The government's kneejerk reaction to allow patients to top-up NHS care with treatment paid for privately is another nail in the coffin of the universal healthcare. We believe sanctioning top-ups is too simple an answer to a very thorny, complex and emotional issue, and doing so risks some serious unintended consequences. There is a danger that this might appease middle England but disregard the real health challenges facing us.
This site explains how the law now allows people to make decisions to refuse treatments including those that sustain life. Many people want to achieve a natural and dignified death, this is one way to help achieve it. This is a free and non-profit NHS website. We suggest people enter the site using the relevent menu section (above). Many people benefit from looking at both sections.
The Handbook to the NHS Constitution is here to give NHS staff and patients all the information you need about the NHS Constitution in one place. It acts as a guide to: - patients’ rights and pledges - responsibilities of patients and the public and staff - staff rights and NHS pledges to its staff At the back of this Handbook is an appendix, which outlines the legal source for both the patient and staff rights in the NHS Constitution.
The NHS's spending watchdog acted unlawfully when it decided to restrict access to drugs that could help thousands of older women with the bone-thinning disease osteoporosis, the high court ruled today. A judge ruled that the National Institute for Health and Clinical Excellence (Nice) wrongly failed to disclose the economic reasoning behind a decision in October to restrict the supply of strontium ranelate, a drug manufactured by Servier laboratories under the brand name Protelos.
GPs’ representatives voted overwhelmingly this week for a system in which patients opt in to any sharing of medical data with third parties—rather than one in which their consent is assumed unless they opt out, the system favoured by the Department of Health. Clinical confidentiality depends on GPs being the prime data holder of their patients’ medical records, said the BMA’s annual conference of local medical committee representatives in London. It also strongly opposed using implied consent as justification for releasing information on named patients.
The Government has published the End of Life Care Strategy - promoting high quality care for all adults at the end of life which is the first for the UK and covers adults in England. Its aim is to provide people approaching the end of life with more choice about where they would like to live and die. It encompasses all adults with advanced, progressive illness and care given in all settings. The strategy has been developed by an expert advisory board chaired by Professor Mike Richards, National Cancer Director, and including key stakeholders from statutory health, social care, third sector organisations, professional and academic organisations. The strategy has been informed and shaped by the work on end of life care undertaken by strategic health authorities for the NHS Next Stage Review.
A LESBIAN couple have won the right to IVF on the NHS after a legal tussle, ahead of laws that will put same-sex patients on an equal footing with heterosexuals. The couple, who remain anonymous, had to go through a legal fight to push the NHS to fund IVF because, at the moment, individual trusts decide whether they wish to pay for treatment for lesbians. The couple were initially refused IVF by their primary care trust because they were of the same sex. One of the women had polycystic ovarian syndrome, which disrupts ovulation, and is one of the most common causes of infertility. From October, clinics will no longer be able to block lesbians by referring to a child’s “need for a father”. Instead, same-sex couples will need to demonstrate only that they can offer “supportive parenting”.
When CQC board member Kay Sheldon spoke out against the health watchdog, it immediately began a concerted campaign to discredit her, she tells Nina Lakhani
Robert Francis, the inquiry chairman, said that one of his top priorities was for the NHS constitution to be rewritten, making it explicit that “patients are put first” and “everything done by the NHS should be informed by this ethos”. He recommended that the Health Secretary also consider stipulating that NHS staff “put patients before themselves”.
At least 100,000 non-medical staff in NHS trusts have access to confidential patient records, claim campaigners. Big Brother Watch, who based the figure on 151 responses from trusts, said it demonstrated "slack security". The group says hospital domestics, porters, and IT staff are among those with access to records in some trusts. The Department of Health says the report muddles paper files and the newer electronic systems for which access will be strictly controlled. Big Brother Watch asked every NHS Trust in the UK for the number of their non-medical staff who had access to confidential patient records.
The doctors' union claims that England's medical records database is being pushed through too fast, with details sometimes being uploaded without patients' knowledge. But those behind the new system say many patients are astonished that hospital doctors still do not have access to basic information, and the process to opt out is very straightforward. What are the issues?
