Artificial human ear grown in lab

31 July 2013 Last updated at 05:48 ET By Helen Briggs BBC News

US scientists say they have moved a step closer to being able to grow a complete human ear from a patient's cells.

In a new development in tissue engineering, they have grown a human-like ear from animal tissue.

The ear has the flexibility of a real ear, say researchers at Massachusetts General Hospital in Boston.

The technique may one day be used to help people with missing or deformed outer ears, they believe.

Tissue engineering is a growing field in medical science, where substitute organs are made in the laboratory in the hope of using them to replace damaged ones.

Continue reading the main story

This research is a significant step forward in preparing the tissue-engineered ear for human clinical trials"

End Quote Dr Thomas Cervantes Massachusetts General Hospital

The US research team is working on artificial living ears to help people born with malformed ears or who have lost them in accidents or trauma.

Previously the researchers had grown an artificial ear, the size of a baby's, on a mouse.

In the latest development, published in the Journal of the Royal Society Interface, they took living tissues from cows and sheep and grew them on a flexible wire frame that has the 3D shape of a real human ear.

This was then implanted into a rat whose immune system they had suppressed enabling the ear to grow.

"We've demonstrated the first full-sized adult human ear on the rat model," Dr Thomas Cervantes, who led the study, told BBC News.

It was significant for several reasons, he said.

"One - we were able to keep the shape of the ear, after 12 weeks of growth in the rat. And then secondly we were also able to keep the natural flexibility of the cartilage."

Titanium scaffold

The cells were grown on a titanium wire scaffold that is modelled on the dimensions of a real human ear, taken from CT scans.

The new work shows that in theory it is possible to grow up enough cells - at least in animals - to make a full-size human ear.

"In a clinical model, what we would do is harvest a small sample of cartilage, that the patient has, and then expand that so we could go ahead and do the same process," said Dr Cervantes.

"This research is a significant step forward in preparing the tissue-engineered ear for human clinical trials."

He said he expected that the process could move into human clinical trials in about five years.

Other research into bioengineered organs is progressing fast.

About a dozen patients have received transplants of artificial wind pipes coated with stem cells taken from either the patient or a donor.

Meanwhile, a kidney grown in the laboratory has been transplanted into a rat, where it started to produce urine.

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Right-to-die campaigners lose battle

31 July 2013 Last updated at 09:32 ET

The family of late locked-in syndrome sufferer Tony Nicklinson and paralysed road accident victim Paul Lamb have lost their right-to-die challenges.

The Court of Appeal upheld a ruling that Mr Nicklinson had not had the right to ask a doctor to end his life. His widow is planning a further appeal.

Mr Lamb who won a battle to join the Nicklinson case also plans to appeal.

But a third paralysed man won his case seeking clearer prosecution guidance for health workers who help others die.

The man, known only as Martin, wants it to be lawful for a doctor or nurse to help him travel abroad to die with the help of a suicide organisation in Switzerland. His wife and other family want no involvement in his suicide.

Continue reading the main story

• The late Tony Nicklinson was paralysed from the neck down after suffering a stroke while on a business trip to Athens in 2005. After losing his High Court battle, he refused food and died, aged 58, a week later. His widow is continuing his fight.
• Paul Lamb, 58, was paralysed from the neck down after a car accident in 1990. He says he endures pain every single day and does not want to keep living - but he has no way out.
• The anonymous man - or "Martin" - suffered a massive stroke in August 2008, leaving him unable to speak and virtually unable to move. The 48-year-old, who cannot be named for legal reasons, says his life is undignified, distressing and intolerable.

The director of public prosecutions, who would be required to clarify his guidance, is seeking to appeal to the Supreme Court against the decision in Martin's case.

Speaking by means of special computer software, Martin said he was "delighted" by the judgement.

"It takes me one step closer to being able to decide how and when I end my life. I am only unable to take my own life because of my physical disabilities.

"Almost every aspect of my daily life is outside of my control. I want, at least, to be able to control my death and this judgement goes some way to allow me to do this."

'Conscience of the nation'

In the Nicklinson and Lamb case, the decision centred on whether the High Court was right in originally ruling that Parliament, not judges should decide whether the law on assisted dying should change.

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Jane Nicklinson, Tony's widow: "It is such a grey area that needs to be clarified"

The three Court of Appeal judges unanimously dismissed Mrs Nicklinson and Paul Lamb's challenge.

In the judgement, the Lord Chief Justice Lord Judge said Parliament represented "the conscience of the nation" when it came to addressing life and death issues, such as abortions and the death penalty.

"Judges, however eminent, do not: our responsibility is to discover the relevant legal principles, and apply the law as we find it."

Mr Nicklinson was 58 when he died naturally at his home in Wiltshire last year. His widow Jane, who has continued his fight, told the BBC she was "very, very disappointed" by the ruling, but "not totally surprised".

She added: "We will carry on with the case for as long as we can so that others who find themselves in a position similar to Tony don't have to suffer as he did. Nobody deserves such cruelty.

"Although we lost, the legal team are quite pleased with the outcome - the appeal judges actually upheld a couple of points which the High Court rejected, which is a step forward."

'Too scared'

Paul Lamb wanted the law changed so any doctor who helped him die would have a defence against the charge of murder.

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Lawyer Richard Stein: "This is a crucial victory for Martin and other people in this tragic position"

The 57-year-old from Leeds has been almost completely paralysed from the neck down since a car accident 23 years ago and says he is in constant pain.

"I was hoping for a humane and dignified end - this judgement does not give me that," he said.

"I will carry on the legal fight - this is not just about me but about many, many other people who are being denied the right to die a humane and dignified death just because the law is too scared to grapple with these issues."

Saimo Chahal, the solicitor acting for Mrs Nicklinson and Mr Lamb, said there was "no prospect of Parliament adjudicating on the issue any time soon" so Paul's only option was to try to persuade the courts that his concerns were "real and legitimate".

But Dr Andrew Fergusson, of the Care Not Killing campaign group, welcomed the Nicklinson and Lamb ruling, saying: "All three judges were very clear on legal, and I think ethical, grounds as well, that the law, if it's to be changed, must be changed by parliament alone. The courts cannot do it."

The British Humanist Association, which has supported Mr Lamb's case, described the matter as the "most important bioethical issue of our time".

It said it should not fall to people who have "already suffered enough" to fight legal case after legal case. Instead, Parliament and government should be putting the work in on changing the law.

Sarah Wootton, of the Dignity in Dying campaign, urged for some parliamentary debate and for MPs to look at the private members' bill tabled by Lord Falconer for the legalisation of assisted suicide for the terminally ill in England and Wales.

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Stafford trust 'should be dissolved'

31 July 2013 Last updated at 10:22 ET

The trust that ran the scandal-hit Stafford Hospital should be dissolved, administrators have recommended.

The Mid Staffordshire NHS Trust went into administration on 16 April after a report concluded it was not "clinically or financially sustainable".

Critical care, maternity and paediatric services should also be cut, the proposals unveiled by Trust Special Administrators (TSA) say.

The trust's two hospitals will come under two other trusts.

Stafford Hospital will be part of the University Hospital of North Staffordshire in Stoke-on-Trent while Cannock Hospital will become part of the Royal Wolverhampton Trust.

The proposals include:

• Stafford Hospital losing its maternity unit but keeping its accident and emergency department, which will continue to open from 08:00 to 22:00, as it has since December 2011
• Downgrading Stafford's critical care unit and losing some emergency surgery
• No longer admitting seriously ill children to Stafford. They will instead go to Stoke-on-Trent
• Both Cannock and Stafford hospitals will gain some minor operations and more patients will be sent to both to recover from complicated surgery
• Introducing a "Frail Elderly Assessment service", which would mean different sources providing information on older people's needs when they are referred to hospital

The proposals will now go to a public consultation, which will end on 1 October.

Continue reading the main story

It was not long ago that people in this town thought they were going to lose their hospital"

End Quote Dr Hugo Mascie-Taylor Trust Special Administrator

They will then go to health regulator Monitor before going to the Health Secretary to make the final decision by the end of the year.

If approved, the proposals will be implemented by 2018.

The Mid Staffordshire NHS Trust provided healthcare for people in Stafford, Cannock, Rugeley and the surrounding areas, covering a total population of about 276,500 people.

'Become unsafe'

In April up to 50,000 people took part in a march from Stafford's town centre to the hospital, protesting at plans to downgrade Stafford's services.

A similar number of people also signed a petition which was sent to ministers calling for the hospital not to lose any of its services.

Support Stafford Hospital campaigners have also tied hundreds of blue ribbons to lamp-posts, bollards and trees in the town to highlight their campaign.

