NHS’s 111 helpline ‘STILL putting lives at risk’: Urgent review demanded amid fears it will not cope over Bank Holiday
Health chiefs are to carry out an urgent review of the NHS 111 helpline amid fears that it will not be able to cope with the pressures of the May Bank Holiday weekend.
The service, meant to make it easier for patients to seek medical help out of hours, remains in a ‘fragile’ state in many areas, admit bosses at NHS England.
Doctors say lives may be at risk if the system is unable to cope with the extra pressure this weekend when GP surgeries close for three days.
In recent weeks the NHS 111 helpline has crashed, with urgent calls going unanswered, while A&E departments have been inundated with patients with non-urgent conditions who have been sent there by unqualified call centre staff. The 111 number has been introduced gradually across the country since February to replace NHS Direct and local GP out-of-hours numbers.
It is run by either ambulance services or private firms. But there are concerns it was rolled out too quickly and neither staff nor the computer system can cope with the demand.
GPs say patients’ lives have repeatedly been put in danger as most calls are dealt with by unqualified workers earning barely the minimum wage.
Board papers issued by NHS England – the new body in charge of the health service – for a meeting in Leeds tomorrow admit: ‘The service is still fragile in a number of areas and many have needed contingency.’
But the papers say there is ‘a vastly improved picture of NHS 111 delivery across the country’ when compared with the period over Easter and add: ‘Most providers are now hitting their key performance indicators for calls abandoned of under five per cent, although the target of calls answered in under 60 seconds is still a struggle for a number of providers.’
Yesterday Dame Barbara Hakin, interim chief operating officer for NHS England, said organisations would have their contracts to run the 111 system revoked if the review found they were below standard.
‘We will be relentless and diligent in making sure that this service is as it should be everywhere,’ she said.
‘I am confident it is a great service in the majority of the country. I am not comfortable with that, it needs to be a great service everywhere.’
But Dr Laurence Buckman, chairman of the British Medical Association’s GPs committee, said: ‘We are still receiving reports that patients are facing unacceptably long waits to get through to an NHS 111 operator and suffering from further delays when waiting for calls back with medical advice, should they manage to have their call answered.
‘The quality of some of the information being given out appears, from anecdotal sources, to be questionable in some instances. If any area of the country is failing to meet high standards of care then its NHS 111 service needs to be suspended. NHS England also need to be more transparent about how the system is functioning across the country.’
Since the number was rolled out, several hospital A&E units have reported an unprecedented surge of patients through their doors. Many of them have been wrongly advised to go to casualty by call handlers given only two weeks’ training, while others have turned up having been unable to get through on the 111 line.
Last week nurses warned that A&E units had become so busy that patients were routinely waiting 12 hours on trolleys to see a doctor.
Patients are wrongly branded drunks, heavy smokers and Alzheimer’s victims… Are doctors writing lies in your medical notes to line their pockets?
Normally mild-mannered and calm, Mary Kerswell found herself becoming unusually angry with the receptionist at her doctor’s surgery.
For the 67-year-old grandmother and retired biomedical scientist had been asked by her GP to take a urine test to monitor a kidney condition she did not have. Bewildered, she asked to have a copy of her medical notes, for which she paid £10. She was told to come back a week later to collect them.
She did, yet when she arrived at the practice last December to find the notes were still not ready, Mary refused to leave without them and staged a sit-down protest in the waiting room.
Astonishingly, the surgery called the police and Mary was taken away in handcuffs.
When Mary did get hold of her notes later that month, the apparent reason for the doctor’s reluctance to release them quickly was clear — they were littered with errors.
As well as being wrongly recorded as having chronic kidney disease, the healthy pensioner was said to be a heavy smoker who suffered from Alzheimer’s. The record also claimed incorrectly that she had undergone a hysterectomy and a double hip replacement.
‘I was utterly shocked,’ says Mary. ‘It read like a post-mortem, it really did. They must have been the entries for someone else.
‘It could have been really dangerous. Who knows what implications these errors could have had if I’d been taken to hospital in an emergency?’
Mary’s doctor said the mistakes were caused by a ‘filing error’.
But, alarmingly, there are concerns that errors on medical notes are not always accidental.
Indeed, there are fears that some GPs are fabricating medical records to reap financial rewards.
If GPs meet targets for monitoring conditions such as asthma and diabetes, they get extra funds — but for these to be made available, naturally some of their patients need to have the conditions in question.