This article examines the implications for patient care, and for the future of rationing within the NHS, of the recent decision to permit NHS patients to supplement their care by paying for medicines — mainly expensive new cancer drugs — which are not available within the NHS. The starting point is the recommendations of the Richards' Report and their implementation through new guidance issued by the DoH and NICE. Practical challenges arise from the insistence upon the 'separate' delivery of self-funded medicines, and more flexible cost-effectiveness thresholds for end of life medicines may have repercussions for other patients. While undoubtedly part of the trend towards explicit rationing, top-up fees might also represent a significant step towards regarding the NHS as a core, basic service. Finally, the issue of top-up fees is located within the broader context of current cancer research priorities and persisting health inequalities.
GPs are considering whether to abandon their involvement in a scheme to put medical records on a computer database. BBC News understands that talks are continuing to try to make it easier for patients to opt out of the system. Thirty million people in England have already been formally contacted about the computer record. Health ministers from the coalition government insist the rollout will continue.
The family of a man left severely brain damaged by a hospital trust's failure to diagnose meningitis promptly have been awarded £3.2m for his future care. Mark Thomas, of Walsall, in the West Midlands, developed an ear infection, which led to the meningitis in 2002. His parents took him for blood tests at Walsall Manor Hospital but the results were not reviewed for five days. Without the delay, Mr Thomas, 20, would not have been left brain damaged, Birmingham High Court was told earlier.
Tom Condliff, who weighs 22st, was not considered fat enough to have a gastric bypass operation by his local Primary Care Trust and both the High Court and the Appeal Court ruled that its decision was lawful. But less than a month after his latest setback, the 62 year-old from Staffordshire has been told that his latest “individual funding request” has been successful on the grounds of his exceptional circumstances and he will now be treated. He told the BBC: “I am very, very pleased about the PCT's decision but at the same time I am rather concerned that I haven't changed since the last time the request for IFR in September last year, was put in. “It was turned down then. So I don't know why it has been granted this time. “I am looking forward to being able to get out of the house and to enjoying myself and having a decent quality of life.”
Survey finds 54% of doctors think the NHS should have the right to withhold non-emergency treatment A majority of doctors support measures to deny treatment to smokers and the obese, according to a survey that has sparked a row over the NHS's growing use of "lifestyle rationing".
The National Institute for Health and Clinical Excellence (NICE) has confirmed there will not be NHS funding in England and Wales for the anti-cancer drug Avastin. It is used to combat advanced bowel cancer and research shows the drug can give an extra six weeks of life. About 6,500 people per year may be eligible for the drug. But the health watchdog argued that at a cost of nearly £21,000 per patient, the drug is just too expensive.
All new IVF treatment will stop in Surrey as the NHS tackles a deficit this year of £125m. The board of NHS Surrey met in Cobham on Friday to look at how to tackle "serious financial challenges". A spokesman said current courses of IVF would continue and women nearing 40 would still be considered, with IVF policy to be reviewed next November. NHS Surrey is also no longer funding some treatments including acupuncture and some cosmetic procedures. Treatments which would no longer be funded included male baldness, facial blushing, tattoo removal and spinal epidural injections for chronic back pain.
In the recent White Paper, Equity and Excellence: Liberating the NHS, there is a commitment to providing better value from the resources available to healthcare. This requires the NHS to address variations in activity and spend. Such variations indicate the need to focus on appropriateness of care, and to investigate the possibilities that there is overuse of some interventions and that some lower value activities are undertaken. In the Atlas, Right Care presents a series 34 of maps of variation selected from topics which National Clinical Directors and others have identified as being of importance to their clinical specialty. We have worked with a wide range of teams in the Department of Health, Observatory network and primary care organisations to create this Atlas.The Atlas also contains a guide to the tools and data available for analysing health investment.
The 2009 Equality Bill will, if enacted, make age based discrimination in the provision of health care and social care illegal for the first time in the United Kingdom. In a speech in 2008, the then health secretary, Alan Johnson, said, "Old age is the new middle age. Health and social care services need to adapt to the changing needs of today’s older people . . . to promote health in old age and help older people to maintain independence and quality of life."
Frances Swaine and Merry Varney are instructed by David Tracey, whose wife, Janet Tracey, sadly died in Addenbrooke’s Hospital on 7 March 2011. Following her admission to Addenbrooke’s, a ‘Do Not Attempt Cardio Pulmonary Resuscitation Order’ (known as a DNACPR or DNR) was placed on Janet’s medical notes. Janet was unaware of the DNACPR and when she became aware of it several days later, she clearly stated it was against her wishes and that she wanted to be resuscitated. As a result the DNACPR was cancelled. Several days later however a further DNACPR was entered onto her records. We have issued a judicial review and human rights claim against the NHS Trust responsible for Addenbrooke’s and against the Secretary of State for Health seeking Declarations from the Court that the Trust’s policy on the use of DNACPR is unlawful, and for the Secretary of State for Health to issue national guidance for patients and their families to know their rights concerning the use of DNACPRs.
