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Thursday, December 15, 2011

NHS staff’s poor English is potential danger to patients

The General Medical Council (GMC) says some overseas doctors come to the NHS with ‘little or no preparation’ for working in the UK.Along with the Nursing and Midwifery Council, it wants the right to test the English language skills of applicants from within the EU in the same way they test applicants from outside of Europe.

But an EU red tape Directive prevents any systematic testing of language skills of doctors from the European Economic Area (EEA).

The GMC says UK legislation – the Medical Act 1983 – ‘gold plates’ the directive and prevents the GMC from doing any language-testing of doctors from the EEA at all.

Employers are allowed to assess the language skills of applicants from the EEA, but it is thought many do not.

A spokesperson from the GMC said: “Doctors who come to work in the UK make a vital contribution to our healthcare system, but we must make sure they receive the support they need to practise safely and to conform to UK standards.”

“It is unacceptable that the current system enables doctors to practise in the UK without a sufficient grasp of English.”

The GMC says some overseas doctors come to the NHS with “little or no preparation” for working in the UK and those trained under different cultural and professional standards need more support.

The GMC is planning a basic induction programme for all doctors – including those who qualify in the UK – to help understand how healthcare is practised in the UK.

A spokesperson from the Department of Health said: “This government is determined to make sure that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language skills.”

“We do think the Directive needs updating and we are in the process of responding to the EU proposals, but we can’t pre-empt that response.

“We have already taken steps to strengthen the current system by introducing a duty for responsible officers to check the qualifications, experience and references of all doctors, including foreign doctors.”

But poor English language standards are not just an issue among some European NHS staff, for whom English is not their first language.

Asian nurses said they found it difficult to understand European colleagues – particularly those from Eastern Europe.

But when one was asked what a patient meant if they said they wanted to ‘spend a penny’ – slang for go to the lavatory – she replied “they want to spend money”.

A spokesperson from Imperial College Healthcare NHS Trust, said: “We take patient experience and patient complaints very seriously.”

“We care for a diverse patient population and employ a diverse workforce, and understand the importance of staff being able to talk to patients and their families in an appropriate way.”

NHS to abandon £12 billion IT project as a labour failure

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.The integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

Numbers of heroin and crack cocaine users in treatment falls

The number of heroin and crack cocaine users needing treatment in England has fallen by 10,000 in two years. The National Treatment Agency for Substance Abuse said the number of adults that began treatment for the class A drugs fell from 62,963 in 2008/09 to 52,933 in 2010/11.

The steepest decline was in the under 30 age group.

The number of people accessing treatment for all drugs also fell for the second year running.

The latest figures also show an increase in the number of drug users “recovering” from addiction – people who no longer need treatment.

Some 27,969 users were classed as recovering in 2010/11, a rise of 18% on the previous year and 150% higher than 11,208 in 2005/06.

The figures showed that, of the 255,556 people who entered a drugs treatment programme since April 2005 for the first time, 28% (71,887) had successfully completed the course and did not need further treatment.

Paul Hayes, the NTA’s chief executive, said the figures showed that “recovery is now becoming a reality for more individuals each year.  More drug users are recovering from addiction, fewer need treatment, and more are getting over their addiction quickly.”

Mr Hayes went on to say he thought the figures showed England had “probably passed the high watermark of the impact of epidemic of the late ’80s and early ’90s and that younger groups of people were reluctant to begin patterns of behaviour… that they’ve seen cause damage to their older siblings, people in their community, sometimes, sadly their mums and dads.”

“They realise the consequences of heroin and crack use and they’re turning their backs on that,” he said.

He said officials were also seeing “significant declines in purity” which “suggests that attempts to restrict supply are having an impact”.

“It’s extremely likely, from where we sit, that the different aspects of the government’s drugs strategy are coming together to have a positive effect,” he added.

But he warned that addiction remained a “serious problem” for many communities, particularly the poorest ones.

“We need to remain vigilant, particularly in a tough economic climate. There’s absolutely no inevitability that rising unemployment among young people will see a rise to ’80s levels of heroin use, but we need to watch that situation very carefully,” he said.

Nurses and midwives urged to get flu jab

Nurses and midwives are being urged to get their flu jabs after figures reveal less than a third did last year.All front line healthcare workers are meant to be vaccinated to stop them going off sick with influenza and spreading the virus to patients.

Last year only 30% of hospital nursing staff in England got immunised compared with 43% of GP practice nurses, 38% of GPs and 37% of other doctors.

Nursing and midwifery groups say having the jab is a “professional duty”.

This is the first time the figures have given broken down by occupation.

The number of healthcare workers getting the vaccine had increased from 26.4% in the 2009 winter to 34.7% in 2010.

However, the majority of nurses who work with the most critically ill over the winter months and midwives who work with pregnant women, were left vulnerable to flu, its potentially life-threatening complications and passing it on to patients and family, says the Department of Health which released the figures.

The data also shows that only 25.2% of youngsters aged six months to two years in at-risk groups were vaccinated last winter, compared with 51.7% of those aged 16 to 65.

Those at risk include people with conditions such as asthma, diabetes, heart disease and liver disease, as well as the over-65s and pregnant women.

