Unqualified carers ‘doing nurses’ jobs’ including taking blood samples, reviving patients and supervising entire wards
Hospital workers without medical qualifications are being told to help resuscitate patients, take blood samples and – in some cases – are being left in charge of entire wards. Healthcare assistants are also being asked to give anti-psychotic drugs to the elderly and perform tests to check for heart attacks, a poll has found.
There are now concerns among nurses that patients are coming to harm at the hands of HCAs who are being asked to carry out complicated tasks for which they have not been properly trained.
A poll of 2,554 nurses for Nursing Standard magazine found many work in hospitals where these staff routinely step in for qualified nurses, who have done at least three years of medical training.
Some reported that HCAs were being asked to help resuscitate newborn babies or other patients. Many said they were routinely taking blood, administering insulin and carrying out ECGs, which show whether patients are having heart attacks.
One said HCAs on her ward were asked to give dementia patients anti-psychotic medication – known as a ‘chemical cosh’ because of its harmful side-effects – even though they had no idea what the drugs did.
And another said nurses were so busy doing paperwork that HCAs were being taught how to do many practical tasks instead.
There are around 300,000 HCAs working in hospitals and care homes in the NHS. They are meant to assist nurses by carrying out basic tasks such as feeding patients, helping them to the toilet and answering call bells.
But understaffed NHS trusts are increasingly asking the workers to carry out tasks normally only performed by nurses or junior doctors. And unlike nurses or doctors, there is no official register for HCAs, meaning they cannot be struck off for harming a patient or other wrong-doings. This means if they are sacked from one hospital or care home, there is nothing to stop them getting a job in another.
Howard Catton,of the Royal College of Nursing, said: ‘These findings make it clear that if we want to maximise patient safety, we need to push forward with mandatory regulation of support workers. ‘There is also a clear need for education and training of support staff to ensure we do not separate tasks from the knowledge required for clinical assessment and decision making.
‘Registered nurses need to carry out clinical tasks to maintain their clinical competence. ‘If their clinical skills deteriorate, they will no longer be able to…supervise support workers safely in carrying out clinical tasks.’
‘There was no care for my mother at all’: Hospital made 140 blunders over gran who died
A stroke victim died in hospital after bank holiday staff shortages led to appalling basic errors in her care.
Christine Lofthouse, 67, was admitted to St James’s Hospital in Leeds late on New Year’s Eve 2010. But instead of receiving prompt medical attention, she was left on a trolley for hours, not given antibiotics to treat a urinary infection for a day and then prescribed the wrong medicine.
Nursing staff failed to monitor her condition, she was missed out by a consultant doing the morning ward round and her medical notes were incomplete.
Mrs Lofthouse’s health deteriorated and she died as a result of the infection three days after her admission.
Her son, Tim, later identified 140 mistakes in her medical notes and charts. He took legal action against the NHS trust and he has now received an apology and a settlement to cover his mother’s funeral expenses.
Mr Lofthouse, 45, was given a damning internal report detailing the catalogue of failures in his mother’s treatment.
‘There was no care at all as far as I’m concerned,’ he said. ‘The basics were all wrong, it was deplorable. How this could have happened I don’t know. They are trying to say it’s due to staffing levels, but doctors failed in their duty of care and so did the nurses.’
Retired seamstress Mrs Lofthouse, a mother-of-two with four grandchildren, suffered a stroke in the year before her death which left her bed-bound and on antibiotics.
Her son, a former postmaster who had given up his job to care for her, called an ambulance on New Year’s Eve because his mother had developed a urinary tract infection.
She had been treated for four similar infections – linked to a catheter she was fitted with – in the previous year, but this time the hospital let her down. Mrs Lofthouse was left on a trolley in the corridor for nearly four hours and eventually got a bed at 2am on New Year’s Day. ‘We called out “Happy New Year” to the seven other people waiting on trolleys at midnight,’ said Mr Lofthouse. ‘You can imagine the chaos.’
The report said the nightshift on Mrs Lofthouse’s ward began with four staff caring for 26 patients. ‘The workload pressures on this day were significant and resources appear insufficient,’ it said.
Mrs Lofthouse was initially given antibiotics in casualty, but blunders meant she didn’t receive any more for 24 hours.
When a second dose was given, the antibiotics had little chance of working because a junior doctor had failed to notice that Mrs Lofthouse had been taking them for a long time, meaning the infection had become resistant to them.
No checks were carried out on her vital signs, including blood pressure, pulse, temperature and breathing, for 15 hours on New Year’s Day and the consultant on the morning round failed to see her.
Mrs Lofthouse was admitted to a high-dependency unit on January 2 and died the next night. The report concluded the failures in care ‘had a major effect’. Mr Lofthouse said: ‘After all that she had been through she was a fighter, and she was let down at the end.’
