Staff shortages are threatening the NHS | Letters

The recruitment crisis shows just how badly the government is managing the NHS (Report, 4 February). The proportion of doctors joining specialist training in the UK – including general practice – has fallen for the fifth year running, with just over 50% of doctors who completed the foundation programme going on to enter British specialist training – compared with 71% in 2011, according to the figures from the UK Foundation Programme Office.

GP recruitment has slumped by 20% and a recent report by the National Audit Office warned that poor access to GPs during the working day could be fuelling Britain’s A&E crisis. It said that rising numbers of patients are being forced to wait a month to see a family doctor, with estimates of a shortage of up to 10,000 GPs by 2020.

Almost every hospital in the UK has a shortage of nurses, but the government has confirmed plans to end bursaries for student nurses and midwives from next year. At the same time the number of nurses from Europe registering to work here since the Brexit referendum has fallen by 90%. Janet Davies, chief executive of the Royal College of Nursing, said: “If this is the beginning of a long-term drop in the number of nurses coming to the UK from other parts of the EU, that’s a serious concern at a time when we’re already facing a crisis in nurse staffing numbers. With 24,000 nursing vacancies across the UK, the NHS could not cope without the contribution from EU nurses. Without a guarantee that EU nationals working in the NHS can remain, it will be much harder to retain and recruit staff from the EU.”

Without staff the NHS cannot function effectively and the march towards privatisation will become unstoppable.
Dr Richard Turner
Harrogate, North Yorkshire

• The government was warned when it removed nursing bursaries it was risking the future of our NHS. Now the reality is becoming clear – fewer people willing to train to work in our hospitals, putting our health system under even greater strain. We already have a huge shortfall in nursing staff, and now the government is making it even worse. At the same time, the government’s half-baked plans to crack down on EU immigration have left 10% of those working in our NHS in limbo. The government cannot go on telling people it cares about the future of the NHS while it cuts support for training, stands by while nurses’ salaries suffer a massive drop in real terms and allows spending per person to sink to dangerous levels.
Norman Lamb MP
Liberal Democrat health spokesman

• As cancellations, delays, and rationing of non-urgent surgery increase in the NHS (1,700 face long surgery delays amid cash crisis, 3 February) the government remains surprisingly unfazed. But if, as I assume, most of its members would buy themselves out of trouble through private medicine, why not?
Michael Sheldon
Norwich

• Join the debate – email guardian.letters@theguardian.com

• Read more Guardian letters – click here to visit gu.com/letters

Staff shortages are threatening the NHS | Letters

Two children suffer life threatening overdose from playing with painkilling skin patches

One child had stuck two patches onto their own skin thinking they were sticking plasters and another fell unconscious showing signs of an opiate overdose after picking at a patch on a user’s arm.

Both were successfully treated for opiate overdose and recovered.

Dr Sarah Branch, Deputy Director of Vigilance and Risk Management of Medicines, said: “It is extremely important when applying a fentanyl skin patch that people check that they are stuck on securely. A patch may cause serious harm if it accidentally sticks to somebody else’s skin or is swallowed.

“The used patch should be folded in half so that the adhesive side sticks firmly to itself. It should then be safely thrown away in a secure bin so that it is not picked up by young children.

“If a patch is transferred to another person, remove it and get medical help immediately. If a patch is swallowed, get medical help immediately.

“People who use fentanyl patches should be careful to keep them out of the reach and sight of children and dispose of them carefully.”

Children are more likely to suck, chew or swallow the patches and have a lower threshold for overdose than adults, it was warned.

Doctors were told to inform patients that if a patch is transferred to another person, it should be removed and the individual should get medical help immediately. If a patch is swallowed, the individual should get medical help immediately.

Two children suffer life threatening overdose from playing with painkilling skin patches

Two young children suffer lifestyle threatening overdose from playing with painkilling skin patches

One child had stuck two patches onto their own skin thinking they were sticking plasters and another fell unconscious showing signs of an opiate overdose after picking at a patch on a user’s arm.

Both were successfully treated for opiate overdose and recovered.

Dr Sarah Branch, Deputy Director of Vigilance and Risk Management of Medicines, said: “It is extremely important when applying a fentanyl skin patch that people check that they are stuck on securely. A patch may cause serious harm if it accidentally sticks to somebody else’s skin or is swallowed.

