Birmingham Link

A working life: the air ambulance paramedic

admin — Fri, 18 May 2012 22:00:44 +0000

Taking to the skies to reach patients might seem glamorous, but for David Fletcher the focus is on care, as well as safety

As the bright red helicopter I’m sitting in shudders and shakes its way off the ground, I think to myself – David Fletcher has one hell of a company car. An air ambulance paramedic, Fletcher spends much of his day 1,500ft in the air, rushing to the scene of accidents and emergencies – making his working life a little like Casualty mixed with Airwolf.

On the day I visit the base of the North West Air Ambulance (NWAA) at Manchester city airport, the weather has finally cleared up enough for me to see Fletcher at work. But Bond Air Services, the company NWAA leases its helicopters from, has grounded its two vivid yellow Eurocopter EC135 vehicles (called Katie and Teddy) due to a fault in the rotors. It means I never get to see them in action, but instead experience an older helicopter that’s scrambled from elsewhere in the country.

The wait for it to arrive gives Fletcher a lengthy opportunity to talk about his work from the confines of an unassuming Portakabin at the airfield. Safety, I discover, is everything. “It is key to everything we do and runs throughout every task we perform. We have to plan for every eventuality …” he says, ” … including the weather. We can fly in anything up to 55 knots but we avoid thunderstorms and will not take any risks. The biggest thing that hinders us is fog.”

While the paramedics’ main objective is to treat injured or sick people, the charity’s pilots ensure the safety of the helicopter and the people inside. Fletcher says this arrangement works well – in other countries the pilots can be more patient-focused, leading to them taking risks in order to reach a destination and land quickly. “If it’s unsafe to fly or land, we won’t. We can’t treat patients if we’ve crashed ourselves, and losing a £2m aircraft will not help the people of the north west, either.”

Nevertheless, the air ambulance can respond much faster than a road ambulance. Each crew can treat and fly patients to a specialist hospital in record time – both helicopters have a maximum flying time of 10 minutes to the nearest appropriate hospital. It can save the lives of people with major trauma, particularly head or spinal injuries, and Fletcher says the charity receives countless thanks from people they have treated. “It’s very different from road paramedics, when you wonder what happened to a patient and never get the chance to find out. Here, people send letters of thanks and even pop in to thank you for saving their life. It’s lovely.”

The NWAA flies around 1,200 life-saving missions each year. The aircrew are often the first on the scene, whether it is a motorway pile-up or someone having a stroke. First, they assess a patient’s condition before giving treatment and transferring them to the nearest hospital.

When a helicopter takes off, the rotor generates three tons of air, which allows the craft to lift off the ground. Anyone in the near vicinity can be knocked off their feet by the force. “We need clearance of about two tennis courts next to each other to be able to safely land or take off,” Fletcher says. Despite that, wherever Fletcher and his crew go the helicopter draws close interest from the public: “At the scene of a rescue, we often get a lot of people watching and they do sometimes come a bit close. I have to be stern with them, for their own safety, of course.”

The helicopters have bear paws at their base rather than a rail, meaning Fletcher and his pilot can land their ambulance in sodden marshes and boggy ground – useful in the region covered by the NWAA. The charity, which has a second base in Blackpool, will attend emergencies as far north as the top of Cumbria, down to south Cheshire and Stoke – an area of 5,500 square miles and a population of roughly eight million people. It makes every working day different.

“You never know what you’re going to get,” Fletcher says. “About four months ago we had an incident when a plane took off from right here, and crashed into some nearby flats. Even though it was just around the corner, we flew to the scene because we were able to take the injured man to a hospital more quickly than a road ambulance. We took him to the burns unit at Wythenshawe Hospital, but it didn’t have a happy outcome. Still, we bought him a little more time, if nothing else.”

Fletcher looks at the ground briefly, recalling the incident. But says he is unaffected by the things he sees and can switch off when he finishes work, even after a day of tragedy and drama: “I can treat an open femur fracture and be back at home later that day without even thinking about it.”

Fletcher’s stoicism is no doubt a byproduct of the familiarity of his work, but it may also be borne from nursing his father through a terminal illness when Fletcher was 16. “He had a brain tumour and would regularly have seizures, so I learned a lot while caring from him. It made me realise I enjoyed helping people, and ultimately made me want to be a paramedic.”

Fletcher is from Wolverhampton, where he performed a number of different jobs growing up. “I’ve been a holiday rep, a bingo caller and I even worked at a reptile house,” he laughs. A semi-professional footballer, Fletcher went to Manchester to study before becoming a paramedic in 2008. He is currently seconded from the NHS for a two-year term, at which point he will likely return to performing his duties out of a road ambulance, though he says he would be keen to try and stay in the air for longer.

