89% Of Nurses Say A&E Patients Put In Danger

Nine out of 10 nurses working in acute and emergency care believe current pressure on A&E services is putting patients in danger, a nursing union has warned.

The Royal College of Nursing (RCN) said a survey of its members found that 89% of nursing staff thought the people they were meant to be caring for were being put at risk.

Some 85% said patient safety was being compromised by the strain on departments, while one in five said this was the case on every shift.

The poll of 416 RCN members found 89% said they had experienced increased pressure in their A&E department in the last six months.

A lack of beds and staff were both key reasons for department strain

More than three quarters cited increased attendance at A&E as the reason for increased pressure, while 74% blamed inappropriate attendance at A&E where patients could have been treated elsewhere.

The survey also found 57% cited a lack of beds for patients coming into A&E, while 54% said there were too few health care staff on duty to cope with demand.

Dr Peter Carter, chief executive and general secretary of the RCN, said: "Our member survey demonstrates the same picture that NHS Confederation leaders are painting - that emergency services and the staff working within them are under increasing pressure which is putting patient safety at risk.

"Staff enter the health profession to save and improve lives through first class care.

"However they simply cannot deliver this if there are too few staff to properly treat and monitor the increasing numbers of patients, not enough beds to put them in and no clear signposting to community care that could prevent attendance at A&E."

The survey was conducted in July.

A Department of Health spokeswoman said: "We know A&E departments are under pressure. There are over one million more people visiting A&E compared to three years ago.

"However we know, on the whole the NHS is performing well, latest weekly figures show 96% of patients were seen in under four hours and there are more clinical staff, including 4,300 more doctors since 2010.

"We have given A&E departments an additional £500m to make sure the best care is available for every patient this winter and the next and have set aside an additional £3.8bn to help join up health and care services."

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Sky Poll: Drunk A&E Patients Should Be Charged

By Thomas Moore, Health Correspondent

Patients who visit A&E while drunk or under the influence of recreational drugs should pay for the treatment they receive, according to the large majority of people questioned for a Sky News poll.

More than seven in 10 of those questioned said anyone needing emergency medical care because they were intoxicated should be charged for using NHS services.

Experts say at least seven million people a year attend A&E while drunk, placing an enormous strain on health service resources.

Sky News is broadcasting from inside the Queen's Medical Centre, Nottingham

The poll commissioned for State of Emergency, Sky News' weekend of live coverage from Nottingham's Queen's Medical Centre, shows that two in three people believe A&E services are in crisis and patients are being put at risk.

The Sky News poll of 1,106 people carried out by Survation also shows that eight out of 10 believe the Government must take immediate action to avoid major issues in A&E.

And more than six in 10 blame government cuts for any staff shortages and poor levels of care.

However, three-quarters of those questioned agreed that doctors and nurses were trying their best, but were being worked too hard.

To address the A&E care crisis, almost two-thirds of those asked thought consultants should be forced to work weekends and nights, with four in 10 saying senior doctors who refuse should receive less pay.

More than nine out of 10 opposed the provision of breast enlargements and tattoo removals on the NHS.

Nearly two-thirds also believed NHS managers were paid too much.

:: A&E Live Updates: Sky News On Emergency Ward

The think tank 2020health estimates that on an average weekday up to three out of every 10 patients attending A&E are there because of alcohol, and at the weekend that goes up to seven in 10.

Chief executive Julia Manning said: "We should be sending a really strong message that this is a misuse of A&E. A&E is there for people who've had road trauma accidents (and) major health incidents.

"It's not there for people who have just been mucking around and drinking too much. So we need to think of a way of creating a disincentive for people to get drunk and go to A&E, and we think one of the ways is that people should be invoiced for that use of A&E."

Health Secretary Jeremy Hunt told Sky News that while he understood the public desire for the move, it would be a difficult measure to introduce.

"I understand why people would want that, but I think in practice it's very, very difficult to differentiate between the people who have a health problem because of a direct decision they've taken themselves, and people who are unlucky.

"I think it's also one of the fundamental things that we all love about the NHS - that in an emergency you can turn up at a hospital and get treated.

