View private hospital, Mr Lamb added.

The minister’s remarks were made as the Government unveiled plans to move out
of long stay hospital every person with a learning disability or autism who
does not need to be there.

Under the plans, the cases of all patients in current placements will be
reviewed by June next year with a view to placing anyone being treated
“inappropriately” in hospital into community-based support by June 2014.

There are currently 3,400 people in NHS-funded learning disability inpatient
beds of which around 1,200 are in assessment and treatment units.

“I want this to be seen as a moment when there is a collective view that there
needs to be a substantial culture change in society, that people with
learning disabilities have the same rights as anybody else, and that we
cannot any longer tolerate inappropriate care or treatment for these people
and we have a collective obligation from top to bottom to change this and
that there is a national imperative that we act decisively on that,” Mr Lamb
said.

In October six members of staff – four support workers and two nurses – were
jailed for between six months and two years for their roles in the abuse at
the Winterbourne View Hospital in Hambrook, South Gloucestershire.

Five others were given suspended prison sentences by a judge at Bristol Crown
Court, who condemned the “culture of ill-treatment” and said it had
“corrupted and debased”.

The prosecutions came after the BBC’s Panorama programme exposed the scandal
in June last year when it broadcast undercover journalist Joseph Casey’s
secret footage of the abuse when he was employed at Winterbourne View as a
care worker.

Mr Lamb noted in the report that he felt “shock, anger, dismay and deep
regret” that vulnerable people had been treated in this way.

Journalist Mr Casey got a job at Winterbourne View after whistleblower Terry
Bryan, a former nurse at the home, went to the BBC after his complaints to
care home owners Castlebeck and care watchdogs were ignored.

His shocking footage showed residents being slapped, soaked in water, trapped
under chairs, taunted, sworn at and having their hair pulled, eyes poked and
being illegally restrained.

On one shocking occasion, three support workers forcibly held down a resident
while a nurse forced paracetamol into her mouth.

Barristers representing the 11 defendants apologised on behalf of their
clients but blamed the culture of Castlebeck – calling it a “disease”, a
“cancer” and a “fog” that had engulfed Winterbourne View.

A serious case review published in August criticised the firm for putting
profits before humanity.

The 26-bed hospital opened in 2006 and by 2010 had a turnover of £3.7 million.
The average weekly fee for a patient was £3,500.

The report published today: Transforming Care, a national response to
Winterbourne View Hospital, said Care Quality Commission inspections of
nearly 150 other hospitals and care homes had not found abuse and neglect
like that at Winterbourne View.

But many of the people at Winterbourne View should not have been there in the
first place and in this regard the “story is the same across England”, the
report noted.

“Many people who are in hospital who don’t need to be there and many stay
there for far too long – sometimes for years,” the report said.

Mark Goldring, chief executive of the learning disability charity Mencap, said
the Winterbourne View scandal had “shone a spotlight on a care system that
has failed the most vulnerable people with a learning disability”.

“In today’s report, the Government shows that it has listened to families and
campaigners by committing to a national programme of change,” he said.

“But words are not enough. To achieve this, commissioners in local government
and the health service must take urgent, joint action to develop local
services, provide support to children and families from early on, and ensure
that no-one else is sent away.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26760a32/l/0L0Stelegraph0O0Chealth0Chealthnews0C97357890CWinterbourne0Eabuse0Escandal0Ecriminal0Elaw0Eto0Ehold0Ecare0Ehome0Eowners0Eto0Eaccount0Bhtml/story01.htm

There are many excellent nurses in the NHS but it has long been apparent that
poor nursing is not some isolated incident but is widespread in many
hospitals. Something fundamental has gone wrong with the way nurses are
trained and managed. Yet to say as much has, until now, invited the charge
of being hostile to the health
service. This heartfelt intervention by a prominent Labour politician may
finally encourage a more realistic debate on the subject. It is significant
that Jeremy Hunt chose to address the issue head-on recently in his first
major speech as Health Secretary. Accepting that there is a problem has
taken far too long. For the sake of the NHS, solutions must be found more
speedily.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/266d5a46/l/0L0Stelegraph0O0Chealth0C97336180CNursing0Egrievances0Bhtml/story01.htm

In one “excruciatingly expensive” home, they came across a “wet room”
containing a mop, bucket and disinfectant. “This display said, plainly, ‘It
would be easier if we just hosed you down,’ ” said Mantel.