He said he was aware that his mother was not being given the attention she needed, but ‘short of physically grabbing the nurses there was a limit to what I could do’. ‘One of the greatest things about this country is the NHS, but when it goes wrong it goes wrong badly,’ he said.
A spokesman for the trust said the care fell short of its standards and it had developed an action plan to ensure lessons had been learned.
A wretched ‘reform’ that could put a lame-duck into the British Prime Ministership
Precisely because the two most boring words in the English language are ‘constitutional reform’, people tend to ignore the subject. This is a pity, because such reforms normally have huge implications that are very far from boring.
For example, until a few weeks ago, if the Prime Minister chose to ask the Queen to dissolve Parliament and call a General Election, he could easily do so.
This was a vital power — particularly at times (like now) when the country was ruled by an unstable coalition, with Cabinet members at each other’s throats to some degree or other.
However, as a result of the new 2011 Fixed-term Parliaments Act, a prime minister has lost that device. For this most offensive and self-serving law of modern times has removed the Queen’s prerogative power to dissolve Parliament. Instead, the power has been placed in the hands of Parliament itself.
Parliamentary terms are now fixed at five years. This means that the next General Election is scheduled to be held in May 2015. Of course, there are circumstances in which an election could be called earlier, but they are dependent on a complex set of events.
For example, Parliament can be dissolved if two-thirds of the House of Commons votes to do so on a no-confidence motion. But unless 434 of the 650 MPs currently in the House vote for the end of the Government, that won’t happen. Even the Blair government, after its landslide in 1997, did not have support on that scale.
Alternatively, the government may resign at any time: but an election is triggered only if, after 14 days, no one else can form an administration.
This could be a means of David Cameron getting an immediate election. However, the process would be messy. It might accidentally put a lame-duck, unelected Miliband government into power.
What’s more, trying to engineer an election in this way would be construed as an act of cynicism and would damage the Conservative Party hugely.
The truth is that very few people seem to be aware of this new Act, and that a major constitutional change has happened. Certainly, no one voted for it.
The new law — which can keep a government in power long after it has passed its sell-by date — has put a sizeable hole in the hull of the glorious ship that used to be called British democracy.
It could, one day, mean this country is ruled — and I use that term advisedly — by a succession of rocky minority governments, or coalitions, that try to stagger on to complete the requisite five-year term. That would be a travesty of democracy.
However, lumbered as we are with five-year Parliaments, we must get used to the notion that when a government runs out of steam it cannot be removed by a simple Commons vote of confidence (as happened to Jim Callaghan’s decrepit Labour government in 1979).
Nor can it resign and ask the country for a new mandate (as Edward Heath did in February 1974). Instead, Britain can become saddled with incompetent, and unrepresentative, governments until the five-year term elapses.
Tragically, the Fixed-term Parliaments Act is but the latest example of the inevitable problem that comes with any attempt to change, or rig, the British constitution: that such changes, or riggings, always have serious unintended consequences.
Often, these are plain to see; but another feature of constitutional reform is that the politicians who legislate for such changes are usually acting out of cynical motives and care little about the effects.
Now investors pay to lend money to Britain, which has become a safe haven thanks to the eurozone crisis
Investors paid for the right to lend money to the UK yesterday, amid fresh fears over the future of the eurozone. The Government sold £700million of bonds – long-term IOUs – in an extraordinary auction that saw it charge lenders to take on the debt.
Governments usually have to pay to borrow on international money markets, but Britain’s austerity measures mean it has emerged as a safe haven while the single currency crisis rages.
Once inflation is taken into account, the interest rate charged by lenders for 35-year bonds hit minus 0.116 per cent – meaning the Government will make rather than lose money on the deal. By contrast, debt-stricken countries in the eurozone are being charged higher and higher rates to borrow.
To make matters worse, ratings agency Fitch warned yesterday that a number of countries – including Italy – could see their credit ratings downgraded by the end of this month. It claimed that Italy is the biggest cause for alarm – and added that bailed-out Greece could crash out of the single currency by the end of the year.
Yet as fears grow about the ability of many European nations to pay their way, Britain and Germany are emerging as the countries of choice for investors seeking shelter from the financial storm.
A source close to Chancellor George Osborne said of yesterday’s events: ‘This reinforces how our plan is delivering fiscal credibility, which in turn is delivering low interest rates for families and businesses up and down the country. Labour would put all that at risk.’
Michael Hewson, an analyst at CMC Markets, said the negative yield – the situation whereby investors must pay to lend – was ‘unusual but indicative of the times we are trading in’. He added: ‘Our economy is not immune to the eurozone troubles, but the UK won’t default because the Bank [of England] will print more money. Whether it will be the same value is another thing, but you will always get your money back.’
Another City analyst, David Buik of BGC Partners, agreed that the auction was a testament to Britain’s strength. ‘It is another classic illustration of a flight to quality created by an immeasurable slew of fear of the unknown,’ he said.
