NHS failing to learn from mistakes, says ombudsman Dame Julie Mellor

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Created on Friday, 20 April 2012 00:00

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Hospitals told to be 'more like John Lewis and M&S' days after damning report into death of man with diabetes

James Meikle

A health watchdog has criticised the NHS for failing to learn from its mistakes, days after a damning report into the death of a man with diabetes who suffered poor care at a hospital where staff appeared to have deliberately tried to cover up failings.

Dame Julie Mellor, the parliamentary and health service ombudsman for England, told the Financial Times the NHS and other public service providers should act "more like John Lewis and Marks & Spencer" in learning from complaints.

Earlier this week, Peter Tyndall, the public services ombudsman for Wales, said he found a lack of detail in medical records and "dubious" completion of a blood-sugar monitoring chart for David Joseph, who died more than three years ago.

{sidebar id=11}Tyndall was speaking after his investigation of the Joseph family's complaint against Bronglais hospital, Aberystwyth. His verdict has implications for the NHS – as an ageing population means more people have long-term conditions that need monitoring while they are treated for apparently more urgent problems.

Joseph's daughter, Rowena Jones, a nurse at another hospital governed by the Hywel Dda health board, said: "I've worked in the NHS all my life. I love the NHS but I'm not prepared to defend poor record-keeping, poor nursing, poor management and lying." Her 86-year-old mother, a former nurse, had been devastated.

It was the second time in three years that Bronglais staff had been criticised by the ombudsman for poor record-keeping and alleged falsification – the other, when it was under different management, involved the transfer of a patient to another hospital.

Tyndall said: "I am concerned at the number of cases I see where proper monitoring of a patient's condition has not been undertaken. Then there are cases where even when monitoring has been undertaken, it has not been properly recorded. In other cases, monitoring has been undertaken and properly recorded, but then the results of the recordings are not acted upon."

Mellor recently succeeded Ann Abraham as ombusdman for England. Her office said: "Since 2010 to date, we have seen several recurrent issues in complaints that have been brought to us to look into. The top 10 complaint causes include poor records management, clinical care and treatment and failure to diagnose." But the key theme from her report, Listening and Learning 2010-11, was poor communication, including when authorities handled complaints.

The Department of Health in England is considering introducing a "duty of candour" which would demand NHS providers be open with patients when things go wrong with their healthcare. There are no such plans in Wales.

Tyndall's report said Joseph had a hypoglycaemic attack, caused by low blood sugar levels, to which the hospital's failings contributed. The attack had an "unspecified causal effect" on his subsequent cardiac arrest and deterioration, that left him needing 24-hour nursing care. He died, aged 81, in April 2009, days after being discharged to a nursing home.

Staff were not vigilant in recording information about his diabetic regime or blood sugar levels and there appeared, Tyndall reported, "to be a false blood sugar reading added retrospectively to the record". The hospital's response to the family was "thin and protracted".

The report added: "Diabetes is a fast growing disease. Increasing numbers of people will be admitted to hospital with acute conditions, whilst suffering from diabetes.

"It is crucial that nursing staff operated a patient centred approach, follow medical direction, monitor patients carefully and have the knowledge to underpin the care they provide."

Joseph, a former regional director of the Open University, had five children and 14 grandchildren.

Tyndall said the health board should pay the family £1,700 for the uncertainty and distress over how the failings might have led to Joseph's death and the timetaken to pursue their complaint.

Jones, a paediatric oncology nurse, said she had "a pretty shrewd idea of what happened to my father", despite the family being "fobbed off" by the health board. She broke the family's anonymity because of the wider implications of the case.

"My father had mild Alzheimer's and I know there would have come a time when we had to make decisions about where he lived and where we cared for him."

But the day before he was admitted to hospital, he had showered and dressed himself, had breakfast, walked the dog and had a long phone conversation. "He was left bewildered, incontinent and immobile."

She wants meetings with ministers in Cardiff and London to stress the importance of stronger clinical leadership in treating diabetes and ensuring NHS managements are more forthcoming when things go wrong.

Caroline Oakley, director of nursing and midwifery at the health board, apologised to Joseph's family.

"Since 2008, when this incident occurred, we have put in place numerous measures, including extra training for nurses in diabetes care and a review of the blood monitoring equipment," she said.

"We are committed to ongoing improvements, specifically for the growing number of patients living with chronic conditions, to ensure that we provide a patient-centred approach for every individual in our care."

She added: "The health board takes seriously any allegation of breaches of professional standards and will always investigate these as it did with the previous case. All nursing staff have been reminded of the professional standards expected of them by the health board and their professional body, the Nursing and Midwifery Council."

Source: Guardian UK, 20 April 2012

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Cholera Outbreak: 19 Deaths Recorded, Spreads To Eastern Region

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Created on Friday, 13 April 2012 00:00

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Cholera Outbreak: 19 Deaths Recorded, Spreads To Eastern Region

The death toll from the Cholera outbreak in the capital has risen to 19 with one thousand two hundred cases being recorded. Health officials have warned that the cases could increase if individuals do not take care of themselves.

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Doctors turn on No 10 over failure to curb obesity surge

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Created on Sunday, 15 April 2012 00:00

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Doctors turn on No 10 over failure to curb obesity surge

Major food and drinks firms fuel crisis with irresponsible marketing, claim doctors, who call for ban on fast-food sponsorship deals.

