NHS and medical watchdog tried to suppress scandal over vaginal mesh implants

NHS bosses and the watchdog that oversees medical devices tried to limit public exposure of the scandal over vaginal mesh implants that have harmed hundreds of women.

Minutes of a meeting held in October 2016 show that NHS England and the Medicines and Healthcare Products Regulatory Agency agreed to “avoid media attention” over the implants, despite the fact they were seeking to encourage patients to report any complications.

The document, obtained by the Press Association, records an agreement to “take the press element out” of the “yellow card” campaign to record adverse reactions experienced by vaginal mesh patients, suggesting that it could be folded into a wider effort, “of which mesh is one element, to avoid media attention on mesh”.

The apparent cooperation between NHS England and the MHRA to minimise media focus on the debilitating problems increasingly associated with the implants appears to breach the NHS’s duty – reiterated regularly by health secretary Jeremy Hunt – to be open and transparent over patient safety failings.

NHS England and the Department of Health both refused to comment on the minutes of the meeting.

One possible reason for the NHS to want to limit exposure of the issuecould be to reduce the number of potential lawsuits faced by the health service.

More than 800 women are suing the NHS and the manufacturers of vaginal mesh implants after suffering serious complications, it emerged this week. Some women reported that implants had cut into their vaginas, with one woman saying she was left in so much pain that she considered suicide. Others have been left unable to walk or have sex, according to the BBC.

Vaginal mesh implants are used to treat incontinence after childbirth or pelvic organ prolapse, where the womb or bladder bulge against the walls of the vagina. Between 2006 and 2016, more than 11,000 women in England were given the implants to treat prolapse or incontinence, NHS data shows.

Around 11%-12% of users have reported problems, while lawsuits in the US have already seen around $ 2bn (£1.5bn) paid to affected women.

Campaigners say that hundreds more women have come forward after learning of the group planning to sue.

Kath Sansom, who runs the campaigning website and Facebook group Sling the Mesh, says the number of women contacting her has risen from a few people a day to more than 200 in the past 24 hours.

“It’s always the same story,” she said. “There are so many women who were told it was just them, that they were a one-off. They can’t believe there are others out there. So many people are told it’s back pain, endometriosis, gall bladder pain, scar tissue. And so many of them accept it, you trust medical professionals.”

Data from the MHRA, which has been looking at the issue since 2011 following complaints from women, shows more than 1,000 adverse incidents have been reported in the past five years.

Despite the problems that have emerged the MHRA insists that the best current evidence supports the continued use of the implants to resolve health conditions that could themselves cause serious distress to patients.

A report into the issue from a working party led by NHS England admits there is a huge lack of data on complications from the devices. Published studies on mesh implants do “not tell the whole story” and there are gaps in NHS knowledge about their safety, it added.

NHS and medical watchdog tried to suppress scandal over vaginal mesh implants

No cancer risk to using glyphosate weedkiller, says EU watchdog

A controversial chemical used in Monsanto’s Roundup weedkiller has been judged safe for public use by the European Chemical Agency (Echa).

Glyphosate has been the subject of a relicensing battle which split governments, regulators and scientists, with one arm of the World Health Organisation linking the substance to cancer, while another denied any risk.

Echa was asked to assess its toxicity after EU countries failed to agree on a reauthorisation for the best-selling herbicide last summer, despite a positive recommendation from the European Food Safety Authority.

Today, the agency decided that “the available scientific evidence did not meet the criteria to classify glyphosate as a carcinogen, as a mutagen or as toxic for reproduction”.

“This conclusion was based both on the human evidence and the weight of the evidence of all the animal studies reviewed,” Tim Bowmer, the chairman of Echa’s Committee for Risk Assessment, said in an online briefing.

A classification that glyphosate causes serious eye damage and is toxic to aquatic life will remain in place. The controversy over its health and environmental effects though, looks set to rumble on.

The new Echa opinion now faces an internal check before it is submitted to the European commission which will restart EU discussions so that a final decision can be reached by the end of the year.

“This is not the end of the process,” a commission spokesperson said.

The Echa team responsible for the study was itself accused of conflicts of interests by Greenpeace, as several of its members had either undertaken consultancy work for chemical firms, or worked for institutes that had.

Greenpeace EU’s food policy director, Franziska Achterberg, said: “Echa has gone to great lengths to sweep all evidence that glyphosate can cause cancer under the carpet. The data vastly exceeds what’s legally necessary for the EU to ban glyphosate, but Echa has looked the other way.”

Industry groups heartily welcomed the assessment. “Science prevailed,” said Graeme Taylor, of the European Crop Protection Agency. “Glyphosate is not carcinogenic. We expect the European commission to move swiftly with the registration process for the substance in the EU and grant a 15-year approval.”

Just hours before today’s ruling was announced, unsealed documents in a long-running US federal suit by non-Hodgkins lymphoma sufferers raised new questions about Monsanto’s relations with Environmental Protection Agency (EPA) regulators.

These suggested that the US agriculture giant was given a heads up by Jess Rowland, an EPA deputy division director, about an International Agency for Research on Cancer report linking glyphosate to cancer, allowing it to mount a pre-publication PR offensive. Rowland also allegedly told a Monsanto executive that he would try to prevent a separate government probe of glyphosate, saying: “If I can kill this, I should get a medal.”

In a statement in the New York Times, Monsanto said: “Glyphosate is not a carcinogen.” Monsanto also rebutted criticisms concerning the academic research it underwrites.

Other documents revealed in the US suit include an extraordinary letter from Marion Copley, an award-winning EPA scientist, who said it was “essentially certain” that glyphosate caused cancer.

Copley, who was herself dying of cancer, made several conflicts of interests allegations.

“I have cancer and I don’t want these serious issues in HED [health effects division] to go unaddressed before I go to my grave,” she wrote in her valedictory letter. “I have done my duty.”

Almost half a million people have signed a petition, started in February, calling for a European ban on glyphosate, regulatory reform and mandatory targets for reducing pesticides use.

If the number of signatories reaches a million, the European commission will have to consider a legislative proposal under its citizen initiative rules.

No cancer risk to using glyphosate weedkiller, says EU watchdog

Children should be taught how to wash hands, says watchdog

Children and young people need to be taught how to wash their hands properly to reduce the risk of infection, a UK medicines watchdog has advised.

The National Institute for Health and Care Excellence (Nice) said good handwashing and drying techniques should be encouraged to help lower the likelihood of spreading germs and therefore limit the use of antibiotics.

The guidance also calls for teenagers attending university to be taught how to care for themselves if they contract a “self-limiting illness” such as cold or flu.

The charity Meningitis Now warned that first-time students, who were often vulnerable to contracting the potentially deadly illness, must be vigilant over their symptoms because meningitis could easily be mistaken for cold or flu.

Health authorities across the world are trying to reduce antibiotic use to slow the growth of antimicrobial resistance.

