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Warning over NHS compensation ads
Hospitals in Wales are being told by the health minister to stop handing out leaflets which include advertisements offering help to claim compensation. Edwina Hart said it is "highly inappropriate" for the NHS to advertise services from personal injury lawyers. She had written to all NHS trusts about it but was "disappointed" adverts were still used at Cardiff's University Hospital of Wales. Cardiff and Vale NHS Trust said the leaflet was distributed by mistake. The health minister was contacted after a patient received an information leaflet at the hospital in Cardiff with advice on exercises for sprained ankles. But on the back was an advertisement with the headline "Been Injured? Not sure what to do next?"
Plaid Cymru AM Leanne Wood, who was contacted by the patient who lives in her South Wales Central constituency, said: "The advertisement then featured details of a company which provided help in claiming compensation for a variety of incidents including road traffic accidents, a slip or trip or accidents at work." She said she understood the advertisements were used to subsidise the cost of patient information leaflets. "But it seems rather odd to me that the Cardiff and Vale NHS Trust should allow advertising along these lines when it could potentially lead to claims against hospitals and encourages the compensation culture," she said. "I noticed in the trust's annual accounts for 2008-09, that the trust set aside £3.2m as potential liabilities for personal injury claims."
The AM wrote to Ms Hart, who said she had written once again written to Cardiff and Vale NHS Trust to express her "disappointment" that the adverts had continued to appear on leaflets, despite previously being asked to stop them.
'Old leaflet'
The health minister said she had written to all NHS organisations in March 2008 and at the start of this year instructing them to stop using the advertisements to subsidise the cost of patient information leaflets. "Cardiff and Vale NHS Trust responded to my officials with assurances that they do not use patient information materials containing advertisements by personal injury lawyers," said Ms Hart. "I am, therefore, extremely disappointed to hear that this activity is continuing. I have written to Jan Williams, Chief Executive of the trust, asking her to provide me with an explanation."
A Cardiff and Vale NHS Trust spokesperson said: "The trust fully supports the withdrawal of all patient information leaflets featuring adverts for personal injury lawyers. Regrettably, this was an occasion where an old leaflet was still in circulation and given to a patient. "Immediate checks are being carried out in all areas so that any leaflets featuring adverts for personal injury lawyers are removed and replaced as soon as possible."
Tuesday 15th September 2009
Mecca pilgrims must have flu jab
Swine flu fears
Pilgrims will also need to be vaccinated against H1N1 swine flu, if a vaccine becomes universally available before the Hajj in November. The new measures have been introduced because of the risks of viruses spreading in such a large concentration of people. The Hajj is the journey that every adult Muslim must undertake at least once in their lives if they can afford it and are physically able.
"It is inevitable that at an event where two million people are expected to meet, viruses will spread quickly - and this year there is greater concern about flu, particularly for vulnerable people", said Communities Minister Shahid Malik. He said any British Muslim planning to travel in November should check the Foreign Office travel advice, or call 0845 850 2829. Pilgrims are also advised to have comprehensive travel insurance, and to carry vaccination cards with them. The Foreign Office is sending its own delegation to the Hajj, which will include doctors and consular staff, to help British pilgrims.
Copyright BBC Health News – Tuesday 15th September 2009
Source: http://news.bbc.co.uk/1/hi/help/6915817.stm
Hospital's inquiry 'too narrow'
A solicitor representing campaigners has condemned a second inquiry into failings at Stafford Hospital as "a narrow, private process." Richard Stein, who is acting for the Cure the NHS (CtN) group, was speaking on the opening day of the inquiry. He said many relatives felt other reports had already established what happened to patients. In March, a Healthcare Commission report said "appalling" emergency care had led to patients "dying needlessly". It also condemned the local NHS trust for allowing unqualified staff to carry out checks on patients. CtN held a silent protest after a meeting on Tuesday.
Oral hearings
Mr Stein said CtN now intended to seek a judicial review of the limited scope of the independent inquiry. "It's extremely disappointing for patients and for bereaved relatives that it's going to be a narrow, private process rather than the open, public and all-embracing one that the people of Stafford need and deserve," he said. Speaking after inquiry chairman, Robert Francis QC, had outlined the terms of reference, CtN founder Julie Bailey described its scope as a "whitewash" which would not establish what went wrong. After meeting with interested parties, Mr Francis promised it would allow patients and their families to give an account of their experiences.
