Fury of dementia sufferer’s wife after her husband is force to move for treatment SEVEN times in just a year
An elderly dementia sufferer has been forced to move seven times in just over a year, leaving his wife fuming. Pauline Hayes says she often finds husband Allan, 73, in tears when she visits him at his care home in Leeds.
The 72-year-old is furious that Allan has been moved from a purpose built unit because of a reorganisation within the local NHS Trust.
Allan was diagnosed with Alzheimer’s disease in 2006 and his wife of 41 years cared for him in their home until last June. He has since been moved seven times something which has upset both him and Pauline as she says his condition means he needs to be settled.
Allan was first taken into a mental health in-patient facility called The Mount in Leeds but was able to return home after several weeks.
He was forced to return following a water infection and was then transferred to an assessment bed in a care home, then back into hospital, then a different care home. Most recently he was sectioned under the Mental Health Act for the third time and moved to Asket Croft.
Pauline said the facility, which was purpose built for dementia patients, was ideal to meet his needs but unfortunately Allan was moved back to The Mount in early August.
It followed a decision made by Leeds and York Partnerships NHS Foundation Trust, which provides mental health care in Leeds, to centralise in-patient dementia services there as part of a plan to create a ‘centre of excellence for older people’ and Asket Croft is to be redeveloped as a community hub for mental health services in east Leeds.
Mrs Hayes say that although the care provided at The Mount is good, the facilities are not and she questioned the judgement of moving patients away from a specially built facility. ‘The Mount does not have the lovely facilities that this purpose-built building had. ‘I want to know why they are closing these places but then re-opening them to someone else.’ ‘It’s terrible. I know he’s safe at The Mount but it’s only a stopping place.’
She said it was devastating to see the ‘gentleman’ with whom she has four children and share six grandchildren and two great grandchildren become a different person because of the disease.
‘Even last year he would say “I know it’s hard for you.” ‘Then this plateau drops and their mind just goes. It’s a horrible, nasty illness.’
A spokesman for Leeds and York Partnerships NHS Foundation Trust said: ‘The service at The Mount offers far more treatment and activity and has access to the skills and experience needed including medical and pharmacy provision.
‘The trust has also reinvested a large resource in both memory services, which will ensure that the need for beds reduces over time, and care home services, so staff can support those with more complex needs who go into long term care.
‘Due to an increasingly ageing population we need to ensure we focus on earlier detection rather than waiting for people in crisis who then need a bed.’
The spokesman added that the trust accepted more could be done to improve facilities at The Mount.
Children dying because of poor NHS care
When Tracey and Miguel Moore-Shakes carried their toddler Jayden into Birmingham City Hospital one evening with breathing difficulties, they desperately hoped he would receive urgent medical help. The two-year-old suffered from asthma, but his wheezing had become so severe that they were worried something was very wrong.
What happened next will haunt them for the rest of their lives.
Jayden received a quick examination by a nurse, and then a doctor. He was diagnosed with a chest infection and they were sent home with antibiotics at 6pm — just 29 minutes after arriving at A&E.
Back home, the youngster’s symptoms worsened and his parents rushed him back to hospital just before 10pm.
Only then, around five-and-a-half hours after his parents first brought him in, was he seen by a paediatrician. It was a delay that may have cost the little boy his life.
At 11.20pm Jayden suffered a cardiac arrest — his body was unable to fight any more — and he died an hour later.
At the inquest, the coroner was damning. The toddler had died from neglect, he said, and a ‘gross failure’ by the hospital to take his severe asthma seriously. He should have been seen by a paediatrician when he first went into A&E and been admitted to hospital.
‘I consider there was a gross failure by staff at the Sandwell and West Birmingham NHS Trust to provide basic medical attention to Jayden on that day,’ said coroner Aidan Cotter. ‘Jayden was only two, he was clearly ill and he deserved much better care than he received.’
So shocked was the coroner that he wrote to hospitals across the Midlands warning of the threat to children’s wellbeing due to lack of specialist doctors in A&E departments.
Experts are warning there is a serious, systemic problem in Britain’s Casualty units when it comes to treating youngsters. They say that many of them are not fully capable of providing critical care for children, or even of properly diagnosing life-threatening ailments.