The administrators said they did not believe other local hospitals would be able to cope with the extra pressure if Stafford's accident and emergency department was completely shut.

All existing services provided at Cannock Chase Hospital will continue with the aim of extending them where possible, the TSA said.

Administrator Alan Bloom said: "We are doing this because services will become unsafe if no changes are made."

"We have looked to provide high quality safe services, to provide them as near to patients' homes as possible without incurring the significant financial problems that have been part of the problem to date.

"We are determined not to shift the clinical or financial problems from one place to another."

'Paying the price'

Fellow administrator Dr Hugo Mascie-Taylor said: "My message [to the people of Stafford] would be to look at the whole package.

"It was not long ago that people in this town thought they were going to lose their hospital. We have brought together a package of changes that financially are far more robust."

The administrators' report said the trust "cost far too much to run compared to the income it receives".

It said an overspend of £20m was predicted for 2013-14 and if "capital costs, for example, equipment is included, the funding needed will rise to £36m".

Rowan Draper, from the Support Stafford Hospital campaign, said there had been some "obvious proposals" such as dissolving the trust, but it was "very disappointing" the maternity and paediatric units would be going.

He said: "After the Francis Inquiry and other reports I have read, at no stage were they to do with the issues.

"But now expectant mothers and babies are paying the price for bad management."

Campaigners had also been fighting to stop Cannock Hospital from closing after the health trust went into administration.

Cannock MP Aidan Burley said it was "good news" the hospital in his constituency had been saved.

The Conservative MP added: "It represents a victory for all of us who campaigned to keep it open and for it to be properly managed and more fully utilised."

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NHS spends £17m on staff payouts

30 July 2013 Last updated at 05:57 ET

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Welsh Liberal Democrats leader Kirsty Williams called on the Welsh government to review the use of confidentiality clauses in the NHS

Over £17m has been spent by the Welsh NHS in four years on staff payouts which include confidentiality clauses.

More than 600 so-called compromise agreements have been signed since 2009, figures obtained by BBC Wales show.

Ten years ago NHS Wales said the agreements - which can ban ex-employees from talking about their jobs - should only be used rarely.

The agreements can be used when the relationship between an employer and employee has broken down.

But they can also be used when there is a restructure, during redundancies or when an employee has brought a grievance, such as discrimination.

The Welsh government said there is "clear guidance" on their use but it has been urged to review the issue.

Continue reading the main story

"Start Quote

We should not be spending Welsh taxpayers' money on these agreements when we know there is such pressure on NHS resources"

End Quote Kirsty Williams Leader, Welsh Liberal Democrats

Even though members of staff are prevented from talking about the details of their previous employment, they can raise concerns about patient safety.

The figures obtained by BBC shows since 2009 there have been 612 compromise agreements signed by Welsh health boards costing almost £17.5m.

Over half the agreements - 313 - have been made by Betsi Cadwaladr health board in north Wales at a cost of over £9m, while none have been signed in Hywel Dda health board, which serves mid and west Wales.

The vast majority of Betsi Cadwaladr's agreements were signed under what is called a "voluntary early release scheme" (VERs), which means staff voluntarily choose to leave.

Employees leaving the NHS under this scheme are required to waive their rights to pursue claims in the courts.

'New guidance'

In England, health service bodies must first seek the approval of the Treasury and the health department in Westminster to make a compromise agreement.

However, in Wales the responsibility for managing the agreements lies directly with each health board.

In 2003, the then-director of the NHS in Wales, Ann Lloyd, said that on the "rare occasion" organisations might need to consider using a confidentiality clause, they should be regarded as "novel and contentious and consult with the NHS Wales department".

Welsh Liberal Democrats are calling on the Welsh government to look into the guidance surrounding the agreements.

Continue reading the main story

"Start Quote

Every time you reorganise the NHS there will always always be a financial envelope that has to be met"

End Quote Tina Donnelly Director, Royal College of Nursing in Wales

"They need to review whether the directives of the previous NHS director are being followed," said leader Kirsty Williams.

"They need to issue new guidance to limit the number of these agreements and to ensure also that local health boards are reporting correctly the number of these agreements they're working on.

"We should not be spending Welsh taxpayers' money on these agreements when we know there is such pressure on NHS resources."

Tina Donnelly, director of the Royal College of Nursing in Wales, said she believed the spending on compromise agreements was the result of previous government policies to reorganise the health service in Wales and the costs incurred when shedding staff.

Ms Donnelly added: "Constant reorganisation, every two to three years, does have a price.

"We would have concerns if people were having to sign a compromise agreement where you were not able to speak out, and I'm not aware that happens in Wales.

'Dangerous situation'

"But I do think, when you look at the number, questions should be asked as to the frequency with which those are issued as opposed to keeping people in employment and putting them into other employment in the local health board."

Jonathan Morgan, an independent health consultant and a former AM, said the clauses should only need to be used rarely in the NHS.

He said: "If I was still chairing the public accounts committee, as I did in the last assembly term, I'd be asking the auditor general to review why such a large sum of money has been spent, what the circumstances are, what lessons can be learnt and what changes could be made to ensure that these agreements are used as a last resort."

The Welsh NHS Confederation said it understands that the vast majority of agreements within the given figures relate to staff who have requested VERs.

"We are concerned that the current interpretations of these figures is misleading...," a spokesperson said.

"VERs are cost effective and cheaper than alternatives. Funding to support them is provided by Welsh government as part of the Invest to Save initiatives.

Continue reading the main story

"Start Quote

The purpose of such a compromise agreement is to safeguard remaining staff and avoid misuse of public money"

End Quote The Welsh NHS Confederation

"Within such an agreement there is a clause that prevents staff from returning to work in NHS Wales for a stipulated period of time or claiming benefits that could have been accrued had they remained in work.

"The purpose of such a compromise agreement is to safeguard remaining staff and avoid misuse of public money."

The Welsh government said most agreements since 2010 have been part of the voluntary early release scheme, which was developed to support the 2009 NHS Reform Programme in Wales.

"The scheme has been designed as part of the service modernisation programme to assist staff in making a personal decision regarding their future employment," a spokesperson said.

"Where staff volunteer to leave their NHS Wales employment and their post will not be replaced they receive an appropriate compensatory severance payment."

The spokesperson added: "While health boards undergo change, we would expect the number of VERS agreements to increase, and this is being reflected in these figures."

Betsi Cadwaladr's chief executive and chairman stood down last month following a damning report by government watchdogs.

The board is forecasting a debt of £3.9m by the end of this financial year.

BBC Wales research has found that since 2010 the health board has spent £9,073,165 on compromise agreements.

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Time pressures mean 'rationed care'

30 July 2013 Last updated at 04:25 ET

Nurses in England say they are having to "ration" care because of time pressures, a study suggests.

The paper in BMJ Quality & Safety found areas that suffer include monitoring patients adequately.

The fewer nurses there are, the higher the risk care will be compromised, according to the study which involved almost 3,000 nurses.

The Department of Health said it was down to each hospital to decide staffing levels.

The researchers from the Florence Nightingale School of Nursing and Midwifery in London surveyed nurses from 400 general medical or surgical wards in 46 hospitals across England between January and September 2010.

They were asked about "missed care" - care that nurses deemed necessary, but which they were unable to do or complete because of insufficient time.

The 13 areas covered included adequate patient monitoring through to adequate documentation of care, and pain management.

'Talking and comforting'

The researchers wanted to find out if there was any association between nurse staffing levels and the number of these episodes, and whether these were linked to overall perceptions of the quality of nursing care and patient safety in a ward.

They found 86% of the 2,917 respondents said that at least one of 13 care activities on their last shift had been needed, but not done, because of lack of time.

On average, nurses said they had been unable to do or complete four activities.

Continue reading the main story

These are depressing findings and unfortunately not surprising"

End Quote Dr Peter Carter, Royal College of Nursing

The area that suffered most was talking and comforting patients, cited by 66% of the nurses.

Educating patients and developing or updating care plans were identified as not being adequately performed by around half of those questioned.

And pain management was reported as not being done by 7%.

The more patients needed assistance with routine daily tasks, or particularly frequent monitoring, the more likely staff were to say there were "missed care activities".

Staffing levels varied considerably, but the average was 7.8 patients per nurse during day shifts and 10.9 at night.

'Something has to give'

Jane Ball, who led the research, said: "The study not only reasserts the connection between staffing levels and patient outcomes, but provides an indication of the scale of the staffing problems we face.

"The majority of general medical/surgical wards have staffing levels that are insufficient to meet patient needs on every shift."

Ms Ball said publication of the survey had taken three years because "that's the nature of academic work".

Asked if the situation could have improved since 2010, she said evidence suggested "nothing is better" and "if anything, we have had more cuts to staff posts".