The organisation Patients Know Best found that one third of medical records contained errors. And Joyce Robins, a spokeswoman for the health service users’ group Patient Concern, highlights several cases.
One man went to see his doctor suffering from stress because he was being stalked by a woman, who was later convicted of the offence. Some years later, he found that his notes said he was suffering from ‘paranoid delusions’ that he had a stalker.
Ms Robins says: ‘This gentleman has been labelled a fruitcake for ever. He has been unable to get it removed from his records. He should be able to get an annotation on his notes at least, but he can’t. It is an extraordinary state of affairs.’
Another woman, struggling with bloating and lethargy, was called a ‘malingerer’ in her notes. The wheat allergy found to have caused her ‘fusspot’ symptoms was diagnosed only when her records were lost.
Another man found that his records erroneously stated he suffered from heart disease. When he told his GP that this was incorrect, the doctor answered: ‘Can you prove it?’ In fact the patient happened to be chief executive of one of London’s major hospitals, so he was more than able to correct his GP. But others are not so lucky.
‘It could have been really dangerous. Who knows what implications these errors could have had if I’d been taken to hospital in an emergency?’
Recent cases also abound on the internet. On a parenting blog, one mother writes: ‘My doctor casually mentioned my son’s epilepsy during a consultation last year. My son does not have epilepsy.’
Another woman glanced at her doctor’s screen and was ‘gobsmacked’ to see ‘elephantiasis’ — which is caused by tropical parasites — listed as a current condition.
‘My legs are a bit chunky but I doubt they would qualify for this ailment,’ she says. ‘Clearly there has been a mistake, but am unsure about challenging the doctors.’
Fears about the consequences of challenging GPs about their notes are not unfounded. In Mary’s case, she has been struck off the patient list by her local health centre, having been labelled a ‘problem patient’.
Ms Robins insists that this is not an uncommon occurrence. ‘It’s so difficult,’ she says. ‘People say: “I daren’t ask for my notes because I’ll be struck off.” We can’t tell them that this won’t happen because it does.’
Patient Concern wants to see an end to ‘cradle-to-grave’ notes that patients cannot correct.
‘If something is wrong it is round your neck for ever,’ says Ms Robins. ‘It is estimated that 40 per cent of doctors’ notes are inaccurate. These errors could be life-threatening. Yet doctors just don’t like to admit they are wrong.’
She wants easier access to notes and a system whereby errors can be corrected — especially as the national computerisation of medical notes, which has been taking place over the past few years, has led to further mistakes creeping in as records are transferred from paper to computer.
Theoretically, patients have the right to see their medical records under the Data Protection Act 1998. The request can be refused only if it would cause serious harm to the patient’s mental health.
However, some doctors are still against patients having access to their notes, arguing that it restricts what they feel able to write.
Even if patients do manage to see their notes, they can face a struggle to have inaccuracies corrected.
Take the horrifying case of Helen Wilkinson. Browsing through her NHS records in 2004, the local councillor and former NHS manager from High Wycombe, Buckinghamshire, was confronted with an entry labelling her an alcoholic.
‘I went ballistic,’ she says. ‘I have lived locally for a long time and know a lot of people who work in the NHS. They could all have seen it. It was awful.’
Helen had gone into hospital for a surgical procedure when she found that the error dating back to 1988 had been added to her computerised records. She was able to amend her records after a two-year battle, during which her MP raised her case in Parliament.
Helen, 47, now campaigns for The Big Opt Out, a group that opposes the NHS Care Records System — the vast computer network which was introduced in 2010 and holds information electronically.
But this has left her vulnerable.‘I can’t access NHS care, just because I don’t want my data stored in this way,’ she says. ‘I have been removed from NHS databases and don’t even have an NHS number.
‘I’m only able to access treatment when I’m ill because medical colleagues treat me as a favour. Nine years later, I still can’t access care.’
The case of Jo Walsh, a 40-year-old PR consultant, is equally disturbing. She went to see the nurse for a routine matter and saw her notes over the nurse’s shoulder.
Astonished, she realised that a doctor had made false and unpleasant references to her mental health after she complained that he had cut one of her appointments short. Outraged, she asked to see a full copy of her records.
Jo, who lives in London, had gone to see the doctor because she was suffering from extreme bruising, perhaps connected to a dietary deficiency. She says: ‘The references made in my notes were to depression, bipolar disorder, hypomania, drug abuse and psychosis. The doctor made me look like a nutter.
‘This was all inferred from a meeting that was so rushed I couldn’t even explain all my symptoms, and that ended with him pretty much pushing me out of the door. I reckon it lasted around five minutes.