We pop out to look at the grounded 135 helicopter. Up front, the inside is a riot of buttons, dials and lights; while Fletcher’s life-saving equipment is stored at the back: “We’ve got everything you get in a Mercedes Sprinter road ambulance, such as the defibrillator and ventilator, it’s just packed in a bit tighter.” Each helicopter can house the pilot and up to two paramedics plus a patient on a stretcher.

Once airborne, the paramedics will assist the pilot with navigation as well as “keeping constant track of other aircraft, liaising with the coastguard, speaking to the police, keeping in touch with air traffic control, speaking to hospitals – it’s never dull”. Once a patient is in the helicopter, the paramedics’ attention turns to treatment and care, leaving the pilot to find his own way to their destination – every hospital in the country has a dedicated landing site for an air ambulance.

I hear a distant rumbling and the signature sound of a helicopter’s blades gets louder, and Fletcher and I watch as it lands. The air ambulance crew also have to re-fuel the aircraft themselves which, on a busy summer day when they might be called out to job after job (“12 or 13 in one day sometimes”), must be done safely as well as efficiently.

While that is taken care of, I suit up and am given a safety briefing by pilot John Cutler. I’m asked by another paramedic if I’m nervous and pretend I’m not – in truth I’m a little jittery. I get in, put a helmet on and can hear the pilot talking to air traffic control. Once he has run through some pre-flight safety checks with Fletcher, we’re off. There’s a scene at the end of the Tom Tykwer film Heaven, where the two central protagonists ascend towards the heavens in a helicopter, sky filling the screen before fading to black. I think of this as the helicopter lifts off the ground and we fly towards Belmont Reservoir, north of Bolton – it feels like being in a movie.

But Fletcher tells me it’s routine for him: “People see it as a sexy role, but I’m as much of a paramedic as a road paramedic, I just have a different way of getting to people who need care. It’s a fantastic environment to work in, and has certainly added another string to my bow, but I don’t think of it as glamorous. Not many people know that the NWAA is a charity. Many people think it is paid for by the NHS, but it’s not and so I tend to try raise awareness if I’m talking to someone.”

There’s no actual emergency taking place on my flight, but the pilot circles a possible landing site to teach me what factors they would consider before landing (is the ground stable? Is there enough clearance? What other hazards are there?). Then we fly back to base, Bolton’s Reebok stadium visible from the craft, and my stomach finally settles – I can’t imagine doing that all day long without losing my lunch.

Fletcher laughs at this, explaining that air ambulance paramedics don’t always have time for lunch if they’re having a particularly busy day. “We do a nine-and-a-half hour shift, with 30 minutes for lunch, but we don’t always get to take it. I don’t mind because if we haven’t got time to eat it’s because we’re helping someone.”

Later, I tell a taxi driver that I’ve just been in a helicopter and he says my life is like a rock star’s. He couldn’t be more wrong, but Fletcher’s life may well be as exciting as any performer’s – though you’ll never find him boasting about it. Every time I hear that rotor noise, I’ll think of Fletcher humbly going about his work caring for the people of the north west, rather than wondering which celebrity is flying overhead.

Curriculum vitae

Mark King

Juror fined £450 after smoking cannabis joint on break from rape trial

admin — Fri, 18 May 2012 17:01:30 +0000

Shezad Hussain admits contempt of court after juror on another case spotted him smoking at bus stop during lunch hour

A juror on a rape trial who smoked a cannabis joint in his lunch hour was today fined £450 after admitting contempt of court.

Shezad Hussain, 26, smoked the drug at a bus stop just yards from the entrance to Bolton crown court, Greater Manchester.

But he was spotted by a juror on another case who alerted police. Hussain at first denied but then admitted the offence, blaming stress following a violent attack on his family-owned corner shop by “gangsters”.

The father of one from Bolton had been one of 12 jurors on a week-long case of a man accused of raping a child.

Hussain was dismissed from the jury on Monday, charged with contempt of court and told to speak to a solicitor.

Half of learning disability services not meeting core standards

admin — Fri, 18 May 2012 14:36:00 +0000

Half of the learning disability services inspected by the Care Quality Commission in the wake of Winterbourne View are not meeting essential standards on safeguarding residents and caring for them. The CQC said the findings were a cause for concern.

Burstow urges social workers to overhaul ‘crisis’ care system

admin — Fri, 18 May 2012 13:43:00 +0000

The care services minister has put social workers at the heart of his plans to transform social care from a “high-dependency service” to one that supports people to stay independent.