Aims: These guidance notes have been produced to help healthcare workers and organisations to achieve uniformly high standards in making DNAR decisions and in ensuring that all relevant aspects of these decisions are recorded and communicated to others effectively. They are not intended to be a comprehensive guide to decisions about cardiopulmonary resuscitation. Intended audience: Healthcare professionals. Publication history information: Published May 2009. Access: Available to the general public.
The National Library of Guidelines is a collection of guidelines for the NHS. It is based on the guidelines produced by NICE and other national agencies. The main focus of the Library is on guidelines produced in the UK, but where no UK guideline is available, guidelines from other countries are included in the collection. NICE issues guidelines of very high quality. They are based on a systematic review of the evidence and have extensive consultation not only with clinicians but also with patients and, where relevant, industry. Professional associations do not have the resources to carry out this type of consultation but they can follow the principles set out in the AGREE protocol which helps guideline writers minimise bias, meet the needs of all stakeholders and maximise clarity.
I'm not the only woman who has tried to make herself disappear. Anorexia nervosa, the disorder of pathological self-starvation, is on the rise, with an 80% increase in hospital admissions among teenage girls over the last decade. Pressure groups and parents complain that there is still a chronic shortage of specialist care, with many GPs apparently reluctant to refer patients for treatment in the early stages of the disease. And this approach leaves children and their families to struggle on alone - usually until it is too late for simple intervention.
Doctors should apologise and provide explanations to patients and their relatives when treatment goes wrong, according to guidance from the NHS Litigation Authority, the body which defends the NHS against legal claims for clinical negligence. The letter from (KCL MA MEL alumnus) Stephen Walker. the authority’s chief executive, replaces an earlier circular that warned NHS bodies to take care when providing explanations "so as to avoid future litigation risks."
The NHS Constitution was published on 21 January 2009. It was one of a number of recommendations in Lord Darzi’s report ‘High Quality Care for All’ which was published on the 60th anniversary of the NHS and set out a ten-year plan to provide the highest quality of care and service for patients in England. The NHS belongs to us all. The NHS Constitution brings together in one place for the first time in the history of the NHS, what staff, patients and public can expect from the NHS. As well as capturing the purpose, principles and values of the NHS, the Constitution brings together a number of rights, pledges and responsibilities for staff and patients alike. These rights and responsibilities are the result of extensive discussions and consultations with staff, patients and public and it reflects what matters to them.
The hopes of people with mild Alzheimer’s disease have been dashed again by the agency that appraises treatments for use by the NHS in England and Wales, which has reaffirmed its original decision to deny them treatment with dementia drugs. The National Institute for Health and Clinical Excellence (NICE) has issued amended guidance but still asserts that the drugs would not be cost effective for the mild stages of the disease. The original guidance from NICE was challenged by Eisai, the UK licence holder for donepezil (Aricept), one of the class of acetylcholinesterase inhibitors affected. The Court of Appeal ordered NICE to hand over a fully executable form of its economic model for determining the drugs’ cost effectiveness, and Eisai and the Alzheimer’s Society made further representations that highlighted flaws in the model.
The UK government has quietly dropped a passage in the draft handbook to the NHS constitution that said that ministers had decided to give researchers the right to trawl medical records for research participants without the need for patients’ consent. Organisations that are charged with safeguarding patient confidentiality had objected strongly to a section in the draft handbook that said, "Patients can . . . expect that a health professional or a research professional who owes the same duty of confidentiality as a health professional may use care records, in confidence, to identify whether they are suitable to participate in approved clinical trials. Appropriate patients will be notified of opportunities to join in, and will be free to choose whether they wish to do so, after a full explanation."
An Act to establish and make provision in connection with a Care Quality Commission; to make provision about health care (including provision about the National Health Service) and about social care; to make provision about reviews and investigations under the Mental Health Act 1983; to establish and make provision in connection with an Office of the Health Professions Adjudicator and make other provision about the regulation of the health care professions; to confer power to modify the regulation of social care workers; to amend the Public Health (Control of Disease) Act 1984; to provide for the payment of a grant to women in connection with pregnancy; to amend the functions of the Health Protection Agency; and for connected purposes.