"I think the day we started differentiating and saying we're only going to treat some people, and other people are going to have to pay, I think would be a step in the wrong direction."

On Saturday, Mr Hunt warned that it would be "very, very tough" for the NHS to avoid a repeat of last winter's A&E care crisis.

In an exclusive interview with Sky News, the Health Secretary admitted to being "concerned" about the high demand for emergency care and the pressure staff are under.

Health Secretary Jeremy Hunt has warned of a repeat winter A&E crisis

In the first three months of this year 94 out of 148 hospital trusts failed to meet the target for treating 95% of patients within four hours of them arriving at A&E.

Although the pressure eased over the summer, waiting times have begun to climb once more. Some hospitals are already breaching the target, even before winter pressures kick in.

The Government has given the NHS an extra £500m to pay for short term measures over the next two years to help ease the pressure.

That could include employing more locum consultants in A&E departments and setting up GP surgeries inside hospitals.

"A lot of things are happening to give support to the front line," said Mr Hunt.

"But that's not to say we are not worried about it, because it is going to be very tough, and we understand that."

The national director for acute episodes of care for NHS England, Professor Keith Willett, told Sky News that demand for emergency care is likely to rise once again this winter.

He will shortly unveil plans to divert more A&E patients towards the care of GPs, paramedics and chemists.

But in the short term patients will have to accept they have to wait for care.

"Safety is the priority," he said.

"We will do everything we can to maximise the way patients receive their care as quickly and optimally as possible.

"But it is a pressured system and we have to work within the envelope we have and the skills and staff we have."

:: As part of the poll 1,106 adults were surveyed on September 2-3 by Survation on behalf of Sky News.

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Millions 'Should Not Be In A&E' - Exclusive

By Thomas Moore, Health Correspondent

Up to 6.5 million patients every year should avoid going to A&E and be treated by GPs, paramedics and even chemists instead, the doctor leading the review of NHS emergency services claims today.

Around one third of all people who visit A&E each year could be diverted away from hospital under plans to be unveiled shortly by NHS chiefs.

In an exclusive interview with Sky News, the doctor in charge of re-shaping emergency services in England said family doctors, ambulance staff and pharmacists could treat them instead to relieve the pressure on A&E.

Indicating for the first time how he hopes to radically reform A&E, Professor Keith Willett, the national director for Acute Episodes of Care, said: "We know that 15% to 30% of people who turn up to be treated at A&E could have been treated in general practice.

"They did not know that because the system did not obviously make itself available to them."

He said patients with routine medical problems are going to A&E because they cannot get a quick enough appointment with their GP. Others are frustrated by out-of-hours services.

Prof Willett says a long-term solution is needed

"We can look at the way primary care is available to people," he said.

"By changing the way we deliver services we can start to address the demand. We can do the same thing in terms of the ambulance services and how much, how many patients they treat, at the scene, rather than transfer and that's about them having the right information.

"We would look to the public to understand the issues and when the situation does get difficult, to take the advice that I've suggested about phoning first, to get the right advice, to go to the right place, to think of using your general practitioner or indeed your pharmacist, (who) give a lot of advice for minor ailments."

Professor Willett and the medical director for NHS England, Professor Sir Bruce Keogh, will publish their plan for reforming emergency services later this autumn. It is expected to be implemented two years from now.

The plan will acknowledge that demand for care will continue to rise with an ageing population. But it will set out a series of measures for reducing pressure on A&E departments.

They are expected to include:

:: A&E units will have to ensure a consultant is available seven days a week

:: Other senior doctors, such as elderly care specialists, will be expected to help assess and treat patients arriving at A&E

:: Paramedics will treat more patients at home or by the roadside so they don't need hospital care

:: Patients will be encouraged to 'ring first', using the NHS111 helpline to be directed towards appropriate care.

Health Secretary Jeremy Hunt wants GPs to be more proactive

Health Secretary Jeremy Hunt has also said GPs must take on a bigger role. Next week he will call on GPs to do more to prevent patients with chronic conditions, such as diabetes, from suffering emergency complications.

