Patient safety has to be at the forefront of the Welsh NHS

This Western Mail article regarding NHS safety breaches is a cause for concern for anyone working in the NHS, as well as to patients.

Patient safety is paramount at all times in the Welsh NHS, but it would perhaps be naïve to think ALL risks can be removed. For instance, when the health service is running at full capacity, with staff under pressure to get patients in and out of hospital quickly, it is inevitable patient care will suffer at some point. It is also at times like this, with such a high turn over of patients, that cleanliness standards are likely to fall, which can lead to the spread of hospital acquired infections such as C. difficile. Just last week the Welsh Conservatives published figures showing the rate at which such infections are spreading in Wales.

Here are a few of the recommendations the BMA has made in the past in trying to prevent such incidents of hospital super bugs;
• Healthcare professionals must follow hygiene standards relating to hand washing. Effective hand hygiene is the single most important intervention in infection control.
• Hand hygiene needs better ward/clinic design and provision; hot water and liquid soaps play an important role.
• Health professionals are duty bound to ensure that they and their colleagues fulfil their responsibilities with regard to infection prevention and control. Senior staff should lead by example.
Health care settings must be kept clean and dust free. Clinical and non-clinical waste must be disposed of effectively and appropriately.

It’s easy for such basic hygiene measures to fall by the way side, when the pressure is on NHS staff for a quick turn around in treating and discharging patients.
It is also worth highlighting a recent report from the Welsh Liberal Democrats,which showed how unsafe actual NHS buildings are, for both staff and patients, because basic, yet essential maintenance work, isn’t being carried out.

It isn’t really until you start delving a bit deeper and really looking behind these figures that you can identify such issues and then start putting them right. And these statistics show just how important an initiative one like the Save 1,000 Lives Campaign really is, which was set up with the primary aim to reduce risks to patient safety.

BMA Cymru steps up calls for sunbeds to be regulated

BMA Cymru Wales is talking to young people at a school in Swansea today about the potential health risks of using sunbeds.

For at least five years now we have been calling on the UK Government to regulate sunbed use after research showed that some people are having more than 100 sunbed sessions in a single year.

Although the UK Government doesn’t recommend the use of sunbeds, there is currently no training or regulation associated with their use. The World Health Organisation has said that there is ‘an urgent need to reduce the health and environmental impact of increased ultra-violet exposure’ and has called for public education about this issue. And that is exactly what we are trying to do by organising for a consultant dermatologist and a skin cancer survivor to chat to school pupils about the dangers.

Recent cases like Kirsty’s just go to show how important it is that we have a public health campaign in Wales to highlight this.

A suntan is not a sign of good health; a tan, even when there is no burning, always means that the skin has been damaged. It’s ironic that people use sunbeds because they think they’ll look better and yet they will probably end up looking old prematurely and possibly even getting skin cancer. Just one session a month will double the average individual's annual dose of ultraviolet radiation.

Here are just some of the health risks that spring to mind when people use sunbeds:

• Developing certain types of skin cancer – the risks appear to be greatest for the young, with the chances of developing a tumour increasing by up to 20% per decade of sunbed use before the age of 56.
• Premature ageing – people tend to use sunbeds to look better but they could end up with leathery, wrinkled and sagging skin.
• The eyes (in particular the cornea) are very prone to damage from tanning equipment – it is recommended that sunbed users wear protective goggles, but research shows that people may not use them even if they are provided.
• The immune system – increasing evidence shows that sunbeds have an immunosuppressive effect.
BMA Cymru is urging government ministers again, to pass a bill that would compel local authorities to issue licences regulating cosmetic tanning salons.

