6,000 die a year due to poor patient checks
Six thousand patients are dying every year because hospital staff are not properly monitoring vital signs. The health of patients is deteriorating and going unnoticed because important signs, such as blood oxygen levels which can predict heart and lung problems, are either not being recorded at all or often enough.
Bedside health charts are not designed to pick up subtle physiological changes which together can indicate if a patient’s condition is going downhill, according to the Royal College of Physicians.
Doctors would be able to intervene much more promptly and save thousands of lives every year if hospitals used a more comprehensive chart, the report states.
Hospital staff are also being left confused by the more than 100 different types of chart which are used across the country.
There should be just one system used for all staff who check on patients’ conditions – whether they are in care homes, hospitals or in ambulances, a working group set up by the college said.
It has developed a new chart which it is campaigning to have rolled out across all hospitals in the UK.
The chart is a ‘traffic light’ monitoring system of six vital signs such as pulse, temperature and blood pressure, in which each is given a risk score.
The healthcare worker then adds up the score for each sign to give an indication of the severity of illness and whether the patient needs more urgent care.
Bryan Williams, professor of medicine at University College London, chair of the working party which developed the new chart, said it would have a “major impact”.
“Most improvements we make are incremental, but we see this as transformational. It’s going to make a big difference,” he said.
“Subtle changes identified together are often more significant than a single extreme change. That’s why deterioration is often missed.
“If you go into hospitals, you will find very different systems in place. Sometimes staff are not taking all six measurements, but even where they are, they are not being scored in the same manner – sometimes even between wards.
“There is also tremendous variation between hospitals in frequency of monitoring.”
The National Early Warning Score will require nurses and healthcare assistants to monitor temperature, pulse, blood pressure, breathing rate, level of consciousness, and oxygen saturation.
The last is a measure of how much oxygen is in the blood, and has only recently been adopted by hospitals. A low score can indicate heart and lung problems.
The Patients Association welcomed the new chart system, saying it should be implemented “urgently”.
Katherine Murphy, chief executive of the association, said: “The public will be shocked to learn that the NHS has been operating such an ad hoc system of monitoring deterioration in a patient’s condition – with different approaches in each hospital.”
The Royal College of Nursing has been closely involved in the project.
Janet Davies, director of nursing and service delivery, said: “There is nothing nurses and doctors should prioritise more than patient safety, and this system, if implemented across the board, will be a great leap forward for patient care.”
The Society for Acute Medicine also welcomed it, saying the “lack of consistency” between hospitals “may be a contributory factor in the higher levels of mortality in early August when many junior doctors change jobs”.
The Department of Health is not making the system compulsory, saying hospital managers should be able to choose whether to adopt it or not.
But Professor Sir Bruce Keogh, medical director of the NHS, welcomed the method as “an excellent example of how doctors and nurses and other healthcare professionals can take the lead in developing innovations to improve healthcare for patients”.
He said: “Every hospital should be using an effective early warning score to monitor and respond to severely ill patients.
“Catching deterioration in the early stages can mean huge improvements in patient safety and outcomes. This score offers an opportunity for the NHS to standardise how it monitors a patient’s condition across different healthcare settings.”
Britain’s brainless Met Office
An interesting correspondence below — forwarded to me. Among other things, they can’t even spell such simple words as “truly” or “huge”. I start with an email to them:
Dear Met Office,
You may know of the late Mr Norman Holdsworth, who was a senior Met Office weather forecaster for decades. He served at Cyprus ; Aberporth, Wales and Bracknell.
Norman was a lovely man…. a real gentleman of high intellect. He always used to tell me that he never believed in the twin falsehoods……..”global warming” and “climate change”.
Since he’s died, we have had four successive winters in the UK, with long spells of severe weather.
So where is the EVIDENCE for anthropomorphic “global warming” …….. now dubbed “climate change” to try and dupe people even further?
Could you please supply PROOF that there has been global warming over the last 10 years ?
L J Jenkins,
The Met reply below
Dear L J Jenkins,
The evidence for climate change is vast and if you wish to truely understand the physical forces at work you will need to be prepared to do a certain amount of reading to gain this. There are hugh amounts of scientific research available in the public domain. However as a good overview, I would refer you to the web site of the Intergovernmental Panel on Climate Change (IPCC) at http://www.ipcc.ch/publications_and_data/ar4/wg1/en/contents.html and the Met Office Hadley Centre publications which can be found here (in particular the one titled “Evidence”): http://www.metoffice.gov.uk/learning/library/publications/climate-change.
