The healthmatters blog; commentary, observation and review
- 69% of drivers are confused about the new general Government alcohol consumption guidelines
- 47% of these also believe that consuming one or two drinks before driving is legal
TWO THIRDS of Brits admit to being unclear on the new general Government alcohol consumption guidelines.
A survey of 1,000 road users, carried out by drinkdrivesolicitor.com, a website which provides legal advice and representation for motorists, examined how accurate perceptions are of UK drink driving limits.
Despite the new Government guidelines put in place earlier this year, which advise that men and women should not regularly drink more than 14 units of alcohol per week, 69% of UK drivers admitted they weren’t confident about the exact advice given.
In addition, over half believe consuming up to two drinks before getting behind the wheel is legal, irrespective of their individual body types and physical make-up – suggesting current guidelines are not clear enough.
This is despite the fact that there is no legal limit on the number of drinks consumed before driving and the legal drinking limit instead relates to alcohol blood levels rather than drinks consumed, suggesting that many find the legal measurements confusing and unclear.
The alcohol levels in blood differ between individuals and are dependent on weight, age, sex, metabolism, as well as the type of alcohol consumed.
Matthew Miller, Managing Director at drinkdrivesolicitor.com said: “It’s interesting to see just how many drivers in the UK are confused about the legal limits around drink driving – and it’s not entirely surprising, as blood alcohol level is not a simple thing to calculate.
“And as not even half are aware of the comparatively more clear 14 units per week drinking limit, it’s clear to see that there is a lot of confusion around legal limits and guidelines on alcohol consumption.”
“We have had cases of people being charged having only consumed one drink and often it’s been because the drink was poured by somebody else and they were mistaken about how much alcohol was in it. So it’s best not to drink anything at all before driving.”
The research shows that only 5% of drivers in the UK possess a home breathalyser kit – perhaps the best way available of testing whether you are within the limit. It is now compulsory to carry one in the car whilst driving in France.
The Ryman Prize is a $250,000 annual award for the world’s best development, advance or achievement that enhances quality of life for older people.
The prize is awarded each year by an international jury appointed by The Ryman Foundation.
The world’s rapidly ageing population means that in some parts of the globe – including most of the Western world – the population aged 75+ is set to triple in the next 30 years.
This large demographic change brings with it some chronic health issues including diabetes and Alzheimer’s disease.
The intention behind the prize is to reward great work done, and also to stimulate fresh thought from the planet’s best minds into this area of need.
The Ryman Prize is awarded in New Zealand but is open to anyone, anywhere in the world for work completed on an advance that has been proven to enhance quality of life for older people.
The work could include, but is not limited to, a mechanical device, a discovery, an invention, a study, a book, an initiative, an invention, a proven idea, a completed research project or initiative or any other advance that enhances quality of life for older people. The prize is to reward work done – not for speculative projects.
The award can be made to an individual or a team.
Applications close on April 28, 2016.
Study conducted in six European regions contributes to better understanding of how to improve the care for people with incontinence in their daily lives at home and in the community.
Patient involvement, knowledge and provisions based on patient profiles were found to be key in enabling people with incontinence and their carers to live independent and dignified lives.
The results of a major pan-European study which gives insight into the quality of continence care services and provisions was launched on April 19th at the 6th Global Forum on Incontinence: “Sustainable health and social care: The role of Continence Care in enabling Independent and Dignified living”.
The study was conducted by AGE Platform Europe, a European network representing over 40 million older people in Europe, and Svenska Cellulosa Aktiebolaget (SCA) . Entitled Management for Containment – A review of current continence care provisions, the study was conducted amongst people with incontinence and informal carers in six regions in Germany, Poland, England and Spain. It aimed to provide an understanding of the existing knowledge patients and carers had about the containment products that are available, and to what extent they were involved in the decision about which product type to use.
