One of the most significant hospitals in Wales will upgrade some of the most important facilities at its major location.
A £6.6 million extension to a Swansea Morriston Hospital’s cardiac intensive care unit has been unveiled.
Work has been conducted at the hospital since September, while there has been the overarching aim of ensuring that surgery can continue unimpeded in the meantime.
It is hoped that the new facility will enable Morriston Hospital to reduce waiting times for patients.
Abertawe Bro Morgannwg University Health Board said one of the factors behind longer waiting times in the past had been a lack of beds for people after surgery.
And this opinion comes hot on the back of the new official statistics which indicates that bed blocking in the NHS is now worse than at any other time in the history of the health service.
The extension will add four more critical care beds, and it is hoped that this will be particularly beneficial for Accident and Emergency operations at the institution.
Health Secretary Vaughan Gething visited the hospital recently in order to see the final stages of the redevelopment.
It is believed that the unit will be completed later this month, and shortly afterwards go into operation.
Gething indicated that the Welsh government had followed recommendations and feedback from clinical staff already working in the hospital when putting the programme into practice.
The minister also look forward to the quality of care at the Swansea hospital improving.
“I’m pleased that more people will be able to benefit from high quality care closer to home. We have made progress in reducing cardiac waiting times and are now investing to increase capacity in Wales.”
Figures released by the Society for Cardiothoracic Surgery in 2015 ranked Morriston’s unit sixth out of 39 for survival rates between April 2011 and March 2014.
Reports back in January indicated that NHS patients in Wales wait longer for treatment and diagnosis than patients in England for most of the main categories.
And waiting times for hip surgery have deteriorated significantly in Wales over the past four years.
Since 2011/12, the average wait has risen by a fifth for the nearly 6,000 people who had hip operations in 2014/15.
A group of leading doctors have suggested that the NHS must prepare to utilise medicines that prevent rather than merely treating disease.
The Academy of Medical Sciences believes that so-called personalised medicines which are tailored to the needs of individuals provide an excellent opportunity for the health service.
It is believed by the organisation that public health should head in this direction as a general trend.
Meanwhile, a debate is taking place on the subject, as critics of the opinion of the academy suggest that lifestyle focus should be the central facet in preventing illness.
The Academy states that scientific advances mean in future that there will be more opportunities to intervene with treatment before there are any symptoms.
Commenting on the issue, Professor Sir Robert Lechler, the new president of the Academy of Medical Sciences, stated his belief in the concept of prevention.
“I think it’s unarguable that prevention is better than cure, and if you wait until the patient presents with signs or symptoms of kidney disease, liver disease, heart disease, very often most of the damage is done and can’t actually be recovered. So if it were possible to take steps while still in health to prevent or delay the onset of disease that seems to make very good sense.”
As the debate continues over this issue, discussion related to the use of statins has been particularly prominent.
The controversial medicine has been utilised for people at low risk of heart attack and stroke, yet critics suggest that statins have been used too frequently.
Professor Carl Heneghan from the Oxford University Centre for Evidence-Based Medicine, believes that a focus on lifestyle factors will ultimately have a significantly more beneficial influence.
“What we have to do is look at clear lifestyle risk factors. The future of healthcare is a healthier lifestyle. Only in certain diseases such as cancer will we find personalised treatments are effective.”
Many analysts believe that over-medication is a major problem in the NHS, and it has been particularly noted that prescription drugs are the third most common cause of death after heart disease and cancer.
It is noted that it will only be possible to reduce demand on the NHS, and thus consequently improve care in the health service, by addressing a series of toxic lifestyle issues.
Nonetheless, the academy continues to call for closer collaboration between the NHS, academia and the pharmaceutical industry in the research and development of new drug solutions.
AstraZeneca has just had a new lung cancer drug approved by US regulators, in what will be seen as a major coup for the British pharmaceutical manufacturer.
The drug in question is AZD9291, which will be ultimately go on sale under the brand name Tagrisso.