In death – as in life – my mother was rescued by love | Jonathan Freedland

admin — Fri, 18 May 2012 13:30:00 +0000

Sara’s story is an extraordinary one of loss, survival and, at the end, the remarkable bonds between us all

Nearly 11 years have passed since I last broke my own rule and wrote in this place about something deeply personal. Then, in the summer of 2001, it was the birth of my first child and the article was a hymn of praise for the National Health Service that had ushered my son into the world.

Today I write about my mother, who died 10 days ago. Once again – though this is not my only aim – I want to record my praise, even awe, for the people who looked after her. It was not so straightforward this time. Yes, the NHS funded it all, but my mother was tended to – at home in Bournemouth – by a variety of agencies, some public, some voluntary and one private. I confess that before this experience, I would have been wary of such an arrangement. But my prejudices were confounded. The team worked together with perfect efficiency, a coalition of Macmillan and Marie Curie nurses, agency staff, NHS district nurses and care assistants and the local GP. Not once did any information slip through the cracks. It meant we could fulfil our promise to my mother that she would spend her last weeks not in hospital or in a hospice, but at home.

At no point, despite all the equipment and expertise that came through the front door, was money so much as mentioned. Never were we confronted with a choice of a cheaper option or a limit to our “cover”. My mother got all the care she needed and no one presented her or us with a bill. That is the glory of our national health system, one we take for granted too easily. It is a treasure to be cherished.

And yet what will stay with me is a thought not about systems or organisations, but about people. Perhaps two dozen different women helped my mother in those last days. They were gentle and sensitive, speaking softly and with great care. Several of them, it turned out, were motivated by past experience of caring for their own, terminally ill relatives. On the last full day of my mother’s life, I noticed that the eyes of one nurse, Sue, were welling with tears. She had been watching me talk to my mother and had, I think, been reminded of her own farewell to her father. When she said goodbye to me, she said something I shall never forget. “Thank you for letting me in.”

I never asked what any of these remarkable people are paid, but I don’t imagine it’s very much. And yet they do work that is tough, exhausting and priceless. I know the explanation for that paradox but, in truth, it is inexplicable.

Still, what I’ve been thinking about most during these last 10 days is my mother. She won no prizes, she built no monuments – and yet her life was extraordinary. When I wrote a memoir of three generations of my family, including the lives of relatives involved in some of the epic political events of their era, it was nevertheless her story that touched people most.

She was born Sara Hocherman in 1936, in the small town of Petach Tikva in what was then Palestine. She was two months premature: the doctors warned that her life was “hanging by a thread”. Her father was an ultra-orthodox Jew who showed his children what might politely be called distracted neglect. He did not provide for them or his wife and, after an older sister died through malnutrition, my mother’s mother returned to her native London with her two surviving children.

By the time she was five, in 1942, Sara was an evacuee in the Bedfordshire countryside, taken in by a kindly unmarried lady who took a shine to the little girl. But Sara missed her mother terribly. In the spring of 1945, the war’s end approaching, a reunion seemed only weeks away. Then one of the very last V2 rockets to fall on London hit Hughes Mansions in the East End, killing 134 people; 120 of them were Jews, my mother’s 33-year-old mother among them. When everyone else was celebrating VE Day, eight-year-old Sara was in mourning.

What followed were hard years in the post-war East End, and in 1949 a return to what was now Israel, to witness the earliest years of the state. That period was hard too: my teenage mother had to contend with poverty, family estrangement and disease. In 1955, Sara returned to England where she eventually met and found happiness with my father. Illness would strike again when my mother was 43; once more the doctors would say her life was hanging by a thread. But somehow she survived.

There is so much to say about all of this, and one way or another I will spend the rest of my life saying it. But three points stand out.

The first is that my mother’s experience made her much more hawkish than me on matters relating to Israel. To lose her mother (and an aunt) along with so many other Jews to one of Hitler’s bombs meant she had felt the breath of the Shoah on her neck: it entrenched a yearning that she felt as a desperate need, the craving for a place the Jews could call their own. She was not the only one to feel it. Whatever view you ultimately take on the Israel-Palestine question, you cannot hope to understand that conflict unless you also understand this need.

Second, whenever one contemplates war or military intervention anywhere, one needs to contemplate this unbending fact: that every bomb or rocket that falls, no matter where in the world it lands, is destined to create another Sara Hocherman – a child who has lost a parent. And the pain of that act will live on through the decades and through the generations, as it did in my family.