Dr Peter Carter, general secretary of the Royal College of Nursing, said: "These are depressing findings and unfortunately not surprising.

"When nurses are overloaded with tasks, and have extremely limited time to complete them, something has to give."

A spokeswoman for NHS England said it was committed to ensuring that "all patients receive compassionate and competent nursing care".

"We welcome this report and expect providers to use the evidence available to ensure they have sufficient staff on wards with the right skill-mix to provide high quality services to patients."

She said the new chief inspector of hospitals would work closely with the Care Quality Commission to ensure units met standards of care.

A Department of Health spokesperson said: "Hospitals themselves must decide how many and which staff they employ.

"But we have been absolutely clear that these decisions must be based on providing the best patient care."

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36 of 4,500 wards fail patient test

30 July 2013 Last updated at 09:54 ET By Caroline Parkinson and Helen Briggs BBC News

Patients on 36 of 4,500 hospital wards in England would not recommend them to relatives, a new survey suggests.

The latest results of the new "friends and family" test saw one English A&E department out of 144 get a "negative score" - Chase Farm Hospital in London.

Critics say the survey is too blunt an instrument for feedback as response rates at some hospitals are low.

NHS England said the findings contained "home truths" but it was "early data" and should be treated carefully.

The survey, which started in April, looked at patients who stayed in hospital overnight or attended A&E.

The questionnaire, backed by the prime minister, asked the question: "How likely are you to recommend our ward/A&E department to your friends and family if they needed similar care or treatment?"

Continue reading the main story

Analysis

Jane Dreaper Health correspondent, BBC News

---

Large-scale surveys of patient experiences aren't new in the NHS - but the "friends and family" test is different because it's an attempt to get very quick feedback using a single standardised question.

The results have now been added to other data about your local hospitals on the NHS Choices website.

Finding out that hospitals near you are all in the "normal" range of results won't give you much extra insight into their services.

Critics say the question is too narrow to give meaningful results.

But NHS England hope that as the dataset grows, and more patients get used to responding, the results will give a more in-depth picture of healthcare.

About 400,000 people overall responded to the friends and family test data survey. Each hospital was given a score based on patient satisfaction levels, ranging from -100 to + 100.

Out of 4,500 wards in England, 36 received an overall negative figure in June, although response rates in some hospitals were very low.

In A&E, one hospital out of 144 received a negative score in the same month (Chase Farm in north London).

The test is seen as central to the government's response to the Mid Staffordshire inquiry.

Tim Kelsey, NHS England's director of patients and information, said direct patient and citizen feedback was vital to improving services the NHS provides.

"From this first publication, we can see a significant and real variation in the quality of customer services across the NHS," he said.

"There are home truths here and everyone will expect those trusts who have large numbers of their patients choosing not to recommend their services to respond as quickly as possible."

However, he said it was important that this "early data" was treated carefully.

He added: "Low response rates can have a dramatically disproportionate impact on scores. As more and more patients respond, the data will become more and more robust."

Method 'simplistic'

Peter Lynn, professor of survey methodology at the University of Essex, said he was concerned that differences in scores between trusts or between wards may, in some cases, be misleading.

Continue reading the main story

"Start Quote

Collecting feedback is really important, but I think the question patients are asked doesn't make sense"

End Quote Jocelyn Cornwell, Point of Care Foundation

"This can arise because the rather simplistic methodology used to collect the data makes no allowance for differences between trusts or wards in types of patients, types of treatments, or the proportions or types of patients who provide an answer," he said.

"Additionally, variation was allowed between trusts in the way the test was administered. Although the objective is only to shine a light on poorer-performing trusts, the concern is that the light may not be shining in the right places. The methodology of this test really should be improved."

Jocelyn Cornwell, director of the Point of Care Foundation, an independent charity working with health and social care organisations, said: "Collecting feedback is really important, but I think the question patients are asked doesn't make sense.

"Some hospitals were using much better methods of collecting feedback. But they've had to abandon what they were doing and replace it with this rather blunt instrument."

The friends and family test began nationally in April, after a year of pilots in the Midlands and east of England.

There are plans to further expand the test to maternity services in October, and to GP practices, community services and mental health services by the end of 2014, then to all parts of the NHS by the end of March 2015.

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'Dangerous' hospital inquiry call

26 July 2013 Last updated at 14:35 ET

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Surgeons say thousands of operations were cancelled at the start of the year

An MP has called for an inquiry after surgeons said patients had died waiting for heart surgery at the University Hospital of Wales (UHW) in Cardiff.

A Royal College of Surgeons (RCS) report said the situation was "dangerous" and that children were also suffering due to operation delays.

Cynon Valley MP Ann Clwyd claimed it was the Welsh equivalent of the Stafford Hospital scandal.

Hospital chiefs refuted the comparison and said problems were being tackled.

Adam Cairns, chief executive of Cardiff and Vale University Health Board (CVUHB), told BBC Wales Today that 12 patients had died over a 15 month period while on the cardiac waiting list.

He said he could not be certain whether any one of those deaths was avoidable but shortening the times people waiting reduced the risk.

'Urgent attention'

The report by the RCS on UHW - the biggest hospital in Wales - followed a visit of its surgical departments by the college's Professional Affairs Board for Wales (PAB) in April.

The report said there was "universal consensus" amongst the clinicians that services at the hospital were "dangerous" and of "poor quality".

"Urgent attention" by Cardiff and Vale University Health Board (CVUHB) was needed to address the issues, it said.

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Ann Clwyd MP says the report is a 'wake up call'

An action plan has been agreed with the health board and will be reviewed in the autumn.

Ms Clwyd, who is conducting a review into complaints by hospital patients in England, told BBC Radio Wales that a public inquiry into the hospital should be chaired by someone from outside Wales.

She pointed to UHW having the highest mortality rate of any hospital in Wales, adding that UHW accounted for the "vast majority" of complaints she had received from Wales.

"I think it's very serious - I think it's the equivalent of Wales' Mid Staffs," Ms Clwyd said.

"It was mortality rates in Mid Staffs that first raised the alarm [there] and because of that there was an inquiry."

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Colin Ferguson of the RCS says surgeons can't do their work in a 'timely' fashion

The Francis inquiry into failings at Mid Staffordshire NHS Foundation Trust between 2005 and 2008 showed there were between 400 and 1,200 more deaths at Stafford Hospital than would have been expected.

It prompted a separate review of 14 NHS hospitals in England with high mortality rates.

Ms Clwyd added: "This is a shocking set of events and the report from the Royal College of Surgeons, who as you know are fairly conservative in their approach to things, has made these severe criticisms of the University Hospital of Wales.

"And I think both the chairman and the chief executive should consider their own positions.

"They're responsible for running that hospital, they've got questions to answer. And in my view, they have not answered them, and the only way this will happen is through a proper inquiry like the Francis inquiry into Mid Staffs."

'Significant risk'

The RCS report said concerns included:

• Cardiac patients "regularly dying on waiting lists" with "other patients' hearts ... deteriorating while waiting" making subsequent treatment more difficult
• Children regularly being fitted with hearing aids because of a lack of surgical time and resources to insert grommets to treat ear infections
• Patients "suffering complications" because of delays in treating kidney stones
• A&E and intensive care units being "frequently grid-locked" with patients "often stacked up in corridors and ambulances"

The single most common complaint from the hospital's surgeons was the inability to admit patients for scheduled, or elective, surgery.

They reported that more than 2,000 operations were either not scheduled due to a lack of beds or cancelled in the first three months of this year.

Continue reading the main story

It is not a position that we can take any pride in - we need to do better"

End Quote Adam Cairns Chief executive, CVUHB

"I think our colleagues were telling us that they believed there was significant risk as a consequence of their inability to get patients in to have their operations in a timely way," said Colin Ferguson, director of the PAB.

"The reasons for that are obviously complex and relate to the whole system of care within the hospital. They relate to emergency medicine, they relate to the admissions coming through the A&E department.

"They were very frustrated. As a group they were expressing to us very clearly that they thought the current situation was unsustainable, and something had to be done about it."

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Adam Cairns, chief executive of Cardiff and Vale University Health Board, said 12 cardiac patients had died in 15 months

The report said doctors also believed the health board was reducing its scheduled surgery in order to reduce costs "to meet end of year financial targets".

An increase rise in waiting lists, according to the report, meant that patients "were clearly coming to harm".

Mr Cairns said the pressures over the last winter were unprecedented in his 30 years experience but he accepted the situation earlier in the year was cause for concern.

"I'm on record already having apologised to our patients," he said.

"It is not a position that we can take any pride in - we need to do better.

"It is fair to say that this organisation was struggling, like many others, to cope with the pressures," he added.

