Wednesday, 25 September 2013

Liverpool Care Pathway - Nothing Changes But It Stays The Same

They have ploughed £Billions into EoLC. Loadsamoney. Loadsa, loadsa, loadsamoney.
But they still can't find the dosh for weekend cover.

This is the End of Life Baseline Report -
End of life care is a key priority of the North West regional QIPP workstream for 
Demand and Threshold Management and the North West SHA in recognition that improving QIPP across the end of life care pathway will significantly support overall delivery against the £20 billion QIPP challenge by 2014/15. 
The North West vision is for people to be supported to die well in the place of their choice; with a broad aim to reduce avoidable hospital admissions for patients at the end of life and to expedite discharge for end of life care patients who are admitted to hospital for emergency care.

Our population is getting older and sicker. Currently there are around 1.5 million people with long term conditions living in the North West; it is estimated this figure will be 3 million by 2030. In tandem with this, population statistics estimate that the people over the age of 65 will increase by 252% by 2050; described by Sir John Oldham as “a Tsunami of need”.

There is a 'vision' to support people to die. There is no vision to support people to live. And you can say there is no programme to limit life...?
The Baseline Report was published in 2011. The projections are not marrying up. There are 'excess deaths'. There are 'missing' 90 year-olds...
This is Mail Online in September 2013 -
A grieving daughter has accused the NHS of running a Monday to Friday service, blaming the death of her sport-loving father on Britain’s ‘healthcare lottery’.
Christopher Leggatt, 65, died as he was being transferred between hospitals as there were no surgeons available at the first because it was a weekend.
The father-of-four collapsed with a ruptured abdominal aortic aneurysm as he refereed a football match - and had a 70 per cent chance of surviving a routine operation on it.
But he suffered a heart attack in the ambulance taking him from Bradford Royal Infirmary to Huddersfield Royal Infirmary. 
Paramedics managed to revive him but his heart stopped again before he could be operated on. 
His death was recorded at 6.15pm - two hours after he first arrived at Bradford Royal Infirmary.
An inquest was triggered when his daughter Andrea, 43, lodged a formal complaint. 
After the case she said: ‘I don’t want my father to be another statistic. 
‘I hope what has happened highlights the fact that the NHS as it stands is a Monday to Friday service.
‘If my father had collapsed on a weekday then the outcome would have been very different.
‘If he had been operated on straight away he would have most likely survived the operation but there were no surgeons working at the hospital in Bradford that weekend.
‘He was taken to Bradford because it was the nearest hospital but they didn’t have the means to treat him.
Andrea, a company director, said despite sending a letter of complaint to the hospital, she has never received a response.
She said: ‘At the inquest I learnt that if there had been someone there to operate, there was a 70 per cent chance he would have lived.
‘The operation is really simple and only takes around 40 minutes but it was the delay which killed him.
‘To treat a ruptured abdominal aortic aneurysm it is like mending a pipe and the vast majority  of people make a full recovery from it.’
The inquest in Bradford last week heard that Mr Leggatt, a ‘well and active man’ from Pool-in-Wharfedale, West Yorkshire, had been diagnosed within 20 minutes of arriving at Bradford Royal Infirmary.
Paul Needham, a surgical registrar with the Bradford Teaching Hospitals Trust at the time, said the transfer represented his best chance.
He said: ‘Our vascular surgical cover that day was provided by Huddersfield. ‘Our view was that a blue-light ambulance transfer would be more rapid than having a surgeon driving across [to Bradford].”
Consultant vascular surgeon at Calderdale and Huddersfield NHS Trust, Anver Mahomed, told the inquest that the two hospitals took turns to provide acute care cover as part of a formal network arrangement.

