A DIGNIFIED REVOLUTION NEWSLETTER: December 2013
”Never doubt that a small group of thoughtful committed citizens can change the world - indeed it is the only thing that ever does" (Margaret Meade)
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HEADLINE NEWS
It has been reported that an independent review will scrutinise the care offered by staff at the Princess of Wales Hospital in Bridgend and Neath Port Talbot Hospital. The review will be led by Professor June Andrews, Director of Dementia Services Development Centre at University of Stirling. ADR has written to Professor Andrews to point out that the Abertawe Bro Morgannwg (ABM) case that is to be investigated is not unique – ADR has similar case studies from ABM that date back to 2006.
The poor standards of care that have been uncovered in ABM are longstanding and predate the current head of the organisation, Paul Roberts (2011). The previous Chief Executive was David Sissling (2009), who is now Chief Executive of NHS Wales. His predecessor was Sir Paul Williams who was also Chief Executive in Bridgend, before taking responsibility for the NHS in Wales in the Welsh Assembly Government.
It appears that this is not dissimilar to the situation in England. Sir David Nicholson was Chief Executive of the West Midlands Strategic Health Authority, the authority overseeing the Mid Staffordshire NHS Foundation Trust, before being appointed as Chief Executive of the NHS in England.
The outgoing Ombudsman for Wales, Peter Tyndall, has said there is a lack of effective internal scrutiny in the health service in Wales and in his view there is a significant role for independent directors on the health boards.
This month the Care Quality Commission has published a report on the state of health and social care services in England. It has found that there has been no overall improvement in the NHS around treating people with dignity and respect and hospitals have made “no improvement” in monitoring the quality of care.
Among people living in care homes, hospital admissions for avoidable conditions were 30% higher for people with dementia. Once in hospital, people with dementia also have poorer outcomes than those without dementia. 1 in 5 inspections of nursing homes revealed safety concerns, including failure to give out medicines safely or not carrying out risk assessments when starting to care for someone, and on-going staffing pressures. More than 10% of home care agencies did not meet standards in staffing or monitoring quality. Click here to read a related Telegraph article.
ADR is concerned about the quality of student education when on ward placements. We were alarmed to hear from a nurse manager in Wales recently that the last time they were subject of an education audit was 10 years ago. We would be interested to hear whether this is common across the UK?
It has finally been revealed that the Nursing & Midwifery Council (NMC) has a policy for correspondence, though it wasn’t shared with us despite numerous requests. We have been told that the standard time in which to expect a response is 20 working days, but on occasions some issues will take longer than twenty days to prepare a response. We have written to the NMC on numerous occasions since we established and we have rarely received a response unless we have sent a reminder. We would like to hear whether others have similar experiences.
Scroll down the page for more news.
WORKSHOP
Developing An Ethical Approach to Improving Care
ADR is holding a workshop to explore the role, boundaries and focus of ethical leadership as the basis of ensuring patients, clients (and staff) are treated with dignity and respect. It will held from 9am to 1pm on Wednesday, 5 February in Cowbridge. Please email( if you would like more information.
GOOD NEWS STORIES
Last month an executive nurse asked us why we had so little good news in our newsletter. Our reply was that we can only report what people tell us and invited her to send us examples of good news. She responded as follows: “All organisations are required to publish an Annual Quality Statement, which has some good news as well as areas where we need to improve. This is the link to ours”.
SCIE's Social Care TV film "Getting to know the person with dementia" won its category (best factual new media) at the Older People Media Awards 2013.
ACTIVITY
In the last month we have:
· Written to Professor June Andrews regarding the independent review that is planned at ABM
· Sent evidence to professional standards authority for their review of the Nursing & Midwifery Council (NMC)
· Reminded the NMC that they haven’t responded to correspondence sent on 30 October 2013
FEEDBACK
“Thank you for the latest newsletter. Dignified Revolution has a focussed way of highlighting gaps at the highest level; where there should be none! How do we ensure Healthcare Inspectorate Wales (HIW) signs up its recommendations? It is a statutory body funded from public money, surely we need to make it accountable to people by making sure it has the necessary teeth to improve public safety by improving care?”
“Coming from Betsi Cadwaladr Health Board, I fully intend to raise the bar for patients & relatives, as there are still people like me here, who agree with the HIW report, but were not given the opportunity to influence following the merger. We are outspoken, and have ways to get back on our feet. The arrival of the new Director of Nursing is welcomed, so we will press on. I do like working for North Wales NHS. Keep up the good work.”
"Thank you" seems such inadequate words for the work you are carrying out for the good of all the elderly and vulnerable - but you are making such amazing progress with what is coming up and making frontline news. I am so glad your organisation exists as bit by bit you are changing the attitudes of hospital and homes to actually care properly for their elderly. (even though this should be automatically happening.)”
“I was impressed with the videos of the school children discussing dementia and this will make such a difference and understanding in caring for this illness. It impressed upon me that the children of today are caring and understanding of how people suffer and that they genuinely want to help. Also good to see the book on the nursing staff being trained in dementia.”
Another excellent newsletter. Some shocking stories but it's good to know that you are "on the case".
