Friday 10 July 2009

Patients Forum Ambulance Services (London) and the National Patient Safety Agency

On Monday night I was re-elected Vice Chair of the Patients Forum Ambulance Services (London) and heavily defeated for the post of Chair , which I expected, as I was standing against the almost full time national health activist Malcolm Alexander. I had agreed to stand against Malcolm in order to have a democratic election as Malcolm had stood unopposed for the previous two years. But the Vice Chair position was strongly contested, one of the candidates being the Chair of the London Older People’s Forum. There are two Vice Chairs elected and the other successful candidate was a Nigerian nun who has currently been made homeless by her bishop because of her radicalism! I shall not comment here on the hypocrisy of established religion as I would have too much to write.

The Forum is still the only pan-London body for patients and public, although there has been one meeting of a London wide LINk and elections are being planned for this body soon. However, reports are filtering back that the Dept of Health is doing everything possible to destroy both NALM and the London LINk and clearly perceives them both as a threat to its hegemony. It has gone so far as to instruct Host organisations not to co-operate with NALM. More information about this can be gained from Malcolm Alexander, who is NALM Co-Chair.

The issue of Mid Staffs hospital came up at Monday’s meeting and I said that in a recent BBC News report the main campaigner there had said that she had no confidence that the new Mid Staffs management had learnt anything from the disaster, and neither had the NHS. Malcolm, who has attended a number of meetings there, said that when the authorities investigating the situation there tried to get in touch with the local LINk, nobody knew where they were or how to contact them. This is an indication of the built in weakness of the current patient involvement system and the fact that their development has been shambolic in many areas. I believe that the Mid Staffs situation is also worthy of an emergency motion at Green Party conference as the NHS is strongly resisting any calls for a public enquiry and many in the area believe that nothing has really altered.

The National Patient Safety Agency addressed our meeting and gave us some fascinating stats on reporting of incidents. The NPSA does not deal with individual cases but collects examples of bad practice from various NHS bodies and then uses them in a central database so that such incidents are made known throughout the NHS and the practice ceases. They seem to get all of their reports from acute trusts and the rep said that there is almost nothing from ambulance trusts or GPs. Only 0.4% of reports come via GPs. She said in her presentation that low reporting usually denotes a problem at a trust, so I asked her if this implied that the ambulance service in London was problematic. She quickly denied this and said that she had not inferred that and that primary care and ambulance trusts just had history of low reporting. Nick Strang, from the Polyclinics Group at London NHS, picked up on this and said that he would report it back to be built into the polyclinic model – i.e. that GPs were not reporting.

The other interesting fact is that all the reports come from nurses. I asked why this was the case and was told that traditionally nurses have done but that this is gradually changing. The speaker suggested that it was part of the hierarchical structure of the NHS. She was a former nurse herself. She gave as a positive example of what the NPSA had achieved as being the ending of the ‘whoosh test’. This resulted from a number of deaths of children who were being fed by a gastro nasal tube but the tube had been implanted into their lungs instead of their stomachs. After several such cases being reported it was realised that it was the test method which was at fault and they replaced it, as this test had been the standard one used before that. The NPSA has an interesting site where much of this information can be read. They are actively encouraging whistleblowing but reassuring staff that most patients only want an apology or an explanation rather than compensation or legal action. They base this on a survey of patients carried out several years ago. Their site is here http://www.npsa.nhs.uk/

The next meeting of the Forum will be on Monday 7th September @ 5.30pm at the London Ambulance Service HQ in Waterloo and all are welcome. We get a wide range of health activists and organisations from across London and beyond.

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