Tuesday 10 December 2013

32 KING ALFRED AND THE DANES.
sea in long open boats, high at prow and stern, a moved by sails and oars. When they landed, the threw up an intrenchment to defend their boats, an then they seized all the horses they could find, an galloped over the country, burning and pillaging fa and wide.
5. King Egbert did his best to beat off these pirates but he died in 839, and the kings who succeeded hin were not so strong or so skilful as he was. Con sequently the Danes grew bolder. In 855 they passed a winter in the Isle of Sheppey; and from that tim: forward they began to settle in the country. Thl was the first step in the Danish conquest of England
6. Alfred was then a child. He was born in 84 the fourth son of King Ethelwulf, who succeed! Egbert. Erom his childhood he showed great lo^r of learning, but his early life was too active for hit to learn much from books.
7. Alfred’s three elder brothers were all kings England in turn; and with the third of them, Etlui red, Alfred shared the government. By this time I Danes had practically conquered the north and ■ of England, and it was all that Alfred and his brol I could do to defend Wessex against them. In H they fought nine great battles with the Danes.
8. Next year Ethelred died, and Alfred beca.....
king at the age of twenty-two. He had a heavy 11 before him, for his kingdom was reduced to the west half of Wessex, while fresh swarms of DancM W constantly landing in England. For seven years kept up a gallant struggle, but in 878 he was I'm to take refuge in the marshes of Athelney in Somei and was almost driven to despair.

%Iimi I Ihii;"¹. looked worst, however, Alfred lulil v >llni I in which he was nobly sup-IIn immi ol VVchhcx, and he won a decisive IiihI Ill'¹ l*aiiisli host at Ethandun, in ■Ml fill In tv ell 111 ■ the victory by blockading

Sunday 10 November 2013

Tamaris

Plymouth, Devon

Roads
NGRef: SX4755 OSMap: LR201 Type: Roman Settlement, Port
River Tamarus: NNE (20) to VXELIS.

Tamaris - The Town on the River Tamar

There are two clues in Ptolemy's Geography (bk.II, ch.ii); near the the beginning of part 2, which reads:
"Description of the south side below which is the Oceanus Britannicus [English Channel]. After the Ocrium Promontorium [Lizard Point, Cornwall] is the mouth of the Cenio¹ river 14*003 51°45 (then) the mouth of the Tamarus² river 15*40 52°10 (then) the mouth of the Iscas³ river 17*40 52°20 ..."

This river remains unidentified.
River Tamar, Devon/Cornwall.
River Exe, Devon.

and also the very last sentence of part 2:
"Next to these [the Durotriges], but more to the west, are the Dumnoni, whose towns are: Voliba 14*45 52°00 Uxella¹ 15*00 52°45 Tamara² 15*00 52°15 (and) Isca, where is located Legio II Augusta³ 17*30 52°45."

VXELIS (Launceston, Cornwall); the previous entry Voliba remains unidentified.
At the mouth of the Tamar near Plymouth.
ISCA DVMNONIORVM (Exeter, Devon).

The name Tamaris is mentioned in the Ravenna Cosmology (R&C#5) of the seventh century, where it is listed between the entries for NEMETOSTATIO (Nanstallon, Cornwall) and DVRNOVARIA (Dorchester, Dorset).
The river-name Tamar is ancient Celtic, possibly meaning 'the dark one' or simply 'the river'. There are several other British rivers whose names have the same root-meaning; the Thames (Latin Tamesis) in London, the Team in County Durham, the Thame in Buckingham/Oxfordshire, and finally the Tame, of which there are three, in Warwickshire/Staffordshire, Yorkshire/Cheshire and North Yorkshire.

See: Historical Map and Guide - Roman Britain by the Ordnance Survey (3rd, 4th & 5th eds., 1956, 1994 & 2001);
Oxford Dictionary of English Place-Names by A.D. Mills (Oxford 1998).

Sunday 13 October 2013

Big jump in hospital waiting lists in Wales

Opposition parties have called the figures a "crisis" and a "national disgrace"

Figures show another significant rise in the number of patients waiting more than nine months for hospital care.

More than 13,000 in Wales had been waiting over 36 weeks in August, a rise of more than 2,000 in one month.

Welsh Conservatives say First Minister Carwyn Jones should intervene personally in "an escalating crisis".

Health Minister Mark Drakeford said the NHS in Wales had the same challenge as England but "where we differ is the way we respond and deal with these issues".

