This webpage is made up for anything related Health in the news (NHS and so on).
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August 31st 2009.
Healthy people who take aspirin to prevent heart attacks could be doing themselves more harm than good, experts have warned.
The drug, which reduces the risk of
blood clots, can be taken by patients who have already suffered a heart attack or
are at risk of one, according to NHS Direct.
Millions of others are also believed to take a daily dose as an "insurance policy"
in the hope of guarding against heart trouble.
But the routine use of aspirin by healthy people to prevent heart problems "cannot
be supported", professors from the Aspirin for Asymptomatic Atherosclerosis (AAA)
said.
Their study found that the risk of cardiovascular problems had to be set against
the increased risk of internal bleeding.
Professor Peter Weissberg, of the British Heart Foundation which part-funded the
research, said: "We know that patients with symptoms of artery disease, such as
angina, heart attack or stroke, can reduce their risk of further problems by taking
a small dose of aspirin each day.
"The findings of this study agree with our current advice that people who do not
have symptomatic or diagnosed artery or heart disease should not take aspirin, because
the risks of bleeding may outweigh the benefits."
In patients who have already had a heart attack, the risk of a second is so much
higher that the balance is in favour of taking aspirin, Professor Gerry Fowkes,
from the Wolfson Unit for Prevention of Peripheral Vascular Diseases in Edinburgh,
added.
The study recruited 28,980 men and women aged between 50 and 75 who were free of
clinically evident cardiovascular disease in central Scotland.
They were given either a daily dose of 100mg of aspirin or a placebo.
Major bleeding requiring admission to hospital occurred in 34 (2%) subjects in the
aspirin group and 20 (1.2%) of the placebo group.
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31st May 2009.
Nicola Sturgeon.
THE Scottish Government is to press ahead with plans to vaccinate all Scots against
swine flu despite a warning from the BMA it could create serious problems for GPs
and health centres.
Health Secretary Nicola Sturgeon announced she is to spend more than £100 million
buying 11 million doses of swine flu vaccine, to give everyone in Scotland two jabs
to protect them from the next wave of the infection, expected later this year.
The vaccine, currently under development, is expected to be ready by August, with
mass production starting in September.
It will cost £56 million, with an additional cost of more than £50 million to deliver
the vaccinations to five million people.
However, doctors have warned the scheme faces major practical problems.
Massive undertaking
“The proposal would be a massive undertaking,” said Dr Dean Marshall, chairman of
the BMA’s Scottish General Practitioners Committee.
“The BMA is already involved in discussions about how such a programme would be
implemented.
“GPs are best placed to deliver a vaccine to the public but a number of practicalities
would need to be considered.
“For example how would general practice be able to continue to provide routine services
to patients during the vaccination programme?”
But the Scottish Government says it hopes to have half the population vaccinated
before the end of the year.
Those working in the health service will be first to be inoculated, followed by
children, then the elderly.
A Government source explained it had been advised the flu epidemic was expected
to come in two waves, with its return in the autumn, or early winter.
A factory is Germany has been taken out of mothballs by a major vaccine manufacturing
company in preparation for manufacturing the vaccine.
Health Secretary Nicola Sturgeon said she believed this would be the first time
an entire population had been vaccinated against a forthcoming epidemic.
“We are acting on expert medical advice,” she added. “Not to do so would have a
great economic impact on the country. It should all be in place by the end of the
year.”
She added the Scottish Government would be asking Westminster for help in paying
the costs.
“We have no reserves,” she explained. “We believe the money should come out of UK
contingency funds.”
She added all three devolved administrations had now written to the Treasury asking
for financial help in combating swine flu.
By Campbell Gunn (Sunday Post).
copyright D.C. Thomson & Co. Ltd., 2009
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18th July 2009.
Patients should be charged £20 to see
a GP in a bid to limit demands placed on the health service, a centre-right think-tank
says.
The Social Market Foundation said forcing people to pay a fee for an appointment
could help the NHS cope in the tight financial times ahead.
The group said it would not breach the values of the NHS as charges already applied
to dentistry and prescriptions
But both the government and doctors said they were against such a move.
