Nurse 'switched off life support'

24 October 2010 Last updated at 19:25 ET <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Nurse Violetta Aylward was captured on film accidentally switching off her patient's ventilator, leaving him brain-damaged.

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An agency nurse working for the NHS was filmed switching off her patient's life support machine by mistake.

Tetraplegic Jamie Merrett, 37, had a bedside camera set up at his home in Wiltshire, after becoming concerned about the care he was receiving.

Within days, it captured the moment Violetta Aylward switched off the ventilator, leaving him brain-damaged.

Ambition 24hours, which supplied her, said it could not comment as an internal investigation was continuing.

A confidential report by Wiltshire social services into the incident - leaked to the BBC's Inside Out programme - concluded the agency was fully aware it was required to supply a nurse with training in the use of a ventilator, but the company did not have adequate systems in place to check what training their staff had received.

Mr Merrett, from Devizes, has been cared for at home on a life-support machine since 2002 after being left paralysed from the neck downwards following a road accident.

Despite his disabilities, he was able to talk, use a wheelchair and operate a computer using voice-activated technology.

His sister Karren Reynolds said he had become increasingly worried about serious errors involving nurses operating his ventilator, but claimed that health bosses did not act on e-mails of concern which he sent them.

In January 2009, he arranged to have a camera installed in his room. A few days later, the ventilator was switched off.

After 21 minutes, the machine was eventually restarted by paramedics but by then Mr Merrett had suffered serious brain damage.

Legal action

Ms Reynolds, who is considering legal action, said his level of understanding had dropped to that of a young child.

"His life is completely changed. He doesn't have a life now," she said.

"He has an existence but it's nowhere near what it was before. He is very brain damaged compared to what he was before. He was a highly intelligent man and you could have long in-depth conversations with him and now it tends to be more simplistic."

The solicitor acting for Mr Merrett, Seamus Edney of SJ Edney in Swindon, said: "In my experience, this is the worst case of negligence on the part of a nurse.

"No-one has come forward to make any admission, so now almost two years after the event we are trying to get someone to admit liability for what has happened."

The NHS Wiltshire Primary Care Trust said in a statement: "[We have] put in place a series of actions to ensure that such an event will not occur again either for this patient or others. The incident is the subject of likely litigation so the PCT is restricted in what further it may say in public."

Ms Aylward has been suspended while the incident is investigated by the Nursing and Midwifery Council.

Their guidelines say a nurse should work within their level of competence and have the skills to undertake whatever care they are delivering.

Ms Aylward, who is from Reading, has not responded to requests for an interview.

The programme will be shown on Inside Out West and Inside Out South on BBC One at 1930 BST on Monday 25 October.

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Women &#39;miss father health clues&#39;

24 October 2010 Last updated at 19:01 ET

Women at risk of breast cancer miss out on tests and early diagnosis because their father's family's health history is disregarded, a study has suggested.

Canadian researchers say in Lancet Oncology that women were more likely to report a history of the disease on their mother's side.

They found women with a maternal cancer history were five times more likely to be referred by family doctors.

A UK cancer charity said a father's history was "often overlooked".

It is thought that between 5% and 10% of breast and ovarian cancers are the result of a genetic inheritance.

This is equally likely to have come from either the father or mother.

A significant chunk of this genetic risk is known to come from defects on either the BRCA1 or BRCA2 genes, which make it much more likely that a woman will develop breast or ovarian cancer in her lifetime.

If a woman has a strong family history of breast cancer, she can be referred for further testing to see if she has a known gene defect.

She can then take steps to reduce the risk, or simply get checked more regularly to catch the cancer early.

'Sometimes overlooked'

The Lancet Oncology research, led by Jeanna McCuaig from the Princess Margaret Hospital in Toronto, found that despite the equal chance of inheritance from mother or father, the maternal history seemed to be taken more seriously.

They looked at records from their own clinic, and found the difference in referral rates.

Continue reading the main story

"Start Quote

It's important to know that faulty genes can be inherited from the father, as well as the mother. "

End Quote Dr Caitlin Palframan Breakthrough Breast Cancer

They concluded that there were two reasons for this - a lack of knowledge in women about the risks, and a similar problem among family doctors, who did not ask women about the history of breast cancer on their father's side.

She wrote: "Anecdotally, we know of two patients - a man with a substantial history of breast and ovarian cancer, and a woman with a known BRCA2 gene mutation in her paternal family - who were both falsely reassured by their healthcare providers that this history did not increase their, or their daughters' cancer risks.

"The patients were not offered genetic assessment and testing or the appropriate medical options"

The charity Breakthrough Breast Cancer said similar problems could occur in the UK.

Dr Caitlin Palframan, policy manager, said: "We know that a family history on the father's side is sometimes overlooked as a risk factor for breast cancer, but it's important to know that faulty genes can be inherited from the father, as well as the mother.

"However, this is unusual as only around one in 20 of all breast cancers are due to inherited faults in known genes.

"A family history means having an unusually high number of close relatives with breast cancer on one side of the family."

She urged anyone concerned about breast cancer cases in their family history to speak to their doctor.