Lastly, my mother’s life was proof of the power of love. She was rescued first by her aunt, Yiddi, who took her in, and next by my father, who was with her for 52 years and with her at the very end. Their love ensured that, though my mother was unfathomably strong, she was never hard. She contained next to no bitterness, only oceans of empathy.

So this weekend, do yourself this favour, if you can. As my mother would have put it, deploying the idiosyncratic grammar that was part Yiddish, part passive-aggressive self-deprecation, “Phone your mother: she’s also a person.”

Jonathan Freedland has set up a Just Giving page in his mother’s name, for Macmillan Cancer Support

Twitter: @j_freedland

Jonathan Freedland

Dopamine: the two-faced molecule behind addiction and Parkinson’s disease – video | The Newton Channel

admin — Fri, 18 May 2012 13:12:46 +0000

The hormone dopamine is responsible for the cravings of addiction, but when levels are abnormally low it causes the muscular twitches of Parkinson’s disease

Kids’ cardiac service criticised

admin — Fri, 18 May 2012 12:25:37 +0000

An independent panel says cardiac services at Glasgow’s Sick Children’s Hospital “may be unsafe if critical staffing problems are not addressed”.

Today in healthcare: Friday 18 May

admin — Fri, 18 May 2012 12:24:40 +0000

News, comment, blogposts and tweets across the sector

3.11pm: Lizzi Easterbrook writes

Thanks to everyone who took part in our live Q&A on leadership earlier. We will be doing a round-up on the site next week and you can still read all the comments here.

Elsewhere, your views on the news looks at the response from readers working in and using community care services to this piece by Denis Campbell. They are debating the dossier of evidence from RCN that suggests that NHS services outside of hospitals are struggling to cope with growing demands on services. Read their views and let us know what you think by adding your comments.

1.24pm: Jessica Fuhl writes

We’re tackling quite a few hot topics in our live discussion on leading through change at the moment. We’ve covered risk, integrated care, patient leadership and more – so pop over there to see the discussion develop. It’s running until 2pm so there’s still time to post a question for our panel.

12.54pm: Clare Horton writes

Our leadership debate is well underway; as well as keeping an eye on that, here’s the lunchtime headlines:
• HSJ [subscription]: Leeds Hospitals, Mid Yorks and York FT ‘missing elective wait targets’
• BBC: Weight management ‘benefits’ for mother and baby
• Telegraph: Government puts faith in gardening to tackle care crisis
• Shropshire Star: Health chiefs back new £27m Ludlow hospital

12.02pm: Jessica Fuhl writes

Pulse today reports that the chair of the NAPC has warned that CGGs are unlikely to succeed unless they get a firm grip on unwarranted variation in primary care.

According to Pulse:

Speaking at the think tank Reform’s High Quality Healthcare conference in London, Dr Charles Alessi said CCGs would need to spend a lot of time ‘looking inward’ if they were to succeed in transforming care.

Read the article in full online here.

11.01am: Clare Horton writes

The government’s new Can Parent initiative, which is being launched by the prime minister today, includes a digital information service for new parents. A Department of Health press release says parents-to-be and new parents who sign up for the service:

will receive regular emails and text messages containing relevant and timely NHS approved advice as their pregnancy develops and as their child grows.

The NHS Choices tweets:

David Cameron tells chief political correspondent Nicholas Watt:

I would have loved more guidance when my children were babies. We’ve all been there when it’s the middle of the night, your child won’t stop crying and you don’t know what to do
Parents are nation-builders. It’s through love and sheer hard work that we raise the next generation with the right values. That’s why this government is doing everything possible to support parents. This is not the nanny state – it’s the sensible state.

The initiative also includes pilot parenting classes in Middlesbrough, Camden in north London and in High Peak, Derbyshire, and a pilot relationship support service in York, Leeds, north Essex and in some London boroughs for expectant parents and those with children up to the age of two. The idea is a response to last summer’s riots.

9.19am: Clare Horton writes

Making headlines elsewhere today, the Telegraph reports that heart services face being closed or merged with others over fears they are too small. It says a review of services for adults with congential heart problems has been launched after it was found that some units are treating fewer than ten patients a year.

A father who lost his son to leukaemia is calling for young people to be given lessons on how to donate stem cells, blood and organs. Keith Sudbury’s son Adrian received a stem cell transplant which gave him an extra year of life, but died aged 27, having kept a blog documenting his illness. Sudbury told the BBC he wants to raise awareness by making donation part of the curriculum for students aged 16 and over. The Anthony Nolan charity is supporting the idea of ‘Adrian’s Law’.