Even once she was settled in a “bright, cheerful” home, the author said her
friend was treated so poorly she was forced to remind a member of staff that
she was a “resident not a prisoner”.

Mantel said the experience had made her more aware of the “disability agenda”
and her good fortune to be able to walk across a room or sign her name. “In
the worst homes, the clients are dealt with as if they are brutes, or
malfunctioning machines; in the best, they are spoken to in the doting tones
we use with babies,” she told the Sunday Times Magazine.

“Nobody should place the whole blame on scarcity of resources; that would be
too complacent.

“All the money in the world cannot remedy failure of imagination.”

Mantel noted that standards were “far higher” than in the 1970s, when
institutions and care homes were “heart-rending”.

She acknowledged the publicity that surrounded cases where residents were
“grossly violated” but added: “With old age and disability it is the daily,
unspectacular reality that poses a challenge.”

Last month, the Care and Quality Commission reported that a growing number of
pensioners with dementia were being denied help to eat and drink, robbed of
their privacy and treated “as if they were not there”.

David Behan, its chief executive, said finances were not solely responsible
for the flaws, with staff also being badly trained and “poorly deployed”,
and treating their patients as a list of “tasks” rather than individuals.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/266d9388/l/0L0Stelegraph0O0Chealth0Chealthnews0C9732820A0CCare0Ehome0Eresidents0Eare0Etreated0Elike0Emachines0Ewarns0EBooker0Ewinner0EHilary0EMantel0Bhtml/story01.htm

The Australian radio presenters whose prank call to the Edward VII’s hospital is being blamed for the suspected suicide of nurse Jacintha Saldanha, could be questioned by the Metropolitan police.

The Met have spoken to staff at the Australian embassy in London to ensure that police in New South Wales will assist their investigation ahead of an inquest into the death of the 46-year-old nurse.

Nick Kaldas, the deputy commissioner for New South Wales police confirmed the request, with a spokesman promising the force would do anything it could to help the British investigation.

“It hasn’t been indicated to us that an offence has occurred and [the Met] have not actually asked for anything yet,” said Kaldas. “They’ve simply touched base, let us know of their interest and they will get back to us if they actually want something done. Nothing has been requested of us yet.”

A New South Wales police spokesman added: “As our policing colleagues in London continue to examine events leading up to the death of London nurse Jacintha Saldanha, we will be providing them with whatever assistance is required.”

The police could be keen to establish whether there are sections of the hoax call that were not broadcast on the 2Day FM show on Tuesday, during which Mel Greig and Michael Christian persuaded Saldanha to put a call through to a nurse who revealed details about the Duchess of Cambridge‘s health.

Greig and Christian initially boasted that their hoax call was a career-defining moment but, after Saldanha’s death was reported, they discovered instead that they were at the centre of a worldwide backlash, with social media sites bombarded with abusive and threatening messages addressed to the pair.

The presenters have been placed on indefinite leave from the radio station and are said to be receiving “intensive psychological counselling”.

Rhys Holleran, chief executive of Southern Cross Austereo, 2Day FM’s parent company, said there were real fears for the pair following the incident, with particular concern for the mental health of Greig, 30, who is said to be “struggling to cope”.

“Everyone who knows Mel fears for her mental state,” the Sunday Times reported him saying. “There are very real fears she could self-harm, and nobody wants that.”

The DJs, who only began hosting their nightly chart show two weeks earlier have both indicated that they are keen to speak to the media.

A spokeswoman for Austereo, however, suggested the company was keen to keep the pair out of the public eye. She said the timing of any appearance would depend on the presenters’ state of mind – currently described as “fragile”.

“They have expressed a desire to speak,” she confirmed. “We haven’t ascertained when they’re ready for that and how we’re going to organise that, but they certainly want to.”

2Day FM has also suffered from a wave of revulsion over the consequences of the stunt, with so many advertisers pulling out of their slots on the station that it has axed all commercials for the foreseeable future as “a mark of respect”.