Medical information
He confirmed oral hearings, including those involving staff and senior managers at the hospital, would be held in private. Asked why the inquiry would be held in private, Mr Francis pointed out much of the material he would have to consider would be sensitive and confidential medical information. Mr Francis said: "I drew to the secretary of state's attention [to the] view of mine and also the request by Cure the NHS that the terms of reference should be extended. He wrote to me recently... declining in that respect to extend the terms of reference."
Initial checks
The report in March said about 400 more people died at the hospital between 2005 and 2008 than would be expected. It also found receptionists carried out initial checks on patients. The Care Quality Commission, which replaced the Health Commission, said there had been progress, but some areas had to be addressed "urgently". The trust has said lessons had been learned and staffing levels had been increased.
Copyright BBC Health News – Tuesday 15th September 2009
Source: http://news.bbc.co.uk/1/hi/england/staffordshire/8256331.stm
Health Hotline Needs to Improve
A health service hotline needs to improve its integration with the NHS in Wales, an official report recommends. NHS Direct Wales is a 24-hour health advice service used via the telephone or the internet and designed to take pressure off frontline medical staff. But the Wales Audit Office has said it needs to be more efficient, improve call handling and have better promotion of its services. The assembly government said it would consider the report's findings.
NHS Direct Wales costs £9m and in 2008/09 the service received more than 340,000 calls and 450,000 visits to its website in 2008/2009. It is designed to take pressure off frontline NHS staff and many have used it during the swine-flu outbreak. And it has helped a third of callers look after themselves without recourse to GPs or accident and emergency departments. The Wales Audit Office report says costs are roughly comparable with England and it provides a valuable service. The audit office said the £9m-a-year was a valuable service but added that several improvements should be made.
'Realise potential'
But it also said NHS Direct Wales could improve promotion of its service to the public, especially to older people and those in rural areas. Call handling times could be improved and staff absence through sickness and turnover levels cut back. And it said the service could be more seamlessly integrated with the rest of the NHS. The report recommends:
- Information on cost and performance should be given at national and local level.
- Patients' behaviour and choices should be monitored.
- NHS Direct Wales should take action to support more appropriate forms of unscheduled care.
- The assembly government and local health boards should investigate ways NHS Direct Wales could help manage chronic conditions.
The Auditor General for Wales, Jeremy Colman, said: "While NHS Direct provides valuable services which most people seem to like, there is scope for it to be much more effectively integrated within the unscheduled care system, providing a more seamless service for the public. I hope the wider NHS will take on my recommendations in order to realise the potential of NHS Direct to help make the unscheduled care service easier for the public to use."
Chair of the assembly audit committee, Jonathan Morgan AM, said NHS Direct Wales should be recognised as central to the health service. But he said it was seen as something separate, rather than a core part of the unscheduled care system and its contribution was "poorly understood across the NHS". Welsh Liberal Democrat health spokesman Peter Black AM, said the report's findings worried him. "I have had concerns for some time at the way that NHS Direct Wales appears to operate independently of the rest of the health service and this report reinforces my views," he said.
An assembly government spokesperson said: "The Health Minister, Edwina Hart, has received a copy of the report and she will consider its findings and recommendations."
Carol Jones, the director of the Board of Community Health Councils in Wales who used to work at NHS Direct Wales, said more needs to be done to raise public awareness.
She said: "Clearly the majority of the public do not have an awareness about what the service offers. Marketing would help significantly. Very rarely do we hear from anyone within NHS Direct Wales about any issues to do with health, so that really is a bit of a guide as to how much awareness there is. I think a lot can be done to raise the profile."
Tuesday 15th September 2009
http://news.bbc.co.uk/1/hi/wales/wales_politics/8255203.stm
Deal reached over swine flu jabs
A deal has been reached between the government and GPs over the swine flu vaccination programme. Ministers have agreed to pay doctors £5.25 per jab after weeks of talks. It means GPs will be ready to start immunising as soon as the vaccines are licensed, which could be as early as the beginning of next month. About 14m people in the UK, including those with health problems and pregnant women, are earmarked for the first wave of the vaccination programme. The government has yet to decide whether the whole population will get the jab.
Talks
The British Medical Association has argued during the negotiations that they would need to cover staff and admin costs as well as the overtime they may need to do. However, they always accepted they would be getting less than the £7.51 they are paid for seasonal flu and other jabs such as travel inoculations because it could end up being a mass vaccination scheme. Doctors have also been given a bit of leeway over their access targets - guaranteeing appointments within 48 hours as well as advanced bookings - if they achieve high immunisation rates.
