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Saturday, 22 July 2006 09:03
BNN: British Nursing News Online · www.bnn-online.co.uk
BLACK TEENAGERS NEED TO BE TARGETED
The Government says black teenagers need to be targeted to reduce the high number of pregnancies.

Ministers have asked council and health chiefs in England to target black and mixed race Caribbean youngsters.

Even when social deprivation was taken into account, black girls were still over-represented in the numbers of teenage pregnancies.

Data on teenage pregnancies by ethnic group is hard to come by as it is not recorded at birth registration, the Government's latest guidance on teenage pregnancy said.

However, 2001 census data has showed that rates of teenage motherhood are significantly higher among mothers of mixed white and black Caribbean, other black and black Caribbean ethnicity than other groups.

And in 2004, black ethnic groups accounted for 9% of all under 18 abortions despite representing just 3% of the population.

In a letter to council and primary care trust chief executives, Children's Minister Beverley Hughes and Public Health Minister Caroline Flint said teenage pregnancy levels were at their lowest since the mid 1980s.

However, they warned conception rates were still the highest in Western Europe and while some areas had reduced the rates by over 40% since the strategy was launched in 1999, others had seen it increase by over 40%.

The letter said cutting teenage pregnancy was key to helping tackle poverty and reduce inequality.

"Teenage pregnancy is strongly associated with poor outcomes for both young parents and their children.

"It contributes to the transmission of poverty, inequality and low aspirations between generations”.

Gill Frances, chairman of the Independent Advisory Group on Teenage Pregnancy, said the new government guidance was extremely positive.

"Teenage pregnancy is a complex issue, but we have the solutions. The work is producing results and we currently have the lowest teenage pregnancy rate in 20 years”.

A spokesman for the Black Health Agency added: "It is recognised that young black people have problems accessing sex education and contraceptive services.

"This is because they are not culturally appropriate. Too often agencies do not employ people from these communities and do not research what their needs are.

"This guidance is welcome”.

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Friday, 21 July 2006 11:37
BNN: British Nursing News Online · www.bnn-online.co.uk
PEOPLE WITH ALLERGIES ARE LET DOWN BY THE NHS
A government review of services has found that people with allergies often feel let down by the NHS, and can wait months to see a specialist.

More than 20 million people in the UK are believed to be suffering from conditions caused by allergies and several million of them have become seriously ill.

The figures for the review were submitted by doctors who accused the Government of failing patients needing treatment for conditions such as hay fever, eczema and allergic asthma.

The Royal College of Physicians and the patient group Allergy UK led the criticism, pointing out there are only 33 allergy specialists in the country and GPs are not trained in diagnosing allergic causes of disease.

In a foreword, care services minister Ivan Lewis said there was a need "to remedy the shortage of specialist allergists".

"The review has heard that people with allergies often feel let down by a poor and frequently unobtainable service.

"For those living with an allergy severe enough to require specialist care, the lack of allergy services is a problem which can greatly affect their quality of life.

"Not-for-profit organisations help, through helplines and other information services, to fulfil an important need that is yet to be addressed by the NHS, but this is not enough.

"Some people can wait three to nine months for an appointment to see a consultant in secondary care”.

He said GPs should also be able to offer the information and guidance people needed to manage their allergies.

But Dr Pamela Ewan of the Royal College of Physicians, who helped compile a 2003 report on allergy services, said: "The Department of Health review has tried to address the issues, but their recommendations will hardly scratch the surface of the problem.

"This needs central direction and funding and cannot be left to devolved local systems.

"That has been the situation for the last decade, and patient care has not improved”.

She added: "Without funding, targets, and an increase in the number of doctors with expertise in allergy, we will be going backwards”.

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Friday, 21 July 2006 11:18
BNN: British Nursing News Online · www.bnn-online.co.uk
CHILDREN NEED MORE EXERCISE
A study by the Norwegian School of Sports Science in Oslo claim that children need to exercise for at least 90 minutes a day to avoid heart disease when they are older.

