21/01/2013 Inside Out West Midlands


21/01/2013

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Transcript


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Hello, tonight we are on patrol with the the volunteers providing

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vital support to the West Midlands Ambulance Service as heavy snow

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sparks a big interest -- increase in 999 call.

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There are an awful lot of very poorly people that we saw yesterday.

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It was taking an awfully long time to get to the incidence and to get

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back out on the road. We will find out how our region

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coped with it the deluge of snow that followed a Met Office warning.

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We were promised snow and we have This is the male health centre, the

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fictional home of the hugely popular BBC One daytime show

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Doctors. Every day over 800,000 people attend surgeries, more than

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200,000 a visit hospital. How safe are you on the wards? We have

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discovered that nearly half of all serious incidents in hospital

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involved a condition that is almost always preventable.

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This is obviously going back, just general family members and sisters

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and brothers. Some cars. He was really into his cars. Claire Cross,

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from Tewkesbury, loves talking about her first hero, her dad.

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was very quiet actually. Very home loving. But amongst the hundreds of

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photos, there is one that she can hardly bear to look at. He didn't

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really have a quality of life. I don't feel. He just sat in a chair

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watching television or sleeping and that was his life from that point

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on really. So what was it that robbed David Chalkley of his

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independence, forcing him to spend his final days in a nursing home?

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Alarmingly, it was something that happened to him in hospital,

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something that ensured he would never walk again. I feel that he's

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suffered needlessly. I feel that he could have possibly stayed at home

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a bit longer and enjoyed a bit more of family life and being around the

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surroundings that he loved and his garden. Instead of going off into a

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strange place and having to stay there until the end of his life.

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Two years on, Clare wants to know if what happened to her dad could

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have been avoided and if others are suffering as well. We offered to

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help. And we've discovered that each year

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there are thousands of similar incidents in hospitals across

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England, costing the health service billions. And they're almost always

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preventable. What am I talking about? Simple bed sores. The NHS

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insists hospitals record and investigate all incidents that

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unexpectedly cause death or severe harm. It calls them Serious

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Untoward Incidents. So under Freedom of Information laws, we

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asked to see last year's summary. It turns out there were almost

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12,000. They're broken down into more than 70 categories, like child

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deaths, surgical errors, and delayed diagnoses. But more than

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40% of all the serious incidents recorded at English hospitals last

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year involved severe bed sores. They're also known as pressure

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ulcers because they happen when pressure restricts blood supply to

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the skin. And they range from small sores to large open wounds. Their

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severity is graded from one to four. Most aren't suitable to show on

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this programme. And they can be lethal. It was a bed sore that

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claimed the life of paralysed actor Christopeher Reeve, a man who was

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for so long known simply as Superman. Perhaps what's most

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worrying about our research is that the NHS itself admits that in 95%

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of cases bed sores are completely So what's going on? Why are

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thousands of people suffering unnecessarily? Could it be

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something to do with the standard of nursing in our hospitals? We

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asked the Royal College of Nursing. Well, I put it down to a lack of

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staff actually. If we think of the complex needs of some of these

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patients we may need two or in fact three nurses to deliver appropriate

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care to one patient. So for example, turning someone who is obese would

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take more than one nurse and if you've got four nurses who are on

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duty at one time on a ward of say 36 patients, to take three nurses

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off to be able to turn one patient on a regular basis, you know, takes

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time. So is it simply down to a lack of nurses? Well, the

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Department of Health told us nursing ratios are down to

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individual hospitals. So we had a look at the worst offender. Last

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year 192 severe bed sores were recorded under the care of Dudley

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Group NHS Trust, more than any other in England. Half occurred

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here at Russells Hall Hospital and half in the community. So I've come

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to ask the woman in charge why. The latest figures for serious untoward

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incidents, the number of bed sores recorded at hospitals, your

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hospital had the highest number. Is that down to not enough nurses?