David Miller, a partner at Cheviot Asset Management, said investors ‘view Britain as a safe haven and a beacon of sanity in Europe’. He continued: ‘The low borrowing rate will give us a firm foundation for economic recovery.’
British schools that dared to liberate their pupils
Charles Moore reviews The Grammar School: A Secret History
“Sapere aude” (“Dare to be wise”) is the motto of Manchester Grammar School. It is emblematic of the grammar-school tradition, for several reasons. The first is that it is old: it appears on the coat of arms of Hugh Oldham, Bishop of Exeter, who founded the school to help the poor boys of Lancashire in 1515. The grammar-school phenomenon is as old as the public-school one. One could argue that public schools began as a mere subset of grammar schools.
The second is that the motto is in Latin. Latin was the mainstay of grammar schools — it is Latin grammar from which they take their name, which shows that their commitment to learning lay at their root. The third is that the school has a motto at all. Comprehensives tend to eschew mottoes, especially Latin ones, as being pompous, elitist, out-of-date. It was of the essence of grammar schools, as this programme eloquently showed, that they tried to inculcate high ideals. Mottoes do this succinctly.
Finally, the words of the motto express a particular spirit. The concept of wisdom depends on some high, ancient and demanding exterior standard. It is not about self-fulfilment (though it may bring self-fulfilment in its train), but about something beyond self. To tell people to “dare” to be wise is to imply that the search for wisdom requires courage and involves difficulty.
It does, and it did so particularly for all those children, a quarter of the pupils in the first half of the 20th century – including the future prime ministers Edward Heath and Margaret Roberts (Thatcher) — whose parents could not afford to send them to grammar schools without state or county scholarships. For them to “dare to be wise” was also to dare to rise beyond the social sphere in which they had grown up. In most cases, this was done not in despite of their parents’ wishes, but in accordance with them. Across the generations there was a culture, to use a Victorian word, of improvement.
Although this programme (the first of two) pointed out the shortcomings of grammar schools, the thrust of its message, conveyed through the mouths of men and women, now old, who attended them before 1950, was overwhelmingly positive. Even when they described hardships and stresses — exams on which so much depended, homework done in the bathroom because it was the only warm place in the house away from the noise of the gramophone — they did so with a dignity and articulacy which showed that they had been well educated.
One of the most attractive was a very old man called Geoffrey Stone, who won his place at Manchester Grammar in 1929. He put on his old mortar-board to show what it had been like to be a prefect. He had been kept on at the school by bursaries after his father had lost his job. At the end of his war service, he was offered a job in the Foreign Office. This was a rare achievement for a man of his background at that time. Mr Stone considered the situation, however, and decided, selflessly, that this would not be the best use of his talents. He became a teacher, and eventually, the headmaster of a grammar school in Derbyshire. Mr Stone “dared to be wise”, even when it might have been against his own interests.
Yes, some of the curriculum was boring. Much of the life was austere and the discipline petty. Some of the teaching theories were rigid. (It was amusing, in this respect, to note that the title sequence, in which a modern girl in grammar-school uniform writes at an old-fashioned desk, was inauthentic. She was writing left-handed and upside down, habits which, in those days, would almost certainly have been harshly knocked out of her.)
But every former pupil – whether famous and successful, like Sir David Attenborough and Lady (Joan) Bakewell, or entirely unknown; whether happy at school or not — was, visibly, the better for it. A man called Jim Humphries had to leave his grammar school at 14 to get a job which would pay the family rent. On his last day, he hurried out of his last lesson at 12.35, and was working at the factory in Stoke by 2pm. As he looked back, he showed no bitterness, just pleasure at having had the chance to learn.
In fact, what all shared was a respect for what it means to learn things. Joan Bakewell picked up the longing to go to Cambridge simply by getting hold of a picture book about it and seeing the beauty of a place devoted to learning (she got in). One of the worst features of a bad education is that, by purporting to centre on the child, it narrows his or her horizon. It fails to explain how much more interesting the world can be if only you find out more about it. People who say that Shakespeare or Latin or theoretical physics are “irrelevant” to “deprived” children are the people who perpetuate that deprivation. Most of the ex-pupils on this programme gave thanks for teachers who never took that view, but captured their imagination — no, not captured it, liberated it.
Part Two (which runs on Thursday) will show what happened in the 1960s when, as the programme itself put it, grammar schools were phased out by “the very people who had benefited from them most”. I am not sure this is quite fair. Those most scornful of grammar schools tended to be those, like Labour’s Anthony Crosland, with expensive public-school educations. But whoever was guilty, the crime was enormous. Only now can we see the full extent of the damage.
