Ebola virus

Ebola virus

Ebola virus – this deadly disease is still the subject of much debate with high level discussions continuing at the World Health Organisation, hopefully with further positive outcomes.

Are we safe in the UK?

Well  the risk is low unless you have travelled to a known infected area and had direct contact with a person with Ebola-like symptoms, or had contact with an infected animal or contaminated objects.

Fingers crossed, there have been no imported cases of Ebola in the UK. And while it is possible that someone infected with Ebola could arrive in the UK on a plane, the virus is not as easily transmitted as a respiratory virus such as influenza.

The NHS provide up to date advice including symptoms on the following web site:


Overseas medical insurance – Mrsa and waiting lists could be the least of your problems!

Overseas medical insurance – Mrsa and waiting lists could be the least of your problems!

In this age of mobile employment it is important that before sending staff to overseas countries that their medical coverage is closely checked to make sure that they and their family are adequately protected and also meet local regulations. Leaving matters to chance is not an option.

The policies should meet all of the charges they might otherwise face were they to be hospitalised, plus out-patient specialist treatment fees, GP consultation charges and the cost of prescription drugs.

Other options available might include routine dental treatment (including regular check ups) pregnancy and childbirth and even the option to be evacuated to a different country should the necessary local medical standards be suspect. If you think that MRSA and waiting lists are an issue at home, overseas they can be the least of your problems!

It may also be possible to include some pre-existing conditions.

In regard to overseas employees who relocate to the UK, international policies, whist more expensive than a UK only policy, will provide the following additional benefits:

  • Option for maternity cover and routine dental treatment
  • Private GP visits rather than NHS GP’s
  • Cover for hazardous activities
  • Benefits for some Chronic Condition
  • The territorial limits can be easily extended

It is important to remember that employees are of great value to their Employer and provide its intellectual capital. They not only bring their skills and talents; they also bring ideas and creativity to the table. Employees bring innovation, commitment and a desire to learn.  So to maintain this positive contribution please make sure that  when sending them out into the world, away from home, that they and their families have appropriate medical protection.

Naturally if you would like further information or advice then please contact me at:  johncrisford@sherwoodhealthcare.co.uk

John Crisford

Tel: 01277 822922
Twitter: @SherwoodHealth


European Courts decide insurance premiums are sexist.

European Courts decide insurance premiums are sexist.

The decision has been made by the European Courts that from the 21st of December 2012 onward, premiums must no longer be subjective to gender.  This ruling applies to all forms of insurance, with the impact on PMI predicted to be negligible.

Industry feared that the ruling would demand that the changed be enforced immediately, but with the date set over a year away, insurance companies can prepare for the changes.

Speaking to COVER, Lindsey Joseph, executive committee member for the Association of Medical Insurance Intermediaries (AMII), added that she saw a way forward in more sophisticated underwriting.

“The vast majority of PMI providers does not have premiums for gender and for those that do the difference in premium is not particularly significant. For those few with older policies on the books they will need to be adjusted, and in those circumstances we recommend specialist advice.”

It is essential for insurers to use gender to calculate risk based premiums on solid actuarial evidence and statistics. It is price differentiation, not discrimination, as it is not a decision that comes down to the whim of an individual.

The effect of the European Court of Justice (ECJ) ruling on the private Medical Insurance sector is likely to be “negligible” according to an industry body.

AMII has noted an opportunity for an increase in the medically based underwriting within the protection sector. Joseph said: “The advocate general said you cannot differentiate based on gender and the stats that support that.

Will premiums increase across the board to suit insurer’s needs? Or will they mediate the premiums to create a middle ground unopposed by gender? We’ll be keeping a close eye on this subject.

Source: http://www.ifaonline.co.uk/cover/news/2029579/ecj-bans-gender-underwriting-protection-pmi

John Crisford
Tel: 01277 822922
Twitter: @SherwoodHealth

Hospital Risks and Cancer Trials Using Social Media

Hospital Risks and Cancer Trials Using Social Media

I thought I would start this month’s post with a statistic…Experience in healthcare is important and between me and two other consultants here at Sherwood, we have over 200 years of experience between us and…good looks never fade.

Anyway, to news! Worryingly the Charity, Action against Medical Accidents say that too many trusts are still not responding to patient safety alerts in England and goes on to say there is no excuse for non-compliance. What patient safety alert means, is that with each alert not complied with, patients are being put at unnecessary risk and unfortunately, lives are being lost as a result.

The Department of Health data showed there were over 650 cases of NHS trusts not complying with alerts within deadline. Though this is a 50% fall from 2010, Action against Medical Accidents first highlighted the issue in 2010 when it obtained the figures under a freedom of information request.