The main findings of the study were
- 1 in 4 said the product type offered did not always sufficiently support them when taking part in the activities of daily life
- 43% felt that their product type did not always sufficiently support them when taking part in work activities
- 41% experienced disturbed sleep due to product type
- Nearly 40% felt they had no choice on what product type they could use
- 3 out of 4 needed to pay for additional products themselves
“In today’s context of demographic ageing, it is increasingly important to take action to ensure that the support for managing incontinence fully meets the individual’s needs and preferences”, Anne-Sophie Parent, Secretary General of AGE Platform Europe, said. “There is a lot of room for improving the care of people with incontinence by involving them much more in the decision-making when selecting containment products”.
The study highlighted three key factors that could lead to greater user independence and satisfaction in daily management:
- information and knowledge about the different product types
- involvement in selecting the type of product
- tailored funding provisions based on patient profiles and needs
The findings of the study aligned closely with the conclusions drawn from an Expert Roundtable held in 2015. Eight leading European patient and civil society organizations1 joined forces and identified six recommendations to improve the care of people with incontinence in a Joint Position Statement 2 calling to:
- Recognize continence care as a human right which enables people to live independent and dignified lives
- Increase awareness and understanding of incontinence among users and informal carers
- Improve information about incontinence and continence care provisions
- Enable choice, involvement and empowerment of people affected by incontinence
- Develop continence-friendly urban/community and home environments
- Support and prioritize a research agenda on incontinence
John Dunne, President of Eurocarers, the European network representing informal carers stated: “Incontinence is a prime example of a challenge to restore independence and dignity and keep people active in, and contributing to society”.
A new report from NHS Benchmarking, published on April 11th, has for the first time combined financial, workforce, quality and outcome data to paint a uniquely detailed picture of current standards in acute hospital care for older people.
Key findings from this innovative new report show that 46% of older people admitted to a specialist ward have a condition associated with frailty, but that only 42% of hospital trusts currently have a specific frailty unit in place.
The report also provides detailed new data on the use of acute beds, and the amount of hospital capacity taken up by patients with complex needs. Figures show that 45% of total bed days were used by the 6% of patients who remain in hospital for longer than 21 days.
Other figures reveal that 34% of hospital trusts or local health boards have a dedicated geriatric medicine team located in accident & emergency wards, and that 86% of hospital wards specialising in care for older people practice Comprehensive Geriatric Assessment.
Speaking at the launch of the report, Project Director of NHS Benchmarking Claire Holditch said:
“Although the new models of care mean that older people are increasingly being cared for outside hospital, there will always be occasions when an older person needs a period of acute hospital care.It is essential that we understand what happens when an older person is admitted to hospital, and identify factors which can improve the quality of their care or help them to get them home quickly.
This new benchmarking review of the acute pathway concentrates on four elements: admission avoidance in A&E, assessment in the acute pathway, inpatient ward care, and supported discharge. It gives us new details about what is happening currently in acute care, and offers an analysis of best practice in the care of older people.
The project also looks at new models of acute hospital care: interface geriatrics, frailty units, linkages with intermediate care services, primary care, community care and specialist mental health services, and new models for discharging patients from hospital like “discharge to assess”. We hope that Trusts / LHBs will find the report useful, and that its outputs will drive improvements and feedback for the future.”
Professor David Oliver, President of the British Geriatrics Society, said:
“People over 65 account for around half the admissions and three quarters of bed days in NHS hospitals. Many have frailty, dementia, disability and complex co-morbidities. Their care is very variable in terms of processes, assessments, activity and outcomes.
NHS Benchmarking have produced a very broad and deep set of measurements to describe variation, care gaps and areas for improvement which can help clinicians understand their own services, compare them to others and drive improvements in care for patients. I hope that every acute hospital can adopt this audit as a matter of course”
The report ‘Older People’s Care in Acute Settings’ can be found here.
Innovations coming from outside the traditional healthcare industry span a wide spectrum of products and services, but all take advantage of advances in digital technologies and the ability to analyze and present large amounts of data in new ways. From new biosensor technologies and smart devices to portals and physician guidance tools, there are numerous exciting breakthroughs that allow enhanced self-monitoring capabilities and patient adherence – and ultimately superior clinical decision-making and treatment success.
How should a pharma company act in the midst of this rapid change if it is to stay ahead? We have found that many companies are struggling to fully understand the new landscape. This is particularly due to the constraints of being vertically integrated organizations with business models that are essentially built around independence and self-reliance.
