Cutting NHS drug errors could save 16,000 lives a year, says doctor
Nurses are failing to give hospital patients a fifth of drugs that they are meant to, leading to thousands of deaths, according to a doctor who is pioneering a new way of tackling the problem.
Dr David Rosser, executive medical director at University Hospitals Birmingham NHS Foundation Trust (UHB), has calculated that as many as 16,000 lives a year could be saved in English hospitals if they tightened up their prescribing processes.
He said an unfocussed nursing culture meant poor drugs prescribing and delivery habits were standard.
He has helped developed an electronic system of monitoring whether patients have been given their drugs properly, that has saved 100 lives in a year at UHB alone.
The foundation trust saw a 17 per cent drop in deaths of emergency patients over 12 months after it instigated the IT system, which reminds staff to give drugs.
Explaining the problem, Dr Rosser said: “For the last 10 years, modern healthcare has just not given nurses enough of a focus. We have got massive problems.” But he said this had led to a culture – not just in the NHS but worldwide – where drugs omissions and prescribing errors were an accepted part of hospital life.
“For example, when you are a trainee nurse and you are told, ‘This drug isn’t available’, the sister might say, ‘We’ll get it up from the hospital pharmacy’. But it ends up not being given.”
However, he was determined that was not the correct approach. “We have had a view for years at UHB that if you cut out all the ‘silly little errors’, you are going to have fewer negative outcomes.”
Their real time electronic prescribing system was proving their hypothesis correct, he said.
Dr Rosser has written a paper showing UHB saw a 16.9 per cent drop in mortality in emergency care patients in the 12 months after the IT system was switched on, or 100 lives saved.
Their research could not pinpoint who had been saved, although he said there was “clear evidence” that giving antibiotics to emergency patients with severe infections within an hour of admission, halved their risk of dying.
He presented the research to the Mid Staffordshire NHS Foundation Trust public inquiry, currently investigating nursing failings that led to as many as 1,200 “excess deaths” due to substandard care. If the 17 per cent mortality reduction seen at UHB “could be achieved in all emergency admissions [in England] this would equate to 16,000 deaths avoided”, he wrote.
Dr Rosser compared drugs omission rates at UHB with two other, unnamed, hospital trusts. At UHB, they were between about five per cent for antibiotics, with the IT system in use, and about seven per cent for non-antibiotics.
At the two other trusts the respective figures were 10 to 15 per cent and 22 to 26 per cent – or roughly one in five drugs doses omitted overall.
He believed national rates were higher because these two trusts already had electronic prescription monitoring systems, which suggested they took the matter seriously. However, these could only be interrogated weeks later, he said, so they made little difference to actual patient care. “One point about my report is that you can’t just bang an electronic prescribing system in,” he said.
Simon Burns, the Health Minister, welcomed Dr Rosser’s work. He said: “This is an excellent example of how the NHS can harness information to improve patient care. “Our ambition is to unleash a revolution of information throughout the NHS, so that everyone benefits from a modern, responsive service.”
Immigrant child beggars as young as FOUR making £100,000 a year each for gypsy gangs in Britain
Child beggars as young as four earn up to £100,000 each for gypsy gangs, a shocking investigation has revealed. The children work in teams on London’s streets, wheedling money out of tourists in snow and rain.
Some of the children make £500 a day – and hand it all over to their Romany ‘minders’, the BBC’s Panorama programme found.
Reporter John Sweeney called it ‘a 21st-century version of Oliver Twist’ – the Charles Dickens novel in which villain Fagin forces a group of young children to extract cash from rich Londoners for him.
The documentary, screened last night on BBC1, followed the children – all of them gypsies from Romania – over the course of a year. A girl of about four, who the programme-makers called ‘Alice’, used a phone box as a toilet and scavenged for food at McDonald’s as she begged on the streets.
They found the child ‘experienced in begging’, as she tried to coax and wheedle money from them while dressed in a white headscarf.
The children all dressed in modest clothes and wore headscarves, despite not being Muslim – targeting mosques and areas popular with rich tourists from the Gulf States.
The BBC filmed a group of young Roma women controlling several children outside Regent’s Park mosque, including a four-year-old boy.
They followed the group to a house in Ilford, Essex, where a BMW X5 four-wheel drive car sat on the drive.
The programme found that police generally just take the beggars’ details and let them go. They fear the people on the streets are being exploited by other members of their community.
Last year, police launched Operation Golf in an effort to crack down on the con artists running the scam. Many of the criminals were traced back to Romania, where they own numerous luxury properties and cars.