Notable for targeting the genetic mutation known as T790M, Tagrisso effectively usurps existing cancer medication which is unable to deal with this problem.
The drug is intended to specifically target advanced non-small-cell lung cancer; the most common form of lung cancer.
Having passed US regulatory measures, the drug will now be made available to patients in the United States as soon as possible.
Although pricing has yet to be publicised, AstraZeneca have stated that they will reveal the price early this week.
It was stated by a spokeswoman that the pricing will ultimately be comparable to existing cancer treatments.
Lung cancer is the leading cause of cancer death among men and women, accounting for one-third of cancer deaths, more than breast, prostate and colorectal cancers combined.
So this drug breakthrough could be excellent news for cancer sufferers all over the world.
This latest treatment has been developed in Cheshire, and is one of several drugs that AstraZeneca is currently developing.
The company has recently been targeted by American rival Pfizer, the maker of Viagra, but AstraZeneca chief executive Pascal Soriot has cited this drug and other products in a defence against this prospect.
AstraZeneca estimates that Tagrisso could bring in sales of $3bn (£2bn) annually, which is greatly needed by the corporation considering that sales of older drugs are diminishing, and therefore losing patient protection.
The move by AstraZeneca is indicative of a scramble of drug companies to enter the immunotherapy market.
Experts believe that immunotherapy could eventually be worth in the region of £26 billion annually in sales.
Thus, Tagrisso could be an extremely valuable commodity for AstraZeneca, particularly as the drug performed so admirably in trials.
According to Richard Pazdur of the FDA’s centre for drug evaluation and research, the Tagrisso tablet had a “significant effect on reducing tumour size in over half of patients who were treated.”
The approval of the drug is a step in the right direction for AstraZeneca, with the company continuing its odyssey of creating and marketing six new cancer treatments to patients by the end of the decade.
This latest decision follows the previous launch of Lynparza for ovarian cancer in the US.
Tagrisso was first tested on humans just 30 months ago.
It had received breakthrough status in the US and has also received accelerated assessment in the EU following its filing in the summer, as well as priority review in Japan.
Despite pressure from campaigners, NHS England has indicated that it will not publish results of a national audit prompted by the death of a baby girl.
The organisation has been exploring the quality of investigations that were carried out after the tragic incident took place.
But the commissioning body has indicated that although it accepted the recommendations of an independent review, it will not make public the methodology or findings of a national audit suggested by it.
The process had been instigated by the untimely demise of baby Kate Stanton-Davies.
Kate tragically died at a midwifery unit run by the Shrewsbury and Telford Hospitals Trust in March 2009.
It is accepted that there were numerous failures made at the unit at the time of Kate’s death.
The parents of the child have reacted angrily, not unreasonably pointing out that they expected to see a process that could be described as transparent.
Yet NHS England has described the ongoing reaction to the investigation as an internal matter.
NHS England is the existing supervising authority for midwives practising in England.
As part of this responsibility, the organisation commissioned expert Debbie Graham to review events surrounding Kate’s death.
This followed a jury inquest and an investigation by the Parliamentary Health Service Ombudsman in 2013 which both concluded that the death was avoidable.
Both processes also concluded that there had been huge failures in the care throughout the time that Kate stayed in the hospital.
Graham went on to heavily criticise the local supervisor, suggesting that the quality of investigation carried out have been entirely unfit, particularly in terms of containing multiple inaccuracies.
The report had stated at the time that NHS England should carry out an audit in order to “seek assurance that the weaknesses in the investigatory process identified in this review are no longer inherent in the current process.”
Yet it seems now that the results of this process will never be made public. It is those understandable that parents of the infant are extremely disappointed by the process.
According to investigations, Kate was born “hypothermic, pale, floppy and grunting” at Ludlow midwifery led unit in Shropshire, in March 2009.
Her mother had been incorrectly classified as being low-risk.
That decision will be viewed as controversial, and indeed there will be question Marks regarding precisely why it has not been published.
It seems that these questions will go unanswered.