“The used patch should be folded in half so that the adhesive side sticks firmly to itself. It should then be safely thrown away in a secure bin so that it is not picked up by young children.

“If a patch is transferred to another person, remove it and get medical help immediately. If a patch is swallowed, get medical help immediately.

“People who use fentanyl patches should be careful to keep them out of the reach and sight of children and dispose of them carefully.”

Children are more likely to suck, chew or swallow the patches and have a lower threshold for overdose than adults, it was warned.

Doctors were told to inform patients that if a patch is transferred to another person, it should be removed and the individual should get medical help immediately. If a patch is swallowed, the individual should get medical help immediately.

Two young children suffer lifestyle threatening overdose from playing with painkilling skin patches

Mothers and fathers of severely unwell toddler threatening "legal action to keep her alive"

Her dad and mom dread this would imply she would die and stated they have been taking into consideration legal action to keep her alive.

Ms Beilby, from Wigan, explained she was extremely stressed and only desired the greatest for her daughter.

“If Amelia has a sudden deterioration due to the fact of a treatable cause, we want the greatest for her and the chance to get back to how she is now.”

The 29-year-outdated mom said medical doctors agreed the toddler was steady for seven months and not had repeat pneumonias.

The mother said she and her partner then asked that physicians assistance Amelia by way of an acute event like infection or seizure while they deal with it with the knowledge she would return to the condition she is in now.

“Mimi has a very good top quality of daily life – she smiles at me, she tends to make noises in a communicative manner and she isn’t requiring discomfort medicine apart from when she’s teething,” Ms Beilby mentioned.

The mothers and fathers declare the ruling has yet to be confirmed in writing but they are fearful of what may possibly take place in the future.

Despite the parents’ fears, when Amelia stopped breathing on Monday, she was sent to ICU and offered additional breathing assistance.

The mom explained: “As it stands, the daily life plan is being adjusted to say that based on the situation and cause, ICU is not completely ruled out.

“But the ethics committee ruling nonetheless stands,” she claimed.

“I have no notion what is going to come about nonetheless but we are still talking with the medics and I’m presently nonetheless only receiving legal suggestions in excess of the cellphone.”

A spokesman for Alder Hey mentioned it was unable to comment on person cases.

“We recognize that this is a extremely sensitive case and we carry on to liaise closely with the family concerned.

“For every child a care plan is talked about in full with the family members prior to an agreement is reached about the most appropriate ongoing care essential for that little one. If an agreement are not able to be reached, the situation is taken just before a High Court to allow a judge to make a decision.”

Mothers and fathers of severely unwell toddler threatening "legal action to keep her alive"

Obamacare Much less Threatening To Private Employer Employing

The Cost-effective Care Act appears to be “weighing much less heavily” on plans of privately held firms to employ staff than it was a year ago, according to a survey of accountants asked about their organization clients plans for the subsequent twelve months

While U.S. personal firms nevertheless fret about the law’s affect and more than half of companies, or 54 %, saying they are “less very likely to hire” simply because of the ACA, the worries are a lot less than the two-thirds of private companies who stated final 12 months that they were less probably to hire, according to  Sageworks, a firm known for its evaluation of privately held companies.

Small to medium-sized firms that tend to be privately held have bemoaned the so-referred to as “employer mandate” which needs employers with far more than 50 staff to provide well being benefits. In the Sageworks evaluation, the vast majority of the employers, or more than 80 %, are smaller businesses with annual income of less than $ 10 million.

Considering that last year’s Sageworks survey, the Obama administration earlier this yr delayed enforcement of a federal requirement for employers with far more than 50 employees to supply health insurance coverage to their employees. As part of the delay, employers with 100 or much more employees will have more time dependent on the percentage of full-time staff they have. Businesses with 50 to 99 employees have until 2016 to offer wellness insurance coverage to their employees previously the deadline had been extended to  Jan. 1, 2015. Employers with fewer than 50 workers were currently exempt from the mandate.

The delay could be putting at least some employers far more at ease with employing. Some employers are even ramping up employing.

The percentage of privately held companies that stated they would more very likely to employ more than doubled to five.four % this 12 months compared to two percent last year when Sageworks polled employers more than the summer season. The new survey was performed in April and May of this 12 months of more than 500 accountants.

