A&E in England sees worst ever delays in January, leak suggests

A&E patients in England experienced the worst month of delays in January since a four-hour target was introduced 13 years ago, leaked figures suggest.

Provisional data passed to the BBC says an unprecedented number of patients spent longer than the target time waiting to be seen in emergency wards in January.

It showed that more than 60,000 people waited between four and 12 hours for a hospital bed. And more than 780 waited more than 12 hours. Both figures are record highs since the introduction in 2004 of a target that 95% of patients must be seen and either admitted or discharged in under four hours.

The leaked document from NHS Improvement suggests that out of 1.4m visits in January, only 82% were dealt with within the four-hour target.

The NHS Providers chief executive, Chris Hopson, said: “These figures have not been verified and should therefore be treated with caution, but they are in line with the feedback we have been getting from trusts.

“NHS staff have responded magnificently to increased winter pressures, but the situation has become unsustainable. The rise in long trolley waits is particularly worrying, as there is clear evidence they can lead to worse outcomes for patients.”

Hospitals have not hit the target nationally since the summer of 2015.

A Department of Health spokesman said the January data was yet to be verified and that official figures, due out on Thursday morning, only covered December.

He said: “We do not recognise these figures – it is irresponsible to publish unverified data and does a disservice to all NHS staff working tirelessly to provide care around the clock.

“Despite the pressures of winter, the vast majority of patients are seen and treated quickly and hospitals have detailed plans in place to manage busy periods – supported by an extra £400m of funding.”

Dr Mark Porter, chair of the British Medical Association council, said delays in A&E were a symptom of a bigger crisis in social care, which the government was failing to grasp.

“When social care isn’t available, patients experience delays in moving from hospital to appropriate ongoing care settings – preventing patients being admitted at the front end in A&E,” he said.

“The prime minister cannot continue to bury her head in the sand as care continues to worsen.”

A&E in England sees worst ever delays in January, leak suggests

A toxic leak left Corpus Christi with no water for days. A taste of things to come? | Sarah McClung

Corpus Christi, Texas, calls itself the “sparkling city by the sea”. But lately it doesn’t feel very sparkling. The city imposed a four-day ban on consuming any tap water last Wednesday. No one could drink the water, shower, bathe, do dishes, wash laundry, hands, faces or children with it. There were fears that a corrosive asphalt emulsifier Indulin AA86 had snuck all the way from the city’s industrial district into our homes due to a “back-flow incident”. There was water, water everywhere, and not a drop to drink.

On 1 December, the Corpus Christi city hall received the first report of dirty water from Refinery Row. On 7 December the city hall received their second, on 12 December their third. By then the water was shimmery, sudsy – just the kind of sheen we would soon fear creeping into our commodes.

On 14 December, city hall told us not to consume tap water. If it was contaminated with Indulin AA86, then drinking it could sear our stomachs, light up our lungs and burn any bodily organ it contacted through water or air.

Where were the men and women who would put public safety before all else? Where were the leaders who would make sure that the companies in charge installed and maintained a backflow preventer that would have kept Indulin AA86 where it belonged: out of our tap water.

But this is only Corpus Christi, a forgotten scab of a city. A tiny, immaterial industrial outpost marking naught but the dwindling Texas shoreline as it slopes and surrenders on its muddy fall to Mexico. This is the small potatoes of municipal incompetence; until it isn’t. Until we look to the future of the Trump administration and see the shimmering signs of far worse to come.

Streets need their protectors, cities need them too. And countries? Most notably, a country that’s among the biggest environmental offenders, a country whose ties to big business, big oil, big money are notorious for putting profit before the public good? That kind of country doesn’t need Scott Pruitt, it doesn’t need Rex Tillerson and it certainly doesn’t need Rick Perry.

Had Corpus Christi taken as much care with its public facilities as it does with the maintenance of private residencies, my two-year-old daughter might not have known what it was to be thirsty on the morning of 15 December, 2016. But with a Trump administration around the corner, I have to check myself: four days without water is nothing compared to the damage that four years without oversight, without vigilance, without care could do to our water and to our land.

Four days of thirst. Will it foreshadow the harm that Trump’s fossil fuel friends in the cabinet will bring? We all know the line-up: Scott Pruitt, a climate change denier and advocate for fossil fuel, at the helm of the EPA; Rick Perry, a climate change denier and apostle of Texas oil and gas directing the department he famously forgot he wanted to eliminate; and Rex Tillerson, a man whose successful devotion to commercial profit as the CEO of ExxonMobil is the absolute epitome of placing private over public good.