Austereo held an emergency board meeting over the weekend to consider what action it should take, with chairman Max Moore-Wilton saying they would be considering its response to a letter from Lord Glenarthur, chairman of the hospital, in which he condemned the prank phone call, saying he wanted to “protest” against the “extremely foolish” gag.

Calling Saldanha’s death “tragic beyond words”, Glenarthur said the immediate consequence of the station’s “premeditated and ill-considered actions” led to the “humiliation” of Saldanha and another nurse.

The Australian Communications and Media Authority (ACMA), which regulates radio broadcasting, confirmed it had received complaints from all around the world.

It said it is now considering whether it should launch an investigation into whether the presenters breached the commercial radio code of practice.

The chief executive of Austereo, however, insisted that there was nothing illegal about the hoax call.

“Our main concern at this point in time is what happened is incredibly tragic,” said Holleran, who went on to defend the presenters and suggest they would not be sacked.

“We will make sure their well-being is the priority for us,” he said. “We have internally made sure that their needs are addressed and counselling is certainly part of that offer.”

Prank calls have, added Holleran, “been going for decades and decades. They’re not just part of one radio station or one network, or one country, they’re done worldwide. No one could reasonably have foreseen what ended up being an incredibly tragic and very sad day for us.”

He said Greig and Christian were “completely shattered”, adding: “These people aren’t machines, they’re human beings.”

Saldanha was pronounced dead on Friday morning at staff accommodation close to the hospital.

She had answered the presenters’ call and, believing they were members of the royal family, put them through to another nurse who described the Duchess of Cambridge’s condition in detail.

The nurse’s devastated family were being comforted by relatives and friends at their terrace home at Southmead in Bristol.

A friend at the address said Saldanha’s partner Benedict Barboza, 49, and their teenage son and daughter, aged 14 and 16, were “very, very shocked and unhappy at the tragedy”.

In a statement Saldanha’s family said they were “deeply saddened” by the death and asked for privacy.

They said: “We as a family are deeply saddened by the loss of our beloved Jacintha. We would ask that the media respect our privacy at this difficult time.”

A postmortem examination is due to be held this week and an inquest opened and adjourned at Westminster coroner’s court, Scotland Yard said. Saldanha’s death is not being treated as suspicious.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/ecXXV0-v6dw/royal-nurse-prank-callers-metropolitan-police

A nurse at the private hospital treating the pregnant Duchess of Cambridge has been found dead in a suspected suicide three days after being duped by two Australian radio presenters in a hoax call.

The body of Jacintha Saldanha, 46, a mother of two teenage children, was found at her lodgings close to the King Edward VII hospital, central London, at 9.25am on Friday.

It is understood Saldanha, who lived with her family in Bristol but had worked at the London hospital for four years, was the staff member who had answered a telephone call at 5.30am on Tuesday from Sydney’s 2Day FM presenters posing as the Queen and the Prince of Wales. Believing them to be genuine, she had put the call through to a duty nurse, who then divulged intimate medical details of the duchess’s condition to the presenters.

Police and an ambulance were called to a flat in Weymouth Street, central London, at 9.25am where they found Saldanha’s unconscious body. Attempts to revive her were unsuccessful, and she was pronounced dead at the scene.

Scotland Yard said the death “is not being treated as suspicious at this stage”.

The duchess, who was admitted to the hospital on Monday afternoon with acute morning sickness, hyperemesis gravidarum, was discharged on Thursday.

In a statement, St James’s Palace said the duke and duchess were “deeply saddened” at the news of the nurse’s death. “Their thoughts and prayers are with Jacintha Saldanha’s family, friends and colleagues at this very sad time.”

A St James’s Palace spokesman added that the palace had “at no point” complained about the hoax incident. “On the contrary, we offered our full and heartfelt support to the nurses involved and hospital staff at all times”.

After the prank, Prince Charles appeared to brush off the incident, joking with reporters when he arrived at an event at HMS Belfast: “How do you know I’m not a radio station?”

But the call was deeply embarrassing for the hospital, which is the medical institution of choice for the royal family. It is understood when presenters Mel Greig and Michael Christian rang the hospital, no receptionist was on duty as it was too early, so Saldanha answered the phone.

Greig, pretending to be the Queen, asked to speak to “my granddaughter Kate”. In the call, the nurse can be heard saying “Oh yes, just hold on, Ma’am”, before transferring Greig to a duty nurse.