Bernie Gravett, the former Metropolitan Police Supt who led the operation, said: ‘This is modern-day slavery. How does a four-year-old child consent to be exploited? ‘They won’t know that it’s criminal to beg on the streets of the UK. They are kids.’
The joint British-Romanian police operation arrested 26 alleged child traffickers from Tandarei in the south of Romania. The accused were imprisoned for months but denied any wrongdoing and have since been released.
The case continues as two judges in Romania have sent the case back to the prosecution and in the meantime, the accused cannot leave the country.
Mr Sweeney followed ‘Alice’ and her minder – her mother, Denisa Mazarache – to Fetesti in southern Romania. She admitted to having begged in London, but said she had been desperate and had stopped a year ago. However, the BBC said they had filmed her begging in London just two months earlier.
Police have disrupted the gangs in Britain by targeting them for benefit fraud. Nine people, eight of them Romanian Gypsies, went to prison earlier this year for a total of 10 years for not paying £800,000 worth of benefits. Romanians are not ordinarily entitled to UK state benefits, but police told Panorama that gangs produced forged documents.
Chief Inspector Colin Carswell, who was also part of Operation Golf, said one gang put the earning potential of a single child in London at close to £100,000 a year – from begging, stealing and being used for benefit fraud.
Mr Sweeney met one of the men arrested during Operation Golf in Tandarei, a town dotted with luxury villas. The man blamed Britain for the tricksters’ actions. ‘The blame is with the British state, which gives them a lot of money,’ he said. ‘They have lots of children, seven, eight or ten children, and if they have many children they build a villa.’ ‘Some collect £10,000, £12,000, £13,000 a month – they have three or four or five sets of benefits.’
Brits are stuck with elite rule
Eric Pickles, the Communities Secretary, once told me that when canvassing as a councillor in Bradford he knocked on a door and asked if the chap would vote for him.
The answer was: ‘No. I’m not voting as it won’t make a difference — the council always gets in.’
The man was making a simple point: it doesn’t really matter what I think on the major issues, nobody takes any notice of me anyway.
Of course, he’s right. And if you ever wanted proof, just look at the farce over the EU referendum.
Forced by ordinary people to have a debate on holding a referendum (as a result of thousands signing up to the Government’s official e-petition site), David Cameron orders Tory MPs into the ‘No’ lobby. Miliband does the same, as does Clegg.
They know the majority want a referendum — which I suspect would result in a vote for Britain to quit the EU. They know we’ve always wanted a referendum and they are determined not to give it to us.
It’s the same with the death penalty. A referendum would find 70 per cent in favour. No problem. They know we want it, they know we’ve always wanted it and they are determined not to give it to us.
It’s the same with stopping immigration. Although I would vote against such a move, I know the vast majority — including many ethnic minority Britons — would like to see it.
But once again the ruling elite know we want it, they know we’ve always wanted it and they are determined not to give it to us.
Is it any surprise we feel disenfranchised? We read, listen and watch the news as politicians spout on endlessly and we wonder what planet they are on.
I know the planet. It’s the one beginning with the letter ‘U’.
Britain’s faltering battle with red tape as departments are accused of dragging their feet
Measures to protect small businesses from red tape are to be unveiled, amid a Cabinet row over some departments dragging their feet over the proposals.
Under the changes, being drawn up by Business Secretary Vince Cable, thousands of small firms will be told they do not need to implement a wide range of government regulations. And it will be easier for struggling companies to make large numbers of redundancies.
But Mr Cable and Chancellor George Osborne are said to be angry with other departments – such as Theresa May’s Home Office and Iain Duncan Smith’s Department for Work and Pensions – for not prioritising the need to cut red tape.
An ally of Mr Cable said: ‘Vince wants to come forward with a good package for business this autumn, but we want to see other departments putting their weight behind these efforts.’
The Business Secretary is pushing ahead with measures designed to boost job creation by making life easier for employers. The changes will be announced at the end of next month. They include making firms with fewer than ten staff exempt from some rules, and giving those with up to 50 time to implement others.
There are also plans to cut 90-day redundancy consultation periods to 30 days. Mr Cable also wants employers to be able to discuss issues such as retirement plans and work performance openly.
But allies say he is being stymied by Mr Duncan Smith’s failure to bring in simplified health and safety laws. The Work and Pension Secretary’s colleagues said this was ‘complete rubbish’.