This is the very formula for successful municipal management that helped land me and my family thirsty and hunting for water last week. This is the very mindset that may have introduced Indulin AA86 into our water supply. This the very philosophy that sent me scouring supermarket shelves for four hours in three towns while my daughter cried in her carseat.

Our water is back now; the ban has been lifted. But every time I turn on the tap I hesitate, I hope for the best. That feeling will only grow stronger the closer we get to a Trump administration.

A toxic leak left Corpus Christi with no water for days. A taste of things to come? | Sarah McClung

Seven-day NHS: Labour demands inquiry as leak reveals crisis warning

Labour is demanding an inquiry into revelations that senior civil servants fear the government’s push for a “truly seven-day NHS” may be derailed because it faces staffing and money problems.

Tom Watson, the party’s deputy leader, claimed that leaked Department of Health documents obtained by the Guardian and Channel Four News showed Jeremy Hunt had misled the public by pushing ahead with expanding the NHS in England despite his own mandarins’ concerns.

“Leaked secret papers show that junior doctors’ concerns were right. This warrants an inquiry. Hunt misled the public,” Watson tweeted in response to the disclosures, which have prompted renewed scrutiny of a policy that the Conservatives have pledged to deliver in full by 2020.

Senior Tories have responded to the publication of the department’s own risk assessment of the seven-day plan and other papers by making clear that they share the civil servants’ previously private worries.

Dr Dan Poulter MP – who until last year was a health minister alongside Hunt and is also an NHS doctor – tweeted his view that the documents constituted “a warning of the dangers of putting soundbites ahead of properly costed and resourced plans for our NHS”.

Dr Sarah Wollaston MP, the ex-GP who chairs the influential Commons health select committee, tweeted: “Cannot keep piling ever greater responsibilities on to an overstretched service without realistic resource and workforce to cope.”

In a swipe at Hunt she added: “Expect problems when thin evidence is used to bolster an under-resourced political objective instead of policy following the evidence.”

Diane Abbott, the shadow health secretary, said: “This is a scandal. The government is undermining the NHS with plans it knew to be unworkable. I will be writing to Jeremy Hunt to ask him to explain why [he] has contravened his civil servants’ advice and to ascertain whether he has misled parliament.”

Professor Jane Dacre, the president of the Royal College of Physicians, also warned that the drive to expand medical services at weekends was unrealistic because of the NHS’s worsening shortage of doctors, which is leading to more and more gaps in rotas and expensive use of locum medics.

“At the moment we are struggling to deliver care over five days, so to extend that to seven days and expect doctors to be able to provide high quality of care is not realistic. Doctors are working hard and they want to do the best they can for patients, but it is difficult to deliver the quality of care needed seven days a week without extra people to deliver it”, she told C4 News.

“There are just not enough doctors available to run a seven-day service at the moment. We all want to provide better patient care but to provide a seven-day service in our hospitals we need more doctors, and probably more nurses too. We also need pharmacists, occupational therapists and physiotherapists working at weekends as well.”

Hunt has made clear he expects the NHS to fund the expansion of services that he wants by 2020 from within the £10bn rise in its budget it will receive by then.

However, health experts such as Nigel Edwards, chief executive of the Nuffield Trust think-tank, have made clear that with the £10bn only bringing a 0.9% annual increase in NHS funding, the entire amount will be needed to help the service cope with growing pressures, and it will not cover the costs of having more doctors on duty in hospitals and GP surgeries by the end of this parliament.

Seven-day NHS: Labour demands inquiry as leak reveals crisis warning

Nuclear Waste Leak Traced To --- Kitty Litter

You may well have heard that the most probably culprit for the Valentine’s Day radioactive leak was…kitty litter!

Yes. The wrong kitty litter was almost certainly employed to deal with some of the nuclear waste just lately disposed in the world’s only deep underground nuclear waste repository, close to Carlsbad in New Mexico. Cat litter has been used for decades in radiochemistry labs and nuclear facilities to stabilize specified radwastes, like liquid scintillation solutions, evaporator bottoms, and other resources that have nitrate salts in resolution.

Nitrate salt options can ignite when they dry out – which is why it is tough working with nitrate remedies in the lab and why you need to make sure they do not dry out, one thing many a chemistry pupil has discovered out the challenging way. So you need to stabilize nitrate options ahead of they dry out, or stop them from completely drying out.

Conventional cat litter is manufactured from numerous inorganic geologic silicate minerals like diatomaceous earth, zeolites or bentonites, materials that are outstanding in absorbing and stabilizing chemical species like nitrates, ammonia, and urea. This is the very purpose we use minerals for cat litter. Sadly, someone operating with this waste, just before it was to be shipped to WIPP, utilised a new “green” cat litter, manufactured with materials like wheat or corn. These natural litters do not have the silicate properties needed to chemically stabilize nitrate the appropriate way.