Traditionally, healthcare providers, payers and pharma companies have had a conventional supplier-consumer relationship. However, there are now increasing demands from payers and providers around the delivery of better health outcomes and greater cost-effectiveness. These provide a strong driving force for pharma companies to more actively engage in the opportunities arising from the digital revolution and patient-centred care. More than ever, regulatory bodies now insist on pharma companies demonstrating benefits and cost-effectiveness, with many countries introducing reforms that aim to restrain overall spending. Ensuring responsiveness to treatment and patient compliance, while minimizing side effects, are therefore key success factors if pharma companies are to meet society’s demands.
The proven classical, product-centric approach with an indirect value chain (as shown in Table 1) will not be able to embrace the required speed, new collaboration needs, flexibility and ability to learn quickly.
Therefore, as a first step, the company needs to develop a vision of how it will earn money in the new digitalized world. A vision of how a transformed organization can be structured is shown in Table 2. The “customer” is at the centre of this vision. This includes not just the patient/consumer, but also the practitioner and the payer. All products and services, as well as all administrative processes, focus on long-term customer value through customer group-specific journeys.
To create action plans and concrete initiatives, the transformational need has to be cascaded down to processes, data and technology requirements, and management capabilities. The major challenge to success is the need to integrate organizations, concepts, processes and technology. A successful transformation program typically incorporates the major pillars of the new vision within four fields of action, as shown in Table 3: integrated offerings, customer management and coordination, digital touch-point integration and excellence, and analytics.
It is becoming clear that in order to stay relevant in the future healthcare ecosystem, pharma companies must look to business models that foster much more direct patient engagement than previously. New methods offer significant potential to increase the quality and efficiency of care. Digital health solutions could therefore solve the major long-term issues of pharma’s most important client groups – patients, providers and payers – all at the same time.
Authors:Ulrica Sehlstedt, Nils Bohlin, Fredrik de Maré, Richard Beetz
The authors work for the Arthur D Little partnership on Global healthcare, technology and innovation, in Sweden, Germany and the USA. They can be contacted through firstname.lastname@example.org
Radian conference highlights the urgent need for housing associations and health, and care providers to work more closely for the wellbeing of the public
The ‘potential meltdown’ the NHS is suffering has been identified due to the financial challenges verses the increase in demand that an aging and growing population is bringing to society. The increase in government funds is not enough to tackle the growing pressures on the regional NHS, so now more than ever, health and housing need to tackle the problem through collaborative working.
Health and housing organisations from across the south came together to promote healthy living and fight illness at a special conference led by one of the region’s foremost housing, care and support providers, Radian in conjunction with the University of Southampton.
The event which took place at The Nightingale Building, Southampton was driven, in part, by Public Health England statistics which show people in the city have lower life expectancy than the UK average.
The conference was a huge success, with over 100 health providers, housing bodies and Radian residents attending to hear discussions based on the need for housing associations to start working with their local NHS Trusts to get the ball rolling with an integrated approach to health and social care.
The discussions were led by a number of speakers including keynote speaker Lord Hunt, Labour’s health spokesman, Shadow Deputy Leader of the House of Lords, and President of the Royal Society for Public Health.
Lord Hunt outlined just some of challenges being faced by the NHS across the country. These include population growth; the slow pace of technology meaning new innovations can’t be put into practice and growing mental health pressures, as well as budget cuts that together are affecting the overall efficiency of the service. The NHS is currently working at 0.8% efficiency but needs to increase this by 3% in five years to bridge the funding gap, and 70% of funding is swallowed up in staff costs alone. Increasing this efficiency without compromising the quality of service and staff is very difficult, so collaborative working with housing associations to help alleviate this problem and increase efficiency is one way of helping.
Hunt explained that a joined up approach is currently only happening in small pockets at a national level. For it to work effectively it needs to be actively taken on by Clinical Commissioning Groups and other health and wellbeing bodies to see the true benefits start to unfold.