Child priorities

"The circumstances that we found ourselves in, I think, are unacceptable, and we've got to make sure that in the future that we have a much better response."

Mr Cairns said steps had been taken to protect surgical beds for children's services, and to find more resources for cardiac treatment.

"Some of the things that we are already doing are showing some improvements," insisted the chief executive.

"The bottom line here is we can, and we will, do better."

Later, Mr Cairns issued a statement saying: "We are extremely disappointed that Miss Clwyd has chosen to liken the RCS report to what happened at Mid Staffordshire Hospital and would strongly refute her comparison."

He said the health board had "an open and collaborative culture" and was taking steps to rectify problems quickly.

The patients' watchdog Cardiff and Vale Community Health Council also dismissed the Mid Staffordshire comparison, saying it "has major concerns on how this analogy will impact on patients' confidence, who are either undergoing or awaiting treatment in Cardiff".

The RCS has also taken the step of passing its report to Mark Drakeford, health minister in the Labour-run Welsh government, which led to a meeting in June.

"The health minister was very concerned to read the Royal College of Surgeons report and the risks to quality and safety it highlighted," said a Welsh government spokesperson.

It led to an action plan being drawn up by the health board, NHS Wales and Welsh Health Specialised Services.

The RCS said it will now make a return visit to the hospital and health board in September to review the situation.

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Mentally ill 'hit hard by recession'

26 July 2013 Last updated at 19:32 ET

The economic recession across Europe has had a profound impact on people with mental health problems, research from King's College London suggests.

Between 2006 and 2010, the rate of unemployment for those with mental health problems rose twice as much as for other people - from 12.7% to 18.2%.

Men and those with low levels of education were particularly affected, the study said.

The authors warn that social exclusion could increase among the mentally ill.

Scientists collected data from 20,000 people across 27 EU countries using the Eurobarometer survey, which looked at mental health, attitudes to those with mental health problems and current employment rate.

Continue reading the main story

"Start Quote

It's harder for people to get a job if there's already a gap on their CV."

End Quote Dr Sara Evans-Lacko Institute of Psychiatry

For those without mental health problems, the unemployment rate increased from 7.1% in 2006 to 9.8% in 2010 - half the increase compared with the previous group.

In addition, the study identified that men with mental health problems were particularly vulnerable. The unemployment rate for this group increased from 13.7% in 2006 to 21.7% in 2010.

Stigma

The researchers, from the Institute of Psychiatry at King's College London, found that negative attitudes to people with mental health problems were a factor in the rise in unemployment.

The study said: "Living in a country where a higher proportion of individuals believe that individuals with mental illness are dangerous was associated with a higher likelihood of unemployment for people with mental health problems, but did not influence employment rates for those without mental health problems."

It is thought that unemployed people with mental health problems may also be less likely to seek help and and may need specific outreach support.

Dr Sara Evans-Lacko, lead study author and lecturer at the Institute of Psychiatry, said the study did not have unemployment rates for individual EU countries. She suggested the trend was a general one across Europe which was not specific to any one culture.

"During a recession people who already have mental health problems find their economic and social position gets worse.

"We don't exactly know why, but it's harder for people to get a job if there's already a gap on their CV and if employers need to cut staff then these people might be more vulnerable."

The danger is that economic hardship can intensify the social exclusion of vulnerable people, such as those with mental health problems, the study said.

'Legal duty'

Prof Graham Thornicroft, also from the research team at the Institute of Psychiatry, said there were steps which could be taken to prevent this happening.

Continue reading the main story

"Start Quote

Mental well-being depends on many factors, including employment status, working conditions and financial security, all of which can be affected during a recession."

End Quote Beth Murphy Mind

"Governments need to be aware of these risks, and employers need to be aware of their legal duty to comply with the Equality Act to support people with mental health problems coming into, and staying in, employment," he said.

Beth Murphy, head of information at mental health charity Mind, said the findings were worrying.

"Mental well-being depends on many factors, including employment status, working conditions and financial security, all of which can be affected during a recession.

"Since 2008, the Mind Infoline has received an increasing number of enquiries from people concerned about the impact of money and unemployment on their mental health, which could well be attributed to the economic downturn.

"Specifically, redundancy is known to trigger depression and suicidal thoughts, as is the case with debt."

She added: "Losing your job is a sudden change and there can also be financial implications through loss of income, which in itself can cause anxiety. We'd urge anybody struggling with their mental health to seek support."

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Theresa May diagnosed with diabetes

28 July 2013 Last updated at 10:22 ET

Home Secretary Theresa May has revealed she has been diagnosed with Type 1 diabetes but insists it will not affect her political career.

The condition means her body does not produce insulin and she must now inject herself with the hormone at least twice a day for the rest of her life.

She told the Mail on Sunday that the diagnosis "was a real shock" and had taken a while to come to terms with.

But it was a case of "head down and getting on with it", Mrs May added.

'Blood test'

She said: "The diabetes doesn't affect how I do the job or what I do. It's just part of life.

Continue reading the main story

• People with Type 1 diabetes cannot produce insulin. No-one knows exactly what causes it, but it is not to do with being overweight and it is not currently preventable. It usually affects children or young adults, starting suddenly and getting worse quickly. Type 1 diabetes is treated by daily insulin doses, a healthy diet and regular physical activity.
• People with Type 2 diabetes do not produce enough insulin or the insulin they produce does not work properly (known as insulin resistance). They might get diabetes because of their family history, age and ethnic background. They are also more likely to get Type 2 diabetes if they are overweight. Type 2 diabetes is treated with a healthy diet and increased physical activity.

"'It started last November. I'd had a bad cold and cough for quite a few weeks. I went to my GP and she did a blood test which showed I'd got a very high sugar level - that's what revealed the diabetes.

"The symptoms are tiredness, drinking a lot of water, losing weight, but it's difficult to isolate things. I was drinking a lot of water. But I do anyway.

"There was weight loss but then I was already making an effort to be careful about diet and to get my gym sessions in.

"Tiredness - speak to any politician and they will tell you the hours they work. Tiredness can be part of the job. It is full on."

Initially doctors thought Mrs May had Type 2 diabetes but two months ago it was revealed to be Type 1 diabetes.

There had been media speculation that Mrs May losing two stones in weight over 18 months was linked to a potential Conservative Party leadership bid, but she said this had been partly down to the illness.

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Dr Brian Hope: ''As long as they manage it sensibly it's something that shouldn't interfere with anyone pursuing whatever career they wish to''

Asked if her diagnosis would prevent her from one day replacing David Cameron, she told the newspaper: "There is no leadership bid. We have a first-class prime minister and long may he continue."

She added: "It doesn't and will not affect my ability to do my work. I'm a little more careful about what I eat and there's obviously the injections, but this is something millions of people have. I'm OK with needles, fortunately.

"There's a great quote from Steve Redgrave who was diagnosed with diabetes before he won his last Olympic gold medal. He said diabetes must learn to live with me rather than me live with diabetes. That's the attitude."

Meanwhile, the Labour MP Keith Vaz, who was diagnosed with Type 2 diabetes in 2007, has said it is a "shock to be told" you have the condition.

Writing on Twitter, he said "Mine came 6 years ago. Theresa May right to reveal. 500k have it and don't know. Take the test."

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'Diabetes-cure' operation explained

26 July 2013 Last updated at 03:24 ET By James Gallagher Health and science reporter, BBC News

The reason some patients are cured of type-2 diabetes after a gastric bypass may have been explained by US researchers.

Their animal study showed bypassing the stomach made the intestines work harder, use more energy and keep blood sugar levels under control.

They hope their findings, published in the journal Science, will lead to less invasive treatments for the condition.

Diabetes UK said a healthy lifestyle was the best way to avoid the disease.

Type-2 diabetes, which is mostly the result of a bad diet and little exercise, is a growing problem globally.

It leaves people unable to control the amount of sugar in the blood and can culminate in blindness, limb loss and heart disease.

The condition can be managed with insulin injections.

Researchers at Boston Children's Hospital, in the US, were investigating how a type of weight loss surgery affected diabetes.

Continue reading the main story

Surprisingly, we found the sugar was being used by the intestines - it has to work harder as you've bypassed the stomach"

End Quote Dr Nicholas Stylopoulos Boston Children's Hospital

Dr Nicholas Stylopoulos told the BBC: "Gastric bypass is the most effective weight loss procedure, but it also cures diabetes.

"If we knew how this worked we could develop new treatments that don't require surgery."

Missing sugar?

Weight loss itself can reduce the symptoms of type-2 diabetes, however, the condition can be seemingly cured before any pounds have been shed.

The challenge for researchers was to figure out where the extra sugar, which should be ending up in the blood, was going.

They performed the operation to connect the entrance to the stomach with the small intestine - essentially bypassing the stomach - on rats.

