British clinics delivering cosmetic surgery were thrown into crisis by the decision last month of the French government to fund the removal of thousands of breast implants manufactured by the now-closed French company Poly Implant Prostheses (PIP). The implants were found to have used industrial grade silicone made for use in mattresses. Continue reading
Fresh off a trip to powwow with health journalists, academics and officials in England as a Fulbright Senior Specialist, AHCJ Immediate Past President Trudy Lieberman writes on CJR.org about what American health systems can learn from the British National Health Service when it comes to patient safety.
In particular, Lieberman looks at the NHS Institute for Innovation and Improvement, which has pushed a few simple changes that have lead to measurable and marked improvements in several key safety measures and are, she writes, embraced by “almost all U.K. hospitals.”
Since 2007 the Institute has fostered nurse-led innovations to improve care in such areas as patient hygiene, nursing procedures, meals, medicines, and ward rounds that frees up more time to be with patients. Now almost all UK hospitals embrace some of these practices. Positive stats from this “Releasing Time to Care” project show a thirteen percentage point increase in the median time spent on direct care; a seven percentage point increase in median patient satisfaction scores, and a twenty-three percentage point increase in median patient observations.
The innovations include little tricks like nurses donning red pinafores to signal “don’t interrupt me, I’m dispensing medication” and charting patient falls with red dots on a hospital floor plan, so that problem areas can be easily spotted.
According to Lieberman, simple changes like these don’t get the attention or widespread adoption they deserve. Thus, she ends her piece with a call to arms for health journalists, asking them to tell the stories of the sort of simple, easy-to-relate-to steps that are saving lives on both sides of the pond (Oregon, in particular, has been quick to follow the NHS lead in these areas).
So where does the press fit into all this? Media outlets in the UK and the US have something in common—they aren’t much interested in reporting good news and what works. It’s in our journalistic DNA to ferret out the evil, bad, and ugly with the hope that press exposure will change practice. But my visit to the NHS showed that positive change does happen and should be reported. Taylor told me she tried to interest British journos in some of the Institute’s achievements but got “not a sniff.”
“Journalists don’t celebrate success,” she said, “but innovation is to be shared.” Nor has there been any interest from U.S. reporters. CareOregon hasn’t sent out any press releases partly because the results are just coming in and because officials fear that the U.S. stereotype of the NHS is so powerful the program might die a-borning. If I were still a local consumer reporter, I would forget about all that ambiguous, hard-to-interpret data about hospital quality and look for concrete improvements patients and families can relate to, like red pinafores and scorecards for reducing falls. Then I would make a how-to comparison chart showing which hospitals were embracing some of the simple technologies that appear to work.
After a damning report from the U.K.’s national audit office indicating that the National Health Service’s massive health IT program has essentially been a black hole which vacuums up far more money than its lack of progress would justify, politicians are now calling for what amounts to the program’s termination.
Physicians support a national system of health records, but there seems to be a consensus that, in the current climate of British austerity, it may be time to amputate the program to stop the bleeding. After all, the audit indicated that despite a seven-year extension, it looks like the program has no chance of meeting its 2014-15 deadlines, or even of producing meaningful results. Here’s Polly Curtis in The Guardian.
The original aim of the £11.4bn NHS IT programme – to install a patient record database accessible from any point in the NHS in England by 2015 – will fail, the National Audit Office (NAO) warned.
The £2.7bn spent so far on the system has not been value for money, the watchdog said, adding it had no confidence that the remaining £4.3bn would be any better spent.
The nine-year-old project – the biggest civilian IT scheme attempted – has been in disarray since it missed its first deadlines in 2007. While its ambitions have been downgraded in recent years, the bill from the suppliers has remained largely unchanged, the report said.
Victoria Macdonald of Britain’s Channel 4 News, with the help of the nonprofit Bureau of Investigative Journalism, used FOIA requests to expose the National Health Services’ habit of using “gagging clauses” and financial settlements to silence whistle-blowers.
In a number of requests made under the Freedom of Information Act we discovered that over the past decade 170 doctors signed a settlement, or compromise, agreement with their trust. We were given 64 heavily redacted contracts to review. Of those 55 – that is nearly 90 per cent – contained gagging clauses.
…
Under another FOI we asked all 225 hospital trusts in England how much they had spent on settlement agreements over the past decade. Of those who responded, only 71 trusts admitted to entering into these agreements, 40 revealed they had spent a total of £3m. In one case, a doctor was paid a quarter of a million pounds. However, a further 31 trusts simply refused to tell us how much they had paid out.
While not every settlement was designed to muzzle a whistle-blower, a significant portion were, Macdonald found. The effort has created what she found was a “culture of fear,” yet there are no plans to revise the relevant laws.
The Bureau of Investigative Journalism, by the way, is a new not-for-profit with a £2 million ($3.2 million) grant to support long-term investigations at British newspapers.
UK journalist Simon Singh has gained ground in his ongoing defense against a libel suit leveled by British chiropractors, with the reversal of a ruling that had said his words were (potentially libelous) fact instead of (protected) commentary. The words in question included the assertion that the British Chiropractic Association “happily promotes bogus treatments.”
The dispute has been over whether or not his words imply that the BCA was being consciously dishonest and deceptive.
Covering Health has written about UK libel cases in the past, and this case has received a fair amount of attention, but those who haven’t been following the Singh case can find a competent primer on Wikipedia.
The BBC calls it a “landmark ruling,” then explains:
BBC News science correspondent Pallab Ghosh says that, had Justice Eady’s ruling stood, it would have made it difficult for any scientist or science journalist to question claims made by companies or organisations without opening themselves up to a libel action that would be hard to win.
The BBC reported that Singh praised the ruling and said the legal wind finally seemed to be at his back, but that he bemoaned the fact that it had cost £200,000 to get to that point.
“The Court of Appeal’s made a very wise decision, but it just shouldn’t be so horrendously expensive for a journalist or an academic journal or a scientist to defend what they mean.
“That’s why people back off from saying what they really mean.”
