NURSES.

The quality of care offered by the NHS has been placed under a magnifying glass over the past few months. Constantly being in the news it led me to question, why? One of the most let's say 'obvious' answers is of course under staffing. This was most definitely found to be the case with the Mid-staff's scandal where the Francis report had stated that "A chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care,". A lack of nursing staff = more demands on existing nurses = more stress and pressure = more adverse affects on individual attitudes = bad quality of care. This is what was found from the stories stemming from the Liverpool Care Pathway - where patients were often denied food and water due to a number of staff not being correctly educated on the LCP.

It has been predicted that there will be a serious shortage of nurses and midwives by 2016 and this will lead to obvious problems with care offered by the NHS, something the NHS will undoubtedly have to face. One of the biggest reasons for the shortage is thought to be the loss of our UK nurses to other countries. For instance, the US offers a starting salary of around £40,000 compared to the (around) £21,000 offered by the UK, not forgetting the year of experience they are required to also have. This has led the NHS to bring nurses and midwives from abroad, leaving them with almost the same problem.

For me, I have seen first hand the role of a nurse from my voluntary work and my view has developed as I've learned more about their duties. The role of a nurse is so broad and diverse as they need to be able to administer medication, offer emotional support and guidance, educate the family and the patient on the illness as well as making sure all the needs of the patient are met. Nurses truly are the definition of 'front line staff'. Where doctors have the responsibility of seeing through the patient from the diagnosis to the treatment and making decisions on the treatment provided it is the nurses that gets to care for the patients on a more individual level.

It's disheartening to see what has happened to the profession over the years and the issue is of high importance to be addressed. Hopefully, when this happens we'll start to see an improvement on the quality of care offered. :)

READ this if you'd like to know more. Let me know what you think.
http://www.theguardian.com/healthcare-network/2013/aug/20/need-graduate-nurses-nhs

A&E Bailout?

A&E. The headline for the majority of the health news that has been circulating the BBC for quite some time now. Accident and Emergency departments are open 24/7, 7 days a week, 365 days a year, and specialise in just that - accidents and emergencies. However, as we've all been hearing for months now, this is simply just not the case and this is leading to A&E departments being almost on the bring of collapse.

Why are they struggling so much you ask? Well it all comes down to three main reasons:

1: Lack of out of hours services 
Back in 2004, Tony Blair's Government made a deal with GPs to reduce their working hours and allow them to no longer be on call for weekends and evenings all in exchange for £6000 of their salary. This has been described as the root to the cause of A&E disintegrating by Health Secretary Jeremy Hunt. He believes that the current GP contract is 'fundamentally flawed' as responsibility of out of hours services has been removed from the hands of GPs. Many GPs are outraged and annoyed at the constant blame they receive as many of them currently feel 'overworked' and feel that a lot of unnecessary pressure is being placed on them. They also agree that their is a flaw in NHS 111. This is a helpline you can call when your family doctor is not available and so advice is given to you on what you should do next. GPs believe that the system is flawed, as the resulting next step is often advice to visit A&E.

2: The Ageing population
People are living longer. A great statement yes? Well, it does come with its own problems. People are living longer but they as they grow older they are more vulnerable to disease, and more severe diseases at that. It is presently thought the the elderly with complex conditions are now the greatest challenge. Many of them are said to arrive by ambulance and often have to have an extended stay. Which poses another problem - space and beds. David Cameron is proposing that what we should do is concentrate on building the relationship between A&E departments, GP practices and social care departments so that the elderly may receive more help from their local communities.

3. Staff Shortages
With the increase in demands by patients it is clear that staff shortages are a definite problem in need of desperate attention. This is all results in critical cases being handed over to junior doctors who may not be competent enough to deal with the patients thus endangering their safety. This battle between increase in demand, and decrease in supply seems as a fundamental issue at the root of the cause.

The solution to fixing the problem that is A&E waiting services is proving hard to find. However, a 'bailout' as been announced for specific struggling A&E units. This is just a short term solution to a long time problem of course, and many are aware of this.

What are your views on this? Comment/e-mail me, I'd love to know.

Food for thought:
http://www.bbc.co.uk/news/health-23612539#?utm_source=twitterfeed&utm_medium=twitter
http://www.telegraph.co.uk/health/healthnews/10192661/Crisis-in-AandE-as-hospitals-grapple-with-staff-shortages.html
http://fullfact.org/articles/factsheet_crisis_accident_emergency_care-29078

Homoeopathy - out with the old and in with the 'what now'?

It believed that 2013 will be the year to see the end of homoeopathy services provided by the NHS. £4 million go into the spending of this industry and many are concerned that this money is simply being wasted on 'placebos' that have not been 'scientifically proven to work'.

Homoeopathy is another name for complementary and alternative medicines. It is an option available to the patient if they choose, to go alongside or instead of the conventional western medicines available to them. The treatments provided under this branch of medicine follow the general principle that if a treatment or substance can cause a symptom then it can also remove that symptom - when it is present in a diluted form. Some common treatments include the likes of acupuncture and herbal remedies.

Funnily enough, this is not the first time I've come across alternative medicine. For my EPQ (Extended Project Qualification) I investigated the science behind fasting and the truth behind the rumours that it lowered high blood pressure. I came to like the idea of using fasting as opposed to conventional medications as it provided a route free of side effects as well as (when done right) providing effective results. However, this alternative method does not follow the general principles mentioned above and so I'm not entirely convinced it comes under the heading of 'homoeopathy'.

Reviews on homoeopathy are mixed. For instance, earlier this year a report from the Commons Science and Technology Committee concluded that the service was no more than a placebo and recommended to the government that all funding from the NHS should stop.

Obviously, this is an extremely controversial topic so I'm not going to dwell on the opinions on others as realistically the phasing out of such services really comes down to the decisions of GPS.

Currently, homoeopathy is only available in certain areas of the NHS. 3 NHS Hospitals that are known to specialise in these services include the Royal London, Glasgow and Bristol hospitals. However, it is believed that the future of Bristol Homoeopathy looks negative as it's popularity has declined over the year.

GPs are also able to practice homoeopathy and are able to also refer patients to homoeopaths. However, it is believed that the majority of GPs are against the service. As GPs are now responsible for most of the health service budget, due to the new CCGs put in place (Clinical Commissioning Groups), it is now largely in their hands to decide if the treatment should be 'funded' or 'rationed'.

What do you think? Are with or against GPs? Let me know - comment below or e-mail me.

Homoeopathy 101:
http://blogs.telegraph.co.uk/culture/tomchivers/100044581/homeopathy-dropped-by-the-nhs-and-about-time/
http://www.telegraph.co.uk/news/9962151/Doctors-want-homeopathy-on-the-NHS-to-end.html
http://www.quackometer.net/blog/2012/12/2013-will-see-the-end-of-nhs-homeopathy-hospitals-in-england.html