The Business Department also believes the Home Office is slow at cutting costs to firms in applying criminal record checks.
Meanwhile, Steve Hilton, Mr Cameron’s policy guru, has commissioned a report to intensify the heat on Mr Cable.
Our ‘obviously incapable’ teachers: Britain’s new chief schools inspector takes aim at staff who do the bare minimum
Schools are being failed by ‘obviously incapable’ teachers who get away with doing the bare minimum, Ofsted’s new chief inspector has warned.
Sir Michael Wilshaw said it was ‘pretty straightforward’ to identify weak staff by looking at consistently poor behaviour or teaching standards. But a ‘more pressing issue’ was ‘the teacher who just does enough and no more than enough, who year in year out just comes up to the mark, but only just, and does the bare minimum’.
Sir Michael, who takes up his Ofsted post in January, said the quality of teaching ‘has to improve’ and the problem of ‘coasting’ teachers had to be addressed if there were to be more ‘outstanding’ schools.
Ofsted’s last annual report revealed that only around half of lessons were good or better. ‘That is a key issue. It has to be much higher than that,’ said Sir Michael, 65, who is the feted head of Mossbourne Community Academy in Hackney, East London.
His comments are likely to cause disquiet within the profession, which was warned by former Ofsted chief Sir Chris Woodhead in 1996 that there were ‘15,000 incompetent teachers’ in the system.
Asked by the Times Educational Supplement if he was taking Ofsted back to Woodhead-style ‘teacher bashing’, Sir Michael said teaching was a ‘noble profession’ but some teachers were letting it down. He added: ‘The great majority are very professional people who do their best. But in any large body of people there are going to be people that are not very good, and that has to be recognised.
‘It is really important to tell the truth and if there is an issue of poor teaching in our schools it is really important that [the chief inspector] talks about it in a very clear unequivocal manner.’
Sir Michael has previously said head teachers can be divided into those who are ‘fairly mediocre’ and don’t challenge the performance of pupils and staff, and ‘good’ ones who do.
Speaking on BBC Radio 4’s Today programme, he insisted head teachers should challenge staff who were not up to standard. He said: ‘What we’ve got to do in schools is ensure there are strong performance management systems…. to identify not just the hopelessly ineffective and incompetent teacher, but also those that are coasting and letting children down.’
Brian Lightman, general secretary of the Association of School and College Leaders, said he was concerned about the ‘focus’ of Sir Michael’s comments and the balance they struck between emphasising weaknesses and strengths.
Sir Michael, who has been a teacher for 42 years, including 25 as a head, is credited with turning the Mossbourne academy into one of England’s best-performing schools.
Sir Michael has also revealed his Ofsted contract could be shorter than the five years served by his predecessor. Sources suggest it could be as little as two years.
The BBC’s Richard Black can’t see the wood for the trees
He has been doing his best to score points out of the preliminary findings of the Berkeley climate project but is having trouble. The Berkeley people have noted that changes in the Gulf Stream could be responsible for many of the temperature changes observed so he checks with an expert on the Gulf Stream and finds that he too says that changes in the Gulf Stream account for huge tracts of the temperature record. Pesky!
His expert tells him, rather predictably, that human induced CO2 steps in and does the warming when the Gulf stream is not doing much but how plausible is that? What is the switch that suddenly turns on human influences when the Gulf Stream takes a nap?
Black then attacks Anthony Watts and his well-known project of investigating the integrity of U.S. temperature measurements. Black has a bit of a crow — as the Berkeley temperature graph is similar to the existing big three. The Berkeley people however come to their conclusions by relying on “good” temperature measuring stations. But that is an intrinsically difficult enterprise — since Watts has found fault with about two thirds of all U.S. stations — and the U.S. measurements are “good” compared to most of the rest of the world. So it seems possible that the Berkeley people come to the same conclusion only because they use the same crappy data.
Black then asserts quite wrongly that most skeptics have always denied that warming is going on. To the contrary, Warmists have repeatedly pointed out that the recorded warming over the last century or so is trivial and of a piece with previous natural fluctuations. Why do skeptics make such a big thing about the Medieval Warm Period if they deny that there is any warming? Black is just trying to revise history.