The Nice guidance says university students should be shown how to identify illnesses that will get better on their own. They should also be encouraged to use pharmacies, the 111 helpline and the NHS Choices website, it said.

The watchdog recommends that posters be displayed around campus explaining how to wash hands effectively.

Similarly, children at nurseries and schools should be taught good hygiene, particularly after going to the toilet, before eating and after being in close contact with people with colds or other infections, Nice said.

Liquid soap and tepid running water should be used to clean hands after touching a bin.

Other measures to reduce the risk of illness include ensuring food and leftovers are stored in the fridge, cooked at the right temperature and properly heated through.

Prof Dame Sally Davies, the government’s chief medical officer, said: “We need to address the growing problem of drug-resistant infections as the global medicine cabinet is becoming increasingly bare.

“Preventing infections is key and so is education on how to use antibiotics appropriately. This guidance provides important information on how we can keep these important medicines working.”

Rachel Robinson, acting chief executive at Meningitis Now, said good hand hygiene was needed to combat disease but warned of the dangers of self-diagnosis.

“Asking people to self-diagnose and take a view on the seriousness of their illness is a difficult area,” she said. “While meningitis is a relatively rare disease, its early symptoms, such as fever, headache or vomiting, can easily be … misdiagnosed, even by medical professionals.

“People with meningitis can get a lot worse very quickly and we know rapid diagnosis and treatment significantly improve outcomes. We wouldn’t want people to think they should try to manage this themselves.”

Children should be taught how to wash hands, says watchdog

Plans for seven-day GPs not thought out, says spending watchdog

Whitehall’s spending watchdog has criticised government plans to let patients see GPs every day of the week as poorly planned and likely to cost much more than weekday family doctor services.

In a new report, the National Audit Office said that Jeremy Hunt has set targets for rolling out the scheme – a key Conservative pledge – without evaluating the cost or working out where the money for it would come from.

Giving patients access to GPs from 8am to 8pm across the entire week by 2020 was championed by David Cameron while he was prime minister. Ministers also pledged to increase the number of GPs in England by 5,000 by 2020 – promises that have been backed by Hunt and Theresa May .

However, auditors who analysed the pledges found that the minimum additional capacity required by the new commitment equates to £230 per appointment hour at weekends and in the evening for every 1,000 registered patients. In GPs’ core contracted hours, from 8am to 6.30pm, the cost is just £154.

Hunt and the prime minister are under increasing pressure regarding serious problems within frontline services this winter. Ministers have been forced to deny claims by the Red Cross that the service is facing a “humanitarian disaster”.

Dr Chaand Nagpaul, BMA GP committee chair, said the government had been “irresponsible” in making uncosted pledges and must deliver extra investment to ensure patients could receive timely, safe care.

“Given that funding in general practice has failed to meet patient demand, NHS England and commissioners need to fully consider the consequences of their plans to extend access,” he said.

“To proceed without any sort of evaluation into the cost-effectiveness or the consequences of its objectives is irresponsible and could lead to much needed investment being spent on measures which don’t adequately meet patient needs,” he said.

The report, entitled Improving Patient Access, set out to evaluate how the Department of Health (DoH) and the NHS are tackling concerns around access to England’s 42,000 GPs in 7,600 GP practices.

The report found an apparent lack of knowledge within the DoH about the cost of extending GP surgery hours.

“We have not seen evidence that the department and NHS England fully understand the effect of this commitment to extend hours on continuity of care or other arrangements for providing general medical services outside of core hours,” it said.

Auditors, keen to establish the reality of extending opening hours, found that nearly half of all GP practices – 46% – close during core working hours, while 18% closed before 3pm one day a week.

Efforts to increase the workforce are at risk because GPs are leaving the service at a greater rate than they are entering it, thanks to shortfalls in recruitment, the report said.

Health Education England only filled 3,019 (93%) out of a target of 3,250 GP training places in 2016/17, according to auditors.

“The latest available data on part-time working in new GPs suggest there may be 1,900 fewer full-time equivalent GPs by 2020 than Health Education England had estimated there would be,” the report said.

The report sheds light on how patients registered with GP services open for fewer hours than average are more likely to attend accident and emergency departments. It found there were 22 more A&E attendances per 1,000 registered patients [8%] at practices open for 45 hours or less per week, after adjusting for differences in patients’ age and sex.

Meg Hillier MP, the chair of the public accounts committee, claimed that ministers were “trying to shoehorn in seven day access to general practice without a clear idea of the additional costs or benefits it will bring patients or taxpayers”.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said the report “hits the nail on the head” by questioning the cost-effectiveness of forcing GP surgeries to deliver routine services seven days a week.

However, she went on to question why auditors failed to acknowledge the stresses that GPs are under or why surgeries may have to close temporarily during core hours for staff training, patient consultations or home visits.

“If general practice fails, the rest of the NHS collapses behind it. That’s why we urgently need NHS England to deliver in full on the pledges it has promised … swiftly and effectively, and for all governments in the UK to invest properly in the family doctor service, including more GPs,” she said.

The government claims that 17 million patients are already benefiting from evening and weekend appointments.

In response to the report, the health minister David Mowat said evidence shows that extended GP access is helping to relieve pressure on other parts of the health service such as A&E.

“We’re also relieving pressure on GPs by cutting red tape and investing an extra 2.4 bn to recruit 5,000 more doctors – in fact, fill rates for GP training this year were at a record level,” he said.

An NHS England spokesman criticised the NAO report for raising “the rather obvious fact” that it costs more to provide evening and weekend urgent primary care services than it does during Monday to Friday, nine to five.

“The alternative would be that patients simply head to A&E, with all the consequences that brings for more major cases.

“No one is suggesting each individual GP practice should offer this extended access, but there’s quite wide agreement that, as GP numbers expand, practices do need to club together to offer this service, a bit like the out-of-hours duty chemist rota.

“Across much of London, Manchester and a fifth of the country, GPs are already doing this, and more areas will follow next year,” he said.

Plans for seven-day GPs not thought out, says spending watchdog

Watchdog accuses Actavis of hiking price of lifesaving drug by 12,000%

Pharmaceutical company Actavis is facing accusations from the competition watchdog that it hiked the price of life-saving hydrocortisone tablets by over 12,000%, sending the annual cost to the NHS spiralling from £522,000 before 2008 to £70m by 2015.

The Competition and Markets Authority said the price rises took place after the patent lapsed on the drug. About 943,000 packets of the tablets – prescribed to people whose adrenal glands do not produce enough steroid hormones, such as those suffering from Addison’s disease – were distributed over the last year.

As the CMA set out its reasons why the company had broken competition law, the regulator’s senior responsible officer, Andrew Groves, said: “This is a lifesaving drug relied on by thousands of patients, which the NHS has no choice but to continue purchasing.

“We allege that the company has taken advantage of this situation and the removal of the drug from price regulation, leaving the NHS – and ultimately the taxpayer – footing the bill for the substantial price rises,” said Groves.