The think-tank said the NHS was facing a tough couple of years.
While funding is guaranteed until 2011, many are expecting the budget to be frozen
or cut after that to help pay back the debts accrued bailing out the banks.
The Social Market Foundation said the only way for the NHS to cope was to raise
taxes to put more money into the system, limit demand or work more effectively.
The NHS is already looking to make savings and the think-tank said there was little
appetite for tax rises.
Instead, they said charging for GPs would be a good way to reduce demand.
Report author David Furness said: "It would get people thinking twice about whether
the visit was essential.
"If we don't introduce rationing like this, there will be rationing by stealth through
waiting lists, crumbling hospitals and poor quality services."
Opposition
He said the move was not about making money and insisted even a small charge like
this could help reduce appointments by about 5%.
He said children and those receiving tax credits should not be charged and said
the think-tank was opposed to fees being levied on any form of emergency care.
But Dr Chaand Nagpaul, of the British Medical Association's GPs committee, said
the union was opposed to charging.
"All patients have a right to free healthcare that is based on their clinical needs,
not the size of their bank balance.
"I would also be concerned that charging some of my patients to see me would undermine
the doctor-patient relationship. Many would be put off coming to their local surgery
when they might need care."
A spokeswoman for the Department of Health said ministers were also against introducing
charging like this.
She said it would be against the "founding principles of the NHS".
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31st July 2009.
Concerns have been raised that not all
of the NHS in Scotland is ready to cope with new limits on working hours.
The European Working Time Directive means doctors are now not supposed to work more
than 48 hours a week.
BMA Scotland has warned that there could be a significant proportion of junior doctors
working in non-compliant posts as the legislation comes in.
The Scottish Government said it expected NHS boards to be 96% compliant with the
regulations.
The BMA said that data from the end of May showed 38% of junior doctor posts were
still not compliant with the 48 hour working week.
It has warned that the implementation of a 48 hour week will see a "massive rise"
in the number of junior doctors working in non-compliant posts.
The organisation has also said there was the possibility of disruption to patient
services in August and that the quality of training for junior doctors could be
threatened.
Dr Andy Thornley, chairman of the BMA's junior doctors committee, said he feared
many junior doctors could be pressured to lie about their hours.
The working hours of doctors in training should average 48 hours a week or less
over a 26 week reference period starting from 1 August.
A Scottish Government spokeswoman said: "The Scottish Government is closely monitoring
NHS Boards' actions towards achieving compliance with the EWTD and we are providing
support via the Working Time Regulations Advisor to ensure they achieve compliance.
"The advisor is visiting boards to support them in rota and service redesign, while
boards continue to invest in new roles for medical and non-medical staff and to
expand the Hospital at Night model which will reduce junior doctors' hours."
Source.
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17th April 2009.
I have been doing a little research on something that is very close to my heart.
Have you ever thought if you had to go into hospital will you come out with something else?
So I have put a number of relative links in below all with information about how things are going in our hospitals and just what is the Scottish Government doing about this?
New cleaners to blitz dirty wards.
Nicola Sturgeon
Ms Sturgeon said cutting hospital infection was a personal priority.
A total of 600 extra cleaners are to be employed in Scotland's hospitals to tackle
infections on the wards.
*****
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8th April 2009.
More patients to be MRSA screened.
Most people being admitted to hospital for a planned operation will now be screened
for MRSA.
Health Secretary Nicola Sturgeon said
national screening would be introduced after a pilot by three health boards.
Attention will be paid to the elderly and people admitted for kidney disease, skin
problems and vascular surgery, as the pilots showed higher MRSA rates.
It comes as new figures showed a drop in the number of hospital patients infected
with C.difficile and MRSA.
From October to December there were 1,299 cases of C.diff - down 9% on the previous
quarter - and a 19% reduction on the same quarter in 2007.
There were 157 MRSA cases, which was up 7% on the previous quarter but down 24%
on the same quarter in 2007.
This is the second lowest figure ever, and the lowest of any previous quarter in
winter.
'Bearing fruit'
Health Protection Scotland (HPS) has published an interim report into the £3.7m
pilot screening programmes being conducted in the Western Isles, Grampian and Ayrshire
and Arran.