The hoax made international headlines on Wednesday and Thursday. Delighted with the success of “our easiest prank call ever”, the duo had been replaying the call on the station.

But, as news of the death broke, the two, said to be “deeply shocked” took down their Twitter accounts and the station announced they would not return to their radio show until further notice.

It is understood that the hospital, which had described the hoax as deplorable, was not disciplining the nurses involved.

In a statement it said: “We can confirm the tragic death of a member of our nursing staff, Jacintha Saldanha. Jacintha has worked at the King Edward VII hospital for more than four years, She was an excellent nurse and well-respected and popular with all of her colleagues.

“We can confirm that Jacintha was recently the victim of a hoax call to the hospital. The hospital had been supporting her throughout this difficult time”.

John Lofthouse, the hospital’s chief executive, added: “Everyone is shocked by the loss of a much-loved and valued colleague”. Lord Glenarthur, the hospital chairman, said: “This is a tragic event. Jacintha was a first-class nurse who cared diligently for hundreds of patients during her time with us. She will be greatly missed”.

In a statement released through the Metropolitan Police, her family said: “We as a family are deeply saddened by the loss of our beloved Jacintha. We would ask that the media respect our privacy at this difficult time.”

Neighbours near the family home in Bristol said she lived with her partner, Ben, and son , 16, and daughter, believed to be 14. She stayed in London when she was working and lived with her family on days off. One said: “They’re a lovely family – Ben gives my lad a lift when he goes refereeing at Bristol Rovers.”

Another said: “I’ve always known her as the doctor, she was always very smartly dressed. Their son was always really into football, we always saw him with a ball kicking it about with his friends. She was a lovely woman, every time I saw her she would talk to me.”

Another described her as very “smiley and bubbly”. Neighbours said she used to joke she was a “nurse for the queen”. Before going to work at the royal family’s favoured hospital, she had worked at North Bristol NHS Trust, which runs Frenchay and Southmead Hospitals in the city.

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said it was deeply saddening: “This is tragic news, and the thoughts of all at the Royal College of Nursing go to the family of Jacintha Saldanha.”

Lofthouse said on Tuesday the hospital was considering whether to take action against the radio station.

After the show was aired, the station apologised, but continued to promote its hoax, playing clips of the records, and calling it “the prank call the world is talking about”. On Friday, as the backlash grew, both DJs were subjected to abuse and threats on Twitter. There were calls for them to lose their jobs.The radio station’s Facebook page was bombarded with thousands of abusive comments from outraged users.

Scotland Yard is investigating and is treating the death as “unexplained”. In a statement, it said: “Police were called at 9.25am on Friday, December 7, to a report of a woman found unconscious at an address in Weymouth Street, W1.”

“London ambulance service attended and the woman was pronounced dead at the scene. Inquiries are continuing to establish the circumstances of the incident. The death is not being treated as suspicious at this stage”.

In a statement, the London Ambulance service said: “We were called at 9.25am this morning to an address on Weymouth Street. We sent two ambulance crews and a duty officer. Sadly the patient, a woman, was dead.

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/zFIgjU34ISA/royal-hospital-nurse-djs-dead

A member of staff at the private hospital where the Duchess of Cambridge was treated for acute morning sickness has died in a suspected suicide two days after the hospital was duped by a hoax call from an Australian radio station, it has emerged.

The woman, confirmed by the hospital to be Jacintha Saldanha, a nurse who was working on the reception of King Edward VII hospital when the prank call was made, was found unconscious at an address near the London hospital just before 9.30am on Friday.

The hospital said in a statement: “It is with very deep sadness that we confirm the tragic death of a member of our nursing staff, Jacintha Saldanha.

“Jacintha had worked at the King Edward VII hospital for more than four years. She was an excellent nurse and well-respected and popular with all of her colleagues.

“We can confirm that Jacintha was recently the victim of a hoax call to the hospital. The hospital had been supporting her throughout this difficult time.”

Saldanha was married and is understood to have had two children.

A St James’s Palace spokesman said the Duke and Duchess of Cambridge were “deeply saddened” by the news.

“At no point did the palace complain to the hospital about the [hoax] incident,” he said. “On the contrary, we offered our full and heartfelt support to the nurses involved and hospital staff at all times.”