· It never ceases to amaze me what you uncover. Some very worrying things.
· Thank you and well done with all your hard work
· Many thanks, like the quote very much
· “I would like to commend all the effort you have point into your newsletters - excellent material, well targeted and important! Do keep it up.”
HAVE YOUR SAY
The Bevan Commission, an independent expert group, is keen to hear from the Welsh public on the challenges facing the NHS in Wales and potential solutions.
If you are unable to attend the meeting in person but would like to share your views please contact: Julie Lake, , 029 2034 8794.
RESOURCES
Co-production in social care: what it is and how to do it
This is a SCIE guide to what co-production is and how to develop co-productive approaches with people who use services and carers. It is aimed at managers and commissioners, frontline practitioners and people who use services and carers.
Politics and Poor Nursing Care. The quality of nursing care is analysed in a book by Carol Dimon. Click here for more information.
NEWS
Watchdog gives no assurances over hospital deaths repeat
Healthcare Inspectorate Wales has told a committee of Assembly Members that it cannot give "strong assurances" that a situation like the Mid Staffordshire scandal is not happening in the NHS in Wales. Source: BBC News.
What we know now 2013
This report collates information and intelligence collected by the National End of Life Intelligence Care Network and partners over the last year.
Elderly emergency admissions rising
Urgent action is needed to stem the rise in avoidable emergency admissions among the elderly, regulators say. BBC news
Challenging bureaucracy
This NHS Confederation report sets out the findings and what actions should be taken to free the NHS from unnecessary bureaucracy.
Doctors and nurses may face jail for neglect
Doctors and nurses found guilty of "wilful neglect" of patients could face jail, the government is proposing. The offence will be modelled on one punishable by up to five years in prison under the Mental Capacity Act. Source: BBC News
NHS culture
These BMA discussion papers are part of a series which will be examining the reasons why a negative culture has developed in parts of the NHS and how it can be turned around.
Government publishes 'blueprint for trustworthy' NHS
The NHS in England needs to undergo a "profound transformation" to create an open, honest and learning culture, the health secretary says. Source: Telegraph
Ensuring the right people, with the right skills, are in the right place at the right time
This NHS England guidance, published by the National Quality Board, aims to support providers and commissioners to make the right decisions about nursing, midwifery and care staffing capacity and capability.
NHS patients frightened to ask for help as wards stretched to breaking point
The NHS has still not learned from the Mid-Staffs scandal, according to a damning official report which says more than 3,000 inspections last year uncovered basic failings at care homes and hospitals. Source: Telegraph
Colchester hospital placed in special measures
Colchester General Hospital, which is being investigated by police over its cancer waiting times has been placed in special measures. Source: BBC News
Woman abused after her death
Nursing home manager Christina Peacock , who forced a set of dentures into a dead woman’s mouth has been struck off. Source: Lancaster Guardian
Brain damaged father 'left in urine and faeces' in NHS hospital
A brain-damaged father who was left to lay in urine-soaked sheets and covered in faeces in a NHS hospital in an 'appalling' case of neglect that was secretly filmed by his family. Source: Daily Mail
After the NHS's monstrous cruelty, the saviours who gave my wife a good death
A husband gives an account of his and his wife's shocking experience hospital care when she was suffering with breast cancer and he compares it with the compassionate care she received in the local hospice. Source: Daily Mail
Only half of intermediate care services provide staff with dementia training
Only half of home-based intermediate care services provide dementia training to all of their staff, according to a report released by the National Audit of Intermediate care. The report also found that intermediate care services are fragmented.
Those with dementia continue to have the poorest outcomes in hospitals
Those with dementia continue to have the poorest outcomes in hospital, according the 4th state of care report released by the Care Quality Commission. Source: Alzheimer's Society
New GP contract heralds return of 'proper doctors'
A new contract for GPs will see the return of proper family doctors, responsible for round-the-clock care and with dedicated help for the elderly. Source: Telegraph
'Crisis' GP service 'on its knees', senior doctor claims
Family doctors in Wales face a "crisis" and enormous pressures mean the profession is "on its knees", one of Wales' most senior GPs has warned. Source: BBC News
A treatable cause of suicide ignored
PTHP, a serious complication of head injury that can cause impotence, infertility and chronic fatigue will still not feature in NICE’s updated head injury guideline due out January. PTHP may be responsible for up to 90 needless suicides a year (Sources: Times and BMJ website).
Mid Staffordshire Hospital
Ex-chief nurse guilty of misconduct
Janice Harry, former chief nurse at scandal-hit Stafford Hospital has been found guilty of misconduct by the Nursing and Midwifery Council (NMC) Source: Jersey Evening Post
Stafford hospital suspends staff over alleged lack of care for elderly patient
Stafford hospital has suspended three members of staff amid concerns about the lack of nursing care provided to an elderly patient. An incident on 15 November was reported by nursing staff, prompting hospital officials to launch an investigation. Source: Guardian news
Mid Staffordshire NHS Foundation Trust public inquiry: government response
These English Government documents build on the government’s initial response: Patients First and Foremost, which was published in March 2013. They explain the changes that have been put in place since the initial response was published, and set out how the whole health and care system will prioritise and build on this.
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