In an interview for State Of Emergency, Sky News' 24 hours of live coverage from Nottingham's Queen Medical Centre which begins today at 5pm, Mr Hunt said: "The role of GPs in caring for older people needs to be proactive - checking up on people, finding out how they are, heading off problems before they happen - rather than reactive.

"GPs are busy, so to make that happen we have to find ways of getting more capacity in the system and that is a big challenge.

"But we have to address that. In the end, if the NHS is to be sustainable, it has to be about prevention as much as cure."

But GPs say they are already doing what they can.

Professor Mike Pringle, president of the Royal College of General Practitioners, said: "They are overwhelmed by the workload they are expected to deliver.

"We have got to start to build general practice, not blame it, not victimise it.

"We have to invest in it if we are going to solve these problems. And I am sure the Secretary of State recognises that."

England's A&E departments were under severe pressure last winter.

Waiting times reached their worst in nine years between January and March 2013, with more than 300,000 patients waiting more than four hours for treatment.

The Government has given the NHS an extra £500m over two years to find short-term solutions to the likely rise in demand for emergency care in the winter months.

Hospitals could bring GPs into A&E departments to see patients with more minor problems and more locum A&E doctors are likely to be employed to fill vacancies.

Only half the training posts for emergency medicine have been filled in the last two years, and more than a third of hospital trusts have vacancies for A&E consultants.

Professor Willett said a long-term solution is required.

"We do have to address the emergency medicine workforce," he said.

"But that will not produce new consultants for several years. So we have to manage the situation and take away from emergency medicine teams those patients who could be managed by other parts of the system.

"Defaulting to seeing an emergency medicine consultant is not necessary for many of those patients and it is frustrating to wait."

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Buckingham Palace Break-In: Two Arrested

Security Scares For Royal Family

Updated: 6:27am UK, Saturday 07 September 2013

The break-in at Buckingham Palace is the latest in a series of security scares involving the Royal Family.

:: In March 2011, a car carrying the Prince of Wales and the Duchess of Cornwall was mobbed by demonstrators who had split from a protest against higher university tuition fees.

Camilla was visibly distressed after being poked in the ribs with a stick through an open window in the distinctive Rolls-Royce Phantom VI as she and Charles travelled to the Royal Variety Performance at the London Palladium.

:: In 2003, comedian Aaron Barschak managed to get into Prince William's 21st birthday party at Windsor Castle.

The self-styled "comedy-terrorist" set off a series of alarms and was caught on CCTV before he joined 300 guests at the bash and was removed.

:: In 1994, student David Kang charged at Charles while firing a starting pistol during a ceremony in Sydney, Australia.

Kang was wrestled to the ground by New South Wales premier John Fahey and another man, while Charles was praised for his calm reaction.

:: In 1981, six blank shots were fired from the crowd while the Queen rode during the Trooping the Colour ceremony.

The Queen's horse was startled but she managed bring it back under control while police rushed to grab the shooter.

:: In 1974, Princess Anne was the target of an apparent kidnap attempt in The Mall near Buckingham Palace.

Four people, including her bodyguard, Jim Beaton, were injured after shots were fired when their car was forced to halt by another vehicle which blocked their route.

A police officer chased the driver, Ian Ball, and brought him to the ground before arresting him.

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G20 Summit: Syria Tensions Set To Dominate

US Draft Resolution On Syria

Updated: 10:53pm UK, Wednesday 04 September 2013

The full text of the US draft resolution on action in Syria:

JOINT RESOLUTION

To authorize the limited and tailored use of the United States Armed Forces against Syria.

