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.

Wednesday 29 May 2013

Llyn peninsula hit by earthquake of 3.8 magnitude

A small earthquake measuring 3.8 in magnitude hit north Wales in the early hours of Wednesday morning.

The tremor centred on the Llyn peninsula in Gwynedd.

The British Geological Survey (BGS) said the centre point was between the seaside towns of Aberdaron and Nefyn.

People living as far away as Southport, Merseyside, the Isle of Man and Dublin, the Irish capital, reported "intense shaking" at 04:16 BST, but there were no reports of damage or injury.

More than 100 reports from people who felt the earthquake have been made to the BGS, who said the majority were within a 100km radius.

Dr Brian Baptie, head of seismology at the BGS, said the size of the tremor was not unusual for the UK.

"We get an earthquake of this size in the UK maybe once or twice every couple of years," he told BBC Radio Wales.

"We also know that north Wales is one of the more seismically active parts of the UK. It's got a long history of earthquakes over the past few hundred years."

Dr Baptie said the rumblings that residents felt were consistent with an earthquake of this size.

He added: "It might be felt up to a few hundred kilometres away, people could feel the house shake, they could hear audible phenomena like rumbling, and maybe objects would rattle."

Graham Williams, of Pentir, near Bangor, told BBC Radio Wales: "I woke up to a cracking sound and realised the house was shaking.

"I could hear a low rumble for about 15 seconds and then it stopped."

Kevin Clark, of Llynfais, Anglesey, said the tremor came as a bit of a shock.

"I was fast asleep this morning and it sounded like a train running around the outside of the house," he said.

"And considering in Anglesey where we are there's no train, it was a bit of a shock, and the whole place was shaking and rumbling, like a deep rumbling sound."

He added that his 14-year-old daughter woke up to find her chandelier-style light shaking violently.

North Wales was also hit by a smaller earthquake in Caernarfon in February, of 2.3 magnitude.

The latest tremor is just a few miles from the point on the Llyn peninsula where an earthquake struck in July 1984 with a magnitude of 5.4.

It was the most powerful recorded in mainland Britain in the past 200 years.

Dr Baptie said there was no evidence to suggest the number of earthquakes was increasing.

"All of the data we've collected over the last 30 or 40 years, and historical data going back hundreds of years, doesn't bear that out at all," he added.

Monday 27 May 2013

plymouth

Sunday 10 February 2013

Horsemeat is sold legally in France;

Horsemeat scandal: Comigel is huge exporter of French frozen meals

Some Findus UK beef lasagnes have been found to contain up to 100% horsemeat. Photograph: Yui Mok/PA

The French food company at the centre of the horsemeat scandal specialises in pre-prepared frozen dishes, a third of which are exported. Comigel, based in the north-eastern town of Metz, supplies tens of thousands of tonnes of frozen meals to around 15 countries.

It was the manufacturer of the Findus frozen lasagnes, some of which contained up to 100% horsemeat.

Comigel had alerted British food distributors about its doubts over the "conformity of specifications" on certain products, namely lasagnes and spaghetti dishes made supposedly with beef and sold by Tesco, Aldi and other UK supermarkets. The warning suggested the beef was in fact horsemeat. Findus said on Friday it was alerted by Comigel last Saturday.

Erick Lehagre, director of Comigel, did not make any statements on Friday and was said to be unavailable for comment. Comigel risks being subject to large fines as a result of the scandal, even if it is discovered that the alleged fraud has been committed by its suppliers.

The Comigel group makes its ready-made frozen food at its Tavola factory in Capellen, Luxembourg. This site employs 200 people who produce at least 16,000 tonnes of frozen dishes in aluminium trays. These dishes are then sold to food chains like Tesco and in France Cora and Auchan. These groups then sell the products under different brand names.

One quarter of the factory's output goes to restaurants in schools, colleges, hospitals, retirement homes, company canteens and public service restaurants.

On Friday morning, Comigel's website was taken down and a note saying it was under construction placed over pictures of some of the company's food products, among them a lasagne.

In 2010, Comigel was said to employ 200 people. In 2009, it reported an annual turnover of €60m(£51m), a third of which was in exports mainly to the Benelux countries, Germany, Scandinavia and eastern European countries. Its offices are in Metz but its production site run by its 100%-owned subsidiary Tavola, is in neighbouring Luxembourg.

Its sister company, Atlantique Alimentaire, which also makes and distributes frozen food, based in La Rochelle, employs 240 people and had a €41m turnover in 2009. In a Lorraine regional business directory Comigel describes itself as a "specialist in prepared frozen products for brand distribution".

"Since 1976 our sales teams have been active in developing, offering and proposing a wide range of frozen food products adapted to today's various consumer trends.

"Over the years we have specialised in the fabrication and commercialisation of prepared frozen products for brand distribution. Our savoir-faire is recognised by all of our partners and has allowed us to position ourselves as a major and unbeatable player in our markets."

Horsemeat is sold legally in France; there are around 15 "chevalines" – butchers selling horsemeat – in Paris and another in Lyon. Fans argue it is more tender, lower in fat and higher in protein than beef.

The custom of eating horses spread across Europe in the 19th century because of their prevalence as a mode of transport and following several famines.

mengele

dumnonia

Saturday 17 August 2013