A photograph hunting in excess of the prime of nuclear waste emplaced at WIPP in drums, waste boxes and overpacks in Panel seven where the release of radioactive material took spot. One of these drums very likely had the incorrect kitty litter utilized to stabilize nitrate salts, which dried out and burst open the drum on Valentine’s Day. “Green” litter manufactured from wheat or corn does not have the very same chemical properties that standard mineral litters have. Discover the minimum quantity of disruption: the salt rock is intact, roof bolts are intact, the thin metal screening is intact, the plastic gaskets among containers are intact, the other drums appear intact, some MgO sacks that sit on best of the waste are disturbed, but the energy released does not seem to have been extremely huge. Supply: WIPP

We nevertheless require much more visual proof to be totally specified.  The drum considered to have burst is about ten rows back from the waste face. See photo of the waste panel in query. The Valentine’s Day occasion would seem to have originated from a spot exactly where that particular waste stream was placed.

Recall that WIPP, the only working geologic nuclear waste repository, had its 1st minor accident on Valentine’s Day after 15 years of ideal operations. It was a little release of radiation that did not and will not harm any person or have any environmental consequence. The volume of radiation released into the setting was a million occasions significantly less than any EPA level requiring action, so little that, in accordance to the EPA, we didn’t even have to report it.

Each drum going to WIPP is labeled, barcoded and tracked so we know in which they all are and exactly where they came from. We know which drums have been treated with this green litter. Some are stored at WIPP and some are stored at other areas.  We can fix this difficulty.

Because of this event, the basic public has turn into aware for the very first time in 15 years that the United States has a successful nuclear repository, the Waste Isolation Pilot Plant, recognized as WIPP. It will take a few months for the genuine story to get out, for absolutely everyone to understand that WIPP carried out excellently, that this was not the consequence of any security lapse at WIPP or any failure of the repository itself.  We need to have serious, intelligent discussion in this country about nuclear waste.

WIPP is presently licensed only for nuclear weapons waste, transuranic or TRU, but was created to hold any and all nuclear waste. WIPP is located a half-mile beneath the Earth in the enormous ten,000 square-mile Permian-age salt deposits of the Salado Formation inside of the Delaware Basin that cuts across southeastern New Mexico into west Texas.

The Salado has geological, physical, chemical, redox, thermal, and creep-closure properties that make it ideal for long-term waste disposal.  Prolonged-term in this case means better than 200 million years. Simply because it is the ideal area, and the best rock, to place nuclear waste, or anything at all you want isolated from the environment permanently, debate has continued on expanding its present mission to incorporate all nuclear waste. This Valentine’s Day event does not alter that. Rather, it demonstrates the wisdom of the geological and nuclear engineers who developed WIPP. It is fortunate that this drum was in WIPP and not anywhere else when it burst.

WIPP has disposed about 80,000 cubic meters of nuclear waste, some very hot, and has been working for 15 years with no incident.  The performance basis of WIPP is nevertheless outstanding.

When the occasion occurred all specialists began to examine anything that may well have brought on it, from the planning of drums for storage to the overall performance of WIPP.  The initial notion to come to thoughts was that some thing triggered a drum to open. The only thing we could come up with was that a massive slab of salt rock fell from the ceiling of Panel seven and crushed one or much more drums.

But that is undoubtedly not what occurred. Instead, nitrate salts in the incorrect litter possibly dried out sufficiently to burst open a drum, and some material was entrained in the airflow out of the room. Quickly, the underground Constant Air Keep track of alarmed, and the ventilation switched to HEPA filtration, permitting only a little quantity to get out and intersect 21 individuals and some air filters. The levels of Pu and Am launched have been a million instances less than any environmental concern, 1000′s of instances less than any health concern, and forty instances much less than ordinary background.

This is the by-item of currently being ready to see a single atom disintegrating. The sum was so insignificant that we couldn’t see it following the 1st check on the individuals that showed the original hit. We’ll maintain monitoring them, but there is not any concern.

So, as far WIPP itself goes – no wellness concern, no environmental concern, no security concern, and now no operational concern. The efficiency basis of WIPP is still excellent.

Nuclear Waste Leak Traced To --- Kitty Litter

Fears of patient information leak prompt inquiry into mapping internet site

A screengrab taken on Monday from the homepage of on the web mapping firm Earthware. Health authorities have launched an investigation into the site

A support offered by a data mapping site was closed down on Monday, as wellness authorities launched an investigation into the website amid concerns it had apparently acquired millions of identifiable patient records with out regulatory scrutiny.