The bill would require providers of cosmetic tanning facilities, or equipment, to obtain a licence to operate from the local authority. The licensing conditions would be set so that local authorities could:
• Prevent the use of sunbeds by children
• Protect adults from over-exposure
• Ensure that sunbed users are supervised
• End the use of coin-operated machines
• Ensure that sunbed sessions are monitored and limited
• Provide health risk information in sunbed parlours
• Inspect premises

The introduction of such a bill would hopefully mean adults can make informed choices about the risks of sunbed use. The conditions of licensing would require staff to be on premises, which would help to prevent over-exposure to ultraviolet light. It should also reduce the number of burns and accidents currently attributed to the misuse of unsupervised equipment and would drive up standards.

I wonder how many more unfortunate cases like Kirsty’s we will hear about, before any of the above actually happens?

Isn’t it about time England acted on bringing in free prescriptions?

England’s Department of Health is looking to extend the list of long-term conditions that are exempt from prescription charges. Instead of doing that, why not bring in free prescriptions, which is undoubtedly the fairest and simplest option, which the Welsh Assembly Government did nearly two years ago now?

It’s questionable as to the wisdom of just adding to the list of those who don’t have to pay when only 11% of prescriptions currently attract a charge across the boarder any way, and that will soon drop further, with the abolition of charges for cancer patients.

Scrapping prescription charges in Wales was seen by some as being a gimmick, when what it actually shows is a long term investment in managing chronic conditions and improving health and ultimately helping to reduce the cost and pressure on the NHS.

Since being introduced in Wales, the scheme has proved to be both popular and beneficial, particularly to those people with long-term conditions. Before the inception of free prescriptions, there was evidence that some patients didn’t take their medicines, simply because they couldn’t afford all those prescribed by their GPs. Now they can take their medications as advised, free of the worry of payment. Scotland and Northern Ireland have followed our lead, surely now it’s about time England bit the bullet and did the same.

New look for Careers Website

I just wanted to highlight the new Wales Deanery website, which is now taking shape, as part of the Cardiff University Uniweb upgrade. There has been a great deal of change in the shape and scope of medical career pathways over the past few years and the need for up-to-date information has grown.

Everyone from medical students, though to the later stages of training, needs information and signposts to relevant, career development resources. And consultants who support trainees as part of their educational supervisor role need to keep on top of best practice techniques to help trainees reflect on their career plans, options and strategies to deal with changes, to plan accordingly.

With this in mind, all previous content was abandoned and the Careers website section now has two parts containing:
- information and resources for doctors
- information and resources for those giving front line career support

Resources for doctors are organised to guide users through four key stages of career planning:
1. Self assessment (Taking a history)
2. Career Exploration (Examination)
3. Decision making (Diagnosis)
4. Plan implementation (Treatment plan)
Why not take a look for yourself!

Could the WAG be following it’s Celtic cousin’s lead in tackling binge drinking?

I think the front page of the Western Mail certainly makes for encouraging reading re. tackling the cheap prices of drink in Wales. In response to the Scottish Government deciding to draw up measures to stop sales of cut-price alcohol, it seems the Welsh Assembly Government wants to do something similar. Of course, the WAG can’t implement any licensing changes without approval from Westminster. But pressure will apparently now be put on the UK Government to make sure change does happen.

This can’t come a moment too soon either, with strong action needed NOW to tackle alcohol misuse in Wales. Doctors see first hand how heavy drinking destroys lives. The health consequences of binge drinking are serious and severe. It’s related to more than 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems.

The BMA has for some time now wanted to see licensing laws altered to take into account the points below;

• Higher taxes on alcoholic drinks and this increase should be proportionate to the amount of alcohol in the product.
• An end to irresponsible promotional activities like happy hours and two-for-one offers.
• Standard labels should be displayed on all alcoholic products that clearly state alcohol units, recommended guidelines for consumption and a warning message advising that exceeding these guidelines may cause the individual and others harm.
• The legal limit for the level of alcohol permitted while driving should be reduced from 80mg/100ml to 50mg/100ml throughout the UK.

One thing’s for sure, if radical action isn’t taken soon on this issue, then the many problems that go hand-in-hand with excessive drinking will get worse and the annual £70-85 million cost to the Welsh NHS of drink-related incidents and diseases will only increase.