The Welsh government has previously blamed the severe winter weather for pushing up the 36-week waiting time.

Its own target is for no-one to wait that long.

The Welsh Conservatives said they recognised the Welsh government had announced extra cash for the NHS in its draft budget announcement this week but waiting times remained "unacceptably long".

Analysis

Owain ClarkeBBC Wales health correspondent

According to the Welsh government nobody should be waiting over 36 weeks for hospital treatment after being referred by their GPs

But since March there's been a steep rise in numbers of patients that have waited longer.

In August 13,147 patients across Wales had waited longer than nine months, which is 3.1% of all patients waiting

And the statistics show the problems are most acute in three health board areas.

Cardiff and Vale had 4.8% of patients waiting longer than 36 weeks, Cwm Taf 4.7% and Betsi Cadwaladr 4.3%.

But don't forget there's another target - 95% of patients should be treated within 26 weeks.

Only 88% of patients across Wales had been treated within that time.

Opposition parties argue that along with missed targets on cancer treatment times, A&E waits, and ambulance response times, it all suggests the Welsh government's is losing its grip on NHS performance,

The result, they argue, is patients having to suffer for longer.

Shadow health minister Darren Millar has written to Mr Jones saying the situation was "a crisis that needs immediate priority".

He said: "I hope you will agree that patients across Wales - particularly the elderly and vulnerable - should not be faced with such long waits."

He added that he sought assurances the NHS delays would dealt with by Mr Jones personally.

Meanwhile, Kirsty Williams, leader of the Welsh Liberal Democrats, said the figures were a "national disgrace".

"Why must patients in Wales have to put up with such an inferior service when compared to the rest of the UK?" she said.

"Years of Welsh Labour incompetence has led to thousands of people having to wait an awful long time until the start of their treatment.

"No one should have to wait this long, but it's particularly dreadful to think of the large amount of elderly people that are being forced to wait months on end."

On Tuesday, it was announced that the Welsh NHS would be given £570m of extra funding over three years during the Welsh government's draft budget.

Finance Minister Jane Hutt said the extra money would help the NHS in Wales to avoid a scandal such as the one in Stafford Hospital, where hundreds of patients died as a result of neglect and abuse.

Health Minster Mark Drakeford said: "We know there are significant challenges in the NHS. These are exactly the same challenges being faced by the NHS in England.

"Where we differ is the way we respond to and deal with these issues.

"As a result of our action, 92% of people in Wales are satisfied with the care they receive from the NHS."

Saturday 17 August 2013

Welsh GP prescriptions

Welsh GP prescriptions up 50% but total cost is falling

Wales dispenses more prescriptions per head than the rest of the UK

The number of prescriptions dispensed by GPs in Wales has grown by more than 50% in 10 years.

More prescriptions are given per person in Wales, which scrapped charges in 2007, than any other country in the UK.

Last year 74.2 million prescriptions were written, up from 48.8 million in 2002.

However the total cost of prescribed medicines has fallen to its lowest level in nine years.

The new figures showing a 52.3% increase in prescriptions have reignited a political debate over Wales' free prescriptions policy.

“Start Quote

Prescribed medicines represent the largest non-staff element of the NHS budget so it is vital to get value for money from this investment”

Raj AggarwalNational Pharmacy Association

Wales became the first UK nation to scrap prescription charges. Scotland and Northern Ireland have since done the same.

Welsh Conservatives would reintroduce charges for some people, spending the money saved on other parts of the NHS.

But the Welsh government pointed out that it was up to doctors to decide if a patient needed a prescription, and making them free had not changed that.

Wales dispenses 24.3 prescription items per head of population, compared to 20.8 in Northern Ireland, 18.7 in England and 18.6 in Scotland.

A Welsh government spokeswoman said: "The number of prescription items dispensed increased by 20% in Wales between 2007 and 2012 and 26% in England over the same period.

"There is no link between the number of prescriptions per head and prescription charges - Wales has dispensed more prescriptions per head than England since as far back as 1973."

Conservative shadow health minister Darren Millar said the "freebie policy" had created a perception that medicines cost nothing.

"The truth is that there is no such thing as a free prescription," he said.

"Welsh Conservatives would end this culture by scrapping Labour's free-for-all and invest the savings into improved access to modern cancer treatments, extra cash for our hospice movement and improvements in stroke care."

Raj Aggarwal, a pharmacist from Cardiff and a board member of the National Pharmacy Association, said: "Prescribed medicines represent the largest non-staff element of the NHS budget so it is vital to get value for money from this investment.