The current UK guidelines recommend an hour of exercise - but recent studies found only one in 10 children of school age achieve that limit.

The researchers looked at over 1,730 children, aged nine or 15 years, from schools in Denmark, Estonia, and Portugal.

For each child they measured a combination of risk factors for cardiovascular disease, including blood pressure, weight and cholesterol, to calculate a combined risk factor score.

Over one weekend and two week days the children were asked to wear a monitor that measured how physically active they were.

The researchers found that their risk score for cardiovascular disease decreased with increasing physical activity.

The lowest risk scores were found in the nine year olds who did 116 minutes of moderate to vigorous intensity activity and the 15 year olds who did around 88 minutes daily.

This would correspond to walking at a speed of around 4 km/h for 90 minutes.

Professor Lars Bo Anderson and his team stress that the 90 minutes of daily exercise they are recommending for children would not have to be done in one chunk; it would be spaced over the day.

Neville Rigby of the International Obesity Task Force said children were being stifled from doing exercise.

"When you drive your child to the school gate in your Chelsea tractor you are not helping your child.

"Most kids in a previous generation had to walk to school, cycle to school or catch a bus”.

Professor Chris Riddoch, head of the London Sports Institute at Middlesex University and one of the researchers who conducted the latest study, agreed, saying: "We have engineered a society that does not exercise - kids as well as adults”.

He said children needed to be allowed and encouraged to be active at every opportunity.

"Every little bit helps. If we are not successful then the next generation of adults will be less healthy than we are and we are no role model”.

He said much was being done to improve the situation but that unless things changed the NHS would crumble under the strain of treating escalating ill health.

A spokeswoman from the Department of Health said policy makers would consider the implications of the new findings "very carefully in the context of our efforts to halt the rise in obesity among children under 11 by 2010."

"It is important that we keep our recommendations under review as evidence like this comes to light," she added.

She said there were a number of schemes working to increase physical activity among young people, including issuing schoolchildren with pedometers - devices that measure how many steps someone takes.

The Government also wants all school pupils to receive two hours of PE and sport a day by 2010.

Steve Shaffelburg of the British Heart Foundation said: "For children to develop a lifelong healthy attitude to physical activity, it will take a concerted effort from many groups working together to find long-lasting solutions”.

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Friday, 21 July 2006 10:55
BNN: British Nursing News Online · www.bnn-online.co.uk
ANTIBIOTICS SHOULD NOT BE GIVEN TO PATIENTS WITH A RUNNY NOSE
A study published on bmj.com today suggests that antibiotics should not be given to patients with acute purulent rhinitis (a runny nose with coloured discharge), a familiar feature of the common cold.

The University of Auckland reviewed seven studies looking at antibiotic use for a runny nose with coloured discharge.

They found antibiotics benefited only one in seven people as the runny nose would normally clear up by itself, the BMJ reported.

GPs said they would only prescribe antibiotics in a few exceptional cases.

But report author Professor Bruce Arroll said he believed the opposite.

"GPs often prescribe antibiotics for respiratory tract infections when nasal discharge is purulent [containing pus].

"They are probably effective, but they can cause harm and most patients will get better without them.

"Antibiotics should only be used when symptoms have persisted for long enough to concern parents of patients”.

The study found that antibiotics can often have side-effects, including vomiting, diarrhoea and abdominal pain.

However, Dr Jim Kennedy, prescribing spokesman for the Royal College of GPs, said it was very unusual for family doctors in the UK to prescribe antibiotics for a runny nose - only about 1 in 100 patients would get such drugs.

"There are only a few cases where most GPs would even consider prescribing antibiotics. If a patients has a history of bronchitis and sinusitis.

"The best advice to give is to keep blowing your nose to get rid of the virus.

"If antibiotics are overused as well as possible side-effects, there is a risk that we will encourage resistance”.

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Friday, 21 July 2006 10:40
BNN: British Nursing News Online · www.bnn-online.co.uk
THE MEDICAL PROFESSION CAN LEARN FROM THE AIRLINE INDUSTRY
Professor Sir Liam Donaldson the chief medical officer has suggested that the medical profession can learn from the airline industry as it seeks to reduce errors in healthcare.