The health regulator Monitor has criticised ambulance bosses in a move that could greatly influence the future of the emergency service.
It has been suggested that managers of the ambulance service could be forced to resign their positions after systemic failings over the handling of NHS 111 calls.
Monitor specifically criticised the South East Coast Ambulance Service over a project which increased how long some patients were forced to wait for ambulances.
The organisation was guilty of transferring some NHS 111 calls to the 999 emergency system, in order to give the staff a further 10 minutes of time to respond to calls.
This project was implemented as a response to massive pressures that the ambulance service faced during the winter last year.
Extra time was given to calls which were placed in the second most serious category.
Monitor indicated that there had been a clear failure of management processes, and the health regulator has intervened in order to rectify the situation.
The Health regulator added in a statement that there are major concerns about the way that the trust is being run, and particularly the decision-making process related to ambulances.
Monitor also said it has reasonable grounds to suspect the trust is in breach of its license to provide NHS services.
With an investigation into the matter imminent, the health regulator has indicated that it will commission a review into the way that the project was handled, and more widely into the way that the trust makes decisions.
Paul Streat, Monitor’s regional director, commented that the project was fundamentally flawed and is a massive cause of concern for the health regulator.
“Over the winter, there were significant demands on the NHS and it is understandable that trusts want to explore better ways of delivering the best possible care. But this project was poorly managed from the start, done without the proper authorisation and without enough thought given to how it might affect patients. We have asked the trust to review the action it took to make sure there was no harm to patients, and look again at the way decisions are taken to prevent something like this happening again.”
Paul Sutton, chief executive of the South East Coast Ambulance Service, defended the ethos behind the procedure, but also acknowledge that the health regulator’s concerns were reasonable.
“The process was undertaken to ensure that the right response was provided to patients and that we were able to respond promptly to the most seriously ill patients. However we recognise that it was not well implemented and we did not use our own corporate governance processes correctly. These are serious findings,” Sutton stated.
In addition, Sutton indicated that the organisation had already begun to implement new measures in order to ensure that there was no repeat of the incident.
“We have already begun to take steps to address Monitor’s concerns and as part of this process, independent reviews will assess how decisions are made within the Trust, governance processes and our approach to patient safety. As a Trust, we remain extremely proud of the high quality and compassionate clinical services that SECAmb provides to our patients,” Sutton indicated.
The NHS has announced that it intends to halve the number of hospital beds available for people with learning disabilities and autism.
This latest decision comes in the context of an increasing lack of spare bed in the NHS.
It has been reported by the Healthcare Times that the acute sector is already running at winter levels despite the fact that occupancy wouldn’t be expected to have reached this degree yet.
However, the decision is also a response to the abuse scandal in the NHS at Winterbourne View.
The largest learning disability hospital, Calderstones in Lancashire, will be closed as part of this verdict.
But campaigners opposing the decision have questioned funding in the new system.
Six care workers were jailed and five were given suspended sentences following a culture of cruelty that was reported at Winterbourne View near Bristol.
The NHS has conceded that not only was this a massive scandal, but also that the health service has failed to deal with autism and learning difficulties with satisfactory aplomb.
Around 2,600 such patients are in hospital in the NHS at present, and the majority of these patients are also long-term residents.
NHS figures indicate that every bed within the health service cost £175,000 annually, and the report states that housing people with autism and learning difficulties indefinitely in this condition is frequently inappropriate.
Yet it is often resorted to due to a lack of other viable options.
In a significant shift in the way care is provided, hospital units will be closed and £45m spent over three years to fund the move to community services.
Simon Stevens, the chief executive of NHS England, commented on the matter, and was adamant that the correct decision was being made.
“As good and necessary as some inpatient care can be, people with learning disabilities are clear they want to live in homes, not hospitals. We’ve seen some progress over the last few years, but now is the moment to grasp the nettle and build the excellent community-based support that will allow people to move out of hospitals,” Stevens asserted.