This is The Portsmouth News in November 2009 -

Grieving widower Rex Patterson launched a protest campaign after spending almost a year trying to find out why his wife died in hospital. 
Thelma Patterson, 59, died two days after being admitted to Queen Alexandra Hospital in Cosham with a blood clot on the lung. 
Mr Patterson says she was refused a scan that could have located the clot because the hospital did not operate the machines at the weekends. And he says medical staff left her even though they could not find a pulse or reading for her blood pressure. 
The 61-year-old has written to the hospital 16 times since his wife's death on January 11. NHS guidelines say most complaints should be resolved within 25 days. 
Mr Patterson says that on nine occasions his letters were ignored. 
He has sent the order of service from his wife's funeral to the hospital on the 11th of every month to remind it of his case 
And in a desperate bid for attention, this week he parked his wife's car, covered in the words 'Killed by medical neglect at QA Hospital', in the hospital car park. 
'I have tried so hard to get answers', said Mr Patterson, a former police officer of Swanage Road, Lee-on-the-Solent. 'But I have just been ignored or told they're investigating and will be in contact, and then I've heard nothing. What else could I do to make them listen?' 
Recalling the hours leading up to his wife's death, Mr Patterson said: 'She was told she'd need a scan to locate the clot. But then we were told she would have to wait until Monday as the machine wasn't operated over the weekend. All they did was put her on blood-thinning drugs. 
'She was getting weaker and weaker. At one point she actually said to me "I'm going to die in here. They are not doing anything."' 
Mr Patterson said a nurse checked his wife's blood pressure and pulse at 3pm on the day of her death. 'There was no reading for either. But the nurse just said "I will do it again later." 
'Several more nurses tried over the next few hours and still got no reading. One even said "Maybe the machine's broken." I was pleading with them to call a doctor. I even said to them, "You are killing my wife.'" 
A senior health official arrived about 6.45pm. 
Mr Patterson said: 'They said they were treating her with a drug that would kill the clot but their concern was that she had been left too long and her body was too weak to recover.' 
A cardiac team then arrived and at about 7.30pm Mrs Patterson died. A post-mortem examination revealed she died of a build- up of fluid on the lungs. 
Mr Patterson said: 'I feel she was killed by negligence. She was left too long.' 
Portsmouth Hospitals NHS Trust, which runs QA, said it had reviewed Mrs Patterson's case and her husband would now be invited to the hospital to discuss the findings. 
Peter Mellor, the trust secretary, said: 'A thorough investigation has been carried out. Because the investigation needs to be thorough, it takes time. 
'We recognise that the death of Mrs Patterson is a tragedy for which we are sorry. If we have not kept Mr Patterson as well informed about our progress I can only apologise for that. That is a shame on our behalf.' 
In a desperate attempt to get hospital officials to give him answers about his wife's death, Rex Patterson parked his wife's Mini Cooper S outside Queen Alexandra Hospital, Cosham, on Monday. 
He had put pictures of his wife, Thelma, on the car and slogans such as 'Killed by neglect at QA'. 
The car was parked at the hospital from 7.30am and caused chaos at the front entrance. 
Security guards could be seen covering the car in a white sheet, and a group of security men, later joined by police, were stationed around the vehicle throughout the morning. 
A security car was also parked behind the vehicle, blocking one lane of the road and slowing traffic.
The car was being treated as a suspicious vehicle and so police were called. 
Mr Patterson returned to his car at 11.30am. Health officials said the car was covered up to protect other patients. Peter Mellor, the secretary of Portsmouth Hospitals NHS Trust, which runs QA, said: 'I fully recognise that Mr Patterson is upset and distressed and I fully recognise his right to ask difficult questions, criticise, and we enjoy the freedom of speech in this country. 
'However, putting up statements like that in view of other patients arriving at the hospital were likely to cause harassment, alarm and distress. This was not about covering anything up. It was about shielding patients.' 
Thelma Patterson had the ability to put a smile on the face of all those who knew her, husband Rex said.
She was a happy, popular and witty woman and a much-loved wife, mother and grandmother.
Her untimely death at just 59 has left an enormous void in her family's lives, especially Rex's, her life-long sweetheart.
The pair met when they were just children – Thelma aged three and Rex five. Both lived in Cherry Close, Lee-on-the-Solent.
As they grew up they went to the same school and started dating as teenagers, eventually marrying in 1969.