The watchdog is continuing other investigations into the pharmaceutical sector. The latest allegations come after last week’s £84.2m fine on Pfizer for increasing the cost of an anti-epilepsy drug. The drugs distributor Flynn Pharma was fined £5.2m for charging excessive and unfair prices in the UK for an epilepsy treatment.

Groves said the current findings against Actavis were provisional and that it was too early to conclude there had been a breach of competition law. “The CMA will carefully consider any representations of the parties under investigation before determining whether the law has been infringed,” said Groves.

Actavis – formerly Auden Mckenzie – is facing accusations about the prices of two forms of the hydrocortisone tablets. The CMA said the increase in price to the NHS for 10mg packs rose from 70p in April 2008 to £88 by March 2016 – a 12,000% rise. For 20mg sizes the price rise was 9,500% – increasing to £102.74 per pack by March 2016, compared with £1.07 when the treatment was still branded.

Once medicine and treatments are no longer branded – known as generic medicine – they are no longer subject to price regulation, a move that is usually expected to reduce the cost rather than inflate it.

Actavis did not immediately comment.

Watchdog accuses Actavis of hiking price of lifesaving drug by 12,000%

Hospitals fail too often to investigate deaths, NHS watchdog finds

Hospitals are failing to investigate far too many deaths and frequently ignore and exclude relatives of patients who have died, a major NHS inquiry has found.

The health service’s failure to properly look into deaths is “a system-wide problem” that means hospitals are not learning from their mistakes and thus stopping other tragedies from occurring, its report says.

The Care Quality Commission report, ordered by health secretary Jeremy Hunt, is scathing about hospitals’ shoddy and insensitive treatment of bereaved relatives’ requests for information and to be involved in an inquiry. One relative told the CQC that they encountered “more courtesy at the supermarket checkout” after their loved one’s death.

Prof Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “Families and carers are not always properly involved in the investigations process or treated with the respect they deserve. We found this was particularly the case for families and carers of people with a mental health problem or learning disability which meant that these deaths were not always identified, well investigated or learnt from.”

Prof Sir Mike Richards: ‘Families and carers are not always … treated with the respect they deserve.’ Photograph: John Stillwell/PA

Deborah Coles, director of the charity Inquest, which investigates deaths in custody, said the review of how hospitals respond to deaths had exposed “a defensive wall surrounding NHS investigations, an unwillingness to allow meaningful family involvement in the process and a refusal to accept accountability for NHS failings in the care of its most vulnerable patients”.

The CQC, the care watchdog for England, intends to overhaul how hospitals look into unexpected patient deaths or deaths owing to mistakes by staff. Investigations in future should be more thorough, more open and involve families much better, it promised.

Hunt told the CQC to undertake the inquiry after it emerged that Southern healthcare NHS foundation trust only investigated 1% of all deaths among patients with learning disabilities over a four-year period and even fewer – 0.3% – of those with mental health problems.

A review group the CQC set up to assess hospitals’ procedures said any relative should be told how and why their loved one had died.

“Yet throughout the review process we have heard from families who had to go to great lengths themselves to get answers to these questions, who were subjected to poor treatment from across the healthcare system and who had their experiences denied and their motives questioned,” said Dr George Julian, the regulator’s special adviser on family and carer experience. This was particularly the case for relatives of patients who had had either a mental health problem or learning disabilities.

One parent told the CQC: “I was put in a room. I shall never forget what the nurse in the room told me. She said, ‘You have got to accept that his time has come.’ Bearing in mind my son was just 34 years old.”

Katherine Murphy, the chief executive of the Patients Association, said the report confirmed that too many hospitals did not honestly and openly investigate complaints from relatives. “These families have already lived through heartbreaking times – watching their loved one pass away – and they simply should not then be treated with so little respect and consideration,” she said.

The review team based their findings on assessing how 12 NHS trusts responded to unexpected or unusual patient deaths or deaths where errors had occured, discussion with more than 100 families and a survey of all NHS trusts in England.

When the team reviewed 27 investigations hospitals had undertaken they found that the families’ views had been taken onboard in just three cases. Many relatives were not kept informed about how investigations were progressing, often causing further distress.

The Academy of Medical Royal Colleges, which represents doctors, will help the CQC draw up an agreed system for investigating unusual deaths. Coles said a truly independent investigation framework was needed to tackle head-on the dangerous systems and practices which were “costing people’s lives”.

Problems the CQC found included families’ involvement in investigations being merely “tokenistic”, the views of NHS staff being given greater weight than that of relatives and hospitals seeing family members as “antagonistic” if they sought too much information or involvement.

Hospitals fail too often to investigate deaths, NHS watchdog finds

Watchdog puts "unsafe" Cornwall care homes in special measures

Elderly people have been living in “grim, shoddy and unsafe” conditions in four care homes run by a private company in Cornwall, the health and social care watchdog has found.

Residents of the Morleigh Group homes lay in urine-soaked bedclothes, sat in chairs for hours with plates of unfinished food in front of them and waited weeks to receive medical attention, the Care Quality Commission said.

Publishing reports on the four homes on Friday, the CQC said all the homes had been rated inadequate and placed into special measures after separate inspections.

Andrea Sutcliffe, the chief inspector of adult social care, said:“These reports make horrifying reading – people in distress being ignored by staff; a person lying in a urine-soaked bed for two hours; people sat in the same chair all day with uneaten meals in front of them, and no help to eat or drink; someone needing medical attention waiting weeks to be referred to their GP.

“These and so many other examples show why we have rated each of these homes as inadequate and are taking further action to protect the safety and welfare of the people living there.”

Clinton House nursing home, in St Austell, closed earlier this month after an undercover investigation by BBC’s Panorama.

The CQC reports concluded:

• At Clinton House, there were not always enough staff on duty. Inspectors noticed one person in distress and crying for 90 minutes while staff walked by three times without speaking to the person to find out if they needed anything or to comfort them. The management of medicines was not robust. One person had not been given one of their prescribed medicines for three days. Inspectors had to intervene when one person – who had previously been assessed as being at risk of falls – was left unattended and nearly fell out of their wheelchair.


• At Elmsleigh care home, in Par, inspectors found one person who suffered from incontinence and was at risk of pressure sores, but was not routinely turned or checked by staff. Records showed that for several days the person often received no personal care – exposing them to the risk of urine burns to their skin. People sitting in the same seat all day, with their meals left in front of them uneaten, even though most needed encouragement to eat. Some appeared not to realise it was mealtime. Some people had sustained substantial weight loss but it was not clear what action had been taken to help them maintain a healthy weight.


• At Collamere nursing home, in Lostwithiel, inspectors witnessed people with dementia calling out repeatedly for some time with no response. One person shouted throughout the day and night. It was only after the inspection that their GP was asked to review their pain relief – and then they appeared to sleep without signs of distress.


