Unapproved ‘mix match’ metal on metal hips

Concerns have been raised for thousands of patients who may suffer serious disability and early failure due to metal hip implants made from components supplied by different manufacturersIt has been discovered that surgeons are mixing and matching component parts into the hip joint. The parts may not fit together properly resulting in damage to the bone and extra wear meaning metal debris can break off and enter the blood stream.

A spokesman for the British Orthpaedic Association said “while some components match extremely well it has become clear that more modern cutting edge technologies can create critical combinations which have produced new problems, most notably, but not exclusively, metal surfaces which move slightly. Very minor design or material differences have created unexpected clashes magnified by the extreme use we expect from our joints.”

The use of mix and match components is not illegal but the guidance is they should only be used where there is no suitable alternative already on the market.

I act for a client whose life, sadly, was turned upside down by the hip components wearing which caused metal ions to be released into the blood stream. He had to undergo further surgery and continues to have problems. His story may, it seems, be the tip of the iceberg.

By Sara Westwood of Morgan Jones & Pett. sarawestwood@m-j-p.co.uk

Legal Aid Cuts – the knock on effect

On the 4th December 2014, during a session before the House of Commons public accounts committee (PAC), a senior civil servant at the Ministry of Justice admitted the speed at which they brought in the Legal Aid Sentencing and Punishment of Offenders Act did not allow for evidence to be gathered to investigate the impact of legal aid cuts. The civil servant added ‘The piece of evidence that was overwhelming was the level of spending. The evidence required was that government said we wish to cut the legal aid bill.’

Evidence of the impact is now aplenty. Sadiq Khan, shadow justice secretary, said: ‘There are now parts of the country where people are struggling to access valuable legal advice. And the 30% rise in litigants in person and the drastic fall in mediation assessments mean that many of the government’s predicted savings have simply shifted to other departments.’

In a report commissioned by the Legal Action Group a total of 88 per cent of GPs questioned agreed that patients not being able to obtain legal or specialist advice about their problems would have a negative impact on their health.

Two thirds of GPs reported that the number of patients who had issues with benefits would have benefited from legal advice had certainly increased. This was followed closely by debts or financial problems and issues at work as GPs reported a 65 per cent increase.

Just over half of the doctors polled reported a rise in the number of patients with housing problems. A similar proportion reported the same in relation to community care. President of the Law Society, Andrew Caplen, added: "This is independent research that the government should not ignore. GPs are giving a clear warning that lack of legal advice can have consequences for a person's health. The government should look at putting back support for legal and specialist advice services for social welfare law problems."

Whichever party succeeds to Parliament next May, it seems unlikely much, if at all, will be done to remedy the inevitable and foreseeable social and health issues which have arisen as a result of the cuts. It remains to be seen whether the cuts to legal aid have made any real difference to the deficit as the view seems to be they have simply added to costs elsewhere in the economy. 

By Sara Westwood of Morgan Jones & Pett. sarawestwood@m-j-p.co.uk

NHS Highlights Surgeon Performance Data

Performance data for almost 5,000 surgeons in England has been released by the NHS in a move towards greater transparency.

Using the MyNHS website, patients can search for information, including mortality rates for individual specialists.

For more information and the full story, see the BBC report at http://www.bbc.co.uk/news/uk-30094261

Insurers Break Promise on Premiums

Car insurance premiums rose in the third quarter of 2014 for the first time since 2012, signalling an end to the insurers’ promised decline in motor premiums.

“The truth is, falling premiums had more to do with competitive tension than any benefit afforded by reforms. Premiums are, on average, now similar to their 2010 level and are no longer economically sustainable,” said Janet Connor, managing director of AA Insurance.

Simon Bransby of Norwich Personal Injury firm Morgan Jones & Pett said: “Is this really a surprise that car insurance premiums are going up? It was only recently the insurance industry made its promise to Government there would be a clear cost saving to consumers as a result of recent reforms but premiums are on the rise already"

The new duty of candour in the NHS - we have to start somewhere

The Government will soon introduce regulations that require all NHS providers to comply with a statutory duty of candour.  The General Medical Council and Nursing and Midwifery Council have welcomed this, and have introduced their combined draft guidance in a document headed “Openness and honesty when things go wrong: the professional duty of candour”. 

This cannot come too soon, says Simon Bransby of Morgan Jones & Pett, Personal Injury Solicitors in Norwich. This was launched at St Thomas' Hospital in London with Jeremy Hunt, Secretary of State for Health giving the opening speech. Let us hope that the Regulations are fully taken up and produce the desired repsonse.

Costs of Clinical Negligence Claims Criticized by Minister

Last month the Health Secretary, Jeremy Hunt, during a visit to a children’s hospital in Birmingham, described the expenditure on clinical negligence claims as being one of the ‘shocking costs’ of poor care.There is a tendency for the tabloid press to use headline grabbing figures to criticise injured victims for the claims brought against a hospital or doctor however only 1% of the NHS budget is in fact spent on claims. Whilst a modest figure, it still represents many tens of millions which could be better spent on patient care and I know not of one client who wouldn’t rather have their life back to what it was rather than claim compensation for injuries suffered which have often rendered them unable to work or dependent on the care of others.