‘I was so upset afterwards that I went straight to reception and complained that the doctor had been really rude. But it was only later that I found out what he had written in my records.’
After Jo alerted the surgery to these errors, she was told that the notes were the result of a ‘bad day for the doctor’. However, much to Jo’s distress, any information on medical records cannot be removed from the system, only added to.
The Patient Association explains: ‘Medical records cannot usually be changed because they are supposed to show what was written at the relevant time. However, a note can be added to your records explaining why you think they are incorrect and giving the correct version of events.’
Jo is understandably concerned that these erroneous claims are now irrevocably on her record. She is considering legal action.
Dr Mohammad Al-Ubaydli, the founder of Patients Know Best, wants to see a new system where patients are in charge of their own notes and bring them to appointments.
‘A doctor should ask a patient for his or her notes,’ he says. ‘Medical notes are full of errors.
‘They continue to accumulate if patients never see their records. Some are going to be dangerous. It is the patient and their family who have the biggest interest in their records. The patient and doctor should help each other, rather than trying to cover up errors. Then we could avoid all this silliness.’
This would also stop GPs altering patients’ notes to gain more funding from the Government.
Dr Al-Ubaydli adds: ‘If you look at U.S. research, we know that data gets shaped differently when there are financial concerns. Does that happen in the UK? Draw your own conclusions.’
Indeed, GPs in the UK earn around £1 billion a year from bonuses. About a quarter of their average income is linked to achieving government targets.
Whatever the reasons for these errors, they are deeply worrying and seem unlikely to improve in the foreseeable future, despite complaints from numerous patients.
As Ms Robins reflects: ‘We have sat on Department of Health committees on this and nothing is done. After all, GPs are very powerful people.’
Michael Gove is winning the hearts of British state school heads
Teaching unions don’t want you to know, but head teachers support Michael Gove’s education reforms
Michael Gove gave a seminal though little-reported speech last Thursday, his clearest statement yet of his aim for politicians to hand back the education system to the professionals, as long as they maintain the highest academic standards and prove worthy of the trust placed in them. The national curriculum he is introducing should perhaps be the last imposed from the centre; thereafter he wants schools themselves to develop a variety of high grade curricula.
Mr Gove is going way beyond anything Margaret Thatcher achieved in her 11 years of devolving power from government at the centre. No education secretary in the modern era has matched his vision of a largely autonomous education system in which individual schools, heads and teachers are given back their independence and creativity. Only by releasing dynamism in this way does he believe that British schools will be able to compete with the best in Shanghai, Singapore and Scandinavia.
As Mr Gove told his audience in Nottingham, he wants to sweep away the whole structure that has underpinned schools since the war. Schools themselves should conduct research into what produces great teaching and learning, rather than leaving such studies to universities, which he believes have offered little of practical value in terms of improving schools. Leaders should be trained within schools rather than being sent away to acquire abstract diplomas. Teachers should equally be trained within the schools themselves, rather than learning how to teach in university education departments. He wants schools to help each other to raise standards rather than rely on local authorities. All of this is to be achieved by schools becoming “teaching schools”, a system he conceived and which he sees as akin to teaching hospitals. He was in Nottingham to address the latest cohort of heads whose schools had been accepted on to the programme.
I was in the audience because Wellington College is among the first independent schools to join this programme. I was surprised and delighted by what he said, but was even more astonished by the reactions of my 150 fellow heads from the state sector in the audience. I have been used to state school heads denigrating education secretaries, above all if they are Tories. But most of the audience listened appreciatively, and the questions were supportive and enthusiastic.
Mr Gove hated the close relationship the trade union leaders had with Labour before 2010 – the union leaders even had a pass to roam anywhere in the Education Department. His principal targets in his speech were thus the National Union of Teachers (NUT) and the NASUWT, which he described as “increasingly out of touch with the profession as a whole… The leadership teams of the NUT and the NASUWT have demanded their members take industrial action – a work-to-rule – for reasons that are obscure to me but seem to amount to: ‘We don’t like the last 25 years of education reform, why can’t we party like it’s 1968?’” He senses that the public are becoming tired of the constant negative attitude of the unions to academies, free schools, lesson observation by teachers and curricula and exam reforms. His solution is to undercut the unions with a new body called the Royal College of Teachers, which would lead teachers as a profession just as the Bar Council and Law Society do with lawyers, and the 15 or so Royal Colleges do with different parts of the medical profession. Christine Blower, general secretary of the NUT, is contemptuous, believing such a body could not replace a union in fighting for the best conditions for teachers and learners.