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Bitter tastes &#39;could ease asthma&#39;

24 October 2010 Last updated at 14:39 ET

The discovery of "taste receptors" in the lungs rather than on the tongue could point the way to new medicines for asthma, it is suggested.

Experiments in mice revealed that bombarding the receptors with bitter-tasting compounds helped open the airways, which could ease breathing.

The University of Maryland study, published in Nature Medicine, may have implications for other lung diseases.

Asthma UK warned that any new drug would not arrive for some time.

The "taste receptors" discovered in the smooth muscle of the lungs are not the same as those clustered in taste buds in the mouth.

They do not send signals to the brain, and yet, when exposed to bitter substances, they still respond.

Continue reading the main story

"Start Quote

This approach could potentially pave the way for a new range of asthma treatments based on bitter substances. "

End Quote Leanne Metcalf Asthma UK

It was the nature of that response that surprised researchers, who assumed their presence was as a defence against noxious gases, triggering a tightening of the airways and coughing.

In fact, the mouse experiments revealed that exactly the reverse was true.

Protective response

When airway tissue from mice was treated with bitter substances, then exposed to allergens, there appeared to be a protective response.

Dr Stephen Liggett, leading the research, said: "They all opened the airway more profoundly than any known drug that we have for the treatment of asthma or chronic obstructive pulmonary disease."

In asthma, and other lung diseases, the smooth muscle lining the airway contracts, narrowing it, and drugs such as salbutamol help relax and open it, restoring normal breathing.

Dr Liggett said that an inhaler based on bitter substances such as quinine or even saccharine, which has a bitter after-taste, could "replace or enhance" current treatment.

He warned that simply eating bitter foods would not help protect from or relieve an asthma attack.

Dr Yassine Amrani, an asthma researcher at the University of Leicester, said the research was very "encouraging", potentially offering a new target for treatment.

He said future studies could focus on trying to reproduce the effect in human as well as mouse airway tissues, and making sure that the substances did not produce unwanted side effects such as inflammation.

He said: "The concept of having bitter taste receptors in the smooth muscle of the airways is a new one, and activating this receptor could offer a new way to relax them."

Leanne Metcalf, director of research at Asthma UK said that a significant number of the 5.4m asthmatics in the UK did not control their symptoms using existing drugs, and that research into new, more effective treatments, was "vital".

She said: "The effectiveness of bitter substances at overcoming the airway narrowing that causes asthma symptoms has so far only been tested in mice, however this somewhat surprising approach does make sense in terms of what we already know about the cell signalling processes involved in asthma.

"With further in-depth research, this approach could potentially pave the way for a new range of asthma treatments based on bitter substances which could either supplement or replace existing asthma treatments but if this were possible, it would be a long way into the future."

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Charity warns over child drinkers

22 October 2010 Last updated at 19:06 ET

The charity Alcohol Concern has issued a stark warning about the number of children drinking at dangerous levels.

It has published a report estimating the cost of hospital treatment for underage drinkers in England to be about �19m a year.

And the number of under-18s ending up in hospital after drinking too much is rising, the charity has warned.

Young people should be given more support it says, but one expert said parents also have a role to play.

Alcohol Concern's report, entitled Right Time, Right Place, states that alcohol contributes to 5% of young people's deaths - 1.4% more than in the adult population - and is "a significant problem for the UK".

The UK also has the highest rates of teenage alcohol-related injuries in Europe.

Continue reading the main story

"Start Quote

The wider community has a major role in pressing for policies around price, availability and marketing of alcohol that protect children"

End Quote Prof Sir Iain Gilmore Alcohol Health Alliance UK

The number of under-18s admitted to hospital in England, where alcohol was a factor, increased from 10,976 in 2002/3 to 14,501 in 2007/8.

In 2008/9 the number of admissions fell to 12,832.

All these admissions figure exclude emergency department attendances, which could increase the number.

Last year, 8,799 under-18s accessed specialist treatment for tackling alcohol problems, the report says.

'Risky drinking'

The report calls for earlier identification of young people engaged in 'risky' drinking, such as young people attending A&E or getting into trouble with the police for alcohol.

The minute that alcohol appears to be becoming a problem for a young person aged under 18, information, advice and support should be provided, Alcohol Concern says.

Don Shenker, chief executive of the charity, said that drinking in children is a "huge problem".

"Some of these youngsters are as young as 10. Remember these are children we are talking about and their bodies can't process alcohol like adults can."

"We are extremely concerned about the damage to children's health."

He maintained the costs of early intervention are far less than the costs of treating the health problems of long-term alcohol misuse by children and young people.

"Training medical staff as alcohol specialists is a cost-effective measure. The 'do nothing option' is far more costly," Mr Shenker said.

Professor Jonathan Shepherd, who directs Cardiff University's Violence and Society Research Group, said: "These findings demonstrate as never before the need to capitalise on every episode of emergency treatment to educate and protect."

Role models

Professor Sir Ian Gilmore, chair of Alcohol Health Alliance UK, said: "We know that heavy drinking from an early age can diminish the life chances of the young person involved. It is important that parents realise they are role models - their behaviour in relation to alcohol has more impact than what they tell their children.