Under the programme put forward, people with health conditions, such as heart disease and diabetes, pregnant women, those with weakened immune systems and frontline health and social care workers will be the first to receive the jab. This amounts to 14m - about a fifth of the UK population - and is similar in number to those who get seasonal flu, although pregnant women are not included in that programme. Indeed, the hope is that the swine flu jab can be administered at the same time as seasonal flu, which is getting under way in the next few weeks.
The government has signed contracts with two manufacturers for 132m doses of the vaccine. This was done when it was believed two doses would be needed, although trials from one of the drug companies indicate one may be enough. Health Secretary Andy Burnham said the agreement was "great news for patients". "The vaccine is the best line of defence against the virus and I would strongly urge all of those in the at-risk groups to have the vaccine." And he added: "The deal represents good value for money as the vaccine programme will reduce the number of people who will need hospital treatment."
Dr Laurence Buckman, chairman of the BMA's GPs committee, said: "This will be a lot of additional work for practices, but general practice is used to running large vaccination programmes. We are confident that GPs and their teams will have the resources they need in order to run the swine flu vaccination programme smoothly and efficiently."
Copyright BBC Health News – Tuesday 15th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8255522.stm
Anti-depressants 'not overused'
Doctors may be under-prescribing anti-depressant drugs despite claims the medication is being overused, a study has claimed. Researchers from the University of Aberdeen said attempts to hit government reduction targets could be affecting prescription levels. They analysed more than 30 GPs at four north east of Scotland surgeries. Prof Ian Reid said: "It is more likely GPs are initiating anti-depressant treatments conservatively."
The study - published in the British Journal of General Practice (BJGP) - comes amid a general worldwide rise in anti-depressant use. It aimed to find out how well GPs recognised and treated depression, amid claims that doctors have been prescribing anti-depressants too readily. The researchers asked patients - who were attending the surgery for any reason - to complete depression assessment questionnaires. The GPs - unaware of the questionnaire results - then made an assessment of the patients, and recorded whether or not they diagnosed depression.
The researchers then noted what treatments, if any, the GPs arranged, and compared those views and actions with the questionnaire results to assess if they might be giving out anti-depressants unnecessarily. The research team said the new study cleared doctors of overprescribing. Prof Reid said: "Our study shows that GPs are not prescribing anti-depressants unnecessarily, as has been widely assumed. GPs did not arrange treatment for about half of the patients who filled in our questionnaires and who had significant symptoms of depression, because they did not detect the illness at that visit."
'Heartily endorsed'
He said: "Where anti-depressants were prescribed for patients who did not have symptoms, they were being given for reasons other than depression. "These could be for the treatment of pain, or for patients who had been started on anti-depressants for an episode of depression prior to the start of the survey, and who were now sufficiently improved to no longer have symptoms. Out of the 897 patients surveyed in the study, only three were receiving anti-depressants without a clear reason for taking them." He added: "I think the Scottish Government's policy is intended as a spur to increase the availability of non-drug treatments for depression, such as talking therapies. I'd heartily endorse that aim. However, in my view, it would have been better to set a target focussing on non-drug therapies, rather than on prescription volumes."
The SNP's manifesto two years ago said it aimed to reduce the use of anti-depressants by 10% by 2009 as part of a plan to improve mental health. Public Health Minister Shona Robison said: "Our target to level off anti-depressant prescribing is not a criticism of existing practice or of anti-depressants, but reflects the need to ensure that GPs are able to call on and offer the best treatment and not just those that are the most convenient. "It recognises that anti-depressants are just one way of helping people with mental health issues and reflects our aim of increasing the availability of other treatments such as psychological therapies, guided self-help and physical exercise. As this research acknowledges, our target is also designed to encourage regular review of medication to ensure it is still the most appropriate treatment." She added: "We continue to take forward work on access times for psychological therapies."
A Department of Health spokesperson said: "Whilst some people with severe depression will benefit from a course of antidepressants, people with milder cases of depression may be better helped by psychological therapies. Clinicians, in discussion with patients, will decide what is the most appropriate treatment for each individual."
Copyright BBC Health News – Tuesday 15th September 2009
Taking showers 'can make you ill'
Showering may be bad for your health, say US scientists, who have shown that dirty shower heads can deliver a face full of harmful bacteria. Tests revealed nearly a third of devices harbour significant levels of a bug that causes lung disease. Levels of Mycobacterium avium were 100 times higher than those found in typical household water supplies. M. avium forms a biofilm that clings to the inside of the shower head, reports the National Academy of Science.