• At St Theresa’s nursing home, in Callington, inspectors identified one person who had pressure sores, but had not been repositioned for eight hours. There had been a delay of five days in seeking appropriate specialist advice. Medicines were not being managed safely, the premises and equipment were not being maintained, and the collection of soiled laundry from bedrooms and cleaning procedures did not ensure suitable standards of cleanliness.

Sutcliffe added: “These services were providing grim, shoddy and unsafe care – the sort that no one should ever have to put up with. I am sorry that people have had to endure this poor level of care.”

The CQC said the Morleigh Group, which is family owned, had been supported by Cornwall council and the NHS Kernow clinical commissioning group to make improvements. But it said the company had failed to listen.

CQC inspectors visited Collamere on 10 October in response to concerns about the service. They visited Elmsleigh on 25 October to follow up on improvements required by a previous inspection. Planned inspections of Clinton House and St Theresa’s were brought forward following information received from Panorama.

The BBBC investigation included undercover filming showing one nurse threatening to give morphine to a resident “to shut her up”.

Panorama

Watchdog puts "unsafe" Cornwall care homes in special measures

Government scolded by watchdog over NHS funding claims

The watchdog overseeing how ministers use official statistics has told the government to be clearer and more exact in its claims about NHS funding after it investigated Theresa May’s contentious claim that she was giving the health service a £10bn boost.

The UK Statistics Authority looked into the prime minister’s repeated use of the £10bn claim after Labour and the British Medical Association complained that the figure was misleading and wrong. It has asked the Treasury to overhaul how government spending on both the NHS and health more widely is presented in order to minimise the risk of further “confusion” about the size of budget rises.

The UKSA’s intervention followed an increasingly public disagreement between May and Simon Stevens, the chief executive of NHS England, over how much extra funding the government had pledged to give the health service over the course of this parliament. May has put the figure at £10bn in the House Commons, a newspaper interview and at the Conservative party conference. She said that sum meant her administration was giving the NHS more money than the £8bn it had asked for in 2014 in order to transform how it works and close a £30bn budget gap by 2020.

Jon Ashworth, the shadow health secretary, accused the prime minister of exaggerating the true sum and using “spin” to try to present the government in a better light over the NHS. Dr Mark Porter, chair of the BMA’s ruling council, had also asked the UKSA to look into May’s claim.

In 2015, then chancellor George Osborne said the NHS in England would receive £8bn more between 2016-17 and 2020-21. But the Conservatives began saying they were giving it £10bn soon after they won last year’s general election. The larger figure comes from adding in the £2bn boost the NHS received in 2015-16 and was already announced by the time Osborne made his pledge.

Ed Humpherson, the UKSA’s director general for regulation, replied to Ashworth on Monday, saying that the watchdog “has considered the statements made and reflected that for any statement drawing on official statistics or other public data the following principles should be followed: the source of the statement should be clear and accessible; aspects pertaining to the data such as time period represented should be clear and; it should be very clear about what is being measured and in what context.”

He also said confusion had arisen because “while NHS England spending is rising, some other elements of the Department of Health budget are decreasing”. Health thinktanks, NHS groups and Labour and the Liberal Democrats have all criticised Jeremy Hunt, the health secretary, for slashing the non-NHS parts of his department’s budget – such as money for public health and for Health Education England to educate and train health professionals – by several billions of pounds in order to free up cash to help ministers give NHS England the promised £8bn rise.

Humpherson said: “While the Department of Health has been when asked about the nature of the estimated real terms increase in health spending and its split between NHS England and the department’s overall budget, the total health spending figures are much less frequently referred to by government and may be less readily accessible.”

The UKSA intends to ask the Treasury to “investigate whether in future they can present estimates for NHS England and total health sending separately. I will also explore with officials producing these figures other ways in which they might ensure clarity around sources, time periods and what is being measured, and in what context, when reporting on the level of increase in real budget allocations to NHS England.”

While Hunt has acknowledged that the £10bn was the budget increases over a six-year period, May has yet to do the same.

Ashworth said the UKSA’s response showed it had endorsed his concerns about the £10bn figure. “This response makes clear that the government’s claims about an extra £10bn for the NHS are very misleading and I’m glad that the UKSA have asked for the government to present the figures more clearly in future.”

Meanwhile, Dr Sarah Wollaston, the Conservative MP and ex-GP who chairs the health select committee, has thrown her weight behind Stevens after a story in the Mail on Sunday claimed that Downing Street was keen to oust the NHS boss because he had publicly disagreed with May’s account of the NHS’s budget.

“I asked him a question at Commons health [committee] and Simon Stevens was right to answer truthfully. It’s called duty of candour”, she tweeted. “If No 10 aides really are ‘gunning for’ Stevens for upholding his duty of candour, that would set a disgusting example to the NHS.”

Wollaston added that “there cannot be one rule for government and another for NHS staff. I’m sick of post-truth politics and the double standards on duty of candour”.

Government scolded by watchdog over NHS funding claims

English care home closures are leaving vulnerable people at risk, says watchdog

The quality and safety of social care services received by elderly and disabled people in England are in danger, as care homes close and providers pull out because they can no longer make enough money, the care watchdog has warned.

In a bleak assessment of the future of vital services that support millions of people, the Care Quality Commission (CQC) voiced alarm that the care sector as a whole is “at risk”.

Providers are in trouble because their costs have increased by up to 30% in the past year while their profit margins have fallen by more than 40%, it warned. It pinpoints the national living wage (NLW) and the inability of cash-strapped local councils to pay higher fees for these services as the main causes of a growing problem.

The number of care homes overall in England has fallen from 18,068 in September 2010 to 16,614 in July this year, at a time of growing need linked to the ageing population, according to figures released by the CQC.

The total number of beds available in care homes also fell between 2010 and 2016 from 255,289 to 235,799 this summer – a fall of 19,490. While the number of nursing homes increased slightly, from 4,387 to 4,623 in that time, more than one in 10 residential homes – for elderly, often frail, people – have closed. The total of those available has fallen from 13,681 to 11,991 – a drop of 1,690.

The many people who rely on care homes and receiving help in their own homes with washing, dressing and eating could be affected if more and more of the private companies that dominate the market go out of business, the CQC fears.

Andrea Sutcliffe, the CQC’s chief inspector of adult social care, was responding to the leak to the BBC of a recent internal briefing document that spells out how rises in providers’ costs and the squeeze on local councils’ budgets are leaving care services in an unsustainable position.

“We know that the adult social care sector faces many financial pressures which, worryingly, could undermine the quality and safety of care that people receive and rely upon every day,” said Sutcliffe.

She confirmed that information from care providers detailed in the CQC document “does highlight a concern that the long-term sustainability of high-quality care within this sector could be at risk. Given the impact this would have on people’s lives, it is important that we continue to monitor these trends closely.”

