Diabetic patient died after nurses failed to give insulin injections
A diabetic patient at a scandal-hit hospital died after nurses failed to give her insulin injections, an inquest heard. Gillian Astbury, 66, fell into a coma and died at Stafford Hospital in April 2007. The pensioner, from Hednesford, Staffordshire, had been at the hospital receiving treatment for a minor fall.
But a jury at Stafford Coroner’s Court heard that her blood sugar levels were not properly monitored and insulin was not administered in the two days before her death, despite being prescribed by doctors.
The court heard that some of the nursing staff were not informed that Mrs Astbury was diabetic and some said they were too busy to check the patient notes at the foot of her bed.
On April 10, the morning before her death, Mrs Astbury’s blood sugar levels were checked and found to be “very high” but no medication was given and her blood sugar was not monitored for the rest of the day, the court heard.
Senior staff nurse Patricia King told the inquest she had not been told that Mrs Astbury was diabetic and had assumed another nurse was taking care of her medication. She told the inquest: “I wasn’t aware Mrs Astbury was diabetic therefore I wasn’t aware that her blood sugar should have been monitored. “I’m very very sorry, I really do wish I’d had time to look at the handover sheets and been able to have done something sooner.”
Mrs King said she “shocked” when she first started working at Stafford Hospital, adding: “It was like going back 20 years coming to this ward.” She said staff on the ward had to “muddle through” in poor conditions, with no office or nursing station and a shortage of nurses and support workers.
She added: “Day after day, week after week, month after month, you are going home late because you are trying to do everything you can. “This was an appalling case but equally, the conditions we were working in were appalling too. We did try our best, nobody set out to do anybody any harm. It was poorly done and I can only apologise.”
Staff nurse Brenda Laverty said handovers between nursing shifts were not given at the patients’ bedsides, making it difficult to remember information about individuals. She said she believed she could have been informed about Mrs Astbury’s diabetes but may have forgotten, adding: “I am very sorry I didn’t remember from one day to the next. “The handover was given about 20 patients but it’s hard to remember everything about each individual person.”
Health care support worker Michelle Appleton told the inquest she knew Mrs Astbury was diabetic but did not mention it to the nurses on the ward because she assumed they knew.
A police investigation was launched after Mrs Astbury’s death, but the Crown Prosecution Service ruled there was insufficient evidence to bring charges.
Antony Sumara, chief executive of the hospital, has apologised for Mrs Astbury’s care. In a statement released when the inquest was first opened he said: “You can’t defend something as basic as not giving a known diabetic their insulin.”
Stafford Hospital, run by Mid Staffordshire NHS Foundation Trust, was the subject of a lengthy independent inquiry after a Health care Commission report disclosed deficiencies at “virtually every stage”, including inadequately trained staff who were too few in number, junior doctors left alone in charge at night and dirty wards and bathrooms.
Publishing the inquiry findings in February, Chairman Robert Francis QC concluded: “Patients were routinely neglected by a Trust that was preoccupied with cost cutting, targets and processes and which lost sight of its fundamental responsibility to provide safe care.”
As many as 1,200 people are thought to have died at Stafford Hospital through neglect between 2005 and 2008.
FOI and universities
Tony Blair’s recent expressions of regret over his introduction of the Freedom of Information Act has been much chewed over in the news recently.
If I sense things correctly this is just one symptom of something rather bigger. If I discern things correctly, there are moves afoot to start reining back on the scope of the Act. I can’t quite recall what prompted me to do so, but a few weeks back I sent an FoI request to the Justice Ministry, the Whitehall department responsible for the FoI Act. I asked what meetings ministers and officials had had concerning possible changes to the application of the Act in universities. The answer came back that they “didn’t hold the information”. On its own this would be nothing, although a firmer answer – “no such meetings” would have been more encouraging.
But then there was this a heartfelt piece on the subject of FoI from Professor Edward Acton:
[T]here are dilemmas. If data gathered by researchers is to be disclosable before they have completed work on it, issues of commercial and intellectual property become acute. Take the recent ruling by the Information Commissioner (made under the FOIA’s twin, the Environmental Information Regulation) to force Queen’s University Belfast to hand over painstakingly assembled Irish Tree Ring data. Are we to find that commercial companies (located anywhere in the world – our FOIA is wonderfully cosmopolitan) may secure the release of the unworked data of every UK university?
As an aside, I think Doug Keenan, the man who forced QUB’s hand on this issue, might take issue with some of this. For example, the data is decades old and so can hardly count as “unworked”. Also, according to Queens itself, it was stored on an electronic medium that is already virtually obsolete – floppy disks, suggesting that it was not actually being used. Readers of the Hockey Stick Illusion will recognise these issues and will know that the data should have been stored in a secure repository designed for the purpose, such as the International Tree Ring Database.