The vast majority treat children and adults together, and because of cost-cutting and inadequate training at medical schools, many simply do not have specialist children’s doctors or nurses immediately on hand — even though NHS emergency departments treat more than 3.5 million children every year and one in three children will be admitted to hospital in their first year of life.
More than 1,500 children a year die needlessly from common childhood diseases because of failures across the NHS, and particularly in Casualty units.
Such problems help to put Britain at the bottom of the western European league table, with 52 per 100,000 children dying avoidable deaths, compared with fewer than 40 in the safest country, Sweden.
On top of the human cost, failure or delay in diagnosis has cost the NHS more than £20 million in legal settlements in the past 12 years.
Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health (RCPCH), and an expert in avoidable deaths, has warned: ‘We have limited data on the causes, but we have enough statistical evidence to show we are failing 1,500 children a year. ‘Children are not seeing people with a sufficient depth of experience and knowledge the moment they get through the doors of A&E.’
This was highlighted last week in a tragic case revealed by the health service watchdog, the Care Quality Commission, which savaged a Casualty unit in Essex for delays in treating children that involved the death of one youngster.
It issued a formal warning to Basildon and Thurrock University Hospitals Foundation Trust after unannounced inspections found that the trust’s A&E unit was breaking the requirement for children to be assessed (or ‘triaged’) within 15 minutes of arrival.
The inspections followed the death of an infant who was not assessed within the 15 minutes target time. The child, who was suffering from blood poisoning but was not medically assessed for 55 minutes, was later rushed to Great Ormond Street Hospital for specialist care. Sadly, the infant’s condition had deteriorated so far that doctors decided no further treatment was possible.
Inspectors from the CQC subsequently looked at four care records for children at the hospital’s Casualty department and found the 15-minute wait time for triage had been breached in each case.
The trust’s chief executive Alan Whittle, who is due to leave the trust shortly, said that changes had been put in place to ensure the problem did not recur.
The hospital says a subsequent CQC inspection has given the unit a clean bill of health.
However, this is not the first time the trust has fallen foul of such requirements.
In 2009 the CQC’s predecessor, called Monitor, used its legal powers to demand that Basildon and Thurrock tackle ‘inadequate arrangements to treat children in A&E, with few specialist paediatric staff’.
One reason previously cited by healthcare chiefs for the lack of specialist doctors is the extra cost of employing them.
However, Dr Cass argues that this is short-termism, and that increasing the numbers of paediatricians would drive down costs in the long-term. ‘If you deliver better quality of care and better decision-making about who you admit and who you don’t admit and you get things right first time, then in the longer term that can be cheaper.’
The College of Emergency Medicine, which represents A&E doctors, has said it is ‘fully aware’ of inadequacies in Britain’s emergency departments. It has warned that medical schools have prepared graduates poorly for paediatric emergency care.
The Royal College of Paediatrics and Child Health has issued tough new stipulations on how A&E units should care for children, including the need to respond rapidly when they come through the door, and to have qualified experts on hand to examine every youngster properly.
This is the first year that the Royal College has issued strict standards rather than just ‘guidelines’, says Dr Stephanie Smith, an emergency paediatrician. ‘People can ignore guidance very easily,’ she says.
Dr Smith says that specialist expertise in paediatrics is vital in Casualty units because illnesses can display very different symptoms in children compared to adults.
‘For example, potentially lethal meningococcal disease (a bacterial form of meningitis) catches people out. ‘In children it can present with non-specific symptoms, such as a raised temperature or a child not feeling well or just going quiet.’
New standards require that young children are expertly assessed within 15 minutes of entering a Casualty unit. This rapid action can be vital, says Dr Smith. ‘Children can deteriorate very quickly,’ she says.
‘Their bodies are so youthfully healthy that they can maintain being well for a longer time than adults. But if they do succumb, they get ill very quickly.
‘With smaller children, they also don’t have the words to explain what they are feeling.’ Lack of political will to improve children’s A&E standards is partly to blame for poor standards, says Dr Smith.
‘The volume of adults going to A&E is much greater than the volume of children, and there is more political will to manage them than children.’
There is no doubt that Casualty units are facing unprecedented burdens. A&E attendances at English hospitals have exploded from 12.9 million in 2001 to 20.7 million in 2010.