The animals were then scanned and the route of their meals was traced as they passed through the body.

"Surprisingly, we found the sugar was being used by the intestines - it has to work harder as you've bypassed the stomach," Dr Stylopoulos said.

The intestines also had to go through some internal rebuilding as part of the transition, which also used energy.

The study showed the boost in the intestines' energy needs could account for 64% of the change in blood sugar levels. The remaining effect is thought to be down to weight loss and hormonal changes.

Their plan is to come up with ways to activate the intestines to produce the same effect, but without the need for an operation.

Dr Stylopoulos said: "Most patients would prefer something equally effective, but less invasive."

Dr Matthew Hobbs, the head of research at Diabetes UK, said: "This work gives more details about what happens when gastric bypass surgery is used to treat type-2 diabetes.

"The researchers hope that the findings may give us new treatments in the future that would mimic those effects without the surgical procedure.

"While we would welcome any advances in this area, it is clear any new treatments are many years away.

"What we know now is that avoiding type-2 diabetes by maintaining a healthy balanced diet and being physically active is really important."

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'Dangerous' hospital inquiry call

26 July 2013 Last updated at 14:35 ET

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Surgeons say thousands of operations were cancelled at the start of the year

An MP has called for an inquiry after surgeons said patients had died waiting for heart surgery at the University Hospital of Wales (UHW) in Cardiff.

A Royal College of Surgeons (RCS) report said the situation was "dangerous" and that children were also suffering due to operation delays.

Cynon Valley MP Ann Clwyd claimed it was the Welsh equivalent of the Stafford Hospital scandal.

Hospital chiefs refuted the comparison and said problems were being tackled.

Adam Cairns, chief executive of Cardiff and Vale University Health Board (CVUHB), told BBC Wales Today that 12 patients had died over a 15 month period while on the cardiac waiting list.

He said he could not be certain whether any one of those deaths was avoidable but shortening the times people waiting reduced the risk.

'Urgent attention'

The report by the RCS on UHW - the biggest hospital in Wales - followed a visit of its surgical departments by the college's Professional Affairs Board for Wales (PAB) in April.

The report said there was "universal consensus" amongst the clinicians that services at the hospital were "dangerous" and of "poor quality".

"Urgent attention" by Cardiff and Vale University Health Board (CVUHB) was needed to address the issues, it said.

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Ann Clwyd MP says the report is a 'wake up call'

An action plan has been agreed with the health board and will be reviewed in the autumn.

Ms Clwyd, who is conducting a review into complaints by hospital patients in England, told BBC Radio Wales that a public inquiry into the hospital should be chaired by someone from outside Wales.

She pointed to UHW having the highest mortality rate of any hospital in Wales, adding that UHW accounted for the "vast majority" of complaints she had received from Wales.

"I think it's very serious - I think it's the equivalent of Wales' Mid Staffs," Ms Clwyd said.

"It was mortality rates in Mid Staffs that first raised the alarm [there] and because of that there was an inquiry."

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Colin Ferguson of the RCS says surgeons can't do their work in a 'timely' fashion

The Francis inquiry into failings at Mid Staffordshire NHS Foundation Trust between 2005 and 2008 showed there were between 400 and 1,200 more deaths at Stafford Hospital than would have been expected.

It prompted a separate review of 14 NHS hospitals in England with high mortality rates.

Ms Clwyd added: "This is a shocking set of events and the report from the Royal College of Surgeons, who as you know are fairly conservative in their approach to things, has made these severe criticisms of the University Hospital of Wales.

"And I think both the chairman and the chief executive should consider their own positions.

"They're responsible for running that hospital, they've got questions to answer. And in my view, they have not answered them, and the only way this will happen is through a proper inquiry like the Francis inquiry into Mid Staffs."

'Significant risk'

The RCS report said concerns included:

• Cardiac patients "regularly dying on waiting lists" with "other patients' hearts ... deteriorating while waiting" making subsequent treatment more difficult
• Children regularly being fitted with hearing aids because of a lack of surgical time and resources to insert grommets to treat ear infections
• Patients "suffering complications" because of delays in treating kidney stones
• A&E and intensive care units being "frequently grid-locked" with patients "often stacked up in corridors and ambulances"

The single most common complaint from the hospital's surgeons was the inability to admit patients for scheduled, or elective, surgery.

They reported that more than 2,000 operations were either not scheduled due to a lack of beds or cancelled in the first three months of this year.

Continue reading the main story

It is not a position that we can take any pride in - we need to do better"

End Quote Adam Cairns Chief executive, CVUHB

"I think our colleagues were telling us that they believed there was significant risk as a consequence of their inability to get patients in to have their operations in a timely way," said Colin Ferguson, director of the PAB.

"The reasons for that are obviously complex and relate to the whole system of care within the hospital. They relate to emergency medicine, they relate to the admissions coming through the A&E department.

"They were very frustrated. As a group they were expressing to us very clearly that they thought the current situation was unsustainable, and something had to be done about it."

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Adam Cairns, chief executive of Cardiff and Vale University Health Board, said 12 cardiac patients had died in 15 months

The report said doctors also believed the health board was reducing its scheduled surgery in order to reduce costs "to meet end of year financial targets".

An increase rise in waiting lists, according to the report, meant that patients "were clearly coming to harm".

Mr Cairns said the pressures over the last winter were unprecedented in his 30 years experience but he accepted the situation earlier in the year was cause for concern.

"I'm on record already having apologised to our patients," he said.

"It is not a position that we can take any pride in - we need to do better.

"It is fair to say that this organisation was struggling, like many others, to cope with the pressures," he added.

Child priorities

"The circumstances that we found ourselves in, I think, are unacceptable, and we've got to make sure that in the future that we have a much better response."

Mr Cairns said steps had been taken to protect surgical beds for children's services, and to find more resources for cardiac treatment.

"Some of the things that we are already doing are showing some improvements," insisted the chief executive.

"The bottom line here is we can, and we will, do better."

Later, Mr Cairns issued a statement saying: "We are extremely disappointed that Miss Clwyd has chosen to liken the RCS report to what happened at Mid Staffordshire Hospital and would strongly refute her comparison."

He said the health board had "an open and collaborative culture" and was taking steps to rectify problems quickly.

The patients' watchdog Cardiff and Vale Community Health Council also dismissed the Mid Staffordshire comparison, saying it "has major concerns on how this analogy will impact on patients' confidence, who are either undergoing or awaiting treatment in Cardiff".

The RCS has also taken the step of passing its report to Mark Drakeford, health minister in the Labour-run Welsh government, which led to a meeting in June.

"The health minister was very concerned to read the Royal College of Surgeons report and the risks to quality and safety it highlighted," said a Welsh government spokesperson.

It led to an action plan being drawn up by the health board, NHS Wales and Welsh Health Specialised Services.

The RCS said it will now make a return visit to the hospital and health board in September to review the situation.

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Mentally ill 'hit hard by recession'

26 July 2013 Last updated at 19:32 ET

The economic recession across Europe has had a profound impact on people with mental health problems, research from King's College London suggests.

Between 2006 and 2010, the rate of unemployment for those with mental health problems rose twice as much as for other people - from 12.7% to 18.2%.

Men and those with low levels of education were particularly affected, the study said.

The authors warn that social exclusion could increase among the mentally ill.

Scientists collected data from 20,000 people across 27 EU countries using the Eurobarometer survey, which looked at mental health, attitudes to those with mental health problems and current employment rate.

Continue reading the main story

"Start Quote

It's harder for people to get a job if there's already a gap on their CV."

End Quote Dr Sara Evans-Locko Institute of Psychiatry

For those without mental health problems, the unemployment rate increased from 7.1% in 2006 to 9.8% in 2010 - half the increase compared with the previous group.

In addition, the study identified that men with mental health problems were particularly vulnerable. The unemployment rate for this group increased from 13.7% in 2006 to 21.7% in 2010.

Stigma

The researchers, from the Institute of Psychiatry at King's College London, found that negative attitudes to people with mental health problems were a factor in the rise in unemployment.

The study said: "Living in a country where a higher proportion of individuals believe that individuals with mental illness are dangerous was associated with a higher likelihood of unemployment for people with mental health problems, but did not influence employment rates for those without mental health problems."

It is thought that unemployed people with mental health problems may also be less likely to seek help and and may need specific outreach support.

Dr Sara Evans-Locko, lead study author and lecturer at the Institute of Psychiatry, said the study did not have unemployment rates for individual EU countries. She suggested the trend was a general one across Europe which was not specific to any one culture.

"During a recession people who already have mental health problems find their economic and social position gets worse.

"We don't exactly know why, but it's harder for people to get a job if there's already a gap on their CV and if employers need to cut staff then these people might be more vulnerable."