"There is a huge amount of waste - up to half of all medicines for long-term conditions are not taken as intended by the prescriber."

Despite the increase in prescriptions the overall cost has actually fallen to its lowest level in almost a decade - £557.5m.

A Welsh government spokesperson said: "Costs have declined as patents on 25 drugs expired in 2012 and there was a subsequent availability of generic equivalents at a lower cost.

"Over the past 12 months the largest savings were made in medicines for the treatment of cardiovascular disease and for the treatment of central nervous system disorders, showing a total reduction in cost of £28m as a number of medicines came off patent."

Reasons include a fall in the cost of drugs to the NHS when their patents expire, allowing other manufacturers to produce cheaper generic versions.More on This Story

Tuesday 6 August 2013

Patient safety must become the top priority

Patient safety must become the top priority in the NHS in England, according to a major review.

The report by Prof Don Berwick, US President Barack Obama's former health adviser, said problems existed "throughout" the system.

But he added the NHS remained an "international gem" and could be the safest system in the world.

He said a series of cultural changes were needed, but also recommended criminal sanctions in extreme cases.

Prof Berwick said charges should be applied where organisations misled regulators or in the rare cases in which "wilful or reckless neglect" by organisations or individuals had harmed patients.

Case study

Chatting at the bedside to a patient, a nurse updates the information in their electronic record via a tablet computer. This is the raw material driving improvements in safety at the Queen Elizabeth Hospital in Birmingham, writes Branwen Jeffreys.

The information from that individual record is translated into day-by-day monitoring of quality. For the nurse in charge of a ward that means they can get information updated at midnight each day on how they are doing on delivering safe care.

It counts infections, patients falling on wards, how many are assessed for the risk of clots and the many thousands of decisions made about medicines.

Mobile computer units on each ward translate that into colour-coded charts that give an update at a glance. The data shows what each doctor prescribes, and what drugs each nurse is giving to individual patients.

The aim, says the trust, is to make every error count. Teams are held to account if they're lagging behind and new quality targets are set constantly. But perhaps the most powerful tool is transparency - each ward can see how they're doing compared to the others.

But he stopped short of calling for a duty of candour, which would compel the NHS to inform patients of any errors made in their care.

He said this would be too bureaucratic and should instead be applied only after serious incidents had happened.

He also resisted calls for set minimum staffing ratios, but said trusts should be keeping a close eye on staffing levels to make sure patient care was not suffering.

Prof Berwick was asked by ministers to conduct the review after the public inquiry into the neglect and abuse at Stafford Hospital concluded the NHS had "betrayed" the public by putting corporate self-interest before safety.

More co-operation

Many of his recommendations in the 45-page report focus on the creation of a new culture of openness and transparency.

He said all information - apart from personal details - should be made publicly available.

Prof Berwick also called for more co-operation between the various regulators and management bodies in the NHS.

He said the current system was bewildering in its complexity and there should be a review by 2017 to make sure the different bodies were working together on the issue.

And he said staff must be given good support and training to help make sure they took pride and joy in their work.

He said where honest errors were made there should be a culture of "no blame".

If all this was done, Prof Berwick said he could see no reason why the NHS could not become the "safest in the world".

But he said too often in complex organisations like health systems with targets to hit and budgets to manage priorities could become skewed.

Who is Prof Don Berwick?

Prof Don Berwick has won global recognition for his work on making hospitals safer. His mantra has been that health systems should not see mistakes as inevitable - and instead should learn from businesses such as the airline industry which advocate zero harm.

The Institute for Healthcare Improvement, which he co-founded in Cambridge, Massachusetts, has worked with healthcare systems around the world.

Prof Berwick described the NHS as "one of the astounding human endeavours of modern times" in a speech marking its 60th anniversary in 2008.

His admiration for the publicly funded and provided NHS led to criticism from Republicans when President Obama appointed him Administrator of Medicare and Medicaid. He stood down after a year, shortly before facing a nomination hearing.

How many reviews does the NHS need?

"In any organisation, mistakes will happen and problems will arise, but we shouldn't accept harm to patients as inevitable," he said.

"By introducing an even more transparent culture, one where mistakes are learnt from, where the wonderful staff of the NHS are supported to learn and grow, the NHS will see real and lasting change."

The government will respond to the review in detail at a later date.