The Met Office Hadley Centre is the UK’s national centre for climate change research. Partly funded by DECC (the Department of Energy and Climate Change) and Defra (the Department for Environment, Food and Rural Affairs), the Hadley Centre provides in-depth information to the Government and advise them on climate change issues using expert scientific evidence. Our climate scientists undertake studies of the global climate using similar, though more extensive, models of the atmospheres, as are used for the prediction of weather conditions.
In its Fourth Assessment Review, the Intergovernmental Panel on Climate Change (IPCC) stated that there is unequivocal evidence from observations that the Earth is warming. It further stated and that most of the observed warming since the mid-20th century is very likely due to the observed increase in man-made greenhouse gas concentrations. By “very likely”, the IPCC means a 90% probability or greater. This broad climate change message has also been strongly supported by the world’s top Academy of Sciences, including the Royal Society in the UK and the National Academy of Sciences in the USA.
In view of this, the Met Office firmly believes that climate research has captured the essential aspects of what is causing our planet to warm. It is now time to look at strategies for adaptation and mitigation; better defining uncertainty and improving regional detail in climate models. This is where our efforts will and should be directed.
Climate Science Enquiries Coordinator
If Trish had another brain, she’d be lonely
IPCC seeks to influence UK FOI laws
For much of the year, the House of Commons Justice Committee has been conducting a post-legislative review of the Freedom of Information Act, its work taking place in the face of a concerted effort by the bureaucracy to push it into accepting the idea that the Act should be neutered.
The review has now ground to a conclusion, and the news is, on the whole quite good. For example, from the recommendations comes the welcome news that the committee favours a tightening of the legal ramifications for breaches of the Act.
The summary only nature of the section 77 offence means that no one has been prosecuted for destroying or altering disclosable data, despite the Information Commissioner’s Office seeing evidence that such an offence has occurred. We recommend that section 77 be made an either way offence which will remove the limitation period from charging. We also recommend that, where such a charge is heard in the Crown Court, a higher fine than the current £5000 be available to the court. We believe these amendments to the Act will send a clear message to public bodies and individuals contemplating criminal action.
However, one of the other recommendations is less obviously welcome, with the committee concluding that England and Wales adopt the Scottish approach to research data. This allows exemption under two different grounds – a narrow one and a broad one. The narrow exemption is for data held for future publication, the narrowness coming from the requirement that the publication date cannot be more than 12 weeks in the future. The broader, and therefore much more worrying, exemption is for data held as part of an ongoing research programme. I’m not sure that this doesn’t allow those who would rather their research was not examined by outsiders simply to say that they are still using the data and that it cannot therefore be disclosed.
The whole of the university sector seems to have been keen to get a much broader exemption in place. One submission of evidence, from Universities UK is a particularly interesting case in point, which shows that those champions of openness, the IPCC, have also been taking an interest.
[…] evidence of commercial partners being put off working with UK institutions is largely anecdotal. However, in a case involving the Environmental Information Regulations (EIR) recently settled by the Information Commissioner for drafts of a published paper, the University of East Anglia highlighted that:
In another matter, we recently received exactly such representations from the IPCC TSU [Intergovernmental Panel on Climate Change Technical Support Unit] based in Geneva, Switzerland in which they explicitly noted that release of such material would “[…] force us to reconsider our working arrangements with those experts who have been selected for an active role in WG1 AR5 [Working Group One, Fifth Assessment Report] from your institution and others within the United Kingdom.”
British cab drivers being forced by town halls to spy on customers by recording all conversations in their taxis
Town hall bosses have been forcing taxi drivers to record all conversations in their cabs, it emerged last night.
In an alarming extension of the Big Brother state, CCTV and microphones had been installed in all cabs under the control of Southampton City Council – but yesterday the Information Commissioner ordered it to end the policy, claiming that its official snooping had ‘gone too far’.
Southampton began forcing local taxi drivers to record conversations between themselves and passengers in 2009, claiming it would provide greater safety for both parties.
Embarrassing footage is certain to have been captured of passengers worse for wear or making intimate phone calls.