Alerts are issued when potentially harmful situations are identified in health settings, such as the risk of overdoses or using medical equipment. The latest data, from January, showed that there were 654 instances of patient safety alerts not having been complied with – half the figure from August. In total there were 203 trusts which had failed to comply with at least one alert, while five trusts had not complied with 10 or more alerts.

A Department of Health spokesman said: “Although progress has been made, much more needs to be done across the system. We expect trusts to comply with safety alerts.” This is why I am an advocate of private healthcare because the risks are fewer.

Okay now on a completely different tact as I want to put this thought out for debate and it stems from my continuous social media learning and journey; a recent story about US clinical trials got me thinking:

Approximately 8,000 US clinical trials are accepting cancer patients as participants. Interestingly, three-quarters of US cancer patients expect their doctor to inform them of such trials. Yet only 2% of newly diagnosed cancer patients participate.

Research by the Journal of the National Cancer Institute has analysed data from 1533 oncologists, radiation oncologists and surgeons who provide care for lung and colorectal cancer patients. It found that 56.7% of doctors said that they had referred or enrolled at least one patient in a clinical trial in the past 12 months. Medical oncologists were most likely to do so, followed by radiation oncologist then surgeons.

Medics who were affiliated with an academic medical centre were more likely to enrol patients in trials. Moreover, getting paid for referring or enrolling patients was also a contributing factor to increased likelihood of enrolling patients in trials.

There is a school of thought which thinks that by increasing patient enrolment in cancer trials is positive as it helps to increases knowledge of how to treat cancer. So, if we hold this school of thought up, then how do we in the world increase enrolment? How about an award system for doctors who refer or a target sheet, though I believe that this could be a conflict of interest.

So, I wondered if perhaps social media could play a role…Through apps which could track clinical trials, to enable cancer patients to find out more about enrolment with the help of their doctor. Or create social media platforms where patients could discuss the pros and cons of trial involvement. Perhaps clinical trials could involve Twitter, where patients tweet about their experience, or contribute to Facebook, either openly or anonymously to make trial enrolment seem like part of the normal cancer treatment experience? Or should we leave things alone and let the power continue to rest with doctors to make all the calls on who participates in cancer trials?

John Crisford
Tel: 01277 822922
Twitter: @SherwoodHealth


NHS – Excessive spending on paper, clips and gloves.

Yesterday (2 February 2011) a report published by The National Audit Office (NAO) discovered that the NHS could be spending as much as £500m on stationary. From January 2010 to January 2011 the NHS purchased around 66,000 products, most of which were unused, overpriced or simply not needed.

The report continues to warn Ministers that the current “reforming” will reduce the governments influence over the NHS purchasing practises. According to the report (which only includes English hospitals) there were discrepancies with various purchases made throughout the year. Across the 66,000 items purchases there was an average cost variation of 10%, however 5,201 items managed to hit a staggering 50%.

The report goes on to claim that on average each Trust will be able to save between £900,000 and £1.5m per year by paying the lowest price at point of purchase.

Across the 61 trusts 1000 orders were made last year for A4 paper alone. In addition because trusts are not collaborating on orders, there are lots of small purchases and Trusts are missing out on discounts for bulk orders.

Also on four of the key product areas (Gloves, Cannulas, Administration Sets and Paper) it is estimated that by consolidating weekly purchases the 61 trusts, collectively, could save £635,000 per year, in addition by consolidating on monthly purchases the trusts could increase savings to £918,000 per year.

As a result of the trusts not buying in bulk , there is a huge variation in what is ordered by each trust. For example, “21 different types of A4 paper, 652 different types of surgical and examination gloves, 1751 cannula (tubes inserted to remove fluid) 260 different types of administration sets (different types of drip/blood sets, i.e. IV).

Key parts of the Governments reforms for the NHS involve hospitals having MORE independence, inferring that the Department of Health will be unable to influence the purchasing decisions of the hospitals.

NAO goes on to claim that by buying more efficiently, using bulk orders and buying less frequently could save hospitals a minimum of £500 million per year.

Amyas Morse, head of the National Audit Office, said today:

  • “At least 10 per cent of hospitals’ spending on consumables, amounting to some £500 million a year, could be saved if Yrusts got together to buy products in a more collaborative way.
  • “In the new NHS of constrained budgets, Trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold Trusts directly to account to Parliament for their procurement practices.”

Should the government be looking into addressing this problem? Is this a short fall in their newly developed NHS reform? If the reform goes ahead could the problem get even worse as hospitals become more independent of each other?