The health service has received an increase in funds of £8 billion, so why is it facing a potential meltdown? Hunt stated that in 2008 1.9 million of the UK population faced long term health conditions. By 2018, illnesses like these are expected to increase by 1 million, affecting 2.9 million people. The pressure on growing demand matched by the need for quality of service is a hard battle to face. Moreover, with regards to the mental health service, the amount of money invested is not nearly enough to match the growth in service requirement.
Speaking at the conference, Lord Hunt said: “Access to good housing is a major component of good health. It is self-evident that when housing and health have the chance to work together and help each other, there will be good results. I know there are challenges. When the NHS first began in 1948 it was dealing with short term infectious diseases, now the UK is faced with an aging population with more complex long term illnesses that the NHS is struggling to cope with in a modern world. With recent budget cuts and more pressures on the NHS than ever, it is important that it works hand-in-glove with housing and social care.”
Patrick Vernon OBE, Health Partnership Coordinator at the National Housing Federation and non-executive director of Camden and Islington Mental Health Foundation Trust added: “Mental health issues are increasing and it’s those individuals who are not provided with the right care and treatment that go on to face repeated housing evictions. If health and housing could work together to ensure that housing association staff have the right training to work with these residents we would be taking a further step in the right direction”.
It was noted amongst the Q&A panel which included Lord Hunt, Patrick Vernon, Dr Nick Maguire, Deputy Head of Psychology (Education) at Southampton University and Carol Bode Radian Group Chair and non-executive of The Hillingdon Hospitals NHS Foundation Trust, that health and housing have mutual problems in the sense that they face budget issues that prevent the sectors working freely together. Each has its own challenges and limited budgets, so sharing the pot to prevent doubling up on costs could be hugely beneficial.
Moreover, now that the recent devolution deal in Greater Manchester means a transfer of certain powers and responsibilities from national government, this movement of power into the hands of local decision makers is the start of meeting the needs of the people who live and work in there.
Carol Bode commented: “Manchester is the first region in England to benefit from the transfer of power from national government to local decision makers and, from the beginning of this month became the first region to take control of its combined health and social care budgets.
“This shows that the more we can do at a community level, the more effectively and efficiently we can work together. It is about gathering the right local influencers around the right table to kick start a conversation about how, collectively, we can tailor budgets and priorities to meet the needs of residents and improve the health and wellbeing for the region. Manchester has done it and this is direction that we should now be moving in.”
The panel discussions with the audience included ideas on how to share innovation, taking inspiration from the regeneration scheme at Centenary Quay, Woolston by Radian, key issues and pressures to tackle, funding and problem solving for a joined up approach to health and housing.
The National Housing Federation have also just re-launched their health and housing webpages and created an interactive map of health initiatives. The new pages will promote the work of housing associations to health colleagues and the map will allow associations to share good practice and spot possible gaps in the market.
To view the presentations from the day, images taken and videos of Radian resident case studies, please visit http://www.radian.co.uk/health-housing-2016.
A new report by the International Longevity Centre – UK (ILC-UK) demonstrates that a failure to prevent, diagnose, and treat depression, diabetes and urinary tract infections in people with dementia could be costing the UK’s health and social care system up to nearly £1 billion per year.
The report, ‘Dementia and Comorbidities: Ensuring parity of care’, which was kindly supported by Pfizer, shows that people with dementia are less likely to have cases of depression, diabetes or urinary tract infections diagnosed, and those that do are less likely to receive the same help to manage and treat these comorbidities.
This lack of parity can lead to people’s dementia worsening more quickly leading to greater health and social care costs. ILC-UK demonstrate an annual total net loss of up to approximately £994.4 million for just three conditions:
- £501.7 million for people with dementia and depression
- £377 million for people with dementia and diabetes
- £115.7 million for people with dementia and urinary tract infections
The report also finds that the failure to prevent, diagnose, and treat comorbidities in people with dementia is leading to this group having a reduced quality of life and an earlier death than people who have the same medical conditions, but do not have dementia. It highlights how:
Hospital in-patients with dementia are over three times more likely to die during their first admission to hospital for an acute medical condition than those without dementia. Four of the five most common comorbidities people with dementia are admitted to hospital for in the UK are preventable conditions – a fall, broken/fractured hip or hip replacement, urine infection and chest infection. The ILC-UK identifies six key areas which appear to be leading to the discrepancy in health outcomes for people with dementia and comorbidities:
Atypical symptoms. People with dementia often present atypical symptoms which may lead to carers and medical professionals interpreting these problems as worsening dementia and neglecting other conditions as a potential cause. Communication difficulties between medical professionals/carers and people with dementia, and between medical professional themselves, leading to lower standards of care.