In other parts of the country, including London, it is recommended that cabs either install CCTV systems without audio recording functions due to privacy concerns, or use a system which triggers audio recording only in specific circumstances for a short period, such as if the driver has pressed a panic button.
Southampton’s officials claim they view the footage or download recordings from cabs only if a complaint is made against a driver or when police request it while investigating a crime, and other town halls had been intending to copy the scheme.
However, Information Commissioner Christopher Graham, responding to a complaint by a passenger, said most people expect privacy in the back of a cab, and that while CCTV can still be used, recording conversations must stop.
He added: ‘By requiring taxi operators to record all conversations and images while the vehicles are in use, Southampton City Council has gone too far.
‘We recognise the council’s desire to ensure the safety of passengers and drivers but this has to be balanced against the degree of privacy that most people would reasonably expect in the back of a taxi.’
Southampton officials said they may challenge the decision. If successful, it would raise the prospect of passengers being snooped upon across the country.
The watchdog also revealed a similar scheme in Oxford would have breached the Data Protection Act, and that the local authority has now suspended the policy.
Nick Pickles, director of the civil liberties campaign group Big Brother Watch, said: ‘Recording every minute of every passenger’s conversations in taxis is an unjustified and intrusive measure.
‘What is deeply concerning is that two councils have made huge errors of judgment in pursuing audio recording in taxis and that is an issue the commissioner needs to urgently address.
Southampton City Council began enforcing taxi drivers to record their passengers – claiming it would protect both parties
Southampton City Council began enforcing taxi drivers to record their passengers – claiming it would protect both parties
Mr Graham said that images should be recorded only where it is ‘clearly justifiable’ while audio recordings should be made only ‘on very rare occasions, for example where there are a high number of serious incidents and where recording is triggered due to a specific threat’.
Jacqui Rayment, Southampton City Council’s deputy leader, said: ‘We are disappointed with this decision, as it is about safety for both the drivers and passengers.
‘Data is encrypted, kept very securely and only downloaded if there is a specific complaint against a driver or if the police request access in order to investigate an alleged offence. We are currently taking legal advice on the next steps to take, including appeal.’
NINETY British primary pupils sent home every day for attacks in class: Shocking figures reveal rising school violence
A Rising tide of violent indiscipline in primary schools was laid bare yesterday. Official figures revealed that 90 children are sent home every day for attacking teachers or classmates.
And the worst deterioration in behaviour is being seen in the most affluent parts of the country. Teachers blamed parents for failing to equip children with the social skills they need to cope in the classroom.
Last year primary schools expelled nearly 300 pupils aged 11 and under for violence and handed out almost 17,000 suspensions. This means that on any given school day in 2010/11, 90 pupils were ordered out of school for attacking a member of staff or fellow pupil.
Primaries were forced to bar pupils more than 10,000 times for persistent disruption in lessons and 6,390 times for verbal abuse.
Hundreds more pupils were sent home for other serious breaches of school rules such as bullying, racist abuse, sexual misconduct, theft, drugs or alcohol offences and damage to property.
Figures issued by the Department for Education shows that while the number of secondary pupils being suspended or expelled is falling, there is a worsening picture at primary level – especially in the most affluent parts of the country.
The number of suspensions has increased most sharply in the country’s wealthiest areas.
The trend follows claims from teachers that spoilt middle-class children are just as likely to challenge authority at school.
Earlier this year, Dr Mary Bousted, general secretary of the Association of Teachers and Lecturers, said: ‘A minority of children are very aware of their rights, have a total disregard of school rules and are rather less aware of their responsibility for their own learning and how to show respect to staff and other students.
‘This can apply as much to over-indulged middle class children as those from challenging families.’
The latest data emerged days after a psychologist warned that parents who are afraid to discipline their children are creating an unruly generation. Dr Tanya Byron, who featured in BBC TV’s The House of Tiny Tearaways, described the rise of the ‘friend-parent’ who tries to be the child’s equal rather than an authority figure.
Teachers’ leaders said yesterday that a lack of parental support was to blame for discipline problems.
Chris Keates, general secretary of the NASUWT, said a recent survey had shown that two-thirds of teachers highlighted poor support from parents. ‘Sending children to school on time, with basic equipment and clear expectations of how they are expected to behave is a critical part of the job of all parents,’ she said.