“The best thing this Government could do for education,” one state head told me, “would be to abolish the teaching unions outright. The NUT and NASUWT are the worst.” Another said: “The trade union leaders are 100 years out of date: the world has moved on. We are now professionals and they have to reform or die.” An independent school colleague who does much work with state schools said: “The biggest reason why independent schools are so far ahead is that we have so little to do with unions at national level: their negativity and time-watching has held back the achievement of state school children.”
Heads are frightened to say this in public because of fears of reprisals by unions. “They can be very intimidating. If a union decides to target your school, you’re in trouble,” a head told me. Most of those I spoke to draw a distinction between the union leaders and the representatives on the ground, for whom they have much more time. This is certainly my experience: I have often found union representatives to be sensible and constructive. Many heads think they deserve better leaders at the top, who fight for the interests of children without the baggage of ideology, and who don’t resort to strikes. Old-style teaching unions may well be drinking in the last chance saloon unless they can modernise.
A battle royal is being fought for the heart and soul of schools. Mr Gove’s vision, which is shared by some key Labour figures, including Lord Adonis, will probably win the day. A significant number of state school heads and teachers still loathe it, but he is making headway. If Mr Gove can listen as carefully and respectfully to heads as he did last Thursday, he may well carry the day.
One in three babies in England now has a parent who was born abroad
Almost a third of all children born in England and Wales now has at least one foreign-born parent, figures reveal.
In 2011, 224,943 babies had either one or both parents born outside the UK – 31 per cent of the total.
This is a substantial rise on the figure in 2000, when just 21.2 per cent of babies had at least one non-British-born father or mother.
The statistics, obtained by Tory MP Nicholas Soames, show that some 131,288 children had two foreign-born parents – 18.1 per cent of the total number of births in 2011.
A further 12.9 per cent – a total of 93,655 – had one parent who was born outside the UK.
At the end of the year, immigration restrictions will be lifted on Romanians and Bulgarians – prompting concerns that the numbers will rise yet further.
Andrew Green, of MigrationWatch, said the figures were ‘astonishing’. He added: ‘This is the clear result of Labour’s mass immigration policy which is changing the nature of our society at a speed which is unacceptable to the public who of course were never consulted.’
The figures – obtained after a parliamentary question – show that 64.9 per cent of babies born in London in 2011 had either one or two parents born outside the UK.
There were 27,403 births where one parent was foreign-born (20.6 per cent of the total), and 58,905 where both were born abroad (44.3 per cent).
David Green, from the centre-right think-tank Civitas, said: ‘The irresponsible actions of the last government have played havoc with public services, leading to serious harm especially in the NHS, and serious harm in the schools system.
‘Maternity units are in crisis, there are huge pressures on school places, and housing is under even more pressure that it otherwise would have been.’
A spokesman for the Office for National Statistics said that in 2000, the proportion of babies in England and Wales born to at least one foreign-born parent was 21.2 per cent.
It is the first time the figures have been released on both parents. The ONS usually only releases information on what proportion of mothers are foreign-born.
Last October, it was revealed that in 2011, there were 808,000 births, comprised of 612,000 births to UK-born women and 196,000 births to non-UK born women.
This meant that 24 per cent of births in 2011 were to non-UK born women – an increase of two percentage points since 2007.
The top five non-UK born mothers’ countries by number of births were Poland, Pakistan, India, Bangladesh and Nigeria.
Not all births are necessarily to parents who live in Britain permanently, as some could be people who travel to the UK to take advantage of its free NHS.
Last month, a leading surgeon, Professor Meirion Thomas, said the UK was becoming the ‘world’s maternity wing’ as people travel here simply to give birth.
Years of high immigration levels have put intolerable pressure on maternity units because the number of births has been far higher than officials had predicted. There is currently a shortage of more than 3,000 midwives in the NHS.
Nursery assistant, sacked by British nursery for smacking her OWN daughter on the bottom, claims she was unfairly dismissed
A nursery assistant is claiming unfair dismissal after she was sacked for smacking her own daughter at work.
Kyshia Cammock, 25, lost her job at Little Folks Nursery in Birmingham after she hit her two-year-old on the bottom for misbehaving, a tribunal was told.
The mother is suing her former employers, Mishi Nurseries Ltd, for unfair dismissal and seeking compensation.