Whereas Syria is in material breach of the laws of war by having employed chemical weapons against its civilian population;

Whereas the abuses of the regime of Bashar al-Assad have included the brutal repression and war upon its own civilian population, resulting in more than 100,000 people killed in the past two years, and more than 2 million internally displaced people and Syrian refugees in Turkey, Jordan, Lebanon, and Iraq, creating an unprecedented regional crisis and instability;

Whereas the Assad regime has the largest chemical weapons programs in the region and has demonstrated its capability and willingness to repeatedly use weapons of mass destruction against its own people, including the August 21, 2013 attack in the suburbs of Damascus in which the Assad regime murdered over 1,000 innocent people, including hundreds of children;

Whereas there is clear and compelling evidence of the direct involvement of Assad regime forces and senior officials in the planning, execution, and after-action attempts to cover-up the August 21 attack, and hide or destroy evidence of such attack;

Whereas the Arab League has declared with regards to the August 21 incident to hold the "Syrian regime responsible for this heinous crime";

Whereas the United Nations Security Council, in Resolution 1540 (2004) affirmed that the proliferation of nuclear, chemical, and biological weapons constitutes a threat to international peace and security;

Whereas in the Syria Accountability and Lebanese Sovereignty Restoration Act of 2003, Congress found that Syria's acquisition of weapons of mass destruction threatens the security of the Middle East and the national security interests of the United States;

Whereas the actions and conduct of the Assad regime are in direct contravention of Syria's legal obligations under the United Nations Charter, the Geneva Conventions, and the Geneva Protocol to the Hague Convention on the Prohibition of the Use in War of Asphyxiating, Poisonous or other Gases, and of Bacteriological Methods of Warfare, and also violates standards set forth in the Chemical Weapons Convention;

Whereas Syria's use of weapons of mass destruction and its conduct and actions constitute a grave threat to regional stability, world peace, and the national security interests of the United States and its allies and partners;

Whereas the objectives of the United States use of military force in connection with this authorization are to respond to the use, and deter and degrade the potential future use of weapons of mass destruction by the Syrian government;

Whereas the conflict in Syria will only be resolved through a negotiated political settlement, and Congress calls on all parties to the conflict in Syria to participate urgently and constructively in the Geneva process; and

Whereas the President has authority under the Constitution to use force in order to defend the national security interests of the United States:

Now, therefore, be it,

Resolved by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This joint resolution may be cited as the "Authorization for the Use of Military Force Against the Government of Syria to Respond to Use of Chemical Weapons".

SECTION 2. AUTHORIZATION FOR USE OF UNITED STATES ARMED FORCES.

(a) AUTHORIZATION-The President is authorized, subject to subsection (b), to use the Armed Forces of the United States as he determines to be necessary and appropriate in a limited and tailored manner against legitimate military targets in Syria, only to: (1) respond to the use of weapons of mass destruction by the Syrian government in the conflict in Syria; (2) deter Syria's use of such weapons in order to protect the national security interests of the United States and to protect our allies and partners against the use of such weapons; and (3) degrade Syria's capacity to use such weapons in the future.

(b) REQUIREMENT FOR DETERMINATION THAT USE OF MILITARY FORCE IS

NECESSARY- Before exercising the authority granted in subsection (a), the President shall make available to the Speaker of the House of Representatives and the President pro tempore of the Senate his determination that-

(1) the United States has used all appropriate diplomatic and other peaceful means to prevent the deployment and use of weapons of mass destruction by Syria;

(2) the Syrian government has conducted one or more significant chemical weapons attacks;

(3) the use of military force is necessary to respond to the use of chemical weapons by the Syrian government;

(4) it is in the core national security interest of the United States to use such military force;

(5) the United States has a military plan to achieve the specific goals of responding to the use of weapons of mass destruction by the Syrian government in the conflict in Syria, to deter Syria's use of such weapons in order to protect the national security interests of the United States and to protect our allies and partners against the use of such weapons, and to degrade Syria's capacity to use such weapons in the future; and

(6) the use of military force is consistent with and furthers the goals of the United States strategy toward Syria, including achieving a negotiated political settlement to the conflict.

(c) WAR POWERS RESOLUTION REQUIREMENTS-

(1) SPECIFIC STATUTORY AUTHORIZATION- Consistent with section 8(a)(1) of the War Powers Resolution, 50 U.S.C. § 1541, et seq., the Congress declares that this section is intended to constitute specific statutory authorization within the meaning of section

5(b) of the War Powers Resolution, within the limits of the authorization established under this Section.