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What's the reason? No, absolutely not. As an organisation we have

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followed the guidance from the National Patient Safety Agency

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which says that high recording levels of incidents throughout

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hospitals actually tends to be indicative of a high level of

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patient safety culture, of openness, of an honest culture of where

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people report and then learn from it. So are you saying that other

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hospitals aren't doing that? Well, I can't speak for other hospitals

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but what I can speak for is Dudley Group and that we have a system of

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recording and capturing pressure sores throughout the hospital which

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is extremely rigorous and not only do we capture them from within the

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hospital itself but also those that are prevalent in the community.

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you've always been so rigorous, though, at recording and reporting

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these you would have known that there was a problem. Why didn't you

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do something about it sooner? I think the whole NHS has

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acknowledged that there's been a problem with pressures sores.

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That's why it's been a national priority. And we, as an

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organisation, have acknowledged it's been a problem so we started

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the initiatives that we've been running over the last two years.

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That included this awareness campaign in which managers showed

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off parts of the body prone to bed sores. And the hospital says the

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number of cases has now started to come down. It develops under the

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skin. If it is not treated it can quickly become so via... But it's

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not just Dudley Group NHS Trust that believes better awareness and

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training is the answer. This information video has gone out to

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frontline staff across the Midlands. There are simple steps you can take

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to prevent pressure ulcers. education the only solution or so

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do our hospitals be doing even more? Well, there was one in the

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West Midlands that last year didn't record any severe bed sores at all.

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It was this one, the Robert Jones & Agnes Hunt Orthopaedic Hospital in

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Oswestry. And I'm here to discover its secret. How are you? We have

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just turned you so we will check your dressings... Matron Julie

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Roberts has agreed to share that secret. And I'm shocked when I

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realise this is it, nurses simply turn patients and check their skin

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every couple of hours. So this is something that's really, really

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basic in preventing these pressure sores? It is. Yeah. We assess all

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our patients on admission. And obviously we look at their age,

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their skin integrity, any medication that they're on, what

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their mobility is like. And that really makes a difference to

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preventing these sores? As well as physically turning them. You have

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to continually turn them. You and your team of nurses are spending a

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lot of time turning patients aren't you? We are but we do it from the

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top to the bottom. And fortunately a lot of our patients now are quite

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independent and mobile very, very quickly after surgery because we do

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get them up on the day of surgery. So we promote independence very

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quickly. So there isn't as many as you'd think. I'll turn you over to

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your left hand side... It's perhaps unfair, though, to compare this

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specialist orthopaedic trust with general city hospitals which must

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cater for all types of complex conditions. Here they're able to

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invest in expensive specialist equipment like this mechanical

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turning bed and these motorised foot pumps. But perhaps we can

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learn from the ethos here. We're quite old-fashioned. I remember

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when I first started here 25 years ago that I was told by my

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consultant here, patients do not get pressure sores and if they do I

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will chop your hands and head off, because it was so important that

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that didn't happen. And that is what I try to instill in all the

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training in all the nurses on this specific unit and within this

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hospital. Back in Tewkesbury I tell Claire what we've learnt.

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We found that over 40% of serious incidents of bed sores -- of bed

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sores. And show her some of the footage from Oswestry. They're

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checking the skin underneath the hills that they're not red. That's

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something that Dad could have probably done with. Now obviously

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we've only just shown you the numbers and that short film. As

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it's all sinking in, what's your reaction? I'm quite cross now. I

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didn't realise the numbers were so high. And it just makes me want to

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ask the question why hospitals such as Oswestry can't pass on their

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good practice and their training to other hospitals. Why can one

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hospital do it and other hospitals can't? But the hospital where

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Claire's dad got his bed sores has been in touch. The Alexandra

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Hospital in Redditch claims new practices brought in last year have

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helped bring about a significant reduction in the incidence of

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pressure ulcers and Claire has accepted an invitation to see the

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:10:49.:10:52.

changes for herself. Well, if they can improve, it is

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great, they are going in the right direction. There obviously is room

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for improvement on some hospitals and the sooner it happens the

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better really. So, what is your verdict on the

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NHS? You can talk to was right now on Twitter, using the hash tag

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inside out. You can also contact me on e-mail.