In the Proceedings journal, the study authors say their findings might explain why there have been more cases of these lung infections in recent years, linked with people tending to take more showers and fewer baths. Water spurting from shower heads can distribute bacteria-filled droplets that suspend themselves in the air and can easily be inhaled into the deepest parts of the lungs, say the scientists from the University of Colorado at Boulder.
Potential threat
Lead researcher Professor Norman Pace, said: "If you are getting a face full of water when you first turn your shower on, that means you are probably getting a particularly high load of Mycobacterium avium, which may not be too healthy." While it is rarely a problem for most healthy people, those with weakened immune systems, like the elderly, pregnant women or those who are fighting off other diseases, can be susceptible to infection. They may develop lung infection with M. avium and experience symptoms including tiredness, a persistent, dry cough, shortness of breath and weakness, and generally feel unwell.
When the researchers swabbed and tested 50 shower heads from nine cities in seven different states in the US, including New York City and Denver, they found 30% of the devices posed a potential risk. Since plastic shower heads appear to "load up" with more bacteria-rich biofilms, metal shower heads may be a good alternative, said Professor Pace. Showers have also been identified as a route for spreading other infectious diseases, including a type of pneumonia called Legionnaires' disease and chest infections with a bacterium called Pseudomonas aeruginosa.
Hot tubs and spa pools carry a similar infection risk, according to the Health Protection Agency. A HPA spokesperson said: "This is an interesting paper which provides further information about the occurrence of opportunist organisms - germs which do not usually cause infections in humans - in the environment. These bacteria, which belong to the same family as TB, can be found in the environment and occasionally in water supplies but rarely cause disease in healthy people. Further work will need to look at whether finding these organisms is associated with any increased risk of infection."
Monday 14th September 2009
http://news.bbc.co.uk/1/hi/health/8254206.stm
'Stiletto stand' urged on unions
Union members are to be urged to take a stand against the risks of wearing high heels in the workplace in favour of more "sensible shoes". Delegates at the TUC congress will be asked to back a motion requiring some employers to carry out risk assessments about their workers' footwear. The Society of Chiropodists says two million working days are lost a year due to lower limb injuries. But some unions say individuals should be allowed to wear what they want.
'Inappropriate'
The motion to be debated in Liverpool argues that some workers are forced to wear high heels as part of their dress code. As a result, they risk problems ranging from blisters and calluses to serious foot pain and damaged joints. While "high heels may look glamorous on the Hollywood catwalks," the motion says, "they are completely inappropriate for the day-to-day working environment". It states that all firms which promote high heels should examine the risks that employees wearing them face and where this is found to be hazardous, they should be replaced with sensible and comfortable shoes.
"This is a serious issue for women in the workplace," says Eddie Saville, director of employment relations at the Society of Chiropodists. "We want to ensure women workers are never forced to wear high heels which we believe can lead to foot health problems in the short, medium and long term." But the BBC's political correspondent Paul Rowley said some unions, including the University and College Union, would oppose the move
Monday 14th September 2009
Source: http://news.bbc.co.uk/1/hi/uk_politics/8255909.stm
Parents fear for E.coli children
A mother of twin boys with acute kidney failure after an E.coli outbreak at a farm in Surrey has said she fears for their long-term health. Godstone Farm, near Redhill, was closed on Saturday - although the first E.coli case was reported on 27 August. Thirty-six visitors, including 12 children, have been taken ill. Three children remain seriously unwell. Tracy Mock said it was still unclear whether her two-year-old sons would suffer long-term kidney damage. "I'm just so incredibly angry that they shouldn't be there [in hospital], and I'm extremely worried," said Ms Mock of Paddock Wood, Kent.
'Very weak'
Ms Mock, whose daughter was also taken ill after visiting the farm, said her sons Todd and Aaron were both undergoing dialysis. Todd has also had a blood transfusion. "They are quite sleepy and not with it at all. They're just lying in their cots with tubes coming out of them," she said. The Health Protection Agency (HPA) said the outbreak began at the farm on 8 August, but it did not receive details of the first case until 27 August. Experts have described it as one of the UK's largest outbreaks of E.coli.