As Lubos Motl pointed out in his article that I excerpted yesterday, the issue is the CAUSE of the slight warming we have seen. Is it natural or man-made? And “THE SCIENCE” is very much on the side of the warming being natural. Al Gore always speaks of “THE SCIENCE” as something that supports his extravagant predictions but science does no such thing. Science is all about prediction. Making accurate predictions is the test of any theory. But THE WAY scientists make predictions is by saying that things in the future will work just as things have worked in the past. So a continuation of a tiny warming trend is what “THE SCIENCE” predicts. It is the Warmists who are departing from science by saying that nature will suddenly do something quite different from what it has so far been doing and start generating big temperature changes. Warmism in highly speculative prophecy, not science. An excerpt from the Green Mr Black:
The Berkeley project poses a scientific challenge with its contention that water temperature changes in the north Atlantic – perhaps related to the Gulf Stream, as it’s commonly known – are driving year-to-year changes in global temperature.
Even more so, when the authors suggest that a greater part of the warming-cooling-warming history of the 20th Century could be down to the Atlantic Multidecadal Oscillation (AMO) than is recognised.
(Clarification for putative cherry-pickers; the scientific work behind the papers doesn’t examine this idea or even back it, but the authors suggest it as an avenue for further research.)
I had a chat with Michael Schlesinger, the University of Illinois professor who discovered the AMO along with Navin Ramankutty in 1994.
Research he and others have done since shows clearly, he said, that “while the AMO was the dominant influence on global mean temperature during 1904-1944 and 1944-1976, it is not the dominant influence over the entire observational record, 1850 to 2010.
“Over this time period, it is the increase in the concentrations of greenhouse gases caused by humanity’s burning of fossil fuels that is the dominant cause of the observed warming.”
That, I think, is the conclusion that the majority of climate scientists is likely to make, although the whole issue is made more complex by the fact that greenhouse warming can perturb natural cycles such as the AMO.
Claims that US weather station quality affected diagnosis of global warming was rejected. So it’s interesting to see what those who would shape opinion are making of the Berkeley results.
The sceptical blogosphere has been unusually quiet – disappointingly quiet, you might say. James Delingpole, Jo Nova, ClimateAudit… nothing.
One who has waded into the fray, inevitably, is Anthony Watts of Watts Up With That. I say “inevitably”, because his criticisms of weather station quality were among the factors that persuaded Prof Muller to get his project off the ground.
The Berkeley group concluded that although a high proportion of weather stations in the US might not be high quality – for example, if they’re situated in the middle of an expanding city – it doesn’t matter.
High-quality stations show the same warming trend as low-quality ones; so this issue can be taken off the table.
Mr Watts, in his recent postings, isn’t impressed. He argues that the Berkeley team used too long a time period for its analysis. He says it made a few other basic errors.
There’s a fair bit of revisionism going on too, some of it visible in the comments on my news story. “Sceptics don’t say the world isn’t warming,” this narrative goes – “we just debate how much of it is caused by greenhouse gases.”
There are some “sceptics” who do take this line, it’s true. But if the Earth’s temperature record wasn’t an issue, why has so much energy been expended in attempting to discredit it and the scientists behind it?
Electric car maker runs out of charge
“US car maker Tesla has lost a crucial round of its high-profile libel case against the BBC’s Top Gear motoring program.
The electric car specialist had launched legal action against Top Gear and lead presenter Jeremy Clarkson earlier this year after it alleged a 2009 episode of the show deliberately misled viewers regarding the battery range of its Roadster model.
The segment showed the film crew pushing the Tesla off the test track, with controversial host Clarkson claiming the Roadster had run out of charge after just 55 miles on its track. Tesla claims the Roadster can travel 200 miles on a full charge.
A British high court judge, however, this week dismissed Tesla’s libel claim. “In my judgment, the words complained of are wholly incapable of conveying any meaning at all to the effect that the claimant [Tesla] misled anyone,” Mr Justice Tugendhat is reported as ruling.
“This is because there is a contrast between the style of driving and the nature of the track as compared with the conditions on a public road […] are so great that no reasonable person could understand that the performance on the [Top Gear] track is capable of a direct comparison with a public road.”
This is a bit childish on the part of Tesla. Any car uses up more juice when driven fast but that effect is much greater with an electric car. Driving it fast drastically shortens the distance it can go. Apparently Tesla thought Jeremy Clarkson should have emphasized that — but there was no reason for him to do their PR.
Driving cars fast is one of the things he does. He has a test track especially for that — and it was good information for his viewers to show them the effect of that. There is no way what he did was libel. It was in fact just showing the truth: Electric cars don’t go far if you drive them fast.
Electric cars are just expensive Greenie toys anyway. People who buy them are just trying to prove that they are better than everyone else. But all the buyers really prove is that they’ve got more money than sense.