The danger is that economic hardship can intensify the social exclusion of vulnerable people, such as those with mental health problems, the study said.

'Legal duty'

Prof Graham Thornicroft, also from the research team at the Institute of Psychiatry, said there were steps which could be taken to prevent this happening.

Continue reading the main story

"Start Quote

Mental well-being depends on many factors, including employment status, working conditions and financial security, all of which can be affected during a recession."

End Quote Beth Murphy Mind

"Governments need to be aware of these risks, and employers need to be aware of their legal duty to comply with the Equality Act to support people with mental health problems coming into, and staying in, employment," he said.

Beth Murphy, head of information at mental health charity Mind, said the findings were worrying.

"Mental well-being depends on many factors, including employment status, working conditions and financial security, all of which can be affected during a recession.

"Since 2008, the Mind Infoline has received an increasing number of enquiries from people concerned about the impact of money and unemployment on their mental health, which could well be attributed to the economic downturn.

"Specifically, redundancy is known to trigger depression and suicidal thoughts, as is the case with debt."

She added: "Losing your job is a sudden change and there can also be financial implications through loss of income, which in itself can cause anxiety. We'd urge anybody struggling with their mental health to seek support."

21.24 | 0 komentar | Read More

New virus 'not following Sars' path'

26 July 2013 Last updated at 03:23 ET By James Gallagher Health and science reporter, BBC News

The new Mers virus, which has killed half of those infected, is "unlikely" to reach the same scale as Sars, ministers in Saudi Arabia say.

Most of the 90 Mers cases reported so far have been in Saudi Arabia.

Mers is from the same group of viruses as the common cold and Sars, which killed 774 people.

However, a detailed analysis of the Saudi cases, published in Lancet Infectious Diseases, did warn of "major gaps" in understanding of the virus.

The Middle East respiratory-syndrome coronavirus (Mers) emerged in 2012 and has infected 90 people worldwide, 45 of them have died.

The global concern is that cases could spread much further, echoing the Sars outbreak.

Continue reading the main story

So far there is little to indicate that Mers will follow a similar path to Sars"

End Quote Prof Ziad Memish Deputy Minister for Public Health

Cases have been centred on the Middle East - with patients in Jordan, Qatar, Saudi Arabia and the United Arab Emirates. Additional cases in France, Germany, Italy, Tunisia and the UK have all been linked to travel to the Middle East.

Researchers in Saudi Arabia have published details of the 47 cases reported in the country.

They suggest a pattern of mostly older men being infected. Most cases were also in people with other medical problems, more than two-thirds of the reported cases also had diabetes.

Low threat

The lead researcher and Deputy Minister for Public Health, Prof Ziad Memish, said: "Despite sharing some clinical similarities with Sars, there are also some important differences.

"In contrast to Sars, which was much more infectious especially in healthcare settings and affected the healthier and the younger age group, Mers appears to be more deadly, with 60% of patients with co-existing chronic illnesses dying, compared with the 1% toll of Sars.

"Although this high mortality rate with Mers is probably spurious due to the fact that we are only picking up severe cases and missing a significant number of milder or asymptomatic cases.

"So far there is little to indicate that Mers will follow a similar path to Sars."

A report earlier this month showed that the virus struggled to spread in people.

However, it and the latest Saudi investigation both highlighted the need to find where the virus was coming from.

Prof Memish's report said: "Reducing the rate of introduction of Mers coronavirus into human beings is unpredictable because the source of the virus is not yet known.

"We are searching vigorously for the source."

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'Diabetes-cure' operation explained

26 July 2013 Last updated at 03:24 ET By James Gallagher Health and science reporter, BBC News

The reason some patients are cured of type-2 diabetes after a gastric bypass may have been explained by US researchers.

Their animal study showed bypassing the stomach made the intestines work harder, use more energy and keep blood sugar levels under control.

They hope their findings, published in the journal Science, will lead to less invasive treatments for the condition.

Diabetes UK said a healthy lifestyle was the best way to avoid the disease.

Type-2 diabetes, which is mostly the result of a bad diet and little exercise, is a growing problem globally.

It leaves people unable to control the amount of sugar in the blood and can culminate in blindness, limb loss and heart disease.

The condition can be managed with insulin injections.

Researchers at Boston Children's Hospital, in the US, were investigating how a type of weight loss surgery affected diabetes.

Continue reading the main story

Surprisingly, we found the sugar was being used by the intestines - it has to work harder as you've bypassed the stomach"

End Quote Dr Nicholas Stylopoulos Boston Children's Hospital

Dr Nicholas Stylopoulos told the BBC: "Gastric bypass is the most effective weight loss procedure, but it also cures diabetes.

"If we knew how this worked we could develop new treatments that don't require surgery."

Missing sugar?

Weight loss itself can reduce the symptoms of type-2 diabetes, however, the condition can be seemingly cured before any pounds have been shed.

The challenge for researchers was to figure out where the extra sugar, which should be ending up in the blood, was going.

They performed the operation to connect the entrance to the stomach with the small intestine - essentially bypassing the stomach - on rats.

The animals were then scanned and the route of their meals was traced as they passed through the body.

"Surprisingly, we found the sugar was being used by the intestines - it has to work harder as you've bypassed the stomach," Dr Stylopoulos said.

The intestines also had to go through some internal rebuilding as part of the transition, which also used energy.

The study showed the boost in the intestines' energy needs could account for 64% of the change in blood sugar levels. The remaining effect is thought to be down to weight loss and hormonal changes.

Their plan is to come up with ways to activate the intestines to produce the same effect, but without the need for an operation.

Dr Stylopoulos said: "Most patients would prefer something equally effective, but less invasive."

Dr Matthew Hobbs, the head of research at Diabetes UK, said: "This work gives more details about what happens when gastric bypass surgery is used to treat type-2 diabetes.

"The researchers hope that the findings may give us new treatments in the future that would mimic those effects without the surgical procedure.

"While we would welcome any advances in this area, it is clear any new treatments are many years away.

"What we know now is that avoiding type-2 diabetes by maintaining a healthy balanced diet and being physically active is really important."

21.24 | 0 komentar | Read More

'Dangerous' hospital inquiry call

26 July 2013 Last updated at 06:47 ET

An MP has called for an inquiry after surgeons said patients had died waiting for heart surgery at the University Hospital of Wales (UHW) in Cardiff.

A Royal College of Surgeons (RCS) report said the situation was "dangerous" and that children were also suffering due to operation delays.

Cynon Valley MP Ann Clwyd claimed it was the Welsh equivalent of the Stafford Hospital scandal.

Hospital chiefs have said they are addressing the problems.

'Urgent attention'

The report by the RCS on UHW - the biggest hospital in Wales - followed a visit of its surgical departments by the college's Professional Affairs Board for Wales (PAB) in April.

The report said there was "universal consensus" amongst the clinicians that services at the hospital were "dangerous" and of "poor quality".

"Urgent attention" by Cardiff and Vale University Health Board (CVUHB) was needed to address the issues, it said.

Please turn on JavaScript. Media requires JavaScript to play.

An action plan has been agreed with the health board and will be reviewed in the autumn.

Ms Clwyd, who is conducting a review into complaints by hospital patients in England, told BBC Radio Wales that a public inquiry into the hospital should be chaired by someone from outside Wales.

She pointed to UHW having the highest mortality rate of any hospital in Wales, adding that UHW accounted for the "vast majority" of complaints she had received from Wales.

"I think it's very serious - I think it's the equivalent of Wales' Mid Staffs," Ms Clwyd said.

"It was mortality rates in Mid Staffs that first raised the alarm [there] and because of that there was an inquiry."

Please turn on JavaScript. Media requires JavaScript to play.

Colin Ferguson of the RCS says surgeons can't do their work in a 'timely' fashion

The Francis inquiry into failings at Mid Staffordshire NHS Foundation Trust between 2005 and 2008 showed there were between 400 and 1,200 more deaths at Stafford Hospital than would have been expected.

It prompted a separate review of 14 NHS hospitals in England with high mortality rates.

Ms Clwyd added: "This is a shocking set of events and the report from the Royal College of Surgeons, who as you know are fairly conservative in their approach to things, has made these severe criticisms of the University Hospital of Wales.

"And I think both the chairman and the chief executive should consider their own positions.

"They're responsible for running that hospital, they've got questions to answer. And in my view, they have not answered them, and the only way this will happen is through a proper inquiry like the Francis inquiry into Mid Staffs."