Radio DJs Mel Greig and Michael Christian, from Sydney’s 2Day FM station, rang the hospital in the early hours of Tuesday after the duchess’s admission. Greig pretended to be the Queen, while Christian was in the background as “Prince Charles”.

Greig asked to speak to “my granddaughter Kate”. Saldanha thought she was speaking to the Queen and told Greig: “Oh yes, just hold on ma’am”. She then put the call through to a duty nurse, who divulged intimate medical details about the duchess.

In a statement the radio station and its owner, Southern Cross Austereo (SCA), said they were deeply saddened by Saldanha’s death “and we extend our deepest sympathies to her family and all that have been affected by this situation around the world”.

“Chief executive officer Rhys Holleran has spoken with the presenters. They are both deeply shocked and at this time we have agreed that they not comment about the circumstances. SCA and the hosts have decided that they will not return to their radio show until further notice out of respect for what can only be described as a tragedy.”

The Twitter accounts of Greig and Christian have been taken down since the news of Saldanha’s death broke. Earlier they had replayed extended clips of the prank call. Twitter users have called for the pair to lose their jobs, they have been subjected to abuse and Greig has received what appear to be threats on the social networking site.

The radio station is reportedly already serving two five-year licence probations after serious breaches of the regulator’s code.

It is understood the dead woman’s next of kin have been informed.

John Lofthouse, the hospital’s chief executive, said: “Our thoughts and deepest sympathies at this time are with her family and friends. Everyone is shocked by the loss of a much-loved and valued colleague.”

Lord Glenarthur, chairman of the hospital, said: “This is a tragic event. Jacintha was a first-class nurse who cared diligently for hundreds of patients during her time with us. She will be greatly missed.”

Scotland Yard has launched an investigation and is treating the death as “unexplained”.

In a statement, it said: “Police were called at approximately 9.25am on Friday, December 7, to a report of a woman found unconscious at an address in Weymouth Street, W1.

“London ambulance service attended and the woman was pronounced dead at the scene. Inquiries are continuing to establish the circumstances of the incident. The death is not being treated as suspicious at this stage”.

In a statement, the ambulance service said: “We were called at 9.25am this morning to an address on Weymouth Street. We sent two ambulance crews and a duty officer. Sadly the patient, a woman, was dead at the scene.”

The St James’s Palace spokesman said: “The duke and duchess of Cambridge are deeply saddened to learn of the death of Jacintha Saldanha. Their royal highnesses were looked after so wonderfully well at all times by everybody at King Edward VII hospital, and their thoughts and prayers are with Jacintha Saldanha’s family, friends and colleagues at this very sad time.”

The prank call was deeply embarrassing for the hospital, which is the medical institution of choice for the royal family.

Lofthouse said on Tuesday the hospital was considering whether to take action against the radio station.

He added: “I’ve received advice that what the Australian broadcasters did may well have broken the law. On the other hand, they’ve apologised for it so we’re going to have a long and careful think about what, if anything, we do.”

The prank call was pre-recorded and vetted by lawyers before being broadcast to listeners in Sydney.

In their initial apology the two presenters said: “We were very surprised that our call was put through. We thought we’d be hung up on as soon as they heard our terrible accents.

“We’re very sorry if we’ve caused any issues and we’re glad to hear that Kate is doing well.”

The royal couple had made no comment about the hoax call. But Prince Charles appeared to make light of it, joking with journalists at an engagement on Thursday: “How do you know I am not a radio station?”

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “This is tragic news, and the thoughts of all at the Royal College of Nursing go to the family of Jacintha Saldanha.

“It is deeply saddening that a simple human error due to a cruel hoax could lead to the death of a dedicated and caring member of the nursing profession.”

A former neighbour of Saldanha described her as a “nice, lovely lady”.

The woman lived next door to Saldanha, her two sons and partner, Benedict “Ben” Barboza, in Bristol several years ago.

“What a terrible tragedy – just before Christmas as well,” she said. “Those two young boys – they’ll be heartbroken.

“Her and Ben were a lovely couple. They didn’t live here very long, but they were such nice neighbours. They kept themselves to themselves mostly.