A Hertfordshire-primarily based on-line mapping organization, Earthware, which gives providers which includes home data, claimed to enable consumers to locate areas in England exactly where a single person had gone for specialised therapy.

Though this would not always pinpoint the patient concerned, the risk of identification is regarded as so high that information protection rules prohibit the release of info when fewer than 5 individuals are involved. The internet site charged customers for each search, but did provide a totally free support to sample the tool’s usefulness, which allowed the public to search for heart and respiratory circumstances.

In a statement, the company insisted the map contained “mock information”.

On Monday night the Health and Social Care Information Centre (HSCIC) mentioned the website tool had been shut down and an investigation launched into how the information had been obtained, as it had not been cleared by its regulatory method.

A spokesman for the information centre said: “The link to this tool has been taken down following a request by the HSCIC. We are investigating urgently the supply of the data employed and whether controls demanded of any organisation using data have been maintained. Soon after this investigation we will get any necessary action.”

In a statement issued on its site, Earthware explained it was “confident that we have not breached any legal or regulatory guidelines relating to the licensing or publication of [Hospital Episode Statistics] information”.

It stated that the map displayed mock information held by a third party that the business had in no way held HES information on its servers and that no patient-identifiable information was ever displayed on the map. “We will carry on to co-operate totally with the HSCIC if essential,” it concluded.

The investigation comes amid issues that there are probably businesses in the Uk able to generate information dossiers on sufferers by tapping new technologies to unearth ever far more intimate information about the public. The dataset apparently came from hospital episode statistics, which hitherto had been regarded as a fairly “protected” repository of delicate information.

NHS England has previously defended its flagship care.data scheme – which proposes to extract data from GP surgeries – by pointing out that for 25 years hospital statistics had not suffered a major breach of privacy. Roll-out of the scheme was put on hold in February for 6 months.

Phil Booth of medConfidential, which campaigns on healthcare privacy, told the Guardian that “NHS England officials have claimed once again and once again that there has been no misuse of hospital episode statistics. Now a commercial real estate web mapping firm appears to be acquiring entry to hospital patient-level data.”

Booth known as for a “total transparent” disclosure of all the hospital information so far launched and called for the care.information scheme to be “halted”. “Until there has been a complete transparent audit of every single release of patient information the whole program that they propose must be halted.”

Underneath care.information, unless of course individuals opt out, the HSCIC will extract a person’s NHS quantity, date of birth, postcode, ethnicity and gender. After the method is reside, organisations this kind of as university study departments – but also insurers and drug companies – will be capable to apply to the HSCIC to gain accessibility to the database. If an application is approved then firms will have to pay out to extract this information, which will be scrubbed of some personalized identifiers but not enough to make the info completely anonymous – a approach identified as “pseudonymisation”.

This week Jeremy Hunt will push through a number of amendments to the Care bill connected to protecting privacy.

The coalition will produce a new law that would bar any organization that obtains patient data beneath the care.data programme and employs it in a malicious way from ever bidding to use health-related information yet again. Hunt also proposes that the NHS’s confidentiality advisory group, which advises the overall health secretary on accessing confidential patient information without consent – be produced a statutory entire body.

Earlier on Monday, Sarah Wollaston, who practised as a family medical doctor and is now a Tory MP on the well being pick committee, questioned how the NHS hospital patient database for England was handed to management consultants who uploaded it to Google servers based outside the Uk.

Wollaston tweeted: “So HES [hospital episode statistics] information uploaded to ‘google’s immense army of servers’, who consented to that?”

The patient data had been obtained by PA Consulting, which claimed to have secured the “complete begin-to-finish HES dataset across all 3 locations of collection – inpatient, outpatient and A&ampE”.

The data set was so large it took up 27 DVDs and took a couple of weeks to upload. The management consultants said: “Inside of two weeks of starting to use the Google tools we had been ready to generate interactive maps directly from HES queries in seconds.”

Specialists said there had been considerations over the reality that data can effortlessly be shared in the Google technique – and that the danger of an accidental information leak would have catastrophic consequences for trust.

In a statement PA Consulting Group said it had obtained the information from the predecessor of the HSCIC. “The data set does not have info linked to certain individuals. The information is held securely in the cloud in accordance with situations specified and accepted by HSCIC.”

The HSCIC mentioned: “PA Consulting utilized a merchandise known as Google BigQuery to manipulate the datasets offered and the NHS IC was conscious of this. The NHS IC had written confirmation from PA Consulting prior to the agreement becoming signed that no Google staff would be ready to entry the data entry continued to be restricted to the people named in the data sharing agreement.”

Fears of patient information leak prompt inquiry into mapping internet site