 Pondering how Obamacare will affect your health care? The Forbes eBook Within Obamacare: The Fix For America’s Ailing Overall health Care Program answers that question and much more. Available now at Amazon and Apple.

English: President Barack Obama’s signature on the well being insurance reform bill at the White Property, March 23, 2010. The President signed the bill with 22 various pens. (Photo credit score: Wikipedia)

Obamacare Much less Threatening To Private Employer Employing

India admits Delhi matches Beijing for air pollution threatening public wellness

Kids safeguard their faces from Delhi’s smog. The WHO explained Delhi had an average PM2.5 level of 153 – London’s is a tenth of that. Photograph: Hindustan Occasions/Getty

India’s state air monitoring centre has admitted that pollution in Delhi is comparable to that of Beijing, but disputed a World Health Organisation (WHO) obtaining that the Indian capital had the dirtiest environment in the globe.

A examine of one,600 cities across 91 nations released on Wednesday by the WHO showed Delhi had the world’s highest annual average concentration of tiny airborne particles (acknowledged as PM2.5) of 153.

These really fine particles of less than 2.5 micrometres in diameter are linked with enhanced charges of continual bronchitis, lung cancer and heart condition as they penetrate deep into the lungs and can pass into the bloodstream.

Indian officials in the past have bristled at study showing the capital as getting worse than Beijing where thick smog has triggered public overall health warnings and public concern that are mainly absent in Delhi.

“If we assess yearly averages for each yr from 2011-2014 then both cities [Delhi and Beijing] are nearly comparable,” Gufran Beig from India’s state-run Method of Air Quality Weather Forecasting and Study (SAFAR) acknowledged in an email sent to AFP.

He disputed the figure cited by the WHO for PM2.five in Delhi, even so, saying it ought to have been in the range of 110-120 micrograms per cubic metre rather of 153.

Beijing’s was underestimated at 56, he explained, and must have been double this, according to an analysis of readings given out by the US embassy in the city.

“Delhi’s air top quality is much better than Beijing in summertime and considerably greater in monsoon season,” he additional. “It is winter pollution in Delhi and sudden spikes – which is fairly higher as in contrast to Beijing – triggered by meteorology.”

Beig maintained that the WHO figures contained in a searchable database released on Wednesday have been biased and misleading.

But even with an yearly typical PM2.five reading of 110-120, Delhi would nonetheless be among the world’s most polluted cities, if not the outright worst.

Rivals would be the Pakistani city of Karachi with an yearly studying of 117, while the regional Indian cities of Gwalior, Patna and Raipur reported 144, 149 and 134 respectively.

By comparison, London had an annual PM2.5 reading of 16.

“The most recent urban air-good quality database released by the Planet Well being Organisation reconfirms that most Indian cities are turning into death traps since of quite high air pollution ranges,” stated an Indian campaign group, the Centre for Science and Environment.

The centre explained that 13 of the 20 most polluted cities in the planet have been in India.

The tiny particles blighting the air of Delhi and other leading establishing cities around the globe are often dust from building websites, pollution from diesel engines or industrial emissions.

The Indian capital also suffers from atmospheric dust blown in from the deserts of the western state of Rajasthan, as properly as pollution from open fires lit by the urban poor to hold warm in winter or to cook foods.

Even though Delhi ranked as worst on the PM2.five scale in the WTO information, measurements of bigger PM10 particles showed other individuals as far a lot more polluted.

Peshawar and Rawalpindi in neighbouring Pakistan trumped all other cities with readings of 540 and 448 respectively. WHO says concentrations of PM10 particles must stay beneath twenty micrograms per cubic metre, averaged out above the yr.

Delhi has had its air high quality underneath scrutiny for some time now with investigation by Yale University scientists in January this yr also suggesting that it was worse than Beijing.

A Globe Financial institution report last 12 months that surveyed 132 nations ranked India 126th for environmental overall performance and worst for air pollution.

The WHO stressed that its new air pollution database, which relies largely on information gathered by the cities themselves, did not aim to rank cities, pointing out that “some of the worst ones … are not collecting data often.”

India admits Delhi matches Beijing for air pollution threatening public wellness