With the new plans in place, it is anticipated by NHS England that the number of hospitalised patients in this particular niche will fall between 1,300 and 1,700 over the next three years.
In a joint statement, the charities Mencap and The Challenging Behaviour Foundation commented that there are still many unanswered questions that need to be addressed before the situation can be truly clarified.
“We are concerned about whether sufficient resource and investment is being made available up-front to develop the local support and services required. Families will be fearful of the fact that there is little new in the report about how local areas can be compelled to make the necessary changes to support services and guard against a postcode lottery of poor care.”
Around 700,000 people may have autism in the UK, according to the National Autistic Society, or around 1 per cent of the population.
A new scheme will charge foreign patients in the NHS for emergency treatment, possibly even for calling out an ambulance.
New government plans will attempt to raise more cash for the health service, as the Conservative party continues to address the gulf in funding of the NHS.
It is already predicted that there will be a £30 billion deficit by the end of the decade in the health sector, and despite increasing spending by £8 billion, it is clear that there is still a massive gap to plug.
This is before the Tory plans for a seven-day NHS working culture are implemented, which would seem to inevitably place more pressure on the service as a whole.
So the new plan to raise funds from overseas patients must be seen in the context of the wider NHS financial picture.
Certainly some critics of the scheme have simply suggested that this is an unnecessary and unjustified measure merely intended to raise revenue.
Nonetheless, visitors from outside the European Economic Area already pay for planned hospital care.
The Health Secretary Jeremy Hunt indicated that he believed it would be possible to save millions of pounds for the NHS by extending these charges to accident and emergency care.
Yet the British Medical Association was critical of the scheme, indicating that doctors were in no position to deal with the plans.
Overseas visitors can currently receive A&E treatment, ambulance services and GP visits free of charge, but it is possible that such individuals will now be unable to receive treatment until fees are paid.
The Department of Health has indicated that refugees and asylum seekers will be exempt from this scheme, and various other vulnerable groups will be excepted.
Commenting on the plans, a spokesman for the Department of Health outlined the position of the government.
“International visitors are welcome to use the NHS, provided they pay for it – just as families living in the UK do through their taxes. This government was the first to introduce tough measures to clamp down on migrants accessing NHS care and have always been clear we want to look at extending charges for non-EEA migrants.”
But the Royal College of Emergency Medicine questioned the pressure that the scheme would place on doctors.
A spokesman for the Royal College of Emergency Medicine stated that A&E doctors “cannot reasonably be expected to take on the burden of identifying who is eligible for free treatment, and who should be charged”.
Meanwhile, the British Medical Association commented that “a doctor’s duty is to treat the patient in front of them, not to act as border guard. Any plans to charge migrants and short-term visitors need to be practical, economic and efficient.”
New regulations in April ensure that non-EU citizens settling in the UK for longer than six months pay a health surcharge as part of visa applications.
A massive new hospital project in Brighton has been given the go-ahead after receiving approval from the Chancellor of the Exchequer George Osborne.
The £480 million project has recently been rubber stamped by the Treasury after 18 months of deliberation.
Brighton and Sussex University Hospitals Trust will refurbish and rebuild its hospital buildings, which are some of the oldest in the NHS, using £484.7m from the Treasury.
The trust had been asked to provide further assurance regarding its plans for the hospital project due to its deteriorating financial position.
Building work on the state-of-the-art institution will begin in January next year, at least for the first of the two new buildings involved.
Ahead of this building process, all emergency and cranial neurosurgery work was moved from the Princess Royal Hospital to Royal Sussex County Hospital.
The scale of the project is underlined by the fact that the hospital construction will not be completed until 2024.
But the magnitude of what will be achieved in Brighton by this nearly £1/2 billion project was underlined by Trust chief executive Matthew Kershaw.
Commenting on this exciting redevelopment in the Brighton region, Kershaw suggested that this would provide incredible services for people in the local region that would truly revolutionise healthcare.