And the Independent reports that Department of Health figures show the number of breaches of rules on mixed-sex NHS wards rose by nearly 100 last month.

8.58am: Clare Horton writes

Good morning and welcome to the daily blog from the Guardian’s healthcare network. We’ll be bringing you the pick of the news and comment from across the sector throughout the day.

On the network today, we’re discussing leading a changing NHS. Our panel of experts will be live online from noon today to discuss the challenges of change and whether managers will be able to achieve efficiency savings. Post a question now, tweet us @GdnHealthcare, or watch the debate as it happens.

We’ve also a lovely piece by Dorset pharmacist Mike Hewitson, in which he describes his typical day:

My pharmacy is located in a small rural town and has been independently owned for its entire 222 year history. I am immensely proud to be the custodian of such an important community resource, which has been in our hands for the last 4 years.

The Guardian reports on how a teenager diagnosed herself with cancer after watching her illness depicted in a Cameron Diaz movie.

And there’s also an update on Nicholas Crace, the former charity director who has become the UK’s oldest living kidney donor, after giving away one of his ‘Formula One’ kidneys at the age of 83.

If there’s a story, report or event you’d like to share, please add a comment below the line, or tweet us @GdnHealthcare.

NHS
Health

Clare Horton

Jessica Fuhl

Lizzi Easterbrook

Transforming care by improving patients experience event

andrew — Fri, 18 May 2012 10:49:16 +0000

How does Birmingham Community Healthcare Trust use patient experience to improve services? What difference has your feedback made? Find out more about the use of technology in seeking patient feedback.

Details to be found here

Parent classes ‘not nanny state’

admin — Fri, 18 May 2012 10:44:07 +0000

Prime Minister David Cameron defends free parenting classes in England, denying they are the policy of a “nanny state”.

Father wants ‘donation’ lessons

admin — Fri, 18 May 2012 01:37:16 +0000

A father who lost his son to leukaemia is calling for schools and colleges to make a lesson on donating stem cells, blood and organs part of the curriculum.

Dieting ‘safe for pregnant women’

admin — Fri, 18 May 2012 01:36:38 +0000

Dieting in pregnancy is safe and does not carry risks for the baby, a review of research has suggested.

83-year-old gives away one of his ‘Formula One’ kidneys

admin — Thu, 17 May 2012 17:13:15 +0000

Nicholas Crace becomes oldest living kidney donor in UK and one of 100 people who have donated to a stranger while alive

He has given blood 57 times, he is a volunteer driver for a local hospice, and now Nicholas Crace has scored a double first at the age of 83 – becoming the oldest living kidney donor in the UK and the oldest person ever to donate a kidney to a stranger.

The former charity director turned his thoughts to helping someone else in another way after his wife, Brigid, died last summer. “I cannot remember quite what put the idea of being a living kidney donor into my mind,” said Crace, of Overton in Hampshire, “but in September 2011 I thought that it might be worth investigating. After all, I was in good health, had no dependants and had plenty of time at my disposal. I knew that 7,000 people are waiting for a kidney and that one person dies almost every day while waiting.

“I would have been very disappointed if I had been turned down. I was ideally placed to be a donor after the hospital had established that I was fit and had excellent kidneys. One can live perfectly happily with only one kidney – in fact some people are born with only one.”

As he put it on BBC Radio 4′s Today programme on Thursday, doctors discovered he had “Formula One kidneys” – good enough to have come from a 40-year-old.

Crace was aware of the difficulties faced by patients on dialysis – regular trips to hospital, a restricted diet and health problems. He said it was an easy decision to become a donor. “Giving a small part of me to someone else will make little difference to my life but a huge difference to someone else’s. I was lucky to be in a position to help someone else less fortunate than myself.”

Over a period of six months, he made 14 visits to Queen Alexandra hospital in Portsmouth – a round trip of nearly 100 miles – for tests, checks and a three-hour operation to remove a kidney. Within three days of the operation he was back mowing the lawn and riding his bike.

Sam Dutta, the surgeon who performed the operation, said: “We know from numerous studies that a living-donor kidney performs better, works quicker and lasts longer than one from a deceased donor. All the detrimental factors related to being on dialysis are completely taken care of by a good functioning kidney. An altruistic donor coming forward is an amazing thing for us. The recipient just gets a new lease of life.”

Crace is one of a rare breed – just 100 people in the UK have donated a kidney while living, for someone they are never likely to know.

Altruistic kidney donation by a living donor was first carried out in 2006. Altruistic donors were “very special people”, said Annabel Ferriman, chair of the charity Give a Kidney – One’s Enough. “They have the imagination to understand the suffering that people go through on dialysis while waiting for a transplant and the courage and generosity to do something about it.”