'She's the only woman who's ever been in my life,' said Mr Patterson, 61. 'I miss her. Everyone does.'
Mrs Patterson began working life as a bank worker. She then stopped working to have their children, Gary, now 38, and Clair, 36.
Before she died, she had been working as a doctors' receptionist at Lee Health Centre for six years. 
'She was extremely popular,' said Mr Patterson. 'Even at work she had friends both sides of the counter. 
'She had such a wit and would always make people smile. She was just so funny and had an infectious laugh. She loved her family and was such a kind person.' 
Between 2006 and 2007, Mrs Patterson had a battle with breast cancer. Otherwise, she was a healthy and active woman. 
She loved seeing her family and her granddaughter Jess, eight. 
She also loved gardening and enjoyed nothing more than the passion she shared with her husband for Mini racing. 
The pair would travel all over the country for race meetings and Mrs Patterson cherished her beloved Mini Cooper S. 
January 13 - Rex Patterson writes to Ursula Ward, the chief executive of Portsmouth Hospitals NHS Trust, which runs QA, requesting the complaints procedure. 
January 16 - Receives a letter from a secretary at the hospital saying his letter had been forwarded to the head of legal services. 
January 19 - Mr Patterson phones head of legal services Sue Skye and is told to write in, outlining his complaint. 
January 20 - Mr Patterson sends a letter of complaint and a request for admission records. 
January 23 - Receives a letter from hospital saying he cannot have the admission notes until after an investigation has been carried out. 
January 27 - Receives a letter from Amanda Alder saying she has been appointed complaints officer for his case. 
January 27 - Mr Patterson makes another request for admission records. Receives no reply. 
February 9 - Mr Patterson writes to Ms Ward and Ms Skye pointing out his unanswered letter of January 27 and the records issue. 
February 11 - Mr Patterson receives record notes but some are missing. 
February 27 - A letter received from the complaints officer states the NHS guidelines of 25 working days to reply to a complaint could not be met. No extended timescale discussed. 
March 12 - Mr Patterson writes to Ms Ward pointing out time limit for responding to a complaint had passed and there was no agreed 'extended timescale'. 
March 17 - Mr Patterson writes to Ms Ward again as he had had no reply. Still no reply. 
April 9 - Mr Patterson writes to Ms Ward saying that with the three months since his wife's death approaching he expects a reply by April 17 at the latest. 
April 18 - Mr Patterson receives a letter from Ms Ward. It says they could not identify the nurse who found Mrs Patterson had no measurable blood pressure or pulse and an investigation was on-going. 
April 25 - Mr Patterson tries calling Ms Ward but cannot get hold of her. Mr Patterson then responds in writing. He says he would be happy to meet any time and asks for a fixed date for the final report. No reply. 
May 19 - Mr Patterson again writes to Ms Ward for an estimated date for the final report and updates. No reply. 
May 26 - Mr Patterson again writes to Ms Ward pointing out he had no replies and asks if the complaints department had a manager. Again, no reply. 
May 29 - Receives a letter from Sheena King, head of risk management and legal services, saying his complaint was being reinvestigated by an independent healthcare professional under the trust's risk management processes. 
June 3 - Mr Patterson replies to Ms King pointing out the lack of updates and incomplete admission notes. No reply. 
June 9 - Mr Patterson writes again asking for admission notes. 
June 24 - Notes received but no information on updates or final report. 
July 10 - Mr Patterson e-mails Ms King, stating that six months have passed and there is still no report or regular update. 
July 17 - A letter is received from the hospital saying a second draft of the report would be complete by the end of the week and Mr Patterson will be contacted. 
August 11 - Mr Patterson e-mails Ms King to point out there has been no update or agreed date for the report. He also says he will display posters about his case at the hospital. 
August 11 - E-mail asks Mr Patterson not to put up posters. He is told the report will be going to the serious incident review group in September for final sign-off and he will then be invited to a meeting. No news follows about the report or meeting. 
September 11 - Mr Patterson sends a letter to Ms Ward pointing out it has been eight months and still no update. He receives no reply. 
November 16 – Mr Patterson parks his dead wife's car at QA in protest and The News gets involved. The hospital then says it has completed its report and offers to meet Mr Patterson
Readers of these pages will well know that the CQUINs are still being awarded for EoLC Pathways...
Nothing changes but it stays the same.
Further reading -

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