But to return to the original theme, there has now been another strong hint that the bureaucrats are on the move. Today’s You and Yours programme on BBC Radio 4 discussed the question of Freedom of Information and featured someone from the University of Warwick declaring that he felt that universities should be exempt.
His reasoning for this involved a delicious misleading of the interviewer, Julian Worricker. He informed Worricker that Warwick receives 77% of its income “competively” and 23% direct from the state. This suggestion then led neatly into an insinuation that Warwick is 23% state funded (all those grants are competitive, right?), and since 23% is much less than some charities get from the state, universities should be exempt. Here, for those who are interested, is the relevant extract from the Warwick accounts:
Anyway, take a listen. The universities section starts at about 20 mins. Heather Brooke is featured later on, together with some minor discussion of climate.
SOURCE (See the original for links)
A licence to interfere in our everyday lives
The [British] Liberal-Conservative coalition government’s proposed licensing reforms were whisked out for a brief consultation in August, which comes to a close this Wednesday (8 September). The anodyne title of the consultation (‘Rebalancing the Licensing Act’) and the rhetoric of ‘empowering communities’ are little more than pretty wrapping: the content is sinister stuff.
Far from empowering communities, the proposed changes would increase the power of local councils, the police and other authorities, who will be removed from necessary checks and balances. Far from rolling back New Labour’s hyper-regulatory regime, the proposed changes would roll it out much further and faster.
After the Licensing Act 2003, New Labour created a network of Licensing Committees, based in each local authority, to issue licenses to sell alcohol to pubs and other premises. This replaced the previous system of licenses issued by local magistrates. In theory, replacing magistrates with local councillors could have been a good thing – except that the Licensing Act set out four ‘licensing objectives’, which meant that the committee started to play a much more interfering role in licensed premises.
The objectives were wide-ranging: 1) the prevention of crime and disorder; 2) improving public safety; 3) the prevention of public nuisance; and 4) the protection of children from harm. In pursuing these aims, Licensing Committees have imposed petty conditions on pubs and bars that have little to do with genuine public order or legality issues. At the Manifesto Club, we have had cases reported to us of pubs asked to install CCTV cameras or CRB-check their staff, put up ‘responsible drinking’ notices, search customers, or install a ‘Think 30’ ID check policy. These same Licensing Committees were responsible for issuing licenses for what the Licensing Act termed ‘regulated entertainment’, covering everything from live music to the mere possession of a piano, not only in licensed premises but in village halls and old people’s homes.
If this current government is committed to civil liberties, as it claims, then the powers of Licensing Committees should be reduced and not massively increased, as this consultation document proposes.
In our view, the problems with the government’s proposals are as follows.
Overturning principles of due process
The Lib-Con consultation document proposed allowing licensing authorities to bring cases for licence removal before themselves. It also suggests reducing the burden of proof required for a licensing authority to remove a pub’s or bar’s licence – and that licensing authorities hear their own appeals, rather than the appeal being heard in a magistrate’s court as it is at present. Finally, it suggests enacting licensing authorities’ decisions as soon as they are made, rather than pending an appeal.
These proposals go against the basic elements of justice: that a person is innocent until proven guilty; that a state authority must have a very good reason before stopping people from doing things; that an appeal is heard by a different authority from the authority that made the original decision. These proposals essentially give licensing authorities unchecked powers to close down, or impose their conditions on, licensed premises, without being subject to due process.
Accepting the police’s word as truth
The consultation document proposes that licensing authorities accept all representations from the police – for example, to close down a bar – unless there is strong evidence to the contrary. This is a big shift from the current situation, where evidence from the police is generally treated with the same weight as evidence from other bodies.
This is a worrying development. The police have a very particular set of interests, which do not marry with those of civic interest groups. The police, if given the choice, would doubtless not have any bars or nightlife at all, since this would mean less crime and rowdiness and a quieter life for them. In Barking and Dagenham, two police officers put in 22 applications for licence review in the course of a single year; there were even local supermarkets on their list. Should their opinion always prevail? No. The police’s views on these matters must always be tested and weighed in courts or by other independent bodies, not only for their truth but also for their reasonableness when countered against other social interests, such as members of the public wanting to be able to buy beer at their supermarket.
Empowering the health police
The consultation document suggests allowing health authorities to bring licence review cases. It also suggests designating ‘health harm’ as the fifth ‘licensing objective’.