Since June, patients in those areas have been routinely tested for MRSA before being
admitted to hospital.
If they tested positive they were given a five-day course of treatment to make sure
the bacteria did not get into their bloodstream or carry to other patients.
The HPS report indicated that 7.5% of patients who were screened as part of the
pilot carried MRSA harmlessly on their skin.
*****
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22nd March 2009.
Hand washing campaign targets bugs.
A new campaign to boost hospital hygiene is to be launched by the Scottish Government
in a bid to halt the spread of hospital bugs.
The drive aims to raise awareness amongst
staff, patients and visitors about the importance of regular hand-washing.
Posters will be on display throughout hospitals - including above patients' beds
and in staff changing rooms.
They will also be in surgical areas, toilets and public areas.
NHS figures from earlier this year showed doctors were still falling short of a
target of at least 90% compliance with hand hygiene practices.
New inspectorate.
Earlier this month the appointment of a chief inspector of hospital hygiene was
announced.
Ms Sturgeon said the newly created Care Environment Inspectorate will inspect hospitals
to check standards of cleanliness and infection prevention in the fight against
bugs such as MRSA and Clostridium difficile.
It will be headed by a chief inspector, to be appointed next month.
Other measures to tackle HAIs include more regular steam cleaning of hospitals and
a pilot project of screening patients for MRSA before they are admitted, which is
due to be rolled out later this year.
The Holyrood administration also proposes all new-build hospitals will only have
single rooms to help prevent the spread of infection, and has said there will be
no more privatisation of cleaning contracts.
The senior charge nurse role has been revamped, giving them responsibility for ensuring
ward cleanliness and there is also a new staff uniform and dress code.
Source. (External Link).
*****
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1st March 2009.
Steam weapon in superbug battle.
Hospitals
in Scotland are to get more regular steam cleaning as part of the drive to rid them
of infections such as MRSA and Clostridium difficile.
The Scottish Government has announced
it is spending £400,000 on 250 extra steam cleaning machines.
Twenty machines are already available, but the investment will mean every health
board has its own equipment.
Health Secretary Nicola Sturgeon said steam cleaning was an effective method of
reducing infections.
"Tackling healthcare-associated infections is my top priority because it's vital
that the public have confidence in the care they will receive if they need hospital
treatment," she said.
"Steam cleaning is a particularly effective way of cleaning areas affected by C.diff
and substantially increasing the number of steam cleaners available to the NHS will
ensure they are available locally when needed."
Wider approach.
A total of 18 people died and more than 50 were infected during an outbreak of C.diff
at Vale of Leven Hospital in West Dunbartonshire between December 2007 and June
2008.
Labour welcomed the announcement, but said a wider approach to tackling hospital-acquired
infection was needed.
Health spokeswoman Cathy Jamieson said: "Scottish Labour has offered the government
an effective action plan with an ambitious target to cut the number of C.diff cases
by 50% by March 2011.
"Our proposals also include better hand-washing facilities and the appointment of
an independent commissioner to drive progress. The plan has cross-party support
and the government should adopt it in full."
NHS Greater Glasgow and Clyde will get 61 of the cleaning machines, which cost £1,600
each. NHS Lothian will receive 32 machines while NHS Grampian will have 22.
Source.
(External Link).
*****
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12th February 2009.
Hospital bug action plan launched.
Holyrood's five opposition parties have united to launch an action plan to tackle hospital-acquired infections.
The proposals, drawn up with the help
of expert Professor Hugh Pennington, aim to halve the number of C.difficile cases
within two years.
The move came after an outbreak at Vale of Leven hospital in Dunbartonshire, in
which 18 patients died.
Health Secretary Nicola Sturgeon said much of the plan's content was already being
implemented in Scotland.
However, she has asked the national task force on healthcare associated infections
to consider it.
"I do believe this issue is not about party politics," Ms Sturgeon said.
*****
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26th January 2009.
Nurse plea over hygiene crackdown.
Scotland's main nursing body has said disciplinary action against its members for failing to wash their hands should be used only as a last resort.