Denis Campbell and Daniel Boffey

The body that represents every doctor in the country has launched an unprecedented attack on the coalition government's failed strategy to tackle an obesity epidemic in the UK.

The Academy of Medical Royal Colleges demands "bold and tough" measures to put an end to the role of "irresponsible marketing" by major food and drinks firms in fuelling the crisis. It calls on the health secretary, Andrew Lansley, to ditch the government's "inherently flawed" approach, which trusts the industry to voluntarily cut calories, reduce portion sizes and advise the public on healthy eating.

Instead, the academy's vice-president, Professor Terence Stephenson, says the government must take on the major brands, some of which he likens to the tobacco giants of the last century that stalled radical measures designed to save lives in order to protect their profits.

{sidebar id=11}According to the latest research, 48% of men and 43% of women in the UK will be obese by 2030, a trend that will significantly increase the prevalence of strokes, heart disease and cancer, and lead to higher costs for the NHS. The academy, an umbrella organisation for the medical royal colleges and their 200,000 members, demands:

■ A ban on firms such as McDonald's and Coca-Cola from sponsoring major sports events such as the Olympics.

■ A safe area around schools where fast-food outlets are not allowed.

■ A prohibition on the use of celebrities or cartoon figures to sell unhealthy food and drink to children.

■ A legal obligation on all food and drink manufacturers to publish on their products clear guidelines about the amount of calories, sugar, fat and salt.

■ Consideration of "fat taxes" similar to those being implemented in Scandinavia, designed to penalise the buyers of food and drink high in salt, sugar and fat.

Stephenson said the academy was speaking out as it launched an investigation into what can be done to curb the rise in obesity. It will spend six months researching the causes and effects of obesity, and in the autumn will produce a report that will contain far-reaching recommendations for action.

Charlie Powell, campaigns director of the Children's Food Campaign, applauded the academy's intervention. He said: "Andrew Lansley should act on this excellent set of robust recommendations, but his track record suggests that he will once again ignore the advice of our best medical experts."

Speaking to the Observer, Stephenson said urgent action, similar to that undertaken to reduce smoking over the past two decades, was necessary to deal with a society that he defined as "obesegenic" – an environment that positively encourages the gaining of weight.

Stephenson, who is also president of the Royal College of Paediatrics and Child Health, which represents the UK's 11,000 children's doctors, said: "What can you do about this obesegenic environment we live in? The fact that Coca-Cola and McDonald's are two of the big corporate sponsors of the Olympic Games is most unhelpful. One of the biggest events we're ever going to see in the UK, all those people watching TV and going through the doors will be seeing this. People must be influenced by it, or why would Coca-Cola spend a lot of money to be at the Olympics?"

A major part of the government's strategy to deal with obesity and drink-related problems has until now been "responsibility deals" in which the major food and drink brands have been asked to voluntarily curb their excesses and use their influence to encourage healthier living.

The health secretary has been a strong supporter of the policy, but Stephenson said it was a mistake. "I think a lot of people would draw analogies with smoking, where the smoking industry for many years seemed to actually fight what was to doctors clearly a growing, important public health issue for individuals. And that's where their profits come from and they sometimes, by appearing to go along with these ideas, they actually stall or prevent more aggressive measures.

"Doctors think it's inherently unlikely that huge companies that make money from selling high-calorie foods and drinks, like McDonald's and Coca-Cola, are going to persuade their customers [to eat more healthily]. It's like asking the petrol companies to say to people, 'why not go on your bicycle?'. It just does not seem likely that's going to happen."

Stephenson also voiced concern that Carling, the beer company, is the title sponsor of the English Football League's Carling Cup. He said: "For adults, beer is a source of calories. I like going to a football match and drinking beer, but it's the high-profile sponsorship that means that every time we mention this trophy, we mention in the same words Carling Cup."

In criticism of other promotional tactics, Stephenson said he was "concerned" that characters from children's films are used to help sell fast food.

Barbara Gallani, director of food safety and science at the Food and Drink Federation, the body that represents the interests of the UK's food and non-alcoholic drinks manufacturers, said the academy was wrong to dismiss the benefits of partnerships between food and drink brands and sports events, although she agreed some action was needed.

She said: "Food manufacturers have a good track record of making positive contributions to improving public health through a wide range of actions, whether it's developing healthy choices, reformulating recipes of some of the nation's favourite foods, or working to improve the food literacy of consumers."

A spokesman for Coca-Cola said: "Without the support of sponsors such as Coca-Cola as many as 170 of the 200 national Olympic committees would be unable to send athletes to compete."

A Department of Health spokesman said the government was committed to identifying the best possible evidence of what works in tackling obesity.

Source:The Guardian UK, 14 April 2012

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What Are Vitamins? What Vitamins Do I Need?

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Category: Dine & Wine

Created on Wednesday, 11 April 2012 00:00

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What Are Vitamins? What Vitamins Do I Need?

Vitamins are organic compounds which are needed in small quantities to sustain life. We get vitamins from food, because the human body either does not produce enough of them, or none at all. An organic compound contains carbon. When an organism (living thing) cannot produce enough of an organic chemical compound that it needs in tiny amounts, and has to get it from food, it is called a vitamin.

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