Friday, 30 January 2015

Liverpool Care Pathway - Still Playing Games Of Consequences

When targets must be met and books must be balanced, anything is possible.

Essential EPaCCs means everyone’s on board with Care LESS.

Policies have consequences. There are always consequences.

East of England Ambulance Service logged seven 'serious incidents' in December - with patients dying in five of them.

This from Cambridge News –

The deaths came as a result of ambulance delay, hospital delay or clinical treatment.

A sixth incident involved a 'medication management issue' and the seventh relates to 'non-conveyance of a patient'.

The last one follows a complaint from the family of a dementia sufferer who said they were rudely treated by a paramedic who refused to take her to hospital.

The woman had been told she needed to be admitted by her GP but an emergency care assistant sent by a private contractor questioned the decision.

The report said: "The crew have apologised if they have caused any upset by this incident but felt that they had the patient's best interests at heart throughout their attendance."

It added memorandums have been sent to all of its independent ambulance providers to remind them they must convey the patient to the receiving destination as requested.

The identities of the other patients involved in the serious incidents which includes one near Cambridge have not been revealed. The previous month of November saw three serious incidents but the trust recorded 105 in total in 2014.

The doctor flagged for admission. Clearly, a breakdown in EPaCCs.

The Telegraph reported that East of England have a 'secret policy' to downgrade 999 calls and not send ambulances to terminally ill patients.

East of England reportedly admit that 8,000 patients have been affected by the policy and a report discloses that 57 patients died following decisions not to send ambulances to the terminally ill and to those who had given instructions not to resuscitate.

Surprise, surprise... Beware for what you sign up to.

Readers of these pages will not be surprised. These are not secret policies but an ongoing programme.

Bland, innocuous terms are used to camouflage a dark intent.

Work Makes Us Free!

Will they dare dot DATA?

George Murgatroyd is head of intelligence for Dr Foster. George compares the NHS with NASA in an article in HSJ 

Both are public sector organisations that are totemic in the minds of their respective nations. Both are highly respected internationally. And both are sitting on vast stores of data with the potential to help solve problems affecting all mankind.

Over the past five years, this initiative has invited coders from around the world to develop open source software solutions to everything from landslide predictions to public sanitation.
George wants collaboration on DATA. Sharing and collaboratively harnessing data can save lives, he says. Wait a minute...

There is data and there is data...
Liverpool Care Pathway - Data Is Power
For instance, collecting personal data for reasons of diversity and inclusion of ‘minority groups’ might appear innocuous, commendable even; in the wrong hands, such information, so readily accessible, might be applied for far less laudable ends, however. The easy availability of such data would have been very useful to a certain gentleman to pursue his Final Solution.

Both organisations are subject to political control. Both may cancel and ration at a politicians whim. And politicians are not generally renowned for their altruism.

This is the Telegraph 

Eight thousand cancer patients are likely to have their lives cut short following a decision to withdraw NHS funding for 25 treatments.

Medication which offers a last chance to patients with cancer a year - including those with breast, prostate and bowel disease - will no longer be funded by the NHS, under plans to scale back spending from April.
Running round in circles

Jeremy Hunt wants all medical data online and for the NHS to be "paperless" by 2018. Digital records will be shared at the touch of a button. Health and social care services, from ambulance workers to hospital consultants to care homes for elderly people will have access to those ACDs.

Whether Policy, Programme or Grand Plan, it will serve as a Super Electronic Palliative Care Co-ordination System (EPaCCs) and save £5bn a year.

The Guardian
Health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018, two years after health secretary Jeremy Hunt unveiled the ambitious target, exclusive HSJ research has found.
The government has raided a £240m NHS technology fund to bolster financial support for hospitals struggling with accident and emergency demand this winter, senior sources have told HSJ.
What will they dare...?

A Medical Innovation Bill is now proceeding through Parliament. Is this 'innovation' or experimentation?
Liverpool Care Pathway - Somewhere... Is There Erewhon?
According to the NHS England Business Plan 2015/16 -
We will act as a facilitator of research – for example, we are planning to investigate a system of ‘presumed consent’ to take part in research studies for all patients treated in teaching hospitals.
NHS England Business Plan 
...a policy of presumed consent is being investigated.

The NHS operates a policy of non-exclusion. To ensure that no-one shall be excluded from this 'presumed consent' system, hospitals are being given 'University Hospital' status.
university hospital is an institution which combines the services of a hospital with the education of medical students and with medical research. These hospitals are typically affiliated with a medical school or university.
The focus of any health provider is to restore the patient to a condition of health. A healthy population is constructive to maintaining and encouraging a healthy economy but that is an entirely incidental consequence.

We are nearly there.

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