The call came as ministers announced
details of a "zero tolerance" crackdown on hand hygiene failure among health workers
across the NHS.
RCN Scotland said staff had to be given proper hand-washing facilities.
Health boards will also be required to publish results on how they are dealing with
the control of infections.
Under the zero tolerance hand washing scheme, "serial offenders" who repeatedly
fail to comply would face disciplinary action.
RCN Scotland director Theresa Fyffe welcomed the measures, but said incidents of
hospital-acquired infections were "rarely the responsibility of an individual".
She added: "Disciplinary action should be a last resort and should only ever be
considered once all measures to enable staff to meet hand hygiene requirements are
put in place by health boards."
The Scottish Government has contacted health authorities by letter, reinforcing
the need for a "zero tolerance approach to non-compliance for healthcare workers
at all levels".
Health board chief executives, it added, also had a responsibility to ensure their
facilities had the proper resources to ensure staff were able to meet hand washing
requirements.
Hospital infection.
Nicola Sturgeon, the health secretary, said: "Today's launch of the zero tolerance
policy means all staff should be in no doubt that the highest standards are expected
and must be delivered."
The government drive came after 55 people were struck down by the Clostridium difficile
infection at Vale of Leven Hospital, Dunbartonshire, between December 2007 and June
2008.
C.diff was the primary cause of death in nine patients there, and a contributory
factor in another nine.
A government-commissioned, independent investigation found there was no clear surveillance
system in place, infection control procedures had failed and there were failings
in leadership and accountability.
Source. (External Link).
*****
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14th January 2009.
Nurses questioned in C.diff probe.
Nurses are to face police questioning over deaths from Clostridium difficile at a Dunbartonshire hospital, it has emerged.
Officers will interview staff at the
Vale of Leven Hospital, where a C.diff outbreak was linked to 18 deaths.
A report which identified failures in hygiene and infection control was passed to
prosecutors last year.
The Royal College of Nursing (RCN) said its members "would meet legal advisers before
being interviewed".
RCN Scotland associate director of employment relations, Norman Provan, told the
Nursing Standard: "This is a difficult time for staff in the Vale of Leven.
"For those who are asked to attend police interviews, we are arranging for them
to meet with our legal advisers before being interviewed."
Police are working alongside the Health and Safety Executive, which has been reviewing
the hospital's paperwork in relation to infection control procedures.
The police report will be handed to the procurator fiscal service at the end of
the investigation, which is expected to last several months.
Conservative public health spokesman Jackson Carlaw said: "Today's announcement
makes it clear once again that the police investigation is no small matter, and
should never have been dismissed by Labour as being of secondary importance to a
public inquiry.
"If a public inquiry had been established, it may already have been halted to prevent
it from prejudicing this major police investigation."
Infection rules
Liberal Democrat health spokesman Ross Finnie said: "The fact that the police are
conducting interviews with nursing staff indicates the need for a thorough and all
encompassing public inquiry into the C.difficile outbreak at the Vale of Leven hospital."
BBC Scotland health correspondent Eleanor Bradford said: "It's unusual for police
to question NHS staff over outbreaks of hospital infections, although two investigations
into outbreaks at hospitals in England were abandoned because there was no prospect
of securing convictions."
Strathclyde Police said they would not comment on who they were questioning in the
investigation.
The Scottish Government announced new rules this week which will compel health boards
to monitor hospital bug infections more closely.
Rates of infection for the MRSA and C.diff bugs will have to be reported at frequent
intervals for each hospital.
Source. (External Link).
*****
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20th November 2008.
Instant C.diff inquiry ruled out.
Health Secretary Nicola Sturgeon has ruled out an immediate public inquiry into the issue of Clostridium difficile in Scottish hospitals.
Her comments came during question time
at Holyrood after Labour and the Tories said enough was not being done.
The exchanges followed a BBC probe into the death of 18 patients at the Vale of
Leven Hospital, Dunbartonshire.
Ms Sturgeon said tackling infection was a top priority, adding: "It is a responsibility
I will never shirk."
A total of 55 people were affected by the Clostridium difficile bug at the Vale
of Leven Hospital between December of last year and June this year.