The document emerged less than 48 hours before the CQC, which is the NHS and social care watchdog for England, is due to present its annual report on performance and emerging issues, called State of Care, to parliament on Thursday. It is expected to highlight how worsening problems in social care are having a serious impact on the NHS, for example, by leading to patients who are fit to go being trapped in hospital because no package of social care support is available to allow that.

The regulator is worried that more and more home closures could leave needy, vulnerable older and disabled people with nowhere to go.

Its analysis document says that with care homes the “market position is undoubtedly hardening – increasing the pace of home closures”.

The CQC’s anxieties echo those voiced with increasing urgency in recent years by old people’s charities such as Age UK, the Local Government Association, health thinktanks and MPs that deep cuts to town hall budgets since 2011 have led to a major deterioration in social care at the same time as demand for it was increasing.

The CQC document, called “adult social care market insight” and based on data received from 39 major providers, states that: “This is a local authority-funded service user problem. Notwithstanding recent fee increases, the historic level of underfunding remains and in some cases has probably increased as a result of [the] national living wage.”

On the fees that councils pay providers either to care for individuals in a home or to help meet their basic needs while they are still living in their own home, it says: “Fees – At what point will the ongoing focus on fees adversely impact the quality of service being purchased?”

The CQC also warns that businesses have been left out of pocket by having to pay staff more because of the national living wage. It adds: “NLW – Provider sentiment suggests fee increases have generally not covered the cost of NLW. This position is unsustainable.”

It is also worried that the same pressures could push providers of domiciliary care to the wall. “Provider exit and large-scale contract handbacks demonstrate the fragility of this market. At what point can the replacement providers only make the returns work by compromising on the quality of care?” the briefing paper asks.

Barbara Keeley, Labour’s shadow minister for social care, said: “These figures are an alarming reminder of the desperate state of care services in this country. Despite all the spin from ministers, the Tories have left social care on the brink of collapse, with thousands of people’s care at risk as a result. It’s not enough to turn a blind eye to this crisis. We need ministers to step up and guarantee that they will properly fund care services. Anything less will be a betrayal to the most vulnerable in our society.”

Norman Lamb MP, a Liberal Democrat former health minister in the coalition government, urged ministers to prop up social care before the system collapses. “This briefing confirms that the care system is teetering on the brink of collapse. The government has known this for some considerable time yet still they refuse to act. The whole system is now living on borrowed time as more and more providers contemplate leaving publicly funded care and face going out of business because the sums don’t add up,” he told the Guardian.

“The real scandal is that we are rapidly moving to a position where you will be able to get great care if you can afford to pay privately – but if you can’t you will be left with nothing or substandard care. That situation is intolerable and a stain on our country. It would be grossly negligent and morally wrong for the government not to act now. There is an urgent need for additional emergency funding.”

English care home closures are leaving vulnerable people at risk, says watchdog

Give young people and gay men free condoms to reduce STIs, watchdog says

Local authorities should run schemes to supply young people with free condoms and sex advice in an attempt to curtail the number of sexually transmitted infections, a health watchdog body has said.

They should also consider giving free condoms to gay men, among whom the increase in infections such as HIV and gonorrhoea is of serious concern.

The draft guidance from Nice, the National Institute for Health and Care Excellence, has opened for consultation two days after NHS England lost a high court battle brought by Aids campaigners who want it to pay for drugs to prevent gay men who do not use condoms becoming infected with HIV.

NHS England has said it will appeal, but if it loses it will weigh up the value of the drug, Truvada, which costs about £5,000 a year per person, against treatments needed for other groups, including children with cystic fibrosis.

Related: NHS England reconsiders decision over HIV PrEP drug

Nice says condoms need to be more widely accessible to prevent sexually transmitted infections, including HIV, particularly by the 16-24 age group and men who have sex with men. They should be free for those most at risk.

It comes amid concern that the use of condoms is primarily motivated by birth control, rather than their ability to prevent the spread of infections, and are therefore substituted with other forms of stopping pregnancy that do not offer the same protection against STIs.

Approximately 435,000 STIs were diagnosed in England in 2015, including 200,000 cases of chlamydia, says Nice. Syphilis and gonorrhoea rates have risen by 76% and 53% respectively between 2012 and 2015. The Family Planning Association (FPA) has estimated that the cost to the NHS of treating STIs was £620m in 2014. Nearly 4,000 people are infected with HIV in England every year. The lifelong treatment they require costs an average of £380,000.

“We know condoms can protect against many sexually transmitted infections including chlamydia, gonorrhoea and syphilis,” said Christine Carson, programme director of the centre for guidelines at Nice. “The recent increase in rates of gonorrhoea and syphilis among men who have sex with men has been attributed to high levels of sex without using a condom.

“If local authorities and other commissioners can work together to increase condom availability and use among high-risk groups we could significantly reduce the rates of STIs.”

Nice recommends more condom schemes should be set up by local authorities targeted at young people, based on existing models that offer a free supply but tied to sexual advice and counselling. The most common such scheme is the C-card, the most successful of which allows young people to obtain free condoms once they have been through an information and advice session with a trained counsellor.

The FPA said getting condoms to young people was key to tackling STIs. “However, as well as making condoms more easily and widely available, it’s also really important to back that up with education and support and to think about what barriers may exist to people actually choosing to use them,” said chief executive Natika H Halil.

“This should start with statutory sex and relationships education in schools so young people are equipped with the skills and confidence they need to have those important conversations about safer sex with partners.”

Halil added: “Condoms are already available for free in some places but there are always opportunities to reach more people, including in non-traditional health settings.

“It’s also important to reiterate the fact that condoms protect against both unplanned pregnancy and STIs, so even if you are using another method of contraception and don’t think about using condoms, you may be at risk of infection.”

Give young people and gay men free condoms to reduce STIs, watchdog says

NHS medicines watchdog lowers bar for statins prescriptions

Statin tablets. Photograph: Alamy

About 40% of the grownup population could be supplied cholesterol-busting statins medication by their medical doctors, below official advice from the NHS medicines watchdog.

The National Institute for Health and Clinical Excellence (Good) confirmed the draft recommendation it produced in February, which sparked a row among doctors in excess of alleged above-prescribing. Some critics accused Nice’s guideline group of shut ties with the pharmaceutical business.

Prof Mark Baker, director of the centre for clinical practice at Good, strongly defended both the choice to provide the medicines to people with a lower danger of heart condition than previously suggested and the independence of people doing work on the guideline. They had carried out their operate “in the face of some entirely unjustified attacks on their integrity,” he explained.

“I have to remind you that no one will get into our tips group if they have any considerable vested interest, particularly a financial interest,” he explained at the launch of the guideline on tackling the threat of heart attacks and strokes. All the interests of the group members were declared, not like people of some of the critics, he explained. Appointees to the group are essential to have had no economic involvement with pharmaceutical businesses for at least the prior year.

Great says GPs should first talk about life-style measures – a better diet program and much more exercise – with men and women who have a ten% risk of a heart attack or stroke in the subsequent ten years. They can then supply a statin if they believe it appropriate. Previously, GPs have been suggested to intervene when their patient had a twenty% risk.