Some of this is caused by population growth, but much of it is due to GPs cutting surgery opening hours and out-of-hours visits, leaving patients with nowhere else to turn. As a result, many parents with sick youngsters now seek care directly from emergency departments.
‘A&E staffing needs to be expanded to meet growing demand,’ says Dr Smith. ‘The big teaching hospitals attract the paediatrically qualified staff, which leaves some communities very short.’
One mother who suffered as a result of such shortages is Simone Brabner, 24. She rushed her daughter Lylah to A&E last month when the two-year-old was doubled up with stomach pain.
But Simone was told her daughter merely had a virus. Doctors at the North Kent hospital refused to perform blood tests because it was ‘too late in the evening’, and the family was sent home.
But Simone, who lives in Slade Green, Kent, persisted and returned to Casualty the following week demanding proper tests. The truth then emerged. Lylah was suffering from an advanced neuroblastoma, a childhood cancer. A large tumour was found growing in her stomach.
‘A trainee doctor was the one who realised Lylah had swollen lymph glands,’ she says.
Lylah was given an ultrasound exam and, later that afternoon, her mother was told the news. ‘Out of the blue, they said they were 99 per cent sure it was cancer.’
Further tests confirmed the diagnosis. The tumour is half the length of her stomach.
A spokesman for Darent Valley Hospital says: ‘The Trust apologises for not making the correct diagnosis at the first A&E attendance. When Lylah attended a few days later, she was admitted and the diagnosis was promptly made.’
Lylah is undergoing an intensive three-month course of chemotherapy at the Royal Marsden Hospital, London.
‘The doctors at the Royal Marsden have been brilliant,’ says Simone. ‘They have got Lylah’s pain under control. She is playing with other children and seems happier in herself.’
Meanwhile, for the parents of Jayden Theo Moore-Shakes — the two-year-old admitted to Birmingham City Hospital — there was no such second chance. They hope that the inquest verdict will spare other families the devastation of losing a child.
In a statement issued through their lawyer, they said: ‘City Hospital was responsible for a series of gross failings amounting to neglect. ‘We are hopeful that the verdict, coupled with the actions of the coroner, will deliver changes that will help to save the lives of children.’
In a statement, the hospital said it had made changes in the wake of the tragedy. ‘We would like to apologise for the distress that this tragic event has caused,’ it says. ‘As a result of Jayden’s death we have made improvements to our service. ‘The trust accepted that Jayden should have received a senior review much earlier than he did.
‘The Trust has reinforced the policy it already had in place, whereby a child who is admitted via the emergency department into a resuscitation area will be reviewed by a specialist clinician regarding their diagnosis and treatment plan.’
One can only hope that such service improvements are properly introduced at Casualty units right across the country.
British man and his wife arrested at their rural home after two suspected burglars are shot during break-in
A householder was arrested yesterday after he shot two suspected burglars in a midnight break-in at his home. The 35-year-old – believed to be a farm worker – fired a shotgun at a gang of suspected burglars who broke into his isolated cottage in Melton Mowbray, Leicestershire.
The man and his wife, 43, were understood to have called police immediately after the shooting, at 12.26am. He told officers he had fired his shotgun, which is licensed and legally held, and the intruders fled.
Minutes later, ambulance paramedics were called to treat a man with shotgun injuries. The 999 call was understood to have been made by one of the suspected burglars. A second man was treated for shotgun injuries after he walked into Leicester Royal Infirmary, around ten miles from the cottage. Neither of the men’s injuries were said to be serious.
The householder and his wife were arrested on suspicion of causing grievous bodily harm. He is thought to be a farm worker who kept the shotgun legally as part of his job.
Four men in their 20s and 30s were also arrested on suspicion of aggravated burglary. No one has yet been charged in connection with the incident.
A police spokesman said yesterday: ‘Police were called at 12.26am this morning by a man reporting a group of men had broken into his home in Melton. ‘The man stated that during the course of the incident he had fired a legally held shotgun and the intruders had left the scene.
‘Investigations have begun into both reports and six people, five men and one woman, have been arrested.