'Significant risk'

The RCS report said concerns included:

• Cardiac patients "regularly dying on waiting lists" with "other patients' hearts ... deteriorating while waiting" making subsequent treatment more difficult
• Children regularly being fitted with hearing aids because of a lack of surgical time and resources to insert grommets to treat ear infections
• Patients "suffering complications" because of delays in treating kidney stones
• A&E and intensive care units being "frequently grid-locked" with patients "often stacked up in corridors and ambulances"

The single most common complaint from the hospital's surgeons was the inability to admit patients for scheduled, or elective, surgery.

They reported that more than 2,000 operations were either not scheduled due to a lack of beds or cancelled in the first three months of this year.

Continue reading the main story

It is not a position that we can take any pride in - we need to do better"

End Quote Adam Cairns Chief executive, CVUHB

"I think our colleagues were telling us that they believed there was significant risk as a consequence of their inability to get patients in to have their operations in a timely way," said Colin Ferguson, director of Public Affairs for the RCS in Wales.

"The reasons for that are obviously complex and relate to the whole system of care within the hospital. They relate to emergency medicine, they relate to the admissions coming through the A&E department.

"They were very frustrated. As a group they were expressing to us very clearly that they thought the current situation was unsustainable, and something had to be done about it."

The report said doctors also believed the health board was reducing its scheduled surgery in order to reduce costs "to meet end of year financial targets".

An increase rise in waiting lists, according to the report, meant that patients "were clearly coming to harm".

Adam Cairns, chief executive of Cardiff and Vale University Health Board (CVUHB), said he accepted the situation earlier in the year was cause for concern.

"I'm on record already having apologised to our patients," he told BBC Wales.

"It is not a position that we can take any pride in - we need to do better.

"It is fair to say that this organisation was struggling, like many others, to cope with the pressures," he added.

Child priorities

"The circumstances that we found ourselves in, I think, are unacceptable, and we've got to make sure that in the future that we have a much better response."

Mr Cairns said steps had been taken to protect surgical beds for children's services, and to find more resources for cardiac treatment.

"Some of the things that we are already doing are showing some improvements," insisted the chief executive.

"The bottom line here is we can, and we will, do better."

However, the RCS has also taken the step of passing its report to the health minister Mark Drakeford, which led to a meeting in June.

"The health minister was very concerned to read the Royal College of Surgeons report and the risks to quality and safety it highlighted," said a Welsh government spokesperson.

It led to an action plan being drawn up by the health board, NHS Wales and Welsh Health Specialised Services.

The RCS said it will now make a return visit to the hospital and health board in September to review the situation.

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Cause of cat allergy uncovered

24 July 2013 Last updated at 19:48 ET By Helen Briggs BBC News

Scientists have discovered how allergic reactions to cats are triggered, raising hopes of preventative medicine.

A University of Cambridge team has identified how the body's immune system detects cat allergen, leading to symptoms such as coughing and sneezing.

New treatments to block this pathway raise hopes of developing medicines to protect sufferers, they say.

Allergy UK says the research is "a big step forward" in understanding how cat allergen causes allergic reactions.

Researchers led by Dr Clare Bryant of the University of Cambridge studied proteins found in particles of cat skin, known as cat dander, which is the most common cause of cat allergy.

They found that cat allergen activates a specific pathway in the body, once in the presence of a common bacterial toxin.

This triggers a large immune response in allergy sufferers, causing symptoms such as coughing, wheezing, sneezing and a runny nose.

Continue reading the main story

• Cats are among the most common culprits for pet allergies
• People with cat allergies are allergic to proteins in the cat's saliva, urine, and dander (dried flakes of skin)
• Symptoms of a cat allergy can develop in a few minutes or take hours to appear
• Some people with allergic asthma have severe flare-ups after coming in contact with a cat

Dr Bryant told BBC News: "We've discovered how the cat allergy proteins activate the host immune cells.

"By understanding the triggering mechanism, there are now drugs that have been designed that are in clinical trials for other conditions, such as sepsis, that could potentially then be used in a different way to treat cat allergy and to prevent cat allergy."

The charity Allergy UK said the research, published in Journal of Immunology, was a big step forward in understanding how cat allergen causes such severe allergic reactions.

"Cat allergen is particularly difficult to avoid as it is a 'sticky' molecule that is carried into every building on people's shoes and clothes," said director of clinical services Maureen Jenkins.

"It can also still be found in a home, on the walls and ceiling or fittings, even a few years after a cat has ceased to live there.

"Therefore, this new information identifying the specific receptor interaction in the immune system could pave the way for treatments for those with persistent disease triggered by cat allergen and, in the future, potentially dog and house dust mite allergen."

Allergic reactions happen when the immune system overreacts to a perceived danger.

Instead of responding to a harmful virus or bacteria, it misidentifies allergens, such as cat dander, and mounts an immune response.

The research was funded by the Wellcome Trust and the Medical Research Council.

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Psychopaths 'have empathy switch'

24 July 2013 Last updated at 20:59 ET By Melissa Hogenboom Science reporter, BBC News

Psychopaths do not lack empathy, rather they can switch it on at will, according to new research.

Placed in a brain scanner, psychopathic criminals watched videos of one person hurting another and were asked to empathise with the individual in pain.

Only when asked to imagine how the pain receiver felt did the area of the brain related to pain light up.

Scientists, reporting in Brain, say their research explains how psychopaths can be both callous and charming.

The team proposes that with the right training, it could be possible to help psychopaths activate their "empathy switch", which could bring them a step closer to rehabilitation.

Continue reading the main story

• Placed in an fMRI scanner, 18 criminals with psychopathy and 26 control subjects were asked to watch a series of clips without a particular instruction
• The clips showed one hand touching the other in a loving, a painful, a socially rejecting or a neutral way
• They were then asked to watch the same clips again but this time try and feel what the subjects in the clips felt
• In the third part of the study they were slapped with a ruler to localise the pain region of the brain

Mirror neurons

The ability to empathise with others - to put yourself in someone else's shoes - is crucial to social development in order to respond appropriately in everyday situations.

Criminals with psychopathy characteristically show a reduced ability to empathise with others, including their victims. Evidence suggests they are also more likely to reoffend upon release than criminals without the psychiatric condition.

Psychopathy is a personality disorder characterised by superficial charm, pathological lying and a diminished capacity for remorse.

Now scientists have found that only when asked to empathise did the criminals' empathy reaction, also known as the mirror system, fire up the same way as it did for the controls. Without instruction, they show reduced activity in the regions of the brain associated with pain.

This mirror system refers to the mirror neurons in our brain which are known to activate when we watch someone do a task and when we do it ourselves. They are thought to play a vital role in the ability to empathise with others.

'Bleak prospect'

Christian Keysers from the University of Groningen, the Netherlands, and senior author of the study, said it could change the way psychopathic criminals were viewed.

"The predominant notion had been that they are callous individuals, unable to feel emotions themselves and therefore unable to feel emotions in others.

"Our work shows it's not that simple. They don't lack empathy but they have a switch to turn it on and off. By default, it seems to be off."

The fact that they have the capacity to switch empathy on, at least under certain conditions, could have a positive side to it, Prof Keysers said.

"The notion psychopaths have no empathy at all was a bleak prospect. It would make it very hard for them to have normal moral development.

"Now that we've shown they have empathy - even if only in certain conditions - we can give therapists something to work with," Prof Keysers told BBC News.

But he explained that it was not yet known how this wilful capacity for empathy could be transformed into the spontaneous empathy most of us have.

Million-dollar question

Essi Viding from University College London, who was not involved with the study, said it was an extremely interesting finding, but that it remained unclear whether the psychopathic criminals' experience of empathy felt the same as that of the controls.

"It's dangerous to look at brain activation and say that it means they're empathising. They are able to generate a typical neural response, but that doesn't mean they have the same empathetic experience," Prof Viding told BBC News.

"We know they can generate the same response but they do that in an active and effortful way. Under free-viewing conditions they don't seem to. Just because they can emphasise, doesn't mean they will.

"Psychopathic criminals are clearly different. The million-dollar question is whether we can devise therapeutic interventions that would shift them do this more automatically."

Randall Salekin, from the University of Alabama, US, who works with youth offenders said: "These findings fit with much of the treatment I am doing using a mental model program, whereby youth are informed about how the brain works and then asked to make specific plans for improving their lives.

"This study is impressive because it actually shows the brain mechanisms or neural networks involved in activating the inmates' empathy."

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Calls for inquiry into NHS neglect

25 July 2013 Last updated at 03:57 ET By India Pollock BBC News

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The health board has apologised, while the Welsh government said no inquiry is needed

Calls are being made for an inquiry into Welsh NHS care standards and death rates.

It follows allegations that an elderly patient suffered serious neglect at two Abertawe Bro Morgannwg University Health Board hospitals.

Welsh Conservative leader, Andrew RT Davies, wants an inquiry like the Keogh review which has put 11 English NHS trusts in to special measures.

