NHS UNSAFE

Patient safety in hospitals, doctors' surgeries and clinics needs to be improved in the NHS and independent sectors, according to the Government's healthcare watchdog. Most patients received safe care, but standards were inconsistent across England and Wales, with vague and widely varying estimates on numbers of avoidable deaths and injuries, the Healthcare Commission said. Sir Ian Kennedy, the commission's chairman, spoke as its annual State of Healthcare report was presented to Parliament. He said: "The NHS needs to take safety more seriously. It is frustrating that in 2006 we do not have a clearer idea of how many people die or are harmed in hospitals. We should all be troubled when the National Audit Office states that `estimates of death as a result of patient safety incidents range from 840 to 34,000, but in reality the NHS simply does not know'. "I recognise that it is not easy to get this information and that all major countries struggle with it. But without that knowledge, and the reasons behind it, improvement cannot take place."

The report marks the first publication of an overview of standards in the independent sector in England, which includes private and voluntary providers. It discloses that one in ten NHS trusts could not confirm that it fully met core standards on safety and one in ten providers in the independent sector was ordered to improve its management of risks last year.

More than a fifth of the complaints the commission handles relate to safety, which includes infection control, drug administration, clinical negligence, accidents and general health and safety legislation.

One fifth of trusts told the Commission that they could not ensure that all their staff had attended compulsory health and safety training and 13 per cent could not be sure that medical devices were properly decontaminated.

Sir Ian said that failings could also involve things such as GPs not keeping records properly or the misreading of tests. "There is clearly room for improvement in compliance with standards on safety," he added. "And this goes for the independent sector as well as the NHS." About 50 per cent of independent providers met all 32 minimum standards, but one in ten failed five or more, broadly in line with NHS organisations.

Andrew Lansley, the Shadow Health Secretary, said yesterday: "It is a shame that this willingness to improve patient safety is not shared by the Department of Health. In December 2003 the Chief Medical Officer ordered an audit of deaths caused by hospitalacquired infections. We are still waiting for it to be published."

A spokeswoman from the National Patient Safety Agency said that an exact figure had proved difficult to obtain. "There are several disputed extrapolations of deaths due to patient safety problems using different data sources and methods. The most widely quoted figure is 40,000 deaths per year in England. However, in our Patient Safety Observatory report last year we estimated that each year in NHS acute hospitals in England there are approximately 840 reported deaths resulting from patient safety incidents. This is probably an underestimate, but not by 39,000."

A Department of Health spokesman said: "As in any modern health service, mistakes and unforeseen incidents can and will happen. Any mistake is one too many but similar rates of patient safety incidents occur worldwide."

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Hospital kitchen hygiene 'poor' in NHS



Shocking hygiene standards have been found in some UK hospital kitchens, a consumer group reports. Which? reviewed hygiene inspection reports for 50 hospitals and found evidence of cockroaches, mice and mouldy cooking equipment. An online survey by the organisation also revealed 29% of NHS patients still felt hungry after their meals. But the Department of Health said hospital food had improved in the last few years.

Which? said it's trawl of three years' worth of hygiene reports revealed problems such as dirty equipment, cockroach infestations, lack of soap or hot water, with poor refrigeration also cropping up regularly.

Other hospitals used food fridges to store medical supplies, had out-of-date foods and failings in food safety procedures, Which? added. But it said not all hospital catering facilities were dirty and some were highlighted for their cleanliness.

In a separate online survey of 833 hospital patients, the consumer group also found some patients were going hungry. Twenty-nine percent of NHS patients questioned said they felt hungry after their hospital meal compared with 4% of private patients. Neil Fowler, editor of Which?, said: "Hospital food hasn't got the best of reputations but you'd expect the kitchens to be clean at the very least. Unfortunately, we've found this isn't always the case. "Our survey shows a low level of satisfaction with hospital food in NHS hospitals. The government paints a rosy picture but the reality is very different, with many patients left with a nasty taste in their mouths."

A Department of Health spokesperson said: "Last month the independent Healthcare Commission found that nearly all trusts (over 96%) were meeting the core standards on hospital food. "Last year, the independent Patient Environment Action Teams found that 90% of hospitals were rated good or excellent for food standards compared with 17% in 2002. "There are some excellent menus around but we recognise that more needs to be done. The government has made a commitment to establish nutritional standards for the NHS and this work is now under way."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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