(2) APPLICABILITY OF OTHER REQUIREMENTS- Nothing in this resolution supersedes any requirement of the War Powers Resolution.

SECTION 3. LIMITATION. The authority granted in section 2 does not authorize the use of the United States Armed Forces on the ground in Syria for the purpose of combat operations.

SECTION 4. TERMINATION OF THE AUTHORIZATION FOR THE USE OF UNITED STATES ARMED FORCES.

The authorization in section 2(a) shall terminate 60 days after the date of the enactment of this joint resolution, except that the President may extend, for a single period of 30 days, such authorization if -

(1) the President determines and certifies to Congress, not later than 5 days before the date of termination of the initial authorization, that the extension is necessary to fulfill the purposes of this resolution as defined by Section 2(a) due to extraordinary circumstances and for ongoing and impending military operations against Syria under section 2(a); and

(2) Congress does not enact into law, before the extension of authorization, a joint resolution disapproving the extension of the authorization for the additional 30 day period; provided that any such joint resolution shall be considered under the expedited procedures otherwise provided for concurrent resolutions of disapproval contained in section 7 of the War Powers Resolution (50 U.S.C. 1546).

SECTION 5. SYRIA STRATEGY.

Not later than 30 days after the date of the enactment of this resolution, the President shall consult with Congress and submit to the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives an integrated United States Government strategy for achieving a negotiated political settlement to the conflict in Syria, including a comprehensive review of current and planned U.S. diplomatic, political, economic, and military policy towards Syria, including: (1) the provision of all forms of assistance to the Syrian Supreme Military Council and other Syrian entities opposed to the government of Bashar Al-Assad that have been properly and fully vetted and share common values and interests with the United States; (2) the provision of all forms of assistance to the Syrian political opposition, including the Syrian Opposition Coalition; (3) efforts to isolate extremist and terrorist groups in Syria to prevent their influence on the future transitional and permanent Syrian governments; (4) coordination with allies and partners; and (5) efforts to limit support from the Government of Iran and others for the Syrian regime.

SECTION 6. CONGRESSIONAL NOTIFICATION AND REPORTING.

(a) Notification and Provision of Information. Upon his determination to use the authority set forth in section 2 of this Act, the President shall notify Congress, including the Senate Foreign Relations Committee and the House Foreign Affairs Committee, of the use of such authority and shall keep Congress fully and currently informed of the use of such authority.

(b) Reports. No fewer than 10 days after the initiation of military operations under the authority provided by Section 2, and every 20 days thereafter until the completion of military operations, the President shall submit to the Congress, including the Senate Foreign Relations Committee and the House Foreign Affairs Committee, a report on the status of such operations, including progress achieved toward the objectives specified in Section 2(a), the financial costs of operations to date, and an assessment of the impact of the operations on the Syrian regime's chemical weapons capabilities and intentions.

SECTION 7. RULE OF CONSTRUCTION. The authority set forth in Section 2 of this resolution shall not constitute an authorization for the use of force or a declaration of war except to the extent that it authorizes military action under the conditions, for the specific purposes, and for the limited period of time set forth in this resolution.

SECTION 5. SYRIA STRATEGY.

Not later than 30 days after the date of the enactment of this resolution, the President shall consult with Congress and submit to the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives an integrated United States Government strategy for achieving a negotiated political settlement to the conflict in Syria, including a comprehensive review of current and planned U.S. diplomatic, political, economic, and military policy towards Syria, including: (1) the provision of all forms of assistance to the Syrian Supreme Military Council and other Syrian entities opposed to the government of Bashar Al-Assad that have been properly and fully vetted and share common values and interests with the United States; (2) the provision of all forms of assistance to the Syrian political opposition, including the Syrian Opposition Coalition; (3) efforts to isolate extremist and terrorist groups in Syria to prevent their influence on the future transitional and permanent Syrian governments; (4) coordination with allies and partners; and (5) efforts to limit support from the Government of Iran and others for the Syrian regime.