Most local health authorities would no doubt be too busy treating patients to get involved in licensing proceedings. But there is an element of the medical establishment which, like the police, has a particular set of interests that are not necessarily the same as the general public’s. Statements from the National Institute for Health and Clinical Excellence (NICE) and other health bodies show a growing penchant for interfering in people’s liberties for the alleged sake of our health – for example, NICE’s recent call for a minimum alcohol price and for a complete ban on alcohol advertising.
From a pure health perspective, it might be better not to drink at all and to be in bed early every night. However, we do not organise our lives solely around our physical wellbeing, which is why it is better that doctors do not get too involved in politics. Giving health authorities more political powers would encourage the authoritarian strand of the medical establishment. As a licensing objective, it would also give Licensing Committees even more powers to interfere in city nightlife…..
The consultation document proposes increasing the regulation of what are known as ‘temporary events’, with the proposal that holders of temporary events must give longer periods of notice. It also proposes that the police have more time in which to object to applications, and that the number of applications that can be made by one person or in one area are limited.
There is already too much bureaucracy covering applications for ‘temporary events’ – a category that includes carnivals, village fetes, public concerts, beer festivals, and so on. Temporary events are essential and spontaneous parts of community life; it should not be too onerous for members of the public to organise these events, even if they lack expertise in licensing regulation or other forms of local council bureaucracy. The proposal to increase the regulation of temporary events, requiring more procedures, greater notice and more potential for objection from the authorities, would greatly increase the administrative burden and make it harder for local events to go ahead…
Cambridge tops international league table
Cambridge has been named the best university in the world in an international league table. The ancient institution has become the first British university to top the QS World University Rankings which measure research quality, graduate employment and teaching standards.
It was named above Harvard as the American institution was removed from the number one spot for the first time since the league table was published in 2004.
According to figures, four British universities, including University College London, Oxford and Imperial College London, appear in the top 10 and 19 are in the top 100. Only the United States had more top-ranked universities than Britain.
John O’ Leary, executive member of the table’s advisory board, said: “UK universities have had an exceptionally good year. Not only does Cambridge top the ranking for the first time, but there are more UK institutions than ever before in the top 100 and 200.”
For the second year running, UCL was named above Oxford in the league table.
The rankings are created following a survey of 13,000 academics and 5,000 employers. They are also based on the number of international students at each university, faculty sizes and the number of research citations.
A separate university league table – created by Times Higher Education magazine – is released later this month
Been on a diet recently? Research shows four in ten women actually gain weight
Four out of ten women who diet end up heavier than when they started watching their waistline, a study revealed today. The average female dieter actually gained 5.2lbs with a ‘foot off the gas’ approach once a target has been reached and a lack of willpower to blame.
Partners who cook or buy unhealthy food were also targeted as was filling up in the office with cakes and biscuits.
The research also showed that a large percentage of women start noticing the pounds creeping back on just 21 days after reaching their ideal weight.
Yesterday, Dr Ian Campbell of the Jenny Craig weight management programme said: ‘In the UK 61.4 per cent of adults are overweight or obese. ‘Successful weight management requires a long-term commitment in order to lose weight successfully and for good. ‘Too many women simply flirt with the notion of dieting via unhealthy yo-yo dieting or quick fix solutions – rather than entering into a proper long-term relationship with healthy eating.
‘Successful weight management requires a holistic and committed approach focusing on food, body and mind. ‘We can often be too focused on the high impact diets that deliver flash-in-the-pan results and then let us down, rather than thinking about how to keep the weight off in the weeks, months and years down-the-line.
‘Dieting can be a real challenge so setting realistic goals and remaining focused on them is important. ‘Otherwise as this research shows, women could end up heavier than when they started.’
The ‘Food: Body: Mind’ report was commissioned by Jenny Craig who quizzed 2000 women aged between 18 and 65 who diet regularly on their attitudes, beliefs and behaviours around weight loss. Six in ten said they are currently on a diet and one in five women saying they are on a ‘continuous diet’.
It found the most common triggers to start dieting was seeing their ‘reflection in the mirror’, preparing for a summer holiday or unflattering photos posted on social networking sites. Other popular reasons include comments by friends or relatives or remarks from their other half.
However the study showed that one in ten fall off the wagon within one day, while almost a fifth manage to make it to a week or more. The average is ten days.
Many blamed pressure they put on themselves to lose weight too quickly for the weight gain, which leaves them with a bigger appetite than normal. Others blamed colleagues, who tuck into fatty lunches and snacks unaware of the effect it has on the dieter, while mothers who polish off their children’s leftovers was another common cause of weight gain.