The farm, which is popular with families and attracts 2,000 visitors a day at peak times, said suitable control measures were in place and it would not reopen until it had got to the root of the problem. Investigators trying to pinpoint the cause of the outbreak have been conducting tests in and around animal pens in an attempt to identify the source of the bug. A parent, known only as Marianne, from London, said her daughter suffered from kidney failure two days after visiting the farm on 12 August and ended up in hospital for six days.
Stomach cramps
"My daughter is now home but still very weak. We don't know whether her kidneys will have permanent damage and won't know for a year," she said. Diana Wade Scriven, of Bromley, south London, said one of her children was admitted to hospital with "terrible stomach cramps" following a visit and tested positive for E.coli. Jen Hardiman, of Redhill, Surrey, felt parents were not given enough information about the severity of the E.coli outbreak. She said: "We visited the farm on Tuesday. We were told at the gate to read a small photocopied poster which said there had been a few cases of E-coli. Now it has been closed to the public I am very angry we were not told about the severity. This place should have been closed sooner."
Father-of-two Chris Pratley, of Croydon, south London, praised staff and said warning signs were clearly in place. "Godstone Farm is a wonderful attraction and I am alarmed by the sensational tone of the current media coverage. Farm animals carry E.coli and if parents fail to ensure that their children utilise the ample hand-washing facilities available then these outbreaks are likely to happen," he said.
BBC Health News - Monday 14th September 2009
Source: http://news.bbc.co.uk/1/hi/england/surrey/8254280.stm
Genes blamed for early first sex
The fact that children raised in homes without a dad have sex earlier is down to their genes, say US researchers. The study tested for genetic influences as well as factors such as poverty, educational opportunities and religion. The more genes the children shared, the more similar their ages of first intercourse regardless of whether they had an absent father or not. A spokesman for the charity, Brook, said children needed early education to help them make informed choices.
Competing theories
The study published in the journal, Child Development, says several theories have been advanced about the environmental factors which influence this association between absent fathers and early sex. One suggests that because these children observe unstable or stressed parental relationships, they learn that resources are scarce, and people untrustworthy. This leads them to mature in such a way that they are geared towards mating rather than parenting.
Another states that because adolescents reared in single-parent households may have parents engaging in sexual behaviour with partners to whom they are not married, the children may be more likely to view non-marital sex as the norm. And a third theory states that a single-parent family structure may encourage adolescent sexuality by reduced parental control. In other words two parents can much more closely monitor their offspring's activities and social networks, reducing the opportunities for sex. But this study shows these factors are not as important as genes in determining early sexual behaviour.
Results
The researchers at the University of Oregon compared the average age of first intercourse among children whose fathers were always absent, partially absent or always present throughout childhood. They looked at more than 1,000 cousins aged 14 and older from the American National Longitudinal Survey of Youth. For the children whose fathers were always absent, 63.2% reported having had sex. This compared to 52.5% of children whose fathers were sometimes absent. And only 21% of children whose fathers were always present.
The average age of first intercourse for children whose fathers were always absent was 15.28, compared to partially fathered children at 15.36 and 16.11 for children whose fathers were present for all of their childhood. It compared children who were related in different ways to each other, and who differed in whether they had lived with their fathers.
The more genes the children shared, the more similar their ages of first intercourse, regardless of whether or not the children had an absent father.
Genetic risk factor
Jane Mendle, professor of psychology at the University of Oregon, who led the study said: "The association between father's absence and children's sexuality is best explained by genetic influences, rather than by environmental theories alone. While there is clearly no such thing as a 'father absence gene', there are genetic contributions to traits in both mums and dads that increase the likelihood of earlier sexual behaviour in their children. These include impulsivity, substance use and abuse, argumentativeness and sensation seeking." But Professor Mendle said her study did not have the power to discriminate conclusively between genetic and environmental factors and further research with a larger number of children would be necessary.
Simon Blake, from the sexual health charity, Brook Advisory Centre, took issue with the idea that genes were the overriding factor in early sex. He said: "We know from research that factors associated with young people having first intercourse at a younger age are: lower educational achievements; friends and the media being the main source of information about sex education; socio-economic status; early sexual experience and the earlier age at which girls start their periods. "All young people need access to confidential sexual health services as well as high quality education about sex and relationships from a young age. This gives them the skills and information to make informed choices, and the self-esteem and aspirations for themselves for the future. Targeted outreach work is also an effective way of reaching those more vulnerable groups."
Monday 14th September 2009
http://news.bbc.co.uk/1/hi/health/8251483.stm