Health

James Meikle

Last night a DVD saved my life

admin — Thu, 17 May 2012 16:03:06 +0000

A teenager diagnosed herself with cancer after watching her illness depicted in the Cameron Diaz weepie My Sister’s Keeper

No one ever claimed going to the cinema was good for you, but a teenage girl has discovered that paying attention while watching a DVD can save your life, after she diagnosed herself with cancer during a viewing of the Cameron Diaz movie My Sister’s Keeper.

Alex Cooper, 17, realised she was suffering from leukaemia when she noticed symptoms similar to her own in a dying character from the 2009 Nick Cassavetes weepie, which also stars Abigail Breslin and Alec Baldwin. She had previously believed her lethargy was due simply to being a lazy teenager, she told the Telegraph. But when she went to see her GP in October 2010 she was swiftly diagnosed with chronic myeloid leukaemia (CML) and immediately began a course of chemotherapy.

“It was one of those surreal moments in life,” said Alex, of Bredgar, Kent. “I was watching the film and all of a sudden I realised I had the same symptoms. It was terrifying at first but I started to rationalise it and thought – I can’t really be suffering from cancer.

“But I eventually went to my doctor and he sent for blood test straight away. When I was first told about the cancer I was in shock. I thought it was the end. I just thought I am going to lose all my hair and just keep getting more and more ill.

“I suppose if it wasn’t for the film I may not have got my diagnosis in time. When you watch something on screen it makes everything much more real. I guess I am just really lucky to have watched it. However, I can’t bring myself to see it again. It is too upsetting – I have hidden it under my bed.”

Alex, who is now in remission, might have died in less than a year had she not begun taking the chemotherapy drug Distaniv. She is now hoping to go to university after completing A-levels in English, Maths, Art and Psychology.

Ben Child

Computer game for stroke patients

admin — Thu, 17 May 2012 13:10:02 +0000

Newcastle University helps to develop a computer game to help those who have suffered strokes.

Today in healthcare: Thursday 17 May

admin — Thu, 17 May 2012 12:37:33 +0000

News, comment, blogposts and tweets across the sector

5.22pm: Lizzi Easterbrook writes

That’s almost all from us today, but before we go…

The Strategic Society Centre have released a new publication today called ‘The Roadmap: England’s choices for the care crisis’. They are exploring the ‘spending decisions’ and ‘funding decisions’ that need to be taken by the Government to solve the current care funding challenge. You can download the report here.

Paul Corrigan has also written this piece on his Health Matters blog which looks at how cuts in social care are impacting on the NHS – and how this is likely to continue as the cuts really start to bite.

2.17pm: Lizzi Easterbrook writes

The Nursing and Midwifery Council (NMC) has today announced plans to consult on a possible increase in its registration fee to cover the rising number of fitness to practise referrals and the increasing costs of regulation.

The fee has been £76 since 2007 but Judith Ellis, interim chair of the NMC has said that:

An annual fee in the order of £120 is the level that is needed to protect the public and to ensure the integrity and the reputation of the professional register.

1.37pm: Jessica Fuhl writes

A few more stories this lunchtime…

Department of Health: Extra one million people now seeing NHS dentist since May 2010

The Wellcome Trust: NHS set to benefit from UK-led technologies

This is South Wales: ‘Focus on seriously ill patients’, health chiefs

12.59pm: Jessica Fuhl writes

Here’s a round up of this lunchtime’s healthcare stories from around the web…

Guardian Government Computing: Leeds teaching hospitals trust moves to standardised directory

The Independent: Same snack, but with twice the fat

Nice: Shared Learning Awards 2012 winner announced

GP Online: Health secretary says GPs have ‘ethical duty’ to save NHS costs

And because we missed it earlier this week…

Vijaya Nath blogs for The Kings Fund on the Kaiser Permanente health group’s integrated health care system – The secret of their success

11.49am: Jessica Fuhl writes

We have two new pieces on the network today. Richard Vize asks what does the abandonment of two commissioning support services mean for the NHS reforms?

He argues:

Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.

You can read the article in full online here.

Elsewhere on the network, Simon Denegri speaks to us about public involvement in clinical research, why he works in the health sector and his proudest achievements. Watch the video here. He will be taking part in a live Q&A on the healthcare network on 24th May.

10.28am: Jessica Fuhl writes

An article on Pulse today reveals how GPs are routinely overcharged by hospitals’ ‘creative coding’.