Source: http://www.nao.org.uk/publications/1011/nhs_procurement.aspx

John Crisford
Tel: 01277 822922
E-mail: johncrisford@sherwoodhealthcare.co.uk
Web: www.sherwoodhealthcare.co.uk
Twitter: @SherwoodHealth

Is Our Health Just a Numbers Game?

Is Our Health Just a Numbers Game?

As we start 2011 I have been wondering if our health had just become a numbers game. Here’s why:

Did you know that in the UK there are nearly a 100,000 people who are at risk of heart attacks because of failures to screen them for an inherited condition that causes extremely high cholesterol? According to the National Institute for Health and Clinical Excellence, relatives of patients who have very high cholesterol caused by a genetic condition should also be screened for the disease under guidance. However, the Royal College of Physicians said this is not routinely happening. It is estimated that every day one person who has the condition – called familial hypercholesterolemia (FH) – but who has not been diagnosed, has a heart attack. The condition will cause a heart attack in half of men by the time they are just 55 along with one third of women by the time they reach the age of 60. It is thought that that currently, 2.5 m of the UK’s population lives with heart disease.

Then we have the UK’s flu outbreak which has been reported to become a ‘children’s epidemic’ as new figures show that the number of under-fives being brought into doctors’ surgeries with the illness doubled over the recent Christmas period. Now with schools reopen, experts believe the spread of the virus will escalate. The figures, collated by the research centre of the Royal College of General Practitioners, show there is no sign of a letup in the days ahead and many hospitals are on ‘black alert’ – cancelling non-urgent operations and running short of available intensive care beds. Though, the key message here is that it is not too late to get the vaccination. Parents who have a child with asthma or diabetes or chest disease must really take up this vaccination.

Moving on to the swine flu pandemic, of 2009 I am going to connect it with social media! A recent on-line survey showed a link between health and Twitter; this on-line analysis published by PLoS, which is an interactive open access journal for all peer-reviewed scientific and medical research looked at Twitter traffic during 2009’s swine flu pandemic. It compared the volume of tweets about the swine flu and the news coverage. After reviewing two million tweets between May and December 2009, the study showed some interesting finding, some of which I have shared below:

  • News websites were the most popular tweeted info source, providing 23% of the content;
  • Government sites were tweeted 1.5% of the time;
  • 4.5% of tweets were classified as ‘misinformation’; and
  • The one I really liked was – one of the sharpest increases in Twitter traffic was the announcement that Harry Potter actor Rupert Grint had swine flu!

If people tweet about strange health happening around them and link them with hashtags, maybe   we could start to use social media as an epidemiological tool? It could serve as an early warning trigger to health officials.  What do you think; could Twitter become a meaningful way of tracking health issues?

John Crisford
Tel: 01277 822922
Twitter: @SherwoodHealth


NHS – Some good news at last.

Another year where the NHS has been in the public eye, with Budgets not keeping pace with  inflation and efficiencies to achieve there is a bit of  good news at last. It appears that the Government is looking into the issue that is causing a lot of controversy and infringes patient’s liberties – mixed sex wards.

According to a report published by health secretary Andrew Langley over 11,000 patients were subject to mixed sex accommodation during December alone.  It has become apparent that this report was in support of new Government legislation that will impose fines on hospitals.  For every patient that is subjected to mixed accommodation the hospital will be fined £250 per day.  So what will happen to all the money the Government is now collecting on your behalf? Well according to the report it will be re-invested into the NHS to help fund patient care.

This new legislation will be expected to arrive in April and Andrew Langley states, “By April, we expect every hospital to be capable of meeting the single sex accommodation standard.”  To help combat the issue, the Government is increasing the number of single rooms available to the NHS, although we are not entirely sure where this space is coming from.

One of the benefits of Private Medical Insurance is that you are guaranteed your own room. Premiums do not need to be expensive and policies can be tailored to suit your needs.

Source: http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/MixedSexAccommodation/index.htm

Good news for Private Medical Insurance.

House of Lords.

The Office of Fair Trading has announced a review into the Private Healthcare Market. Certain parties are “high jacking” this to draw attention to the habit in the Private Medical Insurance market of Insurers (most)  operating fixed fee scales for Consultants and Anaesthetists – which can have a significant financial impact on a policy holders medical claim.

The matter has even been raised in the House of Lords!!

Many policy holders may not be familiar with the term “fixed fee scales”.  By way of explanation when  referred by your GP to a Consultant you will be charged for the Consultants time, a number of insurers have put a cap on the amount they contribute towards the costs.  This is great news if your Consultant has signed up to the fee cap.   But what happens if they have not?  Well depending on the insurer you will more than likely incur what’s called a fee short fall, an amount of money the insurer refuses to pay and that you the policy holder must cover.