A failure by the health system to recognise the individual as a whole, instead focussing on the person as a patient with a given diagnosis, leading to the optimisation of care for dementia while the individual continues to deteriorate because of poor management of a comorbid condition or vice versa. A knowledge gap of hospital staff and carers in caring for people with dementia and comorbidities. Poor medication management relating to how people with dementia’s medications are prescribed, monitored, administered and/or dispensed. A lack of support to aid self-management and poor monitoring of comorbidities by health professionals. The ILC-UK have set out seven recommendations which will help to ensure that parity occurs:
The National Institute for Health and Care Excellence (NICE) must update its condition specific guidelines to take into account the needs of a people with dementia in order to ensure this group receive the same level of care as the rest of the population. Care homes should modify the care plans of residents with dementia to include checklists covering the symptoms of common comorbidities (such as UTIs) to help ensure early diagnosis and treatment. Health professionals must involve people with dementia, their carers and families in every decision about their care to improve both the diagnosis and management of comorbidities.
Health Education England should consider broadening its tier one dementia awareness training to include how dementia may affect care for both short and long term conditions. Health trusts should develop comprehensive catheter action plans, based around staff education and training, to reduce the incidence of UTIs in people with dementia through unnecessary catheter usage. The Care Quality Commission (CQC) should consider making it mandatory for care homes to undertake annual check-ups for residents with dementia and diabetes where their blood glucose levels, cholesterol levels and vision are monitored.
Clinical Commissioning Groups (CCGs) should commission a wide range of psychological therapies at a suitable capacity to ensure that GPs are not reliant on drugs to treat depression in dementia patients.
Baroness Sally Greengross, Chief Executive of the ILC-UK said: It is an absolute scandal that Doctors, nurses and healthcare workers are too often failing to see people living with dementia as more than simply this disease. As such our health system is too often failing to prevent, diagnose, and treat comorbidities among people with dementia. This failure has a devastating impact on quality of life, and results in earlier deaths. A failure to prevent adds avoidable financial pressures to our cash strapped health service.
Jeremy Hughes, Chief Executive of Alzheimer’s Society, said: The reality for many people with dementia is that they have to contend with other long-term conditions, all of which greatly impact their quality of life. As this report highlights, to view dementia in isolation not only makes poor economic sense, but can cause unnecessary suffering. While initiatives to integrate health and social care services are a step in the right direction, it is clear government plans need to go much further to truly meet the needs of people with dementia and other health conditions.
Alzheimer’s Society is working with the All Party Parliamentary Group on Dementia to better understand the experiences of people living with dementia and other conditions. Our report is due later this month.
Roz Schneider, MD Global Patient Affairs Lead at Pfizer said: “This report clearly highlights disparities in care and health outcomes that are associated with people living with dementia who also have comorbid illnesses. Patients and their caregivers, as well as others in their support community, can provide subtle yet critical insights about medical changes that affect these patient’s lives. Such a collaborative approach could lessen or avoid the progression of some comorbid conditions. That is why this expanded care community stand ready to partner with healthcare teams in order to advance these important healthcare conversations and care decisions.”
As news today suggests that a fifth of the world’s population will be obese by 2025, health initiative BHWA advises employers that they have the power to influence the obesity crisis and it’s in their best interests to act.
According to Majid Ezzati from Imperial College, who led the research, smart food policies and improved healthcare training can help us to avoid an “epidemic of severe obesity”. However, with the potential impact such an epidemic would make to any workforce, Better Health at Work Alliance (BHWA) cautions that employers should not remain indifferent to the power of their influence.