An estimated four.five million much more individuals will be eligible for statins, in addition to the 13 million presently eligible. Great says half these patients will possibly not be presented them or will refuse. Somewhere amongst 5 and 10 million are believed to be taking the drugs at present.

The medication are now off-patent and for that reason cheap. Great says if 80% of the 4.five million newly eligible take them, the cost to the NHS will be £52m, which is tiny in the context of the cost savings from heart assault and stroke treatment method.

If two million – significantly less than half – of the decrease-threat group accept statins, Nice estimates that an additional four,000 deaths from heart attacks will be saved, and eight,000 strokes and 14,000 non-fatal heart attacks prevented.

Critics of statins have contested their rewards in individuals at reduced risk and raised considerations about side-results. Baker rejected these arguments. The evidence from randomised, managed trials of the medication “demonstrate the very same frequency and severity of signs in the statins and the placebo group,” he explained.

“Most of the side-results attributed to the medication but not always brought on by them are very typical. The occurrence of issues like muscle ache has minor or nothing to do with whether folks consider statins.”

A single extreme sort of muscle pain had been reported, but it was very unusual, he explained. He believed that some sufferers and GPs had wrongly assumed the significant response was as common as the mild one particular.

Opposition to statins for the decrease-threat group surfaced in the British Health-related Journal last year. The journal has retracted statements in two papers it published. Independent professionals have been asked by the BMJ’s editor, Dr Fiona Godlee, to advise on whether the papers ought to be retracted, in response to a contact from Professor Rory Collins, joint head of the clinical trials support unit at Oxford University.

Nice’s guidance was welcomed by numerous senior scientists, but some pointed out the importance of attempting to modify people’s life style in preference to handing out medicines. “We must not basically use pharmaceuticals to treat the benefits of unhealthy conditions,” mentioned Sir Michael Marmot, director of the Institute of Health Equity at UCL. “Choosing healthier lifestyles is a lot more challenging simply because our society promotes low cost unhealthy meals, lower alcohol costs, and vehicle use rather of walking or cycling.”

NHS medicines watchdog lowers bar for statins prescriptions

Watchdog will get new powers to near failing care residences

Last month a serious case overview into Orchid View care home, in West Sussex, in which 19 residents suffered unexplained deaths, said independent care home providers need to be subjected to far better scrutiny.

The new scheme will cover 25,000 care residences and suppliers of residence care, this kind of as domestic home-helps.

From April, care services rated as inadequate face following Ofsted-style inspections can be given a constrained time period to make improvements. If they fail to increase, the Care Good quality Commission will be capable to near them down.

Mr Hunt is expected to describe Mid Staffs as a “wake up call” from which the total wellness and care sector should learn.

“Getting discovered from the schooling system, we brought in some of the very best individuals in the organization with the knowledge and dynamism necessary to inspire a various culture,” he will say.

Mr Hunt will say hospitals have tackled “deep-rooted failings” for the 1st time and that the care property sector demands up to face up to its difficulties in the exact same way.

Last evening CQC mentioned two of the trusts, Basildon Basis trust and George Eliot NHS believe in had produced a “remarkable turnaround” in a yr, and now had an total rating of “good.”

Medway trust in Kent- which last week acquired a damning report from regulators – is the only one of the eleven which is identified has obtaining created no progress.

Investigations by The Telegraph identified the hospital has been paying out at least ten senior managers on costs of at least £200,000 a yr, in spite of a shortage of 120 nurses.

Buckinghamshire Healthcare trust and East Lancashire believe in are now out of particular measures, although North Lincolnshire and Goole trust is suggested to comply with shortly. United Lincolnshire and Goole Hospitals Basis believe in, North Cumbria university Hospitals trust and Tameside trust have been all located to have created progress , but will stay in unique measures, with selections awaited on Burton Hospitals Basis believe in and Sherwood Hospitals Basis trust.

Watchdog will get new powers to near failing care residences

Minimal-calorie diet plans ought to be scrapped for the obese, health watchdog warns

Extremely low-calorie diet plans must be scrapped for the obese, the well being watchdog has explained, as it warned diet plans this kind of as the 5:2 really do not operate.

The National Institute for Well being and Care Excellence (Great) said obese individuals on restrictive diet plans should be warned they are most likely to regain excess weight and are at chance of developing an consuming disorder.

Any obese particular person needing to swiftly drop fat (for example for joint replacement surgical treatment) ought to be presented counselling and comply with a reduced-calorie diet program for a highest of ten weeks, in accordance to new draft guidance.

The quantity of people following really minimal-calorie diets, consuming significantly less than 800 kcal a day, has grown in recent years. Diet programs such as the 5:two program, which involves restrictions for two non-consecutive days a week and unconstrained eating the other 5 days, have also elevated in recognition.

The advisable consumption is two,000 kcal for women and 2,500 kcal for guys day-to-day.

Prof Mark Baker mentioned: “Very reduced-calorie diets have grown in reputation in current years, so we now have far more evidence to consider how properly they operate, if the fat reduction can be sustained and the security worries, than we did in 2006.

“The new draft guidance now suggests that they must not be employed routinely for individuals who are obese, only people who have who have a clinical need to drop weight swiftly, such as before joint substitute surgical procedure.”

Minimal-calorie diet plans ought to be scrapped for the obese, health watchdog warns

Wellness watchdog weighs up sugar tax and reduction targets

Campaigners mentioned the phase was “extremely positive” and a signal that the quango had acknowledged the need to have for “emergency action” to combat obesity and Kind 2 diabetes.

Nevertheless, the foods and drink sector is alarmed by the severity of some of the choices in the document. It insists the leads to of obesity are “far wider” than sugar and warns that a tax would hit the poorest families hardest.

The publication of Public Well being England’s document on June 26 will coincide with the release of a extended-awaited report on carbohydrates by the Scientific Advisory Committee on Nutrition, which will incorporate suggestions on sugar intake in Britain. The Planet Overall health Organisation halved its advised day-to-day restrict of sugar in March.

The Telegraph has noticed an early draft of Public Well being England’s paper, made by the Uk Health Forum, a coalition of heart disease experts, which was mentioned at two summits hosted by the quango earlier this month — 1 for specialists, charities and campaigners, and the 2nd for sector representatives.

Two of the principal proposals are a tax to improve rates of sugar products and targets equivalent to these in spot for salt, which would call for companies to slowly lessen amounts of the ingredient in their merchandise.

Six “themes” are set out in the draft, every single containing a quantity of possible actions.

Beneath the heading “use less”, the paper suggests “reformulating” meals and drink products to reduce sugar content, both with government-set targets or voluntary specifications. Such a move would support to keep track of sugar levels and create a “level taking part in field”, it says.

Sugar targets have been backed by campaigners and MPs like Keith Vaz, who has Sort 2 diabetes. The paper states that salt reduction targets have been a success.