According to Gareth Iacobucci:

Hospital staff are accused of a raft of coding errors that have resulted in practices being overcharged by as much as £30,000 in some cases – with one patient reportedly admitted to hospital every day for three months.

9.29am: Clare Horton writes

Making headlines elsewhere this morning, the Telegraph reports on the Reform thinktank’s healthcare conference yesterday, at which Dr David Bennett, chairman and chief executive of Monitor, and Mike Farrar, chief executive of the NHS Confederation, said delivering patient choice will mean hospital closures. They reportedly told the event that struggling district generals, or departments within hospitals, that fail to attract patients should be shut quickly rather than being allowed to linger on and risking “catastrophic failure”.

The Independent reports that one in eight deaths of UK adults under the age of 64 is caused by alcohol. An international conference on tackling problem drinking heard that the social cost of alcohol abuse has been estimated to be £240 a year for each European, with the annual bill for the NHS alone being £2.7bn.

And the BBC reports that at least 150 lives will be saved and thousands of wasted ambulance journeys avoided by a change in 999 response practices. It says that from next month, operators in England will get an extra 60 seconds before they need to dispatch crews to serious but non-life-threatening callouts. During trials of the system, there were fewer double dispatches, which is when two crews are sent, meaning resources were freed up for other calls.

If there’s an event, report or story you’d like to let us know about, please add a comment below the line or tweet us: @GdnHealthcare

9.00am: Clare Horton writes

Good morning and welcome to the daily blog from the Guardian’s healthcare network. We’ll be bringing you the pick of the news and comment from across the sector throughout the day.

The Guardian reports today that millions of over-50s could safeguard their health by taking statins. According to a report in the Lancet, the drugs benefit healthy people with no heart problems. It says as many as 20 million Britons could be offered them, which would add up to £240m to the NHS’s annual drugs bill.

Tesco, Aldi, Caffe Nero and Greggs have all been criticised by Which? for failing to print ‘traffic-light labelling’ on sandwich packaging. Rebecca Smithers reports that inconsistent and confusing labels are making it difficult for shoppers to make meaningful comparisons and choose the healthiest options.

And there’s also the moving story of Nicholas Crace, who at the age of 83 has become the oldest living kidney donor in the UK and the oldest person in the country to give a kidney to a stranger. Crace, a former charity director and veteran blood donor, said:

I knew that 7,000 people are waiting for a kidney and that one person dies almost every day while waiting.
I couldn’t have lived with myself with the knowledge that I had had the chance of changing someone’s life and turned it down.

NHS
Health

Clare Horton

Lizzi Easterbrook

Jessica Fuhl

Prosthetic retina in development

admin — Thu, 17 May 2012 11:19:22 +0000

Scottish scientists are working on a device to restore sight in people with a form of age related blindness.

Sandwich labels misleading consumers

admin — Thu, 17 May 2012 11:17:00 +0000

Tesco, Aldi, Caffe Nero and Greggs criticised by Which? for failing to print ‘traffic-light labelling’ on the front of packs

Inconsistent and confusing labels on best-selling sandwiches on the high street are making it difficult for shoppers to make meaningful comparisons and choose the healthiest options, a consumer group has warned.

Retailers such as Tesco, Aldi, Caffe Nero and Greggs are criticised by Which? for failing to print so-called ‘traffic light labelling’ on the front of packs which claims that portion sizes and nutritional content vary so much that consumers could be eating three times as much fat and double the amount of salt as the same sandwich bought elsewhere.

Which? researchers looked at the calorie, fat, saturated fat and salt content of three of the most popular pre-prepared sandwiches – chicken salad, egg mayonnaise and bacon, lettuce and tomato (BLT) on sale at supermarkets and coffee chains.

But they found that fat and salt content varied widely while inconsistent labelling across stores meant that healthier sandwich options were not always obvious. The traffic light labelling system uses a colour-coded wheel of red, amber and green symbols to indicate levels of salt, fat and other nutrients but is not compulsory in the UK. Six out of the 15 retailers it compared include the traffic light system, but the rest do not.

Of the inconsistencies singled out by Which? are a Morrisons chicken salad sandwich contains 11.7g fat (amber/medium) compared with one from Waitrose which contains 6.0g fat (green/low). Waitrose uses traffic lights, whereas Morrisons doesn’t. A Lidl BLT has 3.36g salt (red/high) but one from Boots has 1.5g salt (amber/medium). Again, Boots uses traffic lights while Lidl doesn’t. And an Aldi egg mayonnaise sandwich contains 22.3g fat (red/high) and one from Asda contains 10.1g (amber/medium). Asda uses traffic lights, Aldi doesn’t.