The new academies are a revolutionary force in British education
There has not been such a radical restructuring since the spread of comprehensive schools 50 years ago
A revolution in British schools is happening under our noses. As Michael Gove announced last week, there are now 1,529 academies, compared with only 200 when the Coalition came to power. Not since the spread of comprehensive schools, 50 years ago, has there been such a radical restructuring.
The academy programme was the brainchild of Tony Blair and his minister, Andrew Adonis. Academies seek to emulate the independence of private schools: they are self-governing and independent of local government, which is one reason why local authorities, unions, and the Left in general have not welcomed their rapid growth. But unlike independent schools, they charge no fees, and receive funding direct from central government. The Government aims for all remaining secondary schools to become academies, and many primary schools too.
Sponsorship by outside bodies is a feature of academies, whether by private individuals such as Sir David Garrard, or organisations, such as Ark. Ten years ago, independent schools were given the option to sponsor academies, either as sole sponsors, as with Dulwich College, Canford School in Dorset and Wellington College, or as a joint sponsor, as with Marlborough and Benenden. For several years, when I was head of Brighton College, I had an unsuccessful fight with the local authority to let the school start an academy there. After I moved to Wellington I was overjoyed that the governors were so supportive of the idea, and an opportunity became available to us in Wiltshire. Hence the birth of Wellington Academy.
Not all academies have been successful; the academy movement has its critics, and not only on the Left. When David Cameron entered the fray last autumn and asked all independent schools to sponsor academies, his comments were greeted with howls of protest from a surprising number of independent school heads.
Last week, David Laws, the former Cabinet minister, joined the critics, and said it was not the job of private schools to deliver state education. Quite right, said one independent school head, who said her parents “thank her for standing up for their rights”.
This sort of reaction saddens me. Sponsoring academies is exactly what independent schools should be doing. Yes, many schools are suffering in the current economic climate, as are parents, many of whom struggle to find the fees, and are already paying through their taxes for others to attend state schools.
But sponsoring an academy gives the independent school, its teachers and pupils, far more than it takes away. It allows the children to share part of their lives with others from very different backgrounds, and teachers to learn about what is happening in the state sector, which in vital respects is now ahead of the independent sector. It does not cost the independent school a penny. Not a single parent at Wellington College has objected to Wellington Academy, and many have praised the opportunities it has given their children.
Independent schools were often founded with a religious or moral purpose. That purpose now dictates, I believe, that we should bring state schools into our own orbits. The independent sector is a great British success story. We need to share what we have if we are to become a more harmonious and united nation.
What we need from independent school heads and governors is courage and moral leadership. We need exactly the same from our political leaders, who for many years have failed sufficiently to articulate a moral agenda, or to provide by personal example the authority that the country needs. Our independent sector, as well as our political leadership, needs bigger hearts and imaginations if we are to break down the barriers that have so bedevilled Britain in the past.
Must not mention the strange behavior of Touretters
“David Cameron [British PM] was forced to apologise yesterday after describing Commons heckling by Labour bruiser Ed Balls as like ‘having someone with Tourette’s sitting opposite you’. He said his jibe at the Shadow Chancellor – someone he has also branded ‘the most annoying person in modern politics’ – had been made ‘off the cuff’.
The remark prompted angry criticism from disability campaigners, who said that the Prime Minister had shown a lack of understanding of the inherited neurological condition which often causes sufferers to swear involuntarily.
Mr Balls has turned his barracking of Mr Cameron during weekly Commons question time into an art form, with carefully rehearsed hand gestures and shouts designed to put him off his stride.
Speaking about the Shadow Chancellor in an interview, Mr Cameron said: ‘He just annoys me. I don’t really hate anyone in life. ‘But I’m very bad, in the House of Commons, at not getting distracted – and the endless, ceaseless banter, it’s like having someone with Tourette’s permanently sitting opposite you.’
Volkswagen’s latest car in controversy over ‘black up!’ model
“As a leading carmaker Volkswagen is revered for its radical thinking and engineering genius. Sadly for the German business, it is a little less adept when it comes to extricating itself from a PR nightmare.
With the launch of its new ‘up!’ supermini looming, the firm decided on a few special editions to boost sales of the model.
One, however, proved a little controversial. While the ‘white up!’ was always on safe ground, the ‘black up!’ was clearly heading for trouble.
UK bosses blocked the name fearing that if it was used in Britain, it could give offence to ethnic minorities – because of the connotation of white actors and singers ‘blacking up’ to perform as minstrels.
The solution they came up with however was hardly inspired. Bosses simply decided to reverse the words and call it the ‘up! black’.
Funnily enough, no one has been convinced and a PR storm that could have been averted now refuses to blow over. Matthew Collins, of campaigning organisation Hope Not Hate, branded the name ‘insensitive’. He said: ‘In this country at the moment we seem to be dealing with an explosion in racism and these are not the wisest of words to have been chosen.’