Beneath “weaknesses”, the paper states that a voluntary technique may possibly lead producers to concentrate on “niche” items. Last month, The Telegraph disclosed how organizations that signed up to the Government’s “healthy eating” pledge have failed to lessen the amount of sugar in some of their main manufacturers.

Below a second theme, “sell less”, the paper suggests a “tax on sugar or merchandise high in sugar” and points to a similar move in France by means of which soft drink income declined.

The paper says that sugary drinks have been described as a “low hanging fruit”, highlighting analysis showing that a twenty per cent tax on sugar-sweetened drinks “could reduce consumption and prevalence of weight problems in adults by one.3 per cent”. This kind of a move has public support, the paper states, “especially when well being benefits are emphasised”.

However, the document also warns that such a tax risks getting a “regressive effect on income” and harming the competitiveness of food and drink firms. It says that the cost of the tax could be absorbed by the industry.

It is understood that the “favoured options” amongst professionals and campaigners at the Public Overall health England summit had been for a triple method of a tax, targets, and banning or severely limiting commercials of ultra-processed food items.

Campaigners say the risk of a tax could force the industry to accept targets.

Dr Aseem Malhotra, a cardiologist and science director of Action on Sugar, a campaign group, stated: “It is extremely optimistic that Public Health England has acknowledged the necessity for emergency action to combat the growing prevalence of Type 2 diabetes and weight problems that is spiralling out of manage.”

The Division of Wellness, which oversees Public Overall health England, has insisted that it is “not thinking about a sugar tax”.

Even so, Graham MacGregor, professor of cardiovascular medication at the Wolfson Institute of Preventive Medicine and chairman of Action on Sugar, said: “If Jeremy Hunt is a true Well being Secretary he has received to do something now — and this is a sensible plan.”

Gavin Partington, director general of the British Soft Drinks Association, explained it was “misguided” to recommend obesity could be “attributed to a single ingredient”.

An market supply advised the quango was attempting to “mitigate” against attainable criticism of the SACN report for not going far ample, and to present that the government was “doing something” to tackle the concern.

Dr Alison Tedstone, chief nutritionist at Public Well being England, sits on the secretariat of the SACN committee.

She stated: “Public Overall health England is actively exploring ways to lessen the volume of sugar men and women eat, to inform a wider method to boost dietary well being and lessen ranges of weight problems in the population.

“Earlier this month, Public Wellness England held two occasions to investigate methods of reducing the intakes of sugar with a range of stakeholders such as academics, customers groups and sector.

“We are now getting ready a paper for discussion on reducing sugars consumption that will be published on the 26th June.”

Final week a study by Action of Sugar of fizzy drinks concluded that individuals had been drinking sugar “by the spoonful” and warned that artisan beverages hold far more of the ingredient than less costly blends.

Wellness watchdog weighs up sugar tax and reduction targets

Gasoline guy should be skilled to spot elderly at risk of dying from cold, says overall health watchdog

The suggestions contain a “one cease” well being and housing referral services offered to people who reside in cold residences, which give entry to housing insulation and heating, far more affordable fuel choices and tips.

Meanwhile, health and social care employees should do a lot more to determine people at chance. They should also guarantee that vulnerable hospital patients are not discharged to a cold residence.

Professor Mike Kelly, director of the Centre for Public Well being at Great, stated: “Even though most triggers of death and sickness differ all through the seasons, there is a clear boost during winter months.

“About 24,000 extra folks die during this time every 12 months in England and Wales, primarily from cardiovascular and respiratory conditions. This is not just about intense cold weather, but normal winter temperatures – when outside temperatures drop beneath 6C.

“Companies to make sure people are warm ample at residence currently exist, but they are patchy across the country, and this lack of consistency tends to make it really challenging for pros to know what help is available locally and how to get aid for people who need to have it.

“This new draft guideline aims to assist reduce these preventable deaths and unwell health. Recommendations incorporate identifying individuals at danger, making sure that a referral can be produced for insulation or heating enhancements if necessary and raising awareness of neighborhood systems and services to support individuals who are living in properties that are as well cold.

“Folks want to be conscious of how the cold influences their well being and exactly where they can look for help if they want it.”

Gasoline guy should be skilled to spot elderly at risk of dying from cold, says overall health watchdog

NHS watchdog defends "real benefits" of excess weight reduction programmes

The man in charge of public wellness at NHS watchdog Nice mentioned obesity could cause a host of severe problems and that there were “real advantages” for folks losing as tiny as 3 per-cent of their physique mass.

His feedback come after Wonderful was criticised for recommending that almost 70% of the population should attend commercial bodyweight-loss programmes like WeightWatchers with the help of state-funding.

“3 per-cent generates tangible positive aspects, and we know these programes can deliver that,” explained Professor Mike Kelly.

He described weight problems as a “main well being dilemma.”

“It is connected with Type-2 diabetes, hypertension, specific varieties of cancer, for illustration breast cancer, endometrial cancer and colon cancer, as properly as osteoarthritis,” he said.

NHS watchdog defends "real benefits" of excess weight reduction programmes

Sufferers ought to get fiscal advice at GP surgical procedure, watchdog says

Mr Selbie highlighted a scheme in Derbyshire, in which Citizens Guidance have set up clinics in practically 100 GP surgeries. They evaluate the economic guidance they give to offering sufferers a flu jab.

He stated: “In Derbyshire, there are 102 GP practices, of which 98 have a weekly clinic operated by the Citizens Suggestions Bureaux to guarantee individuals have access to support, which can resolve nerve-racking issues this kind of as housing, employment and advantages troubles or any other matter obtaining in the way of their excellent overall health.”

The chairman of the Royal College of GPs stated patients could be left feeling that fiscal solutions had been being “forced on them” when they wished healthcare help.

Dr Maureen Baker mentioned monetary tips in surgeries was not one thing that the occupation “could or should” be expected to offer.

She stated: “Doctors are skilled and skilled to diagnose and treat illness this is what our individuals rely on and expect from us, and it is important that this remains our principal priority.

“GPs are already struggling to cope with ever-growing workloads while funding for common practice is at an all-time lower. Some medical professionals are seeing upwards of 60 sufferers a day, and it would not be feasible or proper for them to consider on an extra function as economic advisers.

“We would also be concerned about economic representatives operating from GP surgeries if they have been for-revenue. The partnership between patient and physician is one of trust and confidentiality, and this could be broken if sufferers felt that GPs were forcing other services on them.”

Referring to the Derbyshire scheme, Mr Selbie said: “We know that not getting enough cash to dwell on, or somewhere respectable to dwell are barriers to people’s very good wellness and wellbeing, and we have the voluntary sector, council and CCGs [clinical commissioning groups] functioning collectively in a way which implies men and women have assistance via early intervention guidance services and staying away from the possible require for high-priced wellness care later on.”