“It’s so sad, so tragic. They always spoke to us – she was such a nice lady. I didn’t know what she did for a living, but I knew she was a good person, as far as I knew.

“It’s devastating to hear she’s gone – and in such circumstances that could be so easily avoided.”

Article source: http://feeds.guardian.co.uk/~r/theguardian/rss/~3/Xl_elxqhYZw/duchess-cambridge-hoax-call-nurse-found-dead

In a speech later today in Manchester she will say: “Being a nurse, a
midwife or a care worker is an extraordinary role. We all came into these
roles because we wanted to make a difference to the people we care for and
support.

“We care for people in their own homes, in communities, hospices and in
hospitals. We are proud to be part of a remarkable health and care service
that does make a difference to people’s lives each and every day.

“But the context for health care and support is changing. Most
significantly, with people living longer, we have a greater number of older
patients and people to support, many with multiple and complex needs.

“And while the health, care and support system provides a good – often
excellent – service, this is not universal. There is poor care, sometimes
very poor. Such poor care is a betrayal of what we all stand for.”

But Peter Crome, emeritus professor in geriatric medicine at Keele University,
said staff shortages would make it harder to enforce the strategy.

He told Today: “Without adequate numbers of trained staff, this agenda –
which must be welcomed – will be found difficult to implement.”

Last week Jeremy Hunt, the Health Secretary made it clear that he did not
think cases such as that of a cancer patient who lost a third of his body
fluid because staff did not check on him, were “isolated incidents”.

He said patients all too often experienced “coldness, resentment,
indifference” and “even contempt” and accused the worst hospitals of “a kind
of normalisation of cruelty”.

Welcoming the new strategy, he said: “Ensuring that patients get the best
possible care is a priority for this Government. Nurses play an important
role in this which is why this announcement by nurse leaders is so
important.

“We want to do all we can to support those who care for patients – and
this new vision will help us do that.”

Meanwhile a new report by the Dr Foster Intelligence Unit, the healthcare
information provider, found discrepancies in the care offered to heart and
cancer patients in their 80s compared to those who were younger.

It found those in their 50s were three times more likely to be offered
emergency treatment for their heart attacks than those in their 80s.

The report also found fewer than 5% of women in their 80s had surgery to
reconstruct their breasts after cancer treatment, compared to almost 100% of
those in their 50s, according to the Daily Mail.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/263e905a/l/0L0Stelegraph0O0Chealth0Chealthnews0C9720A6820CPoor0Ecare0Ea0Ebetrayal0Eof0Eour0Evalues0Esays0Enursing0Echief0Bhtml/story01.htm

She said: “A universal healthcare system free at the point of delivery is what
the overwhelming majority of the British people want and is something I
remain firmly committed too.

“However there are increasing complaints about nurses who fail to show care
and compassion to their patients. What exactly will you do about that?”

Mr Cameron told her: “You speak for the whole House and the whole country in
raising this issue and I know how painful it must have been with what you
have witnessed in your own life and your own family.”

He said his own family had received “extraordinary care” from the NHS but that
it had “very real problems”.

The Prime Minister told Ms Clwyd there was no “magic wand” to alleviate the
concerns of those who complained of inappropriate care.

But he said that “simple steps” such as asking patients and staff if they
would be happy for their friends and family to be treated in the same way,
and hourly nurse rounds, could make a “real difference”.

Mr Cameron added: “We shouldn’t have to dictate these things but I think a
proper conversation with our nurses who are angels by the vast degree can
get this sorted out for all our relatives.”

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/264c4795/l/0L0Stelegraph0O0Chealth0Chealthnews0C97246420CMP0EAnn0EClwyd0Efights0Eback0Etears0Eas0Eshe0Echallenges0EDavid0ECameron0Eover0Enursing0Bhtml/story01.htm

Student nurses – as well as their experienced colleagues – should be assessed
for attributes including their “compassion” for patients and “courage” to
point out where things are going wrong, according to Jane Cummings, the
Chief Nursing Officer for England.

Article source: http://telegraph.feedsportal.com/c/32726/f/568556/s/26437f08/l/0L0Stelegraph0O0Chealth0Chealthnews0C97224140CRecruit0Eon0Ecompassion0Enot0Egrades0Ealone0Esays0Etop0Enurse0Bhtml/story01.htm