C.diff was the primary cause of the death of nine patients and was a contributory
factor in another nine deaths.
Scottish Labour leader Iain Gray urged Ms Sturgeon to hold an immediate public inquiry,
adding: "In opposition, the health secretary called for public inquiries with monotonous
regularity - but in government she resists doggedly.
"What is she afraid of? What is she trying to cover up?"
Mr Gray demanded: "She is the only obstacle to the inquiry we need - in the interests
of the families, will she change her mind now?"
Ms Sturgeon said an ongoing police investigation into the events at the Vale of
Leven meant it was not appropriate to stage an immediate public inquiry - but has
not ruled one out altogether.
"I readily recognise that C.diff is a growing concern - it's not a new concern,"
she said, while standing in for First Minister Alex Salmond.
"The death rates from Clostridium difficile in Scotland have been rising steadily
throughout this entire decade. It's an issue that is a problem and an issue that
we are determined to tackle."
The health secretary said funding to tackle hospital infections had been tripled,
while cleaning standards had been toughened up and infection-cutting targets had
been set.
Scottish Conservative leader Annabel Goldie said Scotland was "behind the game"
on tackling hospital-acquired infection, saying Ms Sturgeon needed a "reality check".
"We need to know what is happening, where it is happening, why it is happening and
when it is happening," added Ms Goldie.
Ms Sturgeon said Scotland had been playing "catch up" with England since she took
office, because the last Labour/Lib Dem Scottish Government only introduced mandatory
surveillance three years after south of the border.
*****
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19th November 2008.
Health boards in Scotland have revealed the number of C.diff cases they recorded from December 2007 to May 2008.
more. (External Link).
*****
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19th November 2008.
What is Clostridium difficile (C.diff)?
Clostridium difficile is a member of a large group of bacteria, the clostridia,
that grow in the absence of oxygen and are able to form heat-resistant spores.
C.diff is a very tough bug that lives
in people's intestines. It is common in young children and in people over the age
of 75.
When does it occur?
It becomes a problem when a person's normal gut flora is disturbed, for example
during antibiotic treatment. As well as doing its job to get rid of harmful bugs
in the body, antibiotics also zap away the "friendly bacteria".
Why is C.diff such a problem?
There are very few antibiotics that are effective against C.diff and relapses are
common after antibiotic treatment. Without the aid of "friendly bacteria", the C.diff
grows and produces poison.
How does it spread?
C.diff is very clever in that it makes spores which are very tough. They can last
in the environment for years.
Spores can be spread in the wind, but C.diff's most efficient means of transport
are the hands.
It is very easy for the bug to get on the hands and once the hands touch the mouth,
it is then very easy for it to travel to the gut.
What is it resistant to?
The bug can withstand heat. It can survive disinfectant and it does not mind alcohol.
What are the symptoms of C.diff?
Symptoms of the bug include mild to severe diarrhoea, blood-stained stools, fever
and abdominal cramps.
These symptoms are usually caused by an inflammation of the lining of the large
intestine. In rare cases, C.diff can cause peritonitis, an infection of the lining
in the abdomen, blood poisoning and tears in the large intestine.
In very rare cases, a C.diff infection can be fatal. The risk of this is higher
in elderly people and people who have other very serious health conditions.
Who is Professor Hugh Pennington?
Hugh Pennington is an emeritus professor
of bacteriology at the University of Aberdeen.
He chaired a Scottish Executive established expert group following the E.coli O157
outbreak in central Scotland in 1996.
Prof Pennington also headed a public inquiry into the 2005 E.coli outbreak in Wales
in which a five-year-old boy died.
He has also been credited with having made a significant contribution to the science
and practice of medical microbiology, to the health of the nation and to public
understanding of science.
Source.
(External Link).
*****
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19th November 2008.
NHS Greater Glasgow and Clyde Health Board response to allegations concerning Vale of Leven C.diff outbreak.
Infection-free patients placed into
rooms which contain those infected with C.diff
It has already been acknowledged that there were some occasions when it was not
possible to isolate patients because of a shortage of single rooms. There are occasions
when it is unsafe to put patients into isolation, e.g. if their condition requires
continuous observation by clinical staff or if they are at significant risk of falls.