Professor Sir Liam Donaldson, who publishes his fifth annual report on Friday, said there is too much complacency about the degree of error.

He told the BBC Ten O'Clock News: "Error is common in healthcare around the world - something like one in 10 people who receive hospital care in America, Australia, Britain undergo some sort of medical error. It may just be that their records get confused with another patient's but in some cases tragically it results in death.

"There's a lot we can learn from the airline industry about reporting and analysing incidents and taking action to reduce risk.

"Rather than looking at harm and deaths that occur to patients as one off events, we should look at connections and similarities, the common causes, and use them as a source for learning and action just as the airline industry has done."

Presenter Fiona Bruce asked: "Do you think we're too complacent about the degree of error?"

Sir Liam responded: "Yes I think so - the airline industry has systematically reduced the risk of air travel - healthcare hasn't yet done that whichever country we look at."

His comments come just days after he used a comparison with the airline industry in discussing a suggestion that doctors could have to face MOT-style check-ups to prove they are safe to practise. The proposal was unveiled last Friday in the wake of the murders by GP serial killer Dr Harold Shipman.

Sir Liam said then a five-year check-up could be demanded of all doctors with specialists in high-risk fields having to undergo additional tests. The radical overhaul was triggered by the fifth Shipman Inquiry report, which found the GMC was weighted in favour of doctors.

Calling for a "robust revalidation process", Sir Liam said: "At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise, whereas an airline pilot would face over 100 checks over a similar timescale”.
   

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Friday, 21 July 2006 10:15
BNN: British Nursing News Online · www.bnn-online.co.uk
COMMUNITY HOSPITAL CARE AS COST-EFFECTIVE AS REGULAR HOSPITAL CARE
After research showed there was little difference in cost, doubts have been raised over the move to push care out of hospitals and into the community.

A team from Bradford's St Luke's Hospital looked at the rehabilitation of 220 elderly patients after illness.

The team compared the cost effectiveness of post-acute care at a community hospital and a district general hospital in Yorkshire, England.

They identified 220 patients (average age 85 years) needing rehabilitation after an acute illness that required admission to hospital. 141 patients were randomised to a community hospital and 79 patients were randomised to an elderly care department in a district general hospital.

The health of each patient was measured at the start of the study, one week after discharge, and three and six months after randomisation. These measures were used to calculate a quality of life score. Health and social care costs for each patient were also calculated.

At six months, the average quality of life score was marginally (but non-significantly) higher for the community hospital group than for the district general hospital group. The average costs per patient were similar for the community hospital and district general hospital groups (£7233 v £7351).

Further analyses were carried out to test the robustness of these results, but they did not alter the overall findings.

“These results suggest that a locality based community hospital is as cost effective as a district general hospital for post acute care of older people,” conclude the authors.

Researcher John Green said: "It raises some interesting questions, showing there is no significant cost saving with community treatment.

"However, this is just one type of treatment; there may be different results for other patients”.

Jonathan Fielden, chairman of the British Medical Association's consultants committee, said: "The Government has over hyped the cost benefits of treating people in the community.

"It is not always the cheaper options, mental health patients are an example of this.

"What we shouldn't do is have a headlong rush into pushing everything into the community, in some cases it will be for the best.

"We have to weigh up the options carefully, including the destabilising impact it will have on the hospital sector”.

A Department of Health spokesman said it was important to remember shifting care was something patients had said they wanted to see happen and was not just motivated by saving money.

And he added that the study actually showed community care was £100 cheaper and provided "an encouraging sign" that money could be saved.

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Friday, 21 July 2006 09:50
BNN: British Nursing News Online · www.bnn-online.co.uk
BUDOCK HOSPITAL DUE TO CLOSE
Budock Hospital, near Falmouth, which was criticised in a report for "widespread institutional abuse" of patients, is to close.

Fourteen people with learning difficulties the Hospital will be rehomed by December, the BBC has been told.