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Still to come tonight: Under a blanket of snow, how Red Cross

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volunteers the road to the rescue. They are very appreciative of the

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sport we can -- support we can provide and having a good

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communication link is essential. But next, the NHS is about to

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undergo its biggest ever shake-up. What does this mean for you and me

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and our families? At the doctor and This is lovely, madam, because this

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inhaler would actually go with your coat. And a free examination. Do

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you want to come here and cough, sir? I can give you those half

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price. Plus something for your water retention. I'm a GP. And

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today I'm taking healthcare into the community, where it's needed.

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All the sample bottles you could ever need and I'll throw in a

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crutch. It's all free. It's all paid for. This is what the biggest

:12:16.:12:19.

shake-up in the history of the NHS is all about - giving local doctors,

:12:19.:12:22.

nurses and patients the chance to call the shots and shop around for

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the best care. At least that's the Government's plan. But many doctors

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think the reforms are untested, expensive and over-complicated - a

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view I shared with the former health secretary Andrew Lansley.

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The difficulty with this is that it's 353 pages of wonk. It's

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absolutely impossible to understand it. I choose my words carefully. It

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is unreadable. What did you actually say? It's wonk. But I've

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been wading through the jargon, and it's clear the reforms will affect

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us all. It's vital we put politics aside and try to understand exactly

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what they'll mean for patients. Until now the NHS has been like a

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big supermarket chain that only sells its own brands. It's a one

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stop shop where all the tricky decisions are made for you. In

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theory, you should get the same high quality care whether you live

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in Scunthorpe or Southend. But like any monopoly, it's far from perfect.

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The Government's bringing in the market place model instead -

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introducing more choice and competition, and putting GPs in

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charge instead of civil servants. But will it work?

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So if I just check your eyes there... I can confirm you have two

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eyes. We're doing two X-rays for the price of one. And I can throw

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in a free brain scan if you like. One change we're told patients

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should notice is care much closer to home.

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Hospitals and GPs will have more freedom to bring in innovative

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ideas. Technology might monitor your health at home and routine

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surgery could be done at high street clinics. Hospitals in

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Gloucestershire have already teamed up with a charity to send this

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mobile chemotherapy unit into rural communities. For cancer patients

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like Graham Freeman, it's a lifeline. The concept is great,

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moving the treatment to the person. Because it is a bit of a trauma,

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suffering from the chemotherapy and the travelling. Bringing the

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treatment closer to the person is a lot better. You do feel a little

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bit better. Everything is positive. It is one of the few positives

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since I have found out about cancer. It is one of the positive things we

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have got. But could this shift towards more localised care mean

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hospitals will have to close? To find out I've come to London, to

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one of the world's most respected independent think tanks on health

:14:57.:15:04.

policy - the King's Fund. I don't think we'll see many hospitals

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closing as a result of care coming closer to home. It will mean

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hospitals changing their roles, perhaps fewer A&E departments,

:15:09.:15:15.

fewer maternity services provided in existing hospitals. But that

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could be to the benefit of patients if we're able to plan that in the

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appropriate way and get better outcomes by concentrating those

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services in fewer hospitals. might not be keen though, if it's

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your A&E that's closing. The second thing patients should notice is

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more choice. Three tomatoes for �1! Anybody?

:15:38.:15:41.