SECTION 6. CONGRESSIONAL NOTIFICATION AND REPORTING.

(a) Notification and Provision of Information. Upon his determination to use the authority set forth in section 2 of this Act, the President shall notify Congress, including the Senate Foreign Relations Committee and the House Foreign Affairs Committee, of the use of such authority and shall keep Congress fully and currently informed of the use of such authority.

(b) Reports. No fewer than 10 days after the initiation of military operations under the authority provided by Section 2, and every 20 days thereafter until the completion of military operations, the President shall submit to the Congress, including the Senate Foreign Relations Committee and the House Foreign Affairs Committee, a report on the status of such operations, including progress achieved toward the objectives specified in Section 2(a), the financial costs of operations to date, and an assessment of the impact of the operations on the Syrian regime's chemical weapons capabilities and intentions.

SECTION 7. RULE OF CONSTRUCTION. The authority set forth in Section 2 of this resolution shall not constitute an authorization for the use of force or a declaration of war except to the extent that it authorizes military action under the conditions, for the specific purposes, and for the limited period of time set forth in this resolution.

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Police Chief: 60% Of Crimes Not Investigated

The head of Britain's second largest police force has admitted that 60% of all crimes reported in his area are not investigated.

Greater Manchester Police Chief Constable Sir Peter Fahy said his officers are only able to follow up about 40% of offences.

He said his force targets persistent offenders who commit the most crimes.

His admission comes against a backdrop of huge cuts to police spending, which will see force budgets slashed by 20% in real terms by 2015.

Sir Peter, who is vice-president of the Association of Chief Police Officers (Acpo), said: "In the same way that the health service concentrates on the most serious illnesses and the treatments likely to have most effect, the police have to concentrate on the most serious crimes and those where there are lines of investigation likely to produce evidence of the offender.

Sir Peter Fahy says officers are only able to follow up about 40% of crimes

"In practice, this translates into about 40% of crime being actively pursued at any time.

"We look at all crimes to identify patterns of offending and to build the picture of where we need to target police patrols. In many crimes there are no witnesses, no CCTV and no forensic opportunities."

Blackley and Broughton Labour MP Graham Stringer criticised his comments and said taxpayers expect officers to investigate criminal behaviour.

"That sounds like bureaucratic gobbledegook. De-prioritising the majority of crime is bound to lead to a loss of confidence in the police force," he told the Manchester Evening News.

"I think those victims (whose crimes aren't investigated) have every right to be angry. They have an expectation, having paid their council tax, that they have a better service from the police force."

Javed Khan, chief executive of independent charity Victim Support, said: "It is clearly for the police to decide how best to catch criminals, and prioritise their resources in line with this.

"However, for victims and the public to have confidence in the police, they need to know that, when they make a report, it will be taken seriously and adequately assessed.

"Likewise, any decisions to pursue or otherwise must be properly explained to them."

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Lancashire School Blaze: Five Boys Arrested

Police have arrested five boys aged between 11 and 15 on suspicion of arson following a school fire in Lancashire.

Credit: David Pearson

The blaze broke out on Sunday afternoon at Leyland St Mary's High School on Royal Avenue.

Credit: Lancashire Fire and Rescue Service

At one point, 125 firefighters and 20 fire engines were tackling the fire.

The school, which was built in 1957, had no sprinklers.

Credit: Lancashire Fire and Rescue Service

Lancashire Police announced on Twitter: "Five boys in total, aged between 11 and 15, have now been arrested on suspicion of arson following the fire at Leyland St Mary's High School."

Credit: Lancashire Fire and Rescue Service

Classes were due to resume at the school on Tuesday.

Credit: Lancashire Fire and Rescue Service

A note on the school's website said: "A fire at school today (Sunday) has caused devastating damage.

"This website will post details of when pupils will be able to return ... Please pray for the school at this difficult time."

Credit: Lancashire Fire and Rescue Service

Lancashire County Councillor Matthew Tomlinson said on Twitter: "As a former pupil of Leyland St Mary's, I'm so sorry to hear of devastating fire. I hope to be a part of the LCC team who rebuilds it."

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