In accordance to the Workplace for National Statistics, kids in the richest areas in Britain can count on to reside an energetic lifestyle for up to 20 years longer than their counterparts in the poorest neighbourhoods.

In a survey by StepChange, a charity offering debt guidance, practically 3- quarters of men and women explained that debt worries impacted their sleep, whilst six in ten recommended that mood modifications relating to debt concerns impacted their behaviour.

A spokesman for the British Health-related Association explained it was unlikely that the vast majority of GP practices would have the sources to provide this kind of a support.

Sufferers ought to get fiscal advice at GP surgical procedure, watchdog says

Patients should get financial suggestions at GP surgical treatment, watchdog says

Mr Selbie highlighted a scheme in Derbyshire, where Citizens Advice have set up clinics in almost 100 GP surgeries. They compare the financial advice they give to offering patients a flu jab.

He said: “In Derbyshire, there are 102 GP practices, of which 98 have a weekly clinic operated by the Citizens Advice Bureaux to ensure people have access to help, which can resolve stressful issues such as housing, employment and benefits problems or any other matter getting in the way of their good health.”

The chairman of the Royal College of GPs said patients could be left feeling that financial services were being “forced on them” when they wanted medical help.

Dr Maureen Baker said financial advice in surgeries was not something that the

profession “could or should” be expected to provide.

She said: “Doctors are skilled and trained to diagnose and treat illness; this is what our patients rely on and expect from us, and it is important that this remains our main priority.

“GPs are already struggling to cope with ever-increasing workloads whilst funding for general practice is at an all-time low. Some doctors are seeing upwards of 60 patients a day, and it would not be feasible or appropriate for them to take on an additional role as financial advisers.

“We would also be worried about financial representatives operating from GP surgeries if they were for-profit. The relationship between patient and doctor is one of trust and confidentiality, and this could be damaged if patients felt that GPs were forcing other services on them.”

Referring to the Derbyshire scheme, Mr Selbie said: “We know that not having enough money to live on, or somewhere decent to live are barriers to people’s good health and wellbeing, and we have the voluntary sector, council and CCGs [clinical commissioning groups] working together in a way which means people have support through early intervention advice services and avoiding the potential need for expensive health care later on.”

According to the Office for National Statistics, children in the richest areas in Britain can expect to live an active life for up to 20 years longer than their counterparts in the poorest neighbourhoods.

In a survey by StepChange, a charity providing debt advice, almost three- quarters of people said that debt worries affected their sleep, while six in 10 suggested that mood changes relating to debt issues affected their behaviour.

A spokesman for the British Medical Association said it was unlikely that the vast majority of GP practices would have the resources to provide such a service.

Patients should get financial suggestions at GP surgical treatment, watchdog says

A single in 16 sufferers in NHS hospitals picks up infection, warns watchdog

The Nationwide Institute for Overall health and Care Excellence mentioned physicians and nurses have to ‘redouble’ hygiene efforts to bring costs down. Photograph: Dominic Lipinski/PA

One particular in every single sixteen people taken care of at an NHS hospital fall unwell with an infection, in accordance to a government health company report. The Nationwide Institute for Well being and Care Excellence (Nice) mentioned the charge of infections, which are a “quite actual threat” to patients’ lives, was “unacceptably large”.

Infections can happen in healthy men and women, specially if they are undergoing invasive surgery or making use of catheters or tubes inserted into veins. Children, the elderly and the ill are even much more susceptible.

Common varieties of infection contain pneumonia, reduce respiratory tract infections, urinary tract infections and surgical internet site infections.

While steps have been taken to reduce infection prices of hospital bugs such as MRSA and Clostridium difficile, other infection rates are nonetheless also substantial, Great explained. A spokeswoman stated that doctors and nurses must “redouble” hygiene efforts to deliver the rates down.

Nice has set out new suggestions to handle the difficulty, including advising healthcare employees to clean their hands totally and often and to use catheters or vascular access devices securely and hygienically.

Professor Gillian Leng, deputy chief executive and director of wellness and social care at Nice, stated: “It is unacceptable that infection charges are nevertheless so large inside the NHS. Infections are a pricey and avoidable burden. They hinder a patient’s recovery, can make underlying situations worse, and minimize high quality of lifestyle.

“Though there have been key improvements within the NHS in infection control, specifically in relation to Clostridium difficile and MRSA bloodstream infections in the final few many years, healthcare-linked infections are nevertheless a very real threat to individuals, their families and carers and staff. This top quality regular offers major, local community and secondary care services the most up-to-date guidance on the very best approaches to minimise the dangers of infections.”

The number of deaths from MRSA and Clostridium difficile has fallen in successive many years. According to the ONS, the variety of sufferers in hospitals in England and Wales who died from MRSA fell by 25%, from 485 in 2010 to 364 in 2011.

There have been two,053 deaths relevant to the C difficile infection, compared with two,704 the year just before. The number of sufferers who died after contracting C difficile represented 1% of all hospital deaths in between 2009 and 2011.

Regardless of the fall in the two kinds of infection, wellness officials warn that extreme use of antibiotics has led to an enhance in new strains of infections that are resistant to treatment.

The government uncovered final month that sixteen folks have died in the Manchester region in the past 4 years from a hugely resistant Klebsiella pneumoniae carbapenemase. Most have been really sick and could have been colonised by the bacteria just before admission to hospital. The infection is resistant to carbapenems – antibiotics that, in numerous circumstances, are regarded as the final successful defence towards multi-resistant bacterial infections.

Carol Pellowe, senior lecturer at Guy’s &amp St Thomas’ NHS Foundation Trust and member of the committee that designed the standards, extra: “This good quality standard will market very best practice in infection prevention and control and by offering crucial regions for action, motivate organisations to sustain their efforts in ensuring patient security.”

A single in 16 sufferers in NHS hospitals picks up infection, warns watchdog

Elderly "suffer in silence" beneath NHS care, says watchdog

“But my fear is that as well numerous older people are suffering in silence. Practically 80% of all the investigations we carry out are about NHS solutions.

“Even even though nearly half of NHS care and solutions are given to older men and women, only a third of the well being complaints we investigate are about the care of older individuals.”

She also highlighted widespread themes of complaints created including misdiagnosis, staff attitudes, bad communication with sufferers and families, substandard nutrition, and sufferers not being taken care of with dignity.

The ombudsman called for a modify in attitudes as well as the method of creating a complaint.

She explained: “A lot more wants to be completed to tackle the toxic cocktail of reluctance by individuals, carers and families to complain and a defensive response from the NHS, when they do.

“Creating a complaint must be effortless and transparent. And folks must be supported to do so. Usually older individuals worry damaging repercussions when they make a complaint or they merely do not like to ‘make a fuss’.”

She stressed that if folks have been not happy with the way the NHS handled a complaint, they should complain to the Parliamentary and Overall health Support Ombudsman.

Elderly "suffer in silence" beneath NHS care, says watchdog