‘A 35-year-old man and a 43-year-old woman were arrested in Melton on suspicion of GBH and four men aged 27, 23, 31 and 33 were arrested at Leicester Royal Infirmary on suspicion of aggravated burglary.
‘Inquiries are ongoing and there is very little else we can add at this time.’
The case is likely to reignite public debate over a householder’s right to defend his home against intruders.
In 1999, Norfolk farmer Tony Martin was arrested after shooting burglars during a break-in at his remote farmhouse. He did not have a firearms licence.
Fred Barras, 16, was killed and his friend Brendan Fearon, 29, suffered gunshot wounds to his legs. Fearon later admitted conspiring to burgle the farmhouse, accompanied by Barras, but Martin was tried at Norwich Crown Court and jailed for life for murder in 2000. His murder conviction was later reduced to manslaughter and he was released from jail in 2003.
British education boss confirms GCSEs (Left-inspired junior High shool exams) will be replaced by more rigorous O-Level (old) style qualifications
Pupils who sat GCSEs this summer were all treated ‘unfairly’ and the examination will be replaced with a more rigorous qualification similar to O-Levels, Michael Gove, the Education Secretary, has confirmed.
The new exam, which could come into force as soon as 2014, would be sat by pupils of all abilities, unlike O-Levels which were taken by only the most academically able while other pupils were awarded CSEs.
The use of modular assessments, where pupils’ work is graded throughout the school year rather than in a written examination in June, could be phased out for English GCSE by the summer.
Mr Gove said that all those who took GCSEs were treated unjustly, and not just those who narrowly missed out on a passing C grade due to tougher marking.
But he refused to intervene to order Ofqual, the exam regulator, to re-mark the papers of those who felt that they had received an incorrect grade. And he denied ordering tougher marking for this summer’s examinations, saying that it would be inappropriate for ministers to interfere.
Labour accused the Education Secretary of abandoning this year’s GCSE pupils, and called for the exam papers to be reviewed. Mr Gove said that it had been impossible to prevent GCSEs from going ahead this summer, despite doubts over the rigour of the examination because plans had already been made for pupils to sit them before the current government came to power.
He announced that a consultation into the new exam would be ordered this autumn, with legislation following soon afterwards.
Speaking on BBC Breakfast, he said: “I have an enormous amount of sympathy for young people who sat GCSEs in English this year – I feel they were let down. And they were let down because the examination that they sat was designed in a way which I don’t think was entirely fair to them.”
On Radio 4’s Today Programme, he added: “It reinforces the case for reform in GCSEs. My heart goes out to those who sat their exams this summer because I don’t think the examination was designed in the most appropriate way. There were inherent problems with the system.
“In fact, what we need to do is replace GCSEs with new exams. I think everyone who sat the exam was treated in a way that wasn’t fair.
“It is absolutely right that everyone should be treated fairly … but it would be absolutely wrong for me to give instructions to Oqual.”
Asked on BBC Breakfast if he ordered this summer’s tests to be judged more harshly than those who sat the same exam in January, he said: “I made it clear that no pressure was put by central Government, by me or any other minister, on any exam board.
“How each exam paper is marked and how the marks are allocated is ultimately a decision for the exam boards. I cannot interfere in that process.”
Stephen Twigg, the shadow education secretary, accused Mr Gove of abandoning candidates who had missed out on a passing grade in English this summer, when they may have received a higher mark had they sat the exam in January.
Calling for the papers to be re-marked, he said: “He is responsible as Secretary of State to bang heads together. Clearly there has been a failure here by the system. “I simply do not think it is good enough to link this to the need for reforms but that doesn’t address the concerns of students.”
Mr Gove said that the new examination would be designed to be taken by the “full ability range” with top grades awarded to only the most outstanding candidates.
“The aim is to ensure that we have an examination which recognises the genuinely academically gifted by recognising that someone who gets an A is clearly a high flier. “It is important that there is a discrimination between the top grades and the pass grades.
“It is vital that we move away from exams that, so far as we have seen in the course of the last few weeks, haven’t worked and haven’t served pupils well.”
Mr Gove also suggested for the first time that less able pupils could delay sitting the new examination until they reach the age of 17 or 18, rather than during the summer of the academic year in which they turn 16 as the vast majority of GCSE candidates do, and those taking O-Levels and CSEs did.