This week, the government’s Food Standards Agency (FSA) launched a consultation on nutrition labelling in Northern Ireland and Scotland.

Which? executive director Richard Lloyd said: “With obesity levels reaching epidemic proportions, it’s more important than ever that consumers know exactly what they’re eating. Many retailers are already using traffic-light labelling, but the rest need to catch up and do what works best for consumers. We want to see the government insist that all food companies use traffic lights on their labels, so there’s a clear, consistent system that makes it easier for people to make informed choices about what they eat.”

A spokesperson for the FSA said: “New EU regulations on food labelling were introduced at the end of last year that require manufacturers and retailers to make many changes to their food labels. While providing front-of-pack information is voluntary under the regulations, every company that does so has to provide information about calories alone, or calories plus the amount of fats, saturated fat, sugars and salt.”

A spokesperson for Aldi said: “There is currently a debate about which system of food labelling is best for consumers. We offer our customers the opportunity to make an informed choice by providing Guideline Daily Amount (GDA) labelling as we currently feel that this is the best way of keeping our customers informed. We will continue to review the situation as we approach the implementation of the food information regulation in 2014. As a responsible business, we will continue our work to reduce salt and saturated fats in our food.”

Rebecca Smithers

Rise in ambulance delays at A&E

admin — Thu, 17 May 2012 11:03:31 +0000

Ambulances are spending 50% more time outside hospitals in Kent, Sussex and Surrey, the BBC has learned.

What does the abandonment of two commissioning support services mean for the NHS reforms?

admin — Thu, 17 May 2012 09:57:27 +0000

Richard Vize explores the development of the commissioning support services and the wider implications for the health sector. Are cracks beginning to show?

Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.

The NHS Commissioning Board has revealed that as a result of its “Checkpoint 2″ tests for the viability of the plans for 25 regional commissioning support services, two have had to be abandoned: West Mercia and Peninsula (Devon and Cornwall). A further nine require “more rapid management” to stop them from failing.

The support services are often wrongly described as providing “administrative functions” for clinical commissioning groups. This does not begin to articulate the breadth of their work and their importance in determining whether the reforms succeed or fail.

They will lead change and service redesign, identify gaps in services, spot and manage risks, identify service providers, manage tendering, negotiate contracts and do much else besides.

Getting the support services off the ground would be difficult enough if they were just run of the mill public sector bodies. But they will eventually be “free standing”, selling their services into the NHS. So the commissioning board has been charged with setting them up not only to help CCGs reform the health service but to then blossom into commercial, independent organisations. It takes a fertile imagination to see how a board steeped in a culture of central control can be an incubator for business start-ups.

Any weaknesses in the operation of the support services will be exposed in both service quality and financial stability. The turbulence in the NHS as real-term funding cuts collide with the reforms means there is a serious risk of a financial failure or a local deterioration in quality that goes unspotted or unchecked. The cuts alone increase this risk substantially; support organisations teetering on the brink of failure are unlikely to identify problems and work with providers to address them in time.

The Treasury has been worried about handing over £60bn of public money to new and unaccountable organisations. With the dire verdict of the NHS Commissioning Board on the state of the nascent commissioning support services they now have reason to be terrified.

No-one has ever claimed that GPs’ skills lie in managing NHS finances – their strength is in understanding patient needs and clinical pathways. The support services are vital for effective financial control.

The commissioning board now has to fill the gap left by the abandoned services. The strategic health authorities are moving quickly, and neighbouring services whose preparations are going well could be asked to take over. While expansion has its advantages, changing boundaries and taking on new CCGs and populations will make the further development of their existing operation more complex.

The board also announced it has abandoned plans for a national communications and engagement service for CCGs. The service would have had the advantage of keeping costs down but looked suspiciously like a Ministry of Information for the board, which would have undermined the notion of a locally accountable NHS. Noises are still being made about a nationally co-ordinated communications service, but the hope must be that CCGs will now have more freedom to develop an approach to communications and engagement tailored to their own area – albeit made out of cheap cloth.

But even this is symptomatic of how desperately difficult it is for managers, GPs and the national board to stop the reforms from toppling over. Overlay the problems in support services with the setbacks and difficulties CCGs are experiencing as they struggle to establish themselves, and the wealth of management talent leaving the service, and you have a national picture of growing uncertainty and risk. Staff across the system are fighting to make it all work, but the chances of something going badly wrong are escalating.

This article is published by Guardian Professional. Join the healthcare network to receive regular emails and exclusive offers.

Richard Vize