Three inhalers for the price of two. Come and get them! Two caulies,

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�1.50 over there! We've got a separate queue here for six

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symptoms or less. Competition in the NHS isn't new, but the reforms

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step it up a notch. The NHS will become a marketplace,

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with private companies competing with the NHS for business. So when

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your GP says you need a scan, your options may look less like this,

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and more like this. But it should be quality, not price, that will

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decide which are allowed to offer care. It's already happening here

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on the high street, where Specsavers are treating NHS

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patients in 218 of its hearing centres. When I came to Specsavers,

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they do private and NHS, which I find is better than going to the

:16:29.:16:33.

hospital. You know you go to the hospital, there's a lot of

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travelling and I don't think you get such a personal attention. So

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this is much, much better. When you press the button in, you'll hear

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two beeps which will allow you to use the telephone then. The plan is

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for patients like Doreen to choose their provider by looking at new

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performance league tables. But companies must play by the rules

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and can't encourage NHS patients to go private. Ultimately, Specsavers

:16:59.:17:03.

want to protect the NHS work that we've managed to gain here and we

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don't want to do anything to try and jeopardise that. We're not

:17:07.:17:11.

going to try and sell a hearing aid, upsell a patient at all during that

:17:11.:17:17.

time. More competition could drive up standards and lower costs. But

:17:17.:17:20.

if profits slip, companies could pull out or even go under, leaving

:17:20.:17:25.

patients in the lurch. Remember the collapse of Northern Rock? Imagine

:17:25.:17:28.

if its customers had been queuing not for their life savings but for

:17:28.:17:35.

life-saving surgery. If there is going to be a bigger role for

:17:35.:17:38.

private companies in delivering care to patients, then there is

:17:38.:17:40.

always a possibility, however remote, that that company will not

:17:40.:17:43.

be successful, that we will see something like Northern Rock in

:17:43.:17:46.

healthcare. The Government's anticipating that. It's putting in

:17:46.:17:48.

place what's called a "failure regime" so that the regulator can

:17:48.:17:51.

intervene and ensure continuity of services even if the organisations

:17:51.:18:01.

are not providing care to the right standard. The third thing patients

:18:01.:18:04.

may notice is a shift in their relationship with their GP. So if I

:18:04.:18:08.

said, "Trust me, I know the best place to go to get your heart

:18:08.:18:10.

surgery." Would you say, "Yeah, you're the doctor. Dr Phil, you

:18:10.:18:17.

look like a ginger George Clooney. I love, I trust you."?

:18:17.:18:20.

Since the birth of the NHS, doctors have taken the trust of patients

:18:20.:18:26.

for granted. But as GPs offer more and more treatments, they could

:18:26.:18:29.

find themselves referring patients to their own services. Add private

:18:29.:18:32.

companies into the mix and there's real scope for a conflict of

:18:32.:18:39.

interest. So just open really wide. Say "ahh." Ahh. That's great, thank

:18:39.:18:43.

you. But should we really be worried? In Bath, Jasmine Bishop is

:18:43.:18:46.

seeing a GP on the NHS. But believe it or not, he actually works for

:18:47.:18:49.

Virgin. Yup - they of planes, trains and super-fast broadband

:18:49.:18:54.

fame also run this walk-in centre, along with 170 other NHS services...

:18:54.:19:01.

Although you wouldn't know it from the branding. As Virgin takes over

:19:01.:19:04.

more of the NHS, what's to stop you referring patients on to another

:19:04.:19:07.

Virgin service to make money for the company, rather than in the

:19:07.:19:10.

best interests of the patient? of our GPs, like any GP in the

:19:10.:19:13.

country, have to offer patients a choice when they're being referred

:19:13.:19:20.

for another service. So in the end, it's down to the patient to choose

:19:20.:19:24.

where they go. And of course, GPs and other clinical staff have a

:19:24.:19:27.

professional responsibility too to make sure that they're finding the

:19:27.:19:31.

best care for their patients. That doesn't differ because those GPs

:19:31.:19:37.

are employed by us. And you have to ask if patients really mind who

:19:37.:19:40.

provides their care. Did you know that this health

:19:40.:19:44.

centre was run by Virgin? No. it make any difference to you as a

:19:44.:19:47.

patient whether it's run by an ordinary NHS GP or a private

:19:47.:19:53.

company? No. So all that matters to you is what? What do you care about

:19:53.:19:56.

in your treatment? That I get the best treatment I possibly can get

:19:56.:19:59.

really. Which of these sample bottles would

:19:59.:20:02.

you like, madam? We've got three on choice today.