The health board apologised. The Welsh government said no inquiry is needed.

BBC Wales has investigated the case of an elderly woman who was admitted to the Princess of Wales Hospital, Bridgend, and Neath Port Talbot Hospital on three separate occasions between August 2010 and November 2012, when she died.

Continue reading the main story

"Start Quote

When I asked her why she was screaming at night, she told me that they hadn't taken her leg off in the two weeks that she'd been there"

End Quote Family member on conversation with nurse

When she was first admitted to hospital, the family complained to the health board.

'Barely conscious'

BBC Wales has spoken to the family, none of whom wish to be identified.

"It was absolutely appalling," a relative said. "Quite often I'd go in to visit her and I would find that she had been left nil by mouth for several days until she was weak and wasn't able to lift a glass of water to her mouth, she was dehydrated."

Another family member said: "We sat by her bedside until her tongue swelled up and cracked and her lips split open for want of hydration.

"She became delirious at first, then barely conscious, almost coma-like."

The health board said it would conduct a Protection of Vulnerable Adults (Pova) investigation.

However, the board did not contact the family for six months. It apologised and said that lessons had been learnt but no Pova proceedings took place.

When the woman was readmitted in 2012, relatives said they discovered the same problems.

They reported their concerns to social services which is when they learnt that a Pova investigation had not actually taken place.

Continue reading the main story

"Start Quote

I believe we do need a Keogh inquiry similar to what has gone on in England to address the very real concerns in our hospitals"

End Quote Andrew RT Davies, leader Welsh Conservatives

Pova proceedings were then used and a number of allegations were proved.

The health board admitted giving unnecessary sedation and failing to administer prescribed medication.

The board also failed to care for the woman's amputated leg.

A family member added: "We explained how her prosthesis could be taken off and showed them the bag of clean amputation socks that we'd taken in for her.

"We also gave them oils to treat her leg to ensure it didn't become inflamed. We explained it all to the staff.

"When I complained that she was having unnecessary sedation, they said it was because she was screaming at night. When I asked her why she was screaming at night, she told me that they hadn't taken her leg off in the two weeks that she'd been there.

"A member of staff pulled back the bedclothes and sat by the side of her bed and took her leg off with me, and took off the urine sodden socks that had been left on her amputation for two weeks and he turned away in disgust, holding the urine sodden socks at arms' length."

Heart attack

Recommendations were put in place, but the family said there were similar issues when the woman was admitted to Neath Port Talbot hospital in August 2012.

Then she was transferred to the Princess of Wales Hospital, where she died in November.

The family said they were told by staff that they were stopping her medication as she was dying of pneumonia.

However, a post mortem examination was carried out and the coroner's report said her lungs were free of chronic disease, and that she died of a heart attack.

'Absolutely tragic'

Andrew RT Davies, the Welsh Conservatives' leader, told BBC Radio Wales that mortality rates in some district general hospitals in Wales were "spiking at unacceptable levels".

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"I believe we do need a Keogh inquiry similar to what has gone on in England to address the very real concerns in our hospitals so that we can have confidence that health boards, clinicians and families are having their concerns addressed and structures are put in place so we don't get some of the terrible stories that are emanating out of England," he added.

Peter Tyndall, the Public Service Ombudsman for Wales, said: "It's absolutely tragic for the individual and for the family, and I think although there are lots of people who have very good experiences of the NHS in Wales, there are still too many cases of this kind occurring."

He said there had been a 30% increase in complaints about the NHS in Wales in a year.

Tina Donnelly, director of the Royal College of Nursing in Wales, said it was "extremely distressing to listen to a family who are left with those memories".

She added: "My response to this is that this has been an investigation and we need to know what went wrong - it's in the public interest.

"You can not condone poor care. It's just unacceptable."

Abertawe Bro Morgannwg University Health Board said the case is completely unacceptable and apologised for the shortcomings in her care.

It said staff have had training to improve standards and it has asked the family for details to investigate further.

Arrests

The Welsh government said it is committed to updating the current complaints procedures, and is reviewing the healthcare inspection system.

Health Minister Mark Drakeford has restated the core values of the NHS and set out measures to ensure they are preserved in future.

With these measures in place, the government said it did not see a need for a public inquiry.

In the last two months, South Wales Police arrested two nurses from Princess of Wales Hospital on suspicion of the falsification of records. Both have been suspended from duty.

When asked if there was a connection between these arrests and the patient's case, the health board said it could not comment on police investigations.

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Nurses recorded wrong waiting times

22 July 2013 Last updated at 14:36 ET

Two nurses from Mid Staffordshire NHS Trust have been found to have inaccurately recorded patient waiting times in accident and emergency.

The failings by Sharon Turner and Tracey-Ann White, on various dates between 2000 and 2010, were to avoid breaches of the four-hour target.

It is one of the first full hearings into nurses from Stafford by a Nursing and Midwifery Council (NMC) panel.

The regulator's hearing was adjourned until Tuesday.

'Get real'

The panel will assess their fitness to practise.

Both nurses, who denied all allegations, were found to have instructed staff to transfer patients to wards with soiled sheets.

The hearing was told Turner had ordered one staff nurse to tell another to "lie about it" in reference to the target breaches.

Continue reading the main story

This case helps to expose all that is wrong in the NHS"

End Quote Julie Bailey Cure the NHS

Between December 2003 and October 2009, when Turner worked at the trust, she spoke about patients and staff in an "inappropriate manner", the panel ruled.

Turner was found to have racially abused junior doctors of Asian origin, referring to "the suicide bombers".

The panel ruled Turner made inappropriate comments about three other colleagues.

On hearing one had been admitted to hospital after an overdose, she said words to the effect of: "He should have taken a few more pills and done the job properly", the panel found.

In relation to patients, she said "they want to get real", the hearing was told.

The panel ruled most elements of the six charges of misconduct against her, including falsifying records, failings over patient care and making inappropriate comments about patients and staff, were "proved".

'Can wait'

But it also ruled some elements, such as referring to a nurse as a "junior muppet", were not proved.

Between July 2000 and July 2010 White was accused of inaccurately recording patient discharge times from A&E and ordering other colleagues to follow her example.

White faced five charges of misconduct, but the facts were not proved for one of the charges.

An allegation of falsifying computer records for the time a patient was admitted to A&E was dropped.

The panel also ruled the facts were "not proved" for some elements of the other allegations against her.

The trust was at the centre of a public inquiry after it was found poor care could have led to the deaths of hundreds of patients as a result of maltreatment and neglect.

Chief executive at the trust Maggie Oldham said: "Tracey White is still employed by the trust and works as a clinical site manager.

"We will need to take some time to consider the Nursing and Midwifery Council panel's findings once they announce their decisions.

"Sharon Turner is no longer employed by the trust. She left her emergency department sister post in September 2009."

Stafford Hospital campaigner Julie Bailey, of Cure the NHS, said the group was pleased the NMC had "proven the case against these two nurses, but sad it has taken so long".

She said: "This case helps to expose all that is wrong in the NHS.

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Breakfast linked to 'healthy heart'

23 July 2013 Last updated at 02:53 ET

People should eat breakfast to keep their hearts in good condition, according to researchers in the US.

Their study of 27,000 men, in the journal Circulation, showed those skipping breakfast were at a greater risk of heart problems.

The team at the Harvard School of Public Health said missing the meal put an "extra strain" on the body.

The British Heart Foundation said breakfast helped people resist sugary snacks before lunch.

The men, aged 45-82, were studied for 16 years. During that time there were more than 1,500 heart attacks or cases of fatal heart failure.

However, people who skipped breakfast were 27% more likely to have heart problems than those who started the day with a meal. The researchers adjusted for other lifestyle risk factors such as smoking and exercise.

Researcher, Dr Leah Cahill told the BBC: "The take-home message is eat in the morning when you wake up, preferably within an hour.

"The results show that something is better than nothing, but it's always better to have something healthy and balanced."

She said the timing of the meal seemed to be key and waiting until lunch rather than "breaking fast" may be straining the body over time.

She said this could be increasing the risk of high blood pressure, obesity and diabetes which could in turn damage the heart.

"Don't skip breakfast," Dr Cahill concluded.

Victoria Taylor, a dietitian with the British Heart Foundation, said: "These researchers only looked at men aged over 45, so we would need to see further research to confirm that breakfast has the same impact on the heart health of other groups of people.

"What we do know is that a healthy and filling breakfast can make that mid-morning biscuit less tempting, as well as giving you another opportunity to widen the variety of foods in your diet.

"Wholegrain toast, or cereals like porridge with low fat milk are a good way to start the day. Try a sliced banana or dried fruit on top and you'll be on your way to five-a-day before you've even left the house."

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