In these cases a risk assessment is carried out and these patients may be nursed
on a main ward with the strict application of all the principles of isolation nursing
applied apart from the placement of the patient in a side room.
Failure by hospital staff/infection control team to alert NHS Greater Glasgow and
Clyde health board of the C.diff outbreak in the months of December, January, February,
March and April.
The Vale of Leven Hospital was fully compliant with the requirements of the mandatory
HPS National Clostridium difficile Surveillance System. However, this national system
was designed to monitor trends but not pick up individual outbreaks at the ward
and/or hospital level. The system used to identify outbreaks locally was, until
May, 2008, a coloured card system which flagged positive cases and was based on
a daily visual inspection of the numbers and types of organisms/communicable diseases
in each ward area. With the benefit of having seen subsequently the statistical
process control charts which track the levels of C.diff infection, we might reasonably
have expected an outbreak to have been identified in the first instance in January,
2008 by the local Infection Control Team and ward staff.
Failure to control a senile dementia patient infected with C.diff who repeatedly
wandered a ward having physical contact with infection-free patients.
In these circumstances we would expect a patient with senile dementia to be closely
supervised to avoid the risk of cross infection to other patients in our care. The
nature of senile dementia creates a continual tendency to wander however appropriate
practice would be to ensure any symptomatic patient is closely supervised particularly
in carrying out hand hygiene and other control of infection practices to minimise
the risk to others within the ward environment. This practice has since been reinforced
to staff by the Infection Control Team.
An infection-free patient being placed into the old bed of a C.diff infected patient
just hours after that infectious patient was moved out of the room.
NHS Greater Glasgow and Clyde has a strict policy for the cleaning of isolations
rooms after an infectious patient has been discharged or transferred. This includes
using a chlorine based detergent for the cleaning of near patient equipment and
this includes beds. Provided this procedure is followed there is no need to delay
the admission of the next patient. There is no requirement/recommendation in the
scientific literature or national guidance for a time delay after cleaning prior
to the next patient being admitted to that area or bed.
An example of one auxiliary having to help an infected patient and an infection-free
patient use commodes at the same time.
It is common practice for nurses on wards to have to provide care to both patients
with and without infections. If basic infection prevention principles are applied,
in this case the appropriate use of personal protective equipment (aprons and gloves)
and hand hygiene then the correct barriers are in place to prevent the transmission
of infection from one patient to another.
Testimony from anonymous staff who describe the reduction of cleaning hours and
the knock-on effect in terms of hospital cleanliness and infection control.
There has been no reduction in the budgeted hours for cleaning in the period from
April, 2006 through to September, 2008. The total weekly floor hours figure at April,
2006 was 1370 hours. At January, 2008 it was 1373 hours; and at September, 2008
remains at 1373 hours. In addition, there has been no deterioration in the hospital
compliance against the National Cleanliness Audit. The figure throughout the period
from December, 2007 to May, 2008 has been maintained consistently above 96% compliance.
Relatives having to wash soiled and contaminated clothing in their own homes without
caution or instruction.
We have a policy which describes the advice carers and families should be given
if they are taking home their relatives soiled or contaminated laundry. It should
be pointed out that with the exception of very heavily soiled laundry, it is appropriate
for laundry to be taken home, and laundered and ironed in accordance with the manufacturers
instructions, this is in line with our Infection Control Policy. Nursing staff are
expected to advise families how to handle such clothing. Unfortunately, at the time
of the C.diff incident we did not have written information leaflets that we could
hand to families that would help them follow the guidance at home. Updated patient
information leaflets which contain clear advice on this matter have now been produced.
Crowded conditions of some of the hospital wards.
The Vale of Leven Hospital was designed and built in the late 1950s and extended
and modified during the mid-1960s. The ward accommodation within the hospital met
all extant planning regulations for clinical accommodation, including bed spacing,
consistent with the regulations in force at the time of construction. Since this
time building regulations have been reviewed and modified on numerous occasions
and one of the areas where design guidance has changed over this period is the spacing
between the beds in a multiple occupancy ward area.