But Health Secretary Jeremy Hunt said he would be seeking to act on the recommendations.

"This is a fantastic report. For too long, patient safety and compassionate care have become secondary concerns in parts of the NHS and this has to change."

Royal College of Nursing chief executive Peter Carter said: "Patient safety has to be at the heart of the daily work and culture of everyone in the NHS, from the government and chief executives to porters, cleaners and every clinician.

"For this to happen we need to see a greater transparency, a no-blame culture where individuals can speak up and challenge any problems which threaten the quality or safety of patient care and feel that their concerns are being heard."

But Roger Goss, co-director of Patient Concern, said action was needed.

"Like all reports of NHS's failings, it sounds as if it is long on what is needed but short on how its recommendations will be made to happen.

Friday 5 July 2013

summer shade

Wednesday 19 June 2013

stonehouse

Wednesday 5 June 2013

Operation Jasmine: MP urges care home abuse law change

Dr Prana Das was left brain damaged after a violent burglary at his home

An MP wants a change in the law after the collapse of the UK's biggest investigation into alleged abuse at old people's care homes in south Wales.

Operation Jasmine started in 2005 and cost £11.6m, but was put on hold after Dr Prana Das, the homes' owner, suffered brain damage in a burglary.

Charges against him have been left on file.

Blaenau Gwent MP Nick Smith hopes the UK government will back his proposal, which he said had cross-party support.

“Start Quote

The families and the residents there want justice and I'm going to keep up the campaign to make sure that we have a public inquiry but also try and change the law”

Nick Smith MPBlaenau Gwent

The decision was made to leave the charges on file after a hearing at Cardiff Crown Court in March.

In April, after a criminal trial, a man and a woman were jailed for 15 and 10 years respectively for assaulting and robbing Dr Das and his wife Nishebita, also a doctor, in their home in Newport.

The court was told that Dr Prana Das, 66, was hit about the head so violently that he will never practise medicine again.

He had faced charges relating to neglect and fraud at two care homes - Brithdir Care Home in New Tredegar, near Bargoed, and The Beeches in Blaenavon.

Gwent Police have already welcomed the decision that proceedings could restart if his condition improved.

'Important topic'

Mr Smith told the BBC's Sunday Politics Wales that when he raised the matter at Prime Minister's Questions, fellow MPs recognised there were many issues of "neglect of old people at care homes across the UK".

Blaenau Gwent MP Nick Smith says lessons need to be learned from the case

He will table a Ten Minute Rule Bill at Westminster later this week as a first legislative step.

"I think that this is an important topic," he said. "The families and the residents there want justice and I'm going to keep up the campaign to make sure that we have a public inquiry but also try and change the law.

"There's going to be a social care bill and I want to make sure that we can get an amendment put through to that to make sure that if there are issues of neglect they can prosecuted properly by the authorities".

Operation Jasmine spanned seven years, involved 75 police staff, and 4,126 statements were taken.

Mr Smith said: "Lots of people recognise it is an ongoing issue and a fight worth seeing through".

The MP has spoken about his shock at hearing details of the case and what had happened to 103 alleged victims, 63 of whom have since died.

Operation Jasmine was an inquiry funded by the Home Office into six care homes in south Wales.

'New law needed' after collapse of care home neglect case

5 June 2013

'New law needed' after collapse of care home neglect case

Labels: 'Shame on us cqc, 'Shame on uscare homes

'New law needed' after collapse of care home neglect case

By Fran Abrams

BBC File on 4

A silhouette image of a woman passing a cup of tea to an elderly lady.

Just 170 prosecutions for wilful neglect of the elderly were brought last year.

The collapse of Britain's biggest investigation into elderly care home neglect has prompted calls for a reform of the law.

Former care minister, Paul Burstow wants a new offence of corporate neglect to make it easier to hold those running bad care homes to account.

He is to table an amendment to the government's Care Bill which is currently going through parliament.

Care Minister Norman Lamb says he is considering the issue.

Mr Burstow - who stepped down in last September's reshuffle - said he was determined to ensure the government created the new law following the end of Operation Jasmine.

“Start Quote

We need companies that provide care to realise it's not just about their profits. It's ultimately about the dignity of the people they are looking after”

Paul BurstowMP

Police launched the operation seven-and-a-half years ago following concerns over the death of more than 60 care home residents in six homes in Wales. The investigation by Gwent Police cost £11.6 million and amassed more than 12 tonnes of evidence.