Better Health at Work Alliance is an industry led advice body recently launched to make finding health at work guidance straightforward for employers.
BHWA has advised that straightforward steps an organisation should be looking at include access to healthy food options, promoting an active workplace, providing information on being healthy and incentivising staff to follow it, or making adjustments to the work environment that encourage behavioural change such as standing desks, walking clubs or bike racks.
Charlotte Cross, Director of BHWA, says of the recent news: “Obesity is relevant to all employers and can impact the bottom line of any organisation through obvious health ramifications and associated productivity and performance issues. As the obesity problem grows, employers will inevitably face more of these challenges.
“While simple measures can and should play an important part in any employers approach, the diversity of our expert membership shows us that employers have access to a significant range of evidence based solutions from workplace health specialists ready and willing to help, and the power to make an impact is in their hands. We urge all organisations to get involved and sway this issue which has huge ramifications for the UK working population”
Raising the link to dementia, one of the lesser known health ramifications of obesity and another serious issue for employers, John Picken, Managing Director of CANTAB Corporate Health, a BHWA founder member said: “Worldwide clinical research has shown that obesity in mid-life plays a considerable role in cognitive impairment including preclinical dementia symptoms and dementia. Giving employees the chance to measure their cognitive health as well as their physical health will help them manage this life-threatening but potentially reversible health risk.”
Mark Braithwaite, Managing Director of Gipping Occupational Health, another Founder of the alliance also said: “When dealing with obesity, or any other health taboo, it is key to ensure consistency of response throughout the organisation so that no individual feels inappropriately ‘singled out’.
Providing access to impartial advice and guidance from a qualified health professional, such as an OH Advisor, enables employees to talk openly, learn and improve management of their own health and ultimately take responsibility, whilst equally providing support to the employer in working towards a positive outcome.”
The BHWA is the UK workplace health industry’s first broadly inclusive membership body, launched in Feb 2015 and led by Director Charlotte Cross. Offering access to solutions, information, and guidance via a simple one-stop website, users will be able to tap into expert knowledge through free resources including an ‘Ask the Expert’ forum, collaborative wikis, and guides, BHWA brings together a wide range of leading workplace health specialists and already has the endorsement of over 30 key industry organisations.
For more information on the Better Health at Work Alliance please visit: http://bhwa.org.uk
Factors that influence when boys go through puberty could affect a man’s future risk of developing prostate cancer, a large study funded by World Cancer Research Fund has found.
For the first time, sexual maturation was assessed using genetic markers and the study, published in the journal BMC Medicine, found that these early puberty genes were associated with an increased risk of prostate cancer in later life.
Genes that could indicate sexual maturation were identified and each man was given a score dependent on how many of these maturity genes were present. Measuring sexual maturation in this way allows for a possible causal link to be drawn between reaching puberty early and an increased risk of prostate cancer. This method also is more reliable than the conventional use of physical pubertal changes, which are imprecise and difficult to isolate.
The link between genetic factors that influence when boys enter puberty and prostate cancer could be due to the effect of early and prolonged increased levels of growth hormones which are altered with puberty, although this remains to be examined.
Prostate cancer is the most common cancer in men in the UK with over 47,000 new cases each year. Over 10,000 men die of the cancer each year. Worldwide it is the second most common cancer in men.
Dr Panagiota Mitrou, Director of Research Funding at World Cancer Research Fund, said:
“These results are very exciting as they show evidence of life course influences on prostate cancer risk including the aggressive form of the disease.
“We now need to better understand the findings. If growth factor hormones are shown to be the driving force behind age of puberty and prostate cancer risk and progression, they could help us develop dietary interventions to promote healthy growth and hence protect against prostate cancer in adulthood.
“There are however other ways that men can help reduce their prostate cancer risk, such as maintaining a healthy weight”.
Professor David Neal, study principal investigator at the University of Cambridge, said:
“This is the first time genetic markers have been used to measure sexual maturation. The research is particularly interesting because it has demonstrated a new way to look at risk factors which allows more potential cause and effect relationships to be established.
“With prostate cancer being the most common cancer in men in the UK, prevention is key if we are to see a decrease in the number of men developing the disease.”