The Vale of Leven at no time had more beds in any clinical area than its design
capacity. However, following the accommodation review carried out in early June
2008 it was decided to reduce the bed configuration in a number of the multiple
occupancy areas to reduce the risk of HAI, namely increasing the number of wash-hand
basins in each clinical area and achieving a slightly higher ratio of separation
between the beds.
This work is being taken forward as part of a rolling programme of improvements
to the clinical facilities within the Vale of Leven Hospital. It should be noted
that these modifications do not apply to all inpatient wards areas, indeed a number
of wards do meet the current accepted standards in respect of bed spacing and wash-hand
basin provision.
Admissions or transfers to the Vale of Leven from another hospital despite the Vale
not being equipped to cope with more patients.
Transfers to the Vale of Leven happen routinely for a number of reasons as part
of agreed clinical pathways across Greater Glasgow and Clyde. These transfers are
to ensure that patients receive as much care as possible as close to their own homes
as possible and are usually for rehabilitation or following completion of a treatment
that is not available at the Vale of Leven.
The main reasons for such transfers are:-
* Older people who have had an orthopaedic operation at another hospital and need
a longer period in hospital to receive further nursing or Allied Health Professional
care.
* Patients who have been considered for, and/or received thrombolysis (clot dissolving
treatment) in the Acute Stroke Unit at the Western Infirmary and need a longer period
in hospital to receive further nursing or Allied Health Professional care.
* Patients who have been transferred to the Royal Alexandra Hospital for consideration/completion
of an emergency surgical intervention, and following that require a further period
in hospital.
* Patients who have been admitted to the Royal Alexandra Hospital as an emergency,
following current by-pass protocols, and following initial assessment and treatment
are medically fit to return to the Vale for the remainder of their care.
There were 189 transfers to the Vale between January and May, 2008 from another
hospital within Greater Glasgow and Clyde.167 of these patients were transferred
from the Royal Alexandra Hospital to allow the patients to be cared for in their
local hospital. Patients are not transferred unless a bed has been identified as
available for them.
Repeated and numerous transfers of C.diff-infected patients internally, from ward
to ward.
When patients are admitted as emergencies they are first admitted to a receiving
Ward: at the Vale of Leven this was Ward 6. Once they have been assessed and a treatment
plan agreed they are then moved to another ward. This is standard practice across
Scotland. Patients might then move again if their clinical condition requires it,
for example:
* They require a single room
* They require a higher level of care
* They require a period of rehabilitation
Patients admitted to the Vale with non-fatal conditions, who subsequently died after
contracting C.diff, not having C.diff included on their death certificates.
We clearly cannot discuss individual cases. It is a matter of clinical judgement
whether a condition the patient had at the time of their death, or in the preceding
period, contributed to their death and therefore if the information should be included
on the death certificate. All individual case records and death certificates for
those who died were reviewed as an action from the Outbreak Control Team meetings.
Frontline nursing staff at the rank of ward nurse not having been spoken to directly
by the Independent Review Team for evidential purposes as part of the review process.
Professor Cairns Smith and his team on the Independent Review panel had full and
unrestricted access to interview any NHS staff. The Professor and his team chose
whom to interview which included frontline ward nursing staff and infection control
nurses. The Health Board ensured anyone they wished to interview was made available.
If the BBC or anyone else is suggesting NHS Greater Glasgow and Clyde in anyway
prevented the Review Team from accessing any staff cohort or individual then this
would be a very misleading and untrue allegation.
An email from NHS GGC which was circulated amongst all health board heads of department
warning staff against talking to the BBC and specifically to myself (Samantha Poling).
Individual staff members received letters at their work from Sam Poling offering
the opportunity of an interview as part of a BBC programme.
Individual members of staff telephoned the Director of Communications to say they
had received the letters and wondered how best to respond. The Director agreed to
respond on their behalf as individuals. The NHS Greater Glasgow and Clyde policy
is clear in that any staff approached directly by the media should alert the press
office for advice, support or to discuss how best to facilitate media requests.