Last winter people in at-risk groups were 11 times more likely to die from seasonal flu than people with no underlying health problems.

Chief Medical Officer Dame Sally Davies said: “It is never too early to start thinking about flu. So as NHS staff return from their holidays, I urge them to plan ahead and get vaccinated.”

Dr Peter Carter, of the Royal College of Nursing, said while NHS staff should not be forced to get immunised, they had a professional duty to do so: “Patients and healthcare staff suffer when nurses are off sick.

“It is vital that nurses do all they can to take responsibility for their own health and of those around them. The RCN will be working with our members to ensure they have access to all of the relevant information to enable them to make the right decision about the uptake of the vaccine.”

Louise Silverton, of the Royal College of Midwives, said: “Midwives are strongly advised to encourage all pregnant women to be vaccinated against seasonal flu.

“In addition midwives as key health workers should themselves seriously consider being vaccinated to prevent transmission of influenza to the women for whom they care and also to their own families.”

A National NHS Staff Seasonal Flu Vaccination Campaign launches later this month and will use resources like Twitter and Facebook, as well as leaflets, to encourage more healthcare professionals to get vaccinated.

Nurses- something fundamentally wrong with nursing claims NHS boss

The head of a scandal hit NHS hospital has claimed there is something “fundamentally wrong” with nurses and the nursing profession.Sir Stephen Moss, chairman of Stafford Hospital and himself a nurse for 40 years, said that “too many patients and families” are being let down but that staff shortages are not to blame.

He suggested the problems lie in the training nurses receive as well as the way they work on hospital wards, and plans to lead a new campaign to improve standards.

His comments come in the wake of a series of scandals at NHS hospitals in which vulnerable patients have been neglected with sometimes fatal consequences.

At Stafford Hospital, which Sir Stephen arrived at in 2009 to help turn around its fortunes, as many as 1,200 patients are feared to have died unnecessarily over three years as managers became preoccupied with cost-cutting.

A recent report by the Health Service Ombudsman condemned the NHS for failing to meet “even the most basic standards of care” for pensioners, while spot inspections by the Care Quality Commission have uncovered geriatric wards where doctors are prescribing water to elderly patients to stop them becoming dehydrated.

Unions and professional bodies have suggested that the problems are down to staff being over-worked or forced to focus on Government targets rather than providing personal care.

But other commentators have claimed that too much care is now provided by cheap healthcare assistants, who do not need to meet national training standards and who are not regulated by a professional body; or that nurses think they are “above” feeding and cleaning patients now that they have to be university-educated.

In an interview with a local newspaper, Sir Stephen said: “Not everything in nursing is bad, but after the events at Stafford Hospital, the recent concerns at New Cross Hospital [in Wolverhampton, where high death rates are being investigated] and others around the country you can’t tell me there isn’t an issue here that needs addressing and we have to do something about it.

“There is something fundamentally wrong with the nursing profession and the way it is focused at the moment.  We are getting a lot right but we are also letting down too many patients and families. We can’t just stand by and not do something.”

Sir Stephen is drawing together a group of seven “big hitters” in the health service to suggest ways that hospital care can be improved.

Their plans, to be disclosed in September, will focus on how nurses can be trained for “the real world of the NHS rather than the classroom”.

Ovarian cancer gene raises risk six fold

Researchers have found a gene which increases the chance of developing ovarian cancer six fold.About one woman in 70 is at risk of developing ovarian cancer, which claims more than 4,200 lives a year.

However, for those with a faulty RAD15D gene, the risk is raised to one in 11.

The discovery was made by scientists at the Institute of Cancer Research, which is connected to The Royal Marsden hospital in London.

Professor Nazneen Rahman, head of genetics and epidemiology, said: “At this level of risk, women may wish to consider having their ovaries removed after having children, to prevent ovarian cancer occurring.”

At the moment the discovery, published in the journal Nature Genetics, is limited to the knowledge that faulty copies of this gene raise ovarian cancer risk.

But Prof Rahman said: “There is also real hope on the horizon that drugs specifically targeted to the gene will be available.”

The study was based on comparing the DNA of women from 911 families with ovarian and breast cancer, to that from 1,060 people in the general population.

Cancer Research UK, which helped fund the study, described it as “the most significant ovarian cancer gene discovery for more than a decade”.

Prof Nic Jones, the charity’s chief scientist, said: “It’s incredibly exciting to discover this high risk gene for ovarian cancer.

“It’s further evidence that a range of different high risk genes are causing the development of breast and ovarian cancer and we hope there are more waiting to be discovered in different cancers.

“We believe the results of this research will help inform personalised treatment approaches and give doctors better information about risks of cancer to tell patients.”

About 10 per cent of the 6,500 new cases of ovarian cancer every year are estimated to be in those with “a strong family history” of the disease, said Annwen Jones, chief executive of the charity Target Ovarian Cancer.

She said: “This new information, in the future, could help more women with a family history understand their personal risk of developing this disease.”

Survival rates for ovarian cancer remain poor compared to other types. While 92 per cent of breast cancer patients now survive for at least five year from diagnosis, for ovarian cancer only about four in 10 do.

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