But Mishi Nurseries is fighting the claim and maintains Miss Cammock was sacked for gross misconduct after the incident, which is against company policy.
The police were informed at the time, the hearing was told, but no action was taken. Miss Cammock was on a training scheme at the centre.
She has accused her employers of favouritism among staff, claiming she had been treated less favourably than others.
At the hearing, Miss Cammock said she had been told by management not to deny the smacking accusation because there had been CCTV footage. But it was revealed there was no such footage.
Tribunal judge Victoria Dean said she could not find any reference in a witness statement by Miss Cammock that acknowledged she knew about the firm’s policy against smacking children on the premises.
But Miss Cammock said during the hearing: ‘I knew I was not allowed to smack a child.’
The nursery owners claimed the member of staff had been fully aware of the firm’s ‘behaviour policy’ regarding staff.
The case was adjourned to a later date, to allow more evidence to be provided. Miss Cammock has yet to give verbal evidence.
You CAN’T have it all, says Net-a-porter boss: Entrepreneur reveals trauma at starting business while pregnant with her first child
She has long been regarded as one of the few women who has managed to juggle ‘having it all’ .
But Natalie Massenet has now revealed she deeply regrets her ambitious decision to launch her successful online fashion business when she was pregnant with her first child.
Mrs Massenet has confessed the experience left her so ’traumatised’ that she waited another six years before having her second child.
The 47-year-old entrepreneur, named as one of the world’s most influential women in February, created her online fashion empire Net-a-porter more than a decade ago, when shopping via a keyboard was in its infancy.
Net-a-Porter was reported to be worth £350 million two years ago.
Speaking at the Vogue Fashion Festival at the weekend, Mrs Massenet, who at the time was pregnant with Isabella, now 13, said: ‘At the same time when I started writing the business plan I was also pregnant. And I think fuelled by hormones and delusions that if I could build a baby why not a business?
‘I made a dreadful mistake or opportunity I’m not sure, of doing both of them at the same time, and it was enormously hard.’
She added: ‘I was so traumatised by having a baby and starting a business in the same year that it took six years for the next one to come along.’
Mrs Massenet, who is divorced from her French investment banker husband Arnaud Massenet, gave birth to another girl, Ava, and she jokes that she was ‘building the Net a Porter future consumer base one at a time.’
Mrs Massenet began her business with a team of 15 from an apartment in Chelsea, London. They worked from one bedroom and used the spare as a distribution centre, taking orders via a nineties laptop connected to dial-up internet.
Today 5 million people visit the site’s weekly magazine and 2,600 people are employed. Mrs Massenet has offices in the UK, US and Hong Kong.
She said she still has to ‘pinch herself’ every now and again.
‘While we were in this little rickety apartment in Chelsea and while we had all of our stuff stacked in the back and only 15 people in the room we put all of our energy to what the consumer saw and aimed big, wanted to make people think this was a big company,’ she said.
‘There is no recipe for success, it’s as unique and individual as you are,’ she added. ‘People always ask is it hard being an entrepreneur and a mum and the answer is yes.
‘But the reality is women do it all the time and thankfully we have mentors and women around us who can inspire us.’
British veteran ordered to take down Union Jack flag after neighbours complained it was ‘too noisy’
An ex-serviceman was forced to remove a flagpole flying a Union Jack from his garden after neighbours complained it was ‘too noisy’.
Brian Fairfield, from Hull, East Yorkshire, raised the flag for the first time last week but within days was asked to take it down.
The 80-year-old said his landlord Sanctuary Housing had received five complaints from local residents, complaining it was an eyesore and that it made too much noise.
Mr Fairfield said: ‘It’s the first time I have heard our national flag being described as offensive to look at.
‘I had only managed to raise the flag five or six times before the phone rang to say it had to come down.
‘We all have rights but surely mine count as much as theirs. The least my landlord could have done was to come and see me and the flag for themselves. ‘It’s not causing anybody any harm.’
‘I’m proud to be an Englishman and proud to have been in the forces, so I want to fly my flag, it’s as simple as that.’
Mr Fairfield says he even checked whether he needed planning permission for the flagpole, which is 18ft tall, and hangs his 5ft by 3ft Union Jack flag.
John Hanson, local head of housing operations for Sanctuary Housing, said: ‘Mr and Mrs Fairfield are a lovely couple to work with, and we understand that they have the best of intentions.
‘Objections were about the size of the flag and the noise it created, not the principle of flying one, and we are more than happy to help the Fairfields come to a suitable agreement with their neighbours.’
Publicity does wonders