Corporate Communications had already responded to many media inquiries along the
same lines that as the Procurator Fiscal, Crown Office and Strathclyde Police were
continuing to consider any appropriate future actions which could include Public
Inquiry, FAI or even criminal proceedings that the organization would not be putting
anything else into the public domain than already exists "at this time".
It was agreed that the advice that would be on offer in regard to Vale of Leven
and the C.diff outbreak that was currently undergoing legal scrutiny should be offered
proactively to heads of departments at the Vale of Leven. The advice issued is consistent
with statements previously issued to the BBC and other media organisations over
recent months.
Testimony from anonymous staff who describe an internal investigation into the outbreak
as a 'witch hunt' in which 'fingers were pointed'.
An internal investigation was undertaken by 3 senior managers prior to the external
investigation by Professor Smith and his team. The report produced as a result of
the internal investigation was given to Professor Smith for consideration.
The process of the investigation involved a number of staff being invited to meet
with the 3 managers either on their own or accompanied if they preferred, most chose
to be unaccompanied. Everyone was asked a core set of questions, and their responses
were recorded.
From that an internal report was produced which highlighted a number of 'learning
opportunities' which have now been implemented or are nearing completion. The internal
report did not in anyway 'point fingers' at staff members.
*****
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2nd June 2008.
MRSA screening programme to begin.
Hospital patients in Ayrshire, Grampian and the Western Isles will be screened for the MRSA superbug, as part of a new year-long pilot scheme.
Health Secretary Nicola Sturgeon launched
the initiative during a visit to Crosshouse Hospital in Kilmarnock.
Three health boards are taking part in the programme, in which all patients will
be swabbed for the superbug in an attempt to reduce infection rates.
Screening will be rolled out across the country if the trial is successful.
Healthcare associated infections (HAIs) are believed to be a factor in almost 2,000
deaths every year in Scotland.
NHS Scotland currently spends about £183m on treating HAIs.
'Minimise the risks'
Ms Sturgeon said: "It's crucial that the public have confidence in their NHS and
know that they're going to get the best possible care if they need hospital treatment.
"HAI is a problem for health services around the world and Scotland is no different.
"But we're determined to do all we can to minimise the risk that patients will contract
MRSA, which can cause unnecessary complications."
She added that the move was part of a wider drive to minimise the impact of HAIs.
Ms Sturgeon said that the national hand hygiene campaign and a new reporting system
for the superbug Clostridium Difficile (C.diff) had already been well established.
An interim report on the MRSA pilot project is due by the end of March next year.
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18th August 2009.
Campaigners are welcoming a new move
to invest in specialist cancer care for brain and spinal cord tumours.
Ministers in England will later invite hospitals to bid to become the first national
centre for proton therapy.
The treatment uses radiation to pinpoint cancerous cells without significantly damaging
nearby tissue.
There is already one unit in England, but it only treats the less complex eye cancers,
forcing many patients to go abroad and fund the care themselves.
The treatment, which tends to be used on children and those with tumours close to
the most sensitive parts of the brain and spinal cord, is available in the US and
other European countries, but the bill can often top £100,000.
Experts predict an NHS unit would be used by 400 people a year.
Proton therapy is described as "the most precise form of radiation therapy" as it
pinpoints the cancerous cells without significantly damaging nearby tissue.
It works by depositing energy in the target tumour. These electrons damage the DNA
of cancerous cells and ultimately cause their death.
The existing proton therapy site at Clatterbridge, on the Wirral, uses a low-energy
machine which can only by used to reach cancers near the eye.
Wendy Fulcher, chairman of charity Brain Tumour Research, said: "This is excellent
news.
"Previously patients or parents faced a terrible situation, forced to raise funds
to go abroad for lifesaving treatment, adding to the stress of a brain tumour diagnosis.
"I hope this signals a shift in policy for increased funding for brain tumour treatment
and research which is long overdue."
Martin Ledwick, from Cancer Research UK, added: "It is good to see the department
of health encouraging the development of different forms of radiotherapy.
"Although at the moment the number of people this treatment is likely to help is
quite small, it is possible that, as we learn more about it, proton therapy may
have the potential to have a bigger impact on cancer treatment."
Source.
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This page was last updated on 27/11/2009 14:42:08