"Equally, the wider community has a major role in pressing for policies around price, availability and marketing of alcohol that protect children."

Susie Ramsay, policy adviser at The Children's Society, said that money and time could be saved if more resources were focused on preventative services.

"Early intervention and preventative services have a proven track record, particularly with relation to young people's substance misuse.

"If these are put in place, the number of young people being admitted to A&E due to drinking is bound to be reduced and money saved."

A spokesperson from the Department of Health said: "This report shows the devastating impact that alcohol has on the lives young people who drink too much.

"We must educate them so they understand how bad it is for their health now and in the long term. And we must do more to stop shops selling alcohol to under 18s.

"Everyone has a part to play in this. Parents, police, education and social services need to work together.

"The new Public Health Service will give communities the power and budget to tackle alcohol problems in their areas."

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Care cuts &#39;may hit hospital beds&#39;

22 October 2010 Last updated at 20:01 ET

Hospital beds in England may fill up with the elderly and vulnerable because of cuts to local authority social care funding, a top NHS figure has warned.

The claim came from the head of the NHS Confederation, Nigel Edwards, in a letter to the Daily Telegraph.

Mr Edwards said people who needed medical treatment may be denied a hospital bed as a result of the cuts.

The Department for Health responded that an extra �2bn was being allocated to protect social care.

Health spending was ring-fenced in Chancellor George Osborne's Spending Review.

However, councils in England are facing a 27% cut in central government funding over the next four years.

Mr Edwards, whose organisation represents health service bodies in England, said this funding squeeze could have a "knock-on effect" on the health service.

In his letter to the Telegraph, Mr Edwards said: "Less support from council services will quickly lead to increased pressure on emergency services and hospitals.

"Hospital beds will be blocked for those who badly need care because the support services the elderly require after discharge will not be available."

Continue reading the main story

Spending Review: Key measures

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� �81bn cut from public spending over four years

� 19% average departmental cuts - less than the 25% expected

� �7bn extra welfare cuts, including changes to incapacity, housing benefit and tax credits

� �1.8bn increase in public sector pension employee contributions by 2014

� Rise in state pension age brought forward

� 7% cut for local councils from April next year

� Permanent bank levy

� Rail fares to rise 3% above inflation from 2012

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He added: "When it comes to the care of the most vulnerable in our society, it really is essential that the NHS and local authorities are in it together."

The Department of Health said it understood that "social care can impact on NHS demands".

A spokeswoman said: "That's why we are strengthening programmes like re-ablement and the 30-day re-admission tariff, which will integrate hospital care with care in the community.

"We have allocated an additional �2bn by 2014-15 - this extra boost, alongside an ambitious programme of efficiency, will ensure that there is enough funding available both to protect people's access to services and deliver new approaches to improve quality and outcomes.

"We expect local health and social care professionals will work together to ensure that the funding is spent on joint health and social care priorities and improve outcomes for everyone."

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Aspirin &#39;cuts bowel cancer cases&#39;

21 October 2010 Last updated at 19:20 ET By Nick Triggle Health reporter, BBC News

A daily aspirin tablet may help prevent bowel cancer, a study suggests.

Oxford University found it cut cases by a quarter and deaths by more than a third in a review of 14,000 patients.

Aspirins are already widely used to help protect people against strokes and heart problems, although many healthy middle-aged people do not take them because of the risk of side-effects.

But researchers said their findings - published by the Lancet - "tipped the balance" in favour of taking them.

They followed up four study groups over a period of 20 years to identify the impact of regular small doses of of the drug - the tablets given for medical reasons are often a quarter of a strength of those used to treat headaches.

Continue reading the main story

"Start Quote

To date, for healthy middle-aged people it has been a fine balance as to whether to take aspirins, but this tips it in my view"

End Quote Professor Peter Rothwell Lead researcher

They found it reduced the risk of the incidence of bowel cancer by 24% and of dying from the disease by 35%.

And even though regular aspirin use can have side-effects, the researchers said it was still worthwhile as on such low doses these tended to be relatively minor, such as bruising or nose bleeds.

One in 20 people in the UK develops bowel cancer over their lifetime, making it the third most common cancer. About 16,000 people die each year as a result of it.

The findings build on previous research on the issue, and come after the government announced earlier this month it was looking to start a new screening programme for bowel cancer for 55-year-olds.

Lead researcher Professor Peter Rothwell said the screening would provide the perfect opportunity for doctors to discuss with their patients about whether to take aspirin.

"To date, for healthy middle-aged people it has been a fine balance as to whether to take aspirins, but this tips it in my view.

"There is a small benefit for vascular disease and now we know a big benefit for this cancer. In the future, I am sure it will be shown that aspirin helps prevent other cancers too."

'Talk to GP'

He added those with a high risk of bowel cancer, including the obese and those with a family history of the disease, should give aspirin treatment a particular consideration.

Mark Flannagan, chief executive of Beating Bowel Cancer, said they were "very positive" findings and giving aspirin alongside the new screening programme should be looked at.

But he added: "Anyone considering starting a course of medication should first consult their GP."

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