Among the alleged victims were elderly people who became severely malnourished or dehydrated, or who died because of infected pressure sores.

But despite exhaustive inquiries, the CPS said there was not enough evidence to charge key figures - including one of the care home owners Dr Prana Das - with gross negligence manslaughter or wilful neglect.

Later attempts to bring the care home boss to trial for lesser charges under health and safety legislation failed in March when he was deemed unfit to stand trial after suffering head injuries in a burglary.

Mr Burstow said that under the current legal framework often the only option left open to police was to try to prosecute individual carers with wilful neglect. He argues that a new law should be introduced to make it easier for police to hold owners to account instead.

He said: "We need a new criminal offence of corporate neglect which should take its lesson from the legislation on corporate manslaughter.

"We also need companies that provide care to realise it's not just about their profits, but it's ultimately about the dignity of the people they are looking after."

Find out more

An elderly lady's hand on a walking stick.

Listen to the full report on File on 4 on BBC Radio 4 on Tuesday, 4 June at 20:00 BST and Sunday, 9 June at 17:00 BST.

The call is being backed by Labour MP for Blaenau Gwent, Nick Smith who recently challenged David Cameron to ensure the law in this area was fit-for-purpose.

The BBC asked care minister Norman Lamb whether he would consider creating a law of corporate neglect.

In a statement, Mr Lamb said he was considering the issue - but stopped short of agreeing to a change in the criminal law.

"When I first took on this job in September, I identified a clear gap in the regulatory framework - one which I'm determined will be addressed.

"This summer, we will announce proposals to address the gap in the law on effective corporate accountability," he said.

Figures seen by Radio 4's File on 4 programme show that while English social services investigated more than 25,000 allegations of elderly neglect last year, just 170 criminal prosecutions for neglect were brought before the courts.

The Care Bill had its second reading in the House of Lords in May.

Listen to the full report on File on 4 on BBC Radio 4 on Tuesday, 4 June at 20:00 GMT and Sunday, 9 June at 17:00 BST. Listen again via the Radio 4 website or the File on 4 download.

mengele

dumnonia

Tuesday 10 December 2013

Sunday 10 November 2013

Tamaris

Plymouth, Devon

Tamaris - The Town on the River Tamar

See: Historical Map and Guide - Roman Britain by the Ordnance Survey (3rd, 4th & 5th eds., 1956, 1994 & 2001);
Oxford Dictionary of English Place-Names by A.D. Mills (Oxford 1998).

Sunday 13 October 2013

Big jump in hospital waiting lists in Wales

Big jump in hospital waiting lists in Wales

Analysis

Saturday 17 August 2013

Welsh GP prescriptions

Welsh GP prescriptions up 50% but total cost is falling

“Start Quote

Tuesday 6 August 2013

Patient safety must become the top priority

Case study

Who is Prof Don Berwick?

Friday 5 July 2013

summer shade

Wednesday 19 June 2013

stonehouse

Wednesday 5 June 2013

Operation Jasmine: MP urges care home abuse law change

Operation Jasmine: MP urges care home abuse law change

“Start Quote

'New law needed' after collapse of care home neglect case

5 June 2013

'New law needed' after collapse of care home neglect case

'New law needed' after collapse of care home neglect case

“Start Quote

Find out more

Baker's Pit Cave entrance

dumnonia

Tuesday 10 December 2013

Sunday 10 November 2013

Plymouth, Devon

Tamaris - The Town on the River Tamar

See: Historical Map and Guide - Roman Britain by the Ordnance Survey (3rd, 4th & 5th eds., 1956, 1994 & 2001);Oxford Dictionary of English Place-Names by A.D. Mills (Oxford 1998).

Sunday 13 October 2013

Big jump in hospital waiting lists in Wales

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Analysis

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Saturday 17 August 2013

Welsh GP prescriptions up 50% but total cost is falling

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Tuesday 6 August 2013

Case study

Who is Prof Don Berwick?

Friday 5 July 2013

Wednesday 19 June 2013

Wednesday 5 June 2013

Operation Jasmine: MP urges care home abuse law change

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Related Internet links

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5 June 2013

'New law needed' after collapse of care home neglect case

'New law needed' after collapse of care home neglect case

Related Stories

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More on This Story

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See: Historical Map and Guide - Roman Britain by the Ordnance Survey (3rd, 4th & 5th eds., 1956, 1994 & 2001);
Oxford Dictionary of English Place-Names by A.D. Mills (Oxford 1998).