“This redevelopment is a once in a generation opportunity to build on the excellent care we currently provide to our patients and truly improve acute healthcare for patients in Brighton and Hove and across the region. Today’s announcement marks a genuine turning point; the 3Ts redevelopment is no longer an ambitious plan, it is the future of this hospital,” Kershaw suggested.
Additionally, Kershaw was keen to show his gratitude for everyone that had been involved in the project, which after all been delayed for a considerable period of time.
“I would like to thank everyone who has contributed to the success of the project so far. A great deal of work has gone into bringing us to this point and there is still much more to be done. The result though, having a better hospital for all our patients and staff in the years to come, is worth all this effort and more,” Kershaw added.
Although the project will not be completed for nearly a decade, residents of the Brighton area will still benefit from the decision to construct this facility in the near future.
With preparation work expected to begin in January 2016, it is hoped that the first new building constructed on the site will be ready to open its doors in late 2019.
The transformation is expected to be so dramatic that few people will ultimately recognise the institution as the hospital that they had visited previously.
Figures from the Health and Social Care Information Centre (HSCIC) indicate that there were 58,000 detentions under the Mental Health Act in England over the last 12 months.
The number of detentions this year represents a 10 per cent rise on figures from the previous financial year.
The figures relate to the Mental Health Act legislation, under which it is possible for people with mental health disorders to be detained in hospital against their wishes for treatment.
Statistics have been collated from NHS institutions all over England by the HSCIC, and are considered to be an authoritative representation of the situation.
By way of comparison, the number of people being detained amounts to approximately 0.15 per cent of the UK population; or one in 600 people.
With mental health clearly a major issue across England, it has been pointed out that there are issues relating to resources in this sector.
Having received the figures, one mental health charity commented that doctors were being forced to detain patients in order to find them a suitable hospital bed.
According to the report submitted by HSCIC, there has been a steady rise in detentions over the past three years, certainly a worrying statistic.
An additional 4,000 people were detained or sectioned in NHS hospitals and 1,270 in private hospitals from April 2014 to March 2015, as compared to the previous 12 months.
Considering the declining economic situation in Britain, the extent of mental health issues should perhaps not come as a huge surprise.
Although there can be many different causes of mental health difficulties, research has shown that there is a clear link between socio-economic status and mental health problems.
And Marjorie Wallace, chief executive of the mental health charity SANE, indeed confirmed her belief in this impression in her comments on the latest statistics.
Wallace was particularly concerned with regard to legislation on sectioning.
“It is a scandal that you have to be sectioned in order to get treatment. What we need is more, rather than fewer, beds where those who need sanctuary and healing can receive help without having to be deprived of their liberty,” Wallace asserted.
Another report from the HSCIC contains an even more alarming statistic.
It documented that one-in-28 adults was in contact with mental health services last year in England.
This amounts to around 1.85 million people requiring mental health and learning disability services over a mere 12-month period.
Undoubtedly, this succinctly underlines the extent of mental health issues in the country at present.
The Care Quality Commission has released a statement regarding issues related to Royal Wolverhampton Hospital.
This institution has recently been the subject of media headlines, following a historical case that plagued the Midlands hospital.
Between 2005 and 2010, numerous patients were given inappropriate chemotherapy treatments, not recommended by the national guidelines of the time.
This was not investigated for several years, until the Care Quality Commission was first alerted to concerns related to the Wolverhampton hospital back in September 2013.
At this time, a comprehensive inspection of the trust was carried out, and it became clear that chemotherapy treatment had not been administered appropriately.
After a lengthy investigation, the Care Quality Commission referenced the chemotherapy treatment at Royal Wolverhampton Hospital in its most recent report.
This was published back in September 2015, at which time the Care Quality Commission rated the trust as requiring improvement.
Following on from this assessment, Professor Sir Mike Richards, Chief Inspector of Hospitals at the Care Quality Commission, has been commenting on the ongoing issue, and the existing situation at the Wolverhampton hospital.
Richards firstly noted the history of this particular complaint.