Insurers argue, reasonable, that their actions help reduce claims costs which in turn modify the premiums that policy holders pay. How ever the problem for the poor patient is that at the time of making an appointment they are unaware of how much the Consultant /Anaesthetist will charge. To be fair they have got to many other things on their mind at this time to believe that it is a priority.

Funnily enough the Consultant/ Anaesthetist will want to know if the patient has private medical Insurance in place, assuming they have then it is at this point the patient should be told about any likely fee shortfall. Regretfully this does not happen on a regular basis.

So how could these issues be addressed?

If every consultant agreed to fee scales then there would not be an issue.


More Insurers, particularly the larger ones could look not to apply the fixed fee scale.

It is in the interests of us all to find away forward so that we can maintain and increase the numbers of companies and individual who have or are looking to purchase private medical insurance.

Let us know your thoughts, as this is obviously a troubling matter within the Private Medical Insurance market.

Source: http://www.ifaonline.co.uk/cover/feature/1936149/pmi-medical-cost-vs-care

Would You Friend your Doctor?

I wanted to raise the debate about whether doctors with a profile on Facebook, may be compromising the doctor-patient relationship, because they do not use sufficient privacy settings? A fascinating piece of research was conducted recently in France with 405 post-graduate and trainee doctors who were surveyed about their Facebook habits; 73% of them were on the site and the findings raised some interesting question about patient interaction, and about the relationship between health care and social media.

Doctors I am sure already face potential challenges when it comes to use of e-mail with patients and the health industry as a whole stumbles in its forays into social media in general. So, here are some other stats from the French research to think about:

  • 6% had received friend requests from patients.  Would you consider this inappropriate?
  • 85% of the docs said they’d ignore a patients ‘Friend’ request regardless of who it was, 15% said they’d decide on a case-by-case basis;
  • Reasons given for accepting a friend request included some slightly coercive in nature: Fear of losing a patient or embarrassing them; and
  • Reasons for denying the request included a sense that it was unprofessional, or the patient had romantic intentions.

The researchers insist that friend requests are likely to become more common in the future.

Whether a doctor accepts or rejects a friend request could more be about what they use Facebook for. For example, where a Facebook site is more professional in nature or a place to share experiences, there’s probably less discomfort with letting a patient visit.

I do see some benefits as it allows the patient the opportunity to update their Doctor on their medical conditions since as we all experience very busy and crowded surgeries where our time with our GP is limited. Plus being on-line means the doctor should be able to reassure/treat the patient more easily and quickly.

However, I do wonder if there’s some protocol that shouldn’t be breached in the doctor- patient relationship in terms of socialising, or social media relations? Or is there value in removing the white-coated persona of social and professional stature that surrounds doctors, so that we view them as people with human traits such as compassion, the potential to err and prone to the occasional bad day.

I do believe there is the potential for breach of patient confidentiality. Plus, do the on-line discussions become part of a patient’s notes? How will the discussions be recorded? This is key as life/critical illness and medical insurance relies on information from doctors.

Is social media becoming a levelling ground in health care, allowing doctors to really listen and hear the voices of their patients? As social media is certainly a good tool for listening to people. Or are there other professions where a Facebook friendship would be questionable on ethical grounds?  Teachers? Following your doctors twitter feed isn’t likely to cause controversy since that’s a very public media. So where do we draw the line? What’s your view? Would you ever friend your doctor or other health care practitioner?


Sherwood Healthcare

Tel: 01277 822922





The Hangover

As we begin the New Year I am sure many of us will be nursing hangovers and thought I would give a few tips of how to deal with a bad hangover. However, before I start I just want to mention something we all are aware, yet forget when we are caught up in the festivities, and that there is significant dangers in drinking in excess, not only to yourself but to others, so do keep this in mind.

Anyway, back to the cures. Try to avoid coffee and other caffeinated drinks like Coke if possible – they’ll only dehydrate you more, instead fruit juices are a good option as they contain salt which will help your body retain fluids; tomato juice is a good one. If you are wondering what causes a hangover, it is ethanol – the alcohol in your drinks; a toxic chemical that works in the body as a diuretic (which means it makes you go to the bathroom more and as a result become dehydrated). This is one of the main causes of the headache, dry mouth, dizziness and constant nausea. Your hangover eases as the body turns the ethanol into a less toxic chemical. The other factor that affects a hangover is the type of drink you have consumed. Dark drinks contain a substance called congeners that tend to make hangovers worse.

What are your hangover cures?

Sherwood Healthcare

Tel: 01277 822922