More needs to be done to stop these avoidable, often life changing, medical errors. There is however much work to be done and it is saddening to see a report published recently by the Care Quality Commission which  found 80% of NHS bodies inspected were rated ‘inadequate’ or ‘require improvement’ when it comes to patient safety. We are all right to be proud of the NHS, which is undoubtedly one of the best healthcare systems in the world, but much more needs to be done, and quickly, to avoid this worrying slide in patient care and the inevitable harm it causes to many patients.

By Sara Westwood at sarawestwood@m-j-p.co.uk

Review Calls for End of Unfair Split Between NHS and Social Care

The Barker Commission has come up with radical proposals for an overhaul and merger of the social care systems. It says a merger of the two systems was needed because the ageing population and rise in long-term illnesses had blurred the lines between the two and was now causing "distress and unfairness".

For the full article see http://www.bbc.co.uk/news/health-29047190

Norfolk and Suffolk Mental Health Warn of Funding Issues

The Trust has warned it is struggling to provide a "safe and effective" service and called for fundamental changes. As with many Government departments savings are having to be found. The trust has had to make £20m of savings over the last two years, but is still facing a £1m deficit this year.

The area the Trust covers includes Care Minister MP Norman Lamb's constituency. Mr Lamb believes the new NHS Standards being introduced by the Government could prove a "breakthrough" in giving mental health a "fair deal". He blamed the last Labour Government which had excluded mental health from the same standards as physical health. Mr Lamb said "This injustice inevitably means that funding for physical health is prioritised over mental health at a local level. We are now rectifying this unfairness," and went on to say "I am currently working closely with NHS England to agree details of how key access and waiting time standards for mental health services can be established starting next April.I believe that this could bring a real breakthrough in making sure that mental health gets a fair deal."

Gary Page, chair of Norfolk and Suffolk NHS Foundation Trust, said "We welcome the pledge from the Government about parity of esteem between physical and mental health but that needs to be translated into a fundamental change in the way mental health services are funded. In the acute sector, the amount of funding a hospital receives is linked to how many patients it treats." He went on to explain that "In mental health, we get a fixed amount each year irrespective of whether or not demand is increasing. At the moment, we continue to believe the care we are providing is safe and effective but we can't continue to provide that level of service (under present funding arrangements)."

Mental Health Beds Cut

BBC news has reported plans to cut mental health beds which a campaign group has criticised. The local Clinical Commissioning Group plans are being scrutinised by Norfolk County Councillors. Plans are being considered to cut 20 Norfolk and Suffolk mental health beds and a suite to assess people who may need to be detained. 

The Campaign to Save Mental Health Services in Suffolk and Norfolk said the beds and the suite in Carlton Court in Lowestoft were vital to keep. It seems to be a continued process of more care in the community purely cost cutting. For the full article see http://www.bbc.co.uk/news/uk-england-29054062

Hospital Food-Tough N..

New rules to be brought in for food in Hospitals in England have already been criticized by The Campaign for Better Hospital Food which said the changes were "woefully inadequate" and hard to enforce.




Under new measures being announced by the health secretary a higher standard of food will be expected

The new standards, enforced through legally-binding NHS contracts, will focus on quality, choice and promoting a healthy diet for patients and staff.

Hospitals will also be ranked on the meals they prepare.

See the full article at http://www.bbc.co.uk/news/health-28966949 

Doctors May be Forced to Apologise

The General Medical Council (GMC), the body who regulate all Doctors in the UK are seeking views of the public and specialist groups on plans being considered to bring in tougher sanctions against Doctors who make mistakes in the care of their patients.



One welcome addition is that a dotor could be forced to apologise if they have previously refused to do so.

See the full new article at http://www.bbc.co.uk/news/health-28881560

NHS to offer Mediation

The NHS Litigation Authority (NHSLA) has announced a new mediation service to speed up the process for resolving claims the service will offer a face-to-face discussion between the healthcare provider and the patient, supported by an independent and accredited mediator.



During the process, legal rights remain intact and either party can proceed to court if they are unhappy with the outcome.

The NHSLA says the scheme will be an independent and voluntary process for resolving claims against health authorities. Chief executive Catherine Dixon said: ‘We hope that it will help patients, their families and NHS staff resolve concerns quickly and cost-effectively whilst also enabling all the parties to meet to have their say without the need to go to court.’

However Simon Bransby clinical negligence specialist at Morgan Jones & Pett is sceptical."Mediation may help resolve some complaints" he said."However patients often have little understanding of the complex medical issues surrounding their care and any possible legal claim, which the hospital will, so there is a danger of there being no equality of arms. If the patient needs a legal remedy they will need legal assistance. If patients seek mediation as an alternative to seeking expert legal advice on claims there is a real danger they will end up with a serious undervaluing of their claim."