“We were informed that an internal investigation had been conducted in 2009. This showed that a number of patients had received treatment for their cancer which was not recommended in national guidelines. We were also informed that this non-standard practice had ceased by 2009.
“In 2014, the trust commissioned a further external investigation by two leading oncologists. This concluded that there had been unsatisfactory practice but that with one exception this had resulted in no long-term harm. This review also looked at a more recent group of patients and confirmed that the unsatisfactory practice had ceased.”
Richards followed up by updating healthcare professionals on the action that has taken place during 2015.
“We inspected the trust again in June 2015. Our inspection team included a senior cancer specialist to enable us to look specifically at the trust’s current chemotherapy service. The conclusion of this inspection matched that of the previous reviews. We found that changes had been made and that the trust was providing a safe chemotherapy service. We have had several conversations with a whistleblower about these issues.
“Our report was published in September 2015 with a reference to the whistleblower. It concludes that the trust has acted properly to concerns raised and taken steps to learn from the incident.”
Richards concludes by correcting errors in the published Care Quality Commission report.
“However, although our report went through a factual accuracy check, unfortunately there was a typographical error in it, which should have stated that the care the patients received was ‘not in line with practice at the time’. This has since been corrected.
“Making sure that patients get safe, high-quality and compassionate care continues to be our priority. If we receive information to suggest that patients are not being cared for appropriately then we will not hesitate to take action.”
As a result of the inappropriate conduct at the hospital, fifty-five cancer patients at New Cross Hospital were given extra chemotherapy treatment they did not need in a scandal revealed by an NHS whistleblower.
The closure of a mental health hospital in York has led to the local MP describing the health service as “broken”.
York’s Bootham Park Hospital recently closed its doors permanently, following a decision by the Care Quality Commission.
According to the commission, the systems in place at the institution were insufficient to support patient safety.
Rachael Maskell, MP for York Central, has been extremely critical of the decision and situation, and has asked questions of the Health Secretary Jeremy Hunt regarding the Yorkshire hospital.
The Care Quality Commission particularly condemned the performance of the trust with regard to safety.
An inspection took place to follow up on a report earlier this year, and the commission found that mandated maintenance work and other safety changes had not been carried out as agreed.
In addition, there were issues related to ownership and responsibility which further complicated what was already a disturbing picture for the hospital.
The Vale of York Clinical Commissioning Group’s commissioning responsibility for Bootham Park Hospital resulted in the transfer of the service from Leeds and York Partnership NHS Trust to Tees, Esk and Wear NHS Trust.
With the new establishment unable to carry out the requisite building and service risks, the commission felt that it had no choice other than to shut Bootham Park Hospital.
This unfortunately led to existing patients being dispersed, with some having to be sent away as far as Middlesbrough.
To put this into perspective, Middlesbrough is approximately 50 miles from York.
Commenting on the issue, the aforementioned Maskell stated that she was extremely perturbed by the situation.
“My first concern has been for the patients, families and carers to ensure that their needs are catered for. I have also advocated for staff who are also affected by this crisis. However, due to my detailed understanding of the NHS, and from discussions with all major stakeholder organisations involved in this crisis, it has become evident that huge risk has been created as a result of the complexity of the Health and Social Care Act 2012 where conflicting interests and politicisation of the system has manufactured this situation,” Maskell stated.
The Labour MP also underlined her intention to seek a direct response from the government.
“I have now put calls into the minister for mental health Alistair Burt and health secretary Jeremy Hunt to call for an independent inquiry into Bootham Park to ensure that patient safety can never be put at risk again, and to support an emergency plan to secure the long term health plan for those with mental health challenges in York,” Maskell asserted.
The complexity of the reorganised NHS, where commissioners, providers, regulators and infrastructure bodies, has meant that nine months have passed before essential suicide prevention work at the 18th century hospital could be carried out.
It is clear that the situation led to a significant risk to patient safety, with highly vulnerable individuals having to suffer the ignominy of being moved to new clinical teams mid-course through their rehabilitation.