‘Parents must understand that their responsibility for their child’s behaviour does not end at the school gate.’
Russell Hobby, general secretary of the National Association of Head Teachers, said: ‘Some children are arriving unprepared for what it means to be in a large group of people.’
The figures show that boys are three times more likely to be suspended or expelled than girls. The average suspension was for 2.4 days but 2,900 lasted more than two weeks.
The fall in numbers being barred from lessons in secondary schools is partly due to schools’ increasing use of unofficial exclusions – or ‘managed moves’ – which transfer disruptive pupils to other secondaries.
Primary pupils perpetrate more assaults on teachers than secondary. Some 42 primary pupils are sent home every day for assaults on teachers, compared with 32 secondary pupils.
The Department for Education said the figures justified Coalition moves to strengthen teachers’ powers to keep order in the classroom.
Must not suggest that homosexuality is unhealthy
One of Britain’s most senior Roman Catholics has sparked fury by suggesting an MP and former minister died because he was gay.
The new Archbishop of Glasgow, Philip Tartaglia, said society had kept ‘very quiet’ about the death of Labour MP and former Scotland Office minister David Cairns. Mr Cairns, a former Catholic priest himself, died in May last year at the age of 44 from acute pancreatitis. But Bishop Tartaglia questioned why his body ‘just shut down’.
At a conference on religious freedom held at Oxford University, he said: ‘If what I have heard is true about the relationship between the physical and mental health of gay men, then society is being very quiet about it.
‘Recently in Scotland, there was a gay Catholic MP who died at the age of 44 or so, and nobody said anything, and why his body just shut down at that age.
‘Obviously he could have had a disease that would have killed anybody.
‘But you seem to hear so many stories about this kind of thing, but society won’t address it.’ A source close to David Cameron said the Prime Minister believed the Archbishop’s remarks were ‘totally unacceptable’.
Mr Cairns’s partner of 15 years, Dermot Kehoe, accused him of delivering a ‘hate speech’, and said the comments had added to his grief.
Mr Kehoe said the bishop’s ‘ignorance and prejudice should not go unchallenged’. He wrote on Twitter: ‘Tartaglia’s comments are hate speech. He has position of moral leadership and should not speak from ignorance of the facts… Distressing and painful.’
Long-Term Follow-Up for Mortality and Cancer in a Randomized Placebo-Controlled Trial of Vitamin D3 and/or Calcium (RECORD Trial)
By Alison Avenell et al.
Context: Vitamin D or calcium supplementation may have effects on vascular disease and cancer.
Objective: Our objective was to investigate whether vitamin D or calcium supplementation affects mortality, vascular disease, and cancer in older people.
Design and Setting: The study included long-term follow-up of participants in a two by two factorial, randomized controlled trial from 21 orthopedic centers in the United Kingdom.
Participants: Participants were 5292 people (85% women) aged at least 70 yr with previous low-trauma fracture.
Interventions: Participants were randomly allocated to daily vitamin D3 (800 IU), calcium (1000 mg), both, or placebo for 24–62 months, with a follow-up of 3 yr after intervention.
Main Outcome Measures: All-cause mortality, vascular disease mortality, cancer mortality, and cancer incidence were evaluated.
Results: In intention-to-treat analyses, mortality [hazard ratio (HR) = 0.93; 95% confidence interval (CI) = 0.85–1.02], vascular disease mortality (HR = 0.91; 95% CI = 0.79–1.05), cancer mortality (HR = 0.85; 95% CI = 0.68–1.06), and cancer incidence (HR = 1.07; 95% CI = 0.92–1.25) did not differ significantly between participants allocated vitamin D and those not. All-cause mortality (HR = 1.03; 95% CI = 0.94–1.13), vascular disease mortality (HR = 1.07; 95% CI = 0.92–1.24), cancer mortality (HR = 1.13; 95% CI = 0.91–1.40), and cancer incidence (HR = 1.06; 95% CI = 0.91–1.23) also did not differ significantly between participants allocated calcium and those not. In a post hoc statistical analysis adjusting for compliance, thus with fewer participants, trends for reduced mortality with vitamin D and increased mortality with calcium were accentuated, although all results remain nonsignificant.
Conclusions: Daily vitamin D or calcium supplementation did not affect mortality, vascular disease, cancer mortality, or cancer incidence.