:20:02.:20:05.

The bottom line is that if you have a good idea to improve your care,

:20:05.:20:10.

tell your GP. If he or she can make it happen, we know the reforms are

:20:10.:20:14.

working. It's been a huge upheaval just to get the NHS to listen to

:20:14.:20:20.

patients. And I hope for all our sakes it works. I can't lug all

:20:20.:20:23.

this back again. Come on, it's got to go today. Last

:20:23.:20:33.
:20:33.:20:36.

chance! You are watching Inside out here in

:20:36.:20:39.

the West Midlands. The Met Office did warn it is going to snow and it

:20:39.:20:44.

has cost chaos. 999 services were at full stretch but they were able

:20:44.:20:53.

to call on the vital support of some volunteers.

:20:53.:20:57.

For the last four days, snow and freezing temperatures have gripped

:20:57.:21:02.

in the West Midlands. We still have a Met Office amber warning in place,

:21:02.:21:06.

the second highest and it is staying right the way through to

:21:06.:21:10.

tonight. The snow is staying with us. If snow made driving

:21:10.:21:15.

difficult... This is the worst I have known it for a few years, to

:21:15.:21:20.

be honest. This is the first time we have had to turn around and come

:21:20.:21:24.

back. Emergency services struggled to reach patients in need but there

:21:24.:21:28.

is help at hand. Hundreds of volunteers turned out to exist.

:21:28.:21:32.

Meet one of them, Adrian, a former teacher who has been volunteering

:21:32.:21:37.

for the Red Cross since he was a child. Today he is operational with

:21:37.:21:43.

the 4x4 Red Cross ambulance. I have West Midlands and villains service

:21:43.:21:45.

when the weather gets extreme and I am joining them. Talk me through

:21:45.:21:49.

which you do at the beginning of a shift. There are two main things we

:21:49.:21:54.

like to do when we are setting up the ambulance. One of which is to

:21:54.:21:57.

check the roadworthiness of the vehicle, the lights and the engine,

:21:57.:22:02.

the tyres and bodywork. The next thing is to check the integrity of

:22:02.:22:08.

the vehicle in terms of the supplies. It is quite a long shift

:22:08.:22:14.

and we need to know we have got the right amount of equipment. It is

:22:14.:22:17.

the special Land Rover which makes the team so useful when 10

:22:17.:22:21.

centimetres of snow has fallen. are very lucky to have his vehicle.

:22:21.:22:27.

It is worth its weight in gold, with certainly snow responses and

:22:27.:22:33.

also inaccessible places due to flooding, or also muddied, things

:22:33.:22:40.

like music festivals in the summer. It is useful in any kind of weather,

:22:40.:22:45.

we would be utilised to get too inaccessible places. Either a very

:22:45.:22:50.

rural locations or perhaps places hit hard by the snow and have lots

:22:50.:22:54.

of hills. I will let you get on with your prep because I know you

:22:54.:23:04.
:23:04.:23:07.

have to sign on at the beginning of the shift. Thank you.

:23:08.:23:15.

Signing on for a shift with the today, over. Now, the team are

:23:15.:23:19.

signed on. Adrian just needs to check one last thing. Can I have

:23:19.:23:24.

clarified with regards to transfer a fusion of patience, are all

:23:24.:23:27.

patients when being transported to hospital going Asprey yesterday,

:23:27.:23:33.

over? The weather meant the roads were blocked yesterday so every

:23:34.:23:37.

patient they picked up had to be blue lighted to hospital through

:23:37.:23:45.

the traffic. We had a lot of poorly people yesterday and the problem

:23:45.:23:48.

was that it was taking an awfully long time not only to get two

:23:48.:23:54.

incidents but to get back out on the road. To assist with getting

:23:54.:23:58.

patients into care and to get us back onto the road, we were asked

:23:58.:24:06.

to do that. So it is just a waiting game? I am afraid so, yes. It is

:24:06.:24:11.

one of those things, it can happen at any moment. On Friday, they had

:24:11.:24:17.

six jobs in six hours and they are expecting another busy day. Whilst

:24:17.:24:21.