Professor Richard Martin, study researcher at the University of Bristol, said:
“There are still many unanswered questions around what could prevent prostate cancer. However, these results linking sexual maturation and prostate cancer risk could help fill some of the gaps in our knowledge.
“What might be linking earlier age of puberty with the increased risk of prostate cancer are the effects of growth factor hormones and male sex hormones, which should be examined more closely in future research”.
Ed Fletcher, CEO of the UK’s medical negligence and serious injury law firm, Fletchers Solicitors, argues that fixed fees will create an opportunity to improve care standards and bring the number of medical negligence claims down
In 2014, the Government introduced its ‘Duty of Candour’, aimed at encouraging a more honest and open NHS that would admit when things went wrong. However, recent examples show that some parts of the NHS are still taking a ‘Don’t Ask, Don’t Tell’ approach when mistakes do occur. Examples include the Southern Health Foundation Trust (which failed to investigate the unexpected deaths of more than 1,000 people) and the report by Dame Julie Mellor, the parliamentary and health service Ombudsmen, which found that in 73% of cases investigated by her office (where there was a clear breach of a duty of care), the hospital had previously reported that no error had occurred.
It could be argued that such an attitude is a misguided response from NHS management to limit the NHS’ rising legal bill (£1.3 billion annually at the last count) and in this respect some areas of the legal profession must shoulder a portion of the blame. However, government consultation is beginning on a new policy that could pave the way for a more open relationship between the NHS and lawyers. Fixed fees, set to take effect before the end of the year, will place a cap on the amount lawyers can charge for cases where damages are below a certain amount. A limit would apply to all claims but the most extreme cases, which have been raised as a result of medical mistakes. For the NHS, this should see a reduction in the number of legal claims brought against it, (with weak claims no longer financially beneficial to pursue) and also lower costs in cases where the NHS admits fault or is ruled against by the courts.
Not only this, but as a lawyer who sees the devastating effects medical negligence has on the lives of victims, this is also an opportunity to increase openness and transparency within the NHS. The medical profession must accept its duty of care to the public and take a more active role in ensuring patients get justice for their injury. This will be crucial if the new system is to operate fairly.
Accepting fault at the earliest opportunity (in keeping with the promised Duty of Candour) means that time and resources can be focused on achieving a fast and fair resolution. Failure to do so may mean that some complicated claims are not pursued, particularly if the time and money needed to properly investigate them would exceed the fixed fee cap. Also, in complex cases, greater openness and cooperation (such as sharing a single expert witness to judge on medical matters) would prevent patients’ cases being unfairly disadvantaged.
Restricting access to justice would cause serious harm to the injured patient, adding to the distress and upset already suffered as a result of their injury. It would also cause real harm to the NHS, damaging its reputation as a national institution that is relied on by millions every day. The key for the fair fixed fees process is to encourage good behaviour. Co-operation and reasonableness are a must if the system is to achieve the right result.
By being open and transparent about mistakes, this will undoubtedly help to improve healthcare standards preventing future injury to others, along with relationships between patients and medical staff. It will also go towards ensuring NHS institutions are able to properly exercise their duty of candour. With the fixed fee system still in the consultation phase, we are yet to see how it will be implemented and whether the new rules will include a provision to encourage greater openness (e.g. rewards for behaviour that bring cases to a swift and fair resolution).
However, it’s important to recognise that for the new regime to be successful, both the medical and legal professions need to work together to achieve the right outcomes and help victims to get on with their lives. Fixed fees present the opportunity for both sides to pull together to improve care standards and bring the number of medical negligence claims down. A decrease in mistakes means fewer patients harmed. And who can argue with that?
Established in 1987, Fletchers Solicitors is a North West-based personal injury law firm which solely specialises in motorbike accidents, serious injury and medical negligence law. The firm currently handles one in ten of all clinical negligence claims in the UK. Over the last five years, Fletchers has expanded to build a highly successful and innovative medical negligence department, which has already grown to become one of the leading practices in the UK.For more information, please visit www.fletcherssolicitors.co.uk website here.