The closure follows inspections by the Healthcare Commission and Commission for Social Care Inspection.

Cornwall Partnership NHS Trust was put in special measures for "widespread institutional abuse" of patients at Budock Hospital, which was revealed in the commissions' joint report earlier this month.

The trust launched an investigation after a member of staff at Budock complained in 2003 that patients were being physically and psychologically abused on its Lamorna ward.

Government inspectors found evidence of 64 incidents of abuse over the five years to October 2005.

"These included staff hitting, pushing, shoving, dragging, kicking, secluding, belittling, mocking, and goading people who used the trust's services, withholding food, giving cold showers, over-zealous or premature use of restraint, poor attitude to people who used services, poor atmosphere, roughness, care not being provided, a lack of dignity and respect and no privacy”.

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Friday, 21 July 2006 09:38
BNN: British Nursing News Online · www.bnn-online.co.uk
PATIENTS 'FAILED' BY NHS 24 HELPLINE SERVICE
Sheriff James Tierney has criticised the NHS 24 helpline service over the deaths of two people in Aberdeenshire.

The sheriff said that the system had failed Shomi Miah and Steven Wiseman by not identifying their life-threatening conditions.

He claimed that if NHS staff had "erred on the side of caution" during their diagnosis there was a strong likelihood both patients would have survived.

The families of Ms Miah and Mr Wiseman blamed delays in getting treatment for their deaths in 2004.

Sheriff Tierney's findings followed a lengthy joint fatal accident inquiry, which heard from a range of witnesses including NHS call centre staff.

He said the NHS 24 system, which involves making a diagnosis over the telephone, relied on the quality of the nurse advisors' (NAs) clinical judgement and "a strict adherence to the principle of erring on the side of caution".

His report said that while the system was "not inherently defective"; it had failed both Ms Miah and Mr Wiseman.

"It failed to identify the fact that they were each suffering from a life threatening condition or at least from a condition that the NA did not properly understand," it said.

Dr George Crooks, clinical director of NHS 24, said it would carefully assess the sheriff's observations in conjunction with NHS Grampian.

He said improvements made to the service over the past 18 months included advanced training to raise awareness of meningitis symptoms and changes to the method of dealing with repeat calls.

"The most constructive outcome is that the NHS can learn from these events and continue to improve services for patients in the future," he said.
   

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Friday, 21 July 2006 09:13
BNN: British Nursing News Online · www.bnn-online.co.uk
MOTHER SHOWN THE WRONG BODY IN A MORTUARY MIX-UP
Hospital managers from the North Devon Hospital in Barnstaple have apologised to a grieving mother of a dead baby after she was shown the wrong body in a mortuary mix-up.

Chris and Lynsey Summers' baby Jenson was born 25 weeks premature and died in their arms.

Lynsey asked to see his body but knew she was brought the wrong baby because he was smaller and slightly deformed.

Mr Summers, 36, said: "It was stressful seeing a partly-deformed child. The error went past three staff and they said it had not happened in 30 years”.

A midwife who had brought the box from the mortuary insisted it was the right baby until the mother pointed out that the name on the tiny coffin was different.

Mrs Summers, 32, who is seeing a counsellor, said: "To see another baby was just terrible. I have had emotional problems”.

Brian Aird, of North Devon Healthcare Trust, wrote to apologise, saying the mortician did not have enough training.

He said: "We are truly sorry for both sets of parents and we will be taking appropriate action”.

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Friday, 21 July 2006 09:05
BNN: British Nursing News Online · www.bnn-online.co.uk
CARE HOME FINED £10,000
Buckland Care Ltd a company which runs the Sunnybank House care home in Weymouth, Dorset, were fined £10,000 after they admitted six health and safety breaches.

Weymouth magistrates heard how the residents in the home were left without care after two staff members got locked in a kitchen and another injured herself plunging into a light well,.

Problems began when two members of staff became trapped in the kitchen. They phoned another member of staff, who rushed to Sunnybank but could not get in and then fell 3m into a light well. All three were freed by emergency services.

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