Adrian and the other volunteers wait at kiss, many are out enjoying

:24:21.:24:28.

the snow that has covered the West Midlands. -- which at the base. A

:24:28.:24:38.
:24:38.:24:46.

call has, in. -- has come in. Roger, I do, all received. Lovely, cheers,

:24:46.:24:51.

thank you. You have got to get moving, but what is happening?

:24:51.:24:56.

are going to a patient in Walsall assessed by their GP. It is

:24:56.:25:01.

recommended due to a systemic problem with their joints, and also

:25:01.:25:05.

be a pig feed that they have into their stomach, they need to go into

:25:05.:25:13.

hospital. -- also a feat that they have into her stomach.

:25:13.:25:19.

The snow eased off, so getting to the patient is quick. It is a vital

:25:19.:25:25.

piece of equipment for us and we operate as a resource for the

:25:25.:25:32.

ambulance service. We can get to places that a land ambulance would

:25:32.:25:39.

struggle or possibly even be dangerous for it to go.

:25:39.:25:42.

We will just take that and to check on her.

:25:42.:25:48.

What is the first thing you will do? We will have a chat. This is

:25:48.:25:52.

residential accommodation. We would chat with the staff and patient and

:25:52.:25:57.

find out what has been happening, how they are feeling, what has been

:25:57.:26:07.
:26:07.:26:08.

going on the last couple of days. This is a line in it and it keeps

:26:08.:26:13.

getting moved. Kathleen has only just come out of hospital but is

:26:13.:26:21.

still in pain and her GP wants her to be readmitted. What is your

:26:21.:26:28.

assessment? This lady has had recent surgery and has been

:26:28.:26:34.

receiving antibiotics at home. The main problem for her is that the

:26:34.:26:38.

antibiotics are unable to get into her system because there is a

:26:38.:26:43.

blockage in the tubing she has been set up with. It is important post

:26:43.:26:47.

operatively to receive those drugs on a regular basis so we need to

:26:47.:26:51.

take her to hospital so it can be rectified -- rectified and the

:26:51.:26:57.

medication process can start to harbour with recovery. With their

:26:57.:27:01.

elderly patient on the ambulance, the snow does not stop them getting

:27:01.:27:08.

her into Walsall Manor Hospital. Kathleen has had knee surgery and

:27:08.:27:15.

she needs antibiotics. She had was seen by the community nurses

:27:15.:27:21.

morning and her line is blocked. Hopefully they will be able to give

:27:21.:27:27.

her the antibiotics that she needs in hospital to take the pain away.

:27:27.:27:31.

With this job done, it is back to base with the team, but the weather

:27:31.:27:37.

is still threatening. It may get a lot I see you later on with the

:27:37.:27:42.

prediction of more snow. -- a lot I see her. It could become more

:27:42.:27:51.

treacherous. You might get a cup of tea and! Are if you are lucky.

:27:51.:27:55.

Coming along makes a huge difference, doesn't it? We are very

:27:55.:27:59.

lucky to have as they go and it really comes into its own in bad

:27:59.:28:02.

weather. Certainly with the snow that we have now, I cannot see it

:28:02.:28:06.

not been used over the next two days. I will let you get back and

:28:06.:28:16.
:28:16.:28:16.

get ready for the next job. Thank They at his it. Do not forget you

:28:16.:28:23.

can find more information on our Facebook page. With more of this

:28:23.:28:28.

forecast over the next few days, stay tuned to your local BBC radio

:28:28.:28:34.

station. From snowing Birmingham, good night.

:28:34.:28:39.

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