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A diabetes nursing qualification is being established in England to standardise the qualities needed for nurses specialising in the condition, The Diabetes Times has learned.

NHS England has given its backing to the scheme being put forward by leading nursing organisation TREND-UK (Training, Research and Education for Nurses in Diabetes-UK).

Debbie Hicks, Jill Hill and June James, the co-chairs of TREND-UK, want the role to have a clearer definition and for a single foundation diabetes specialist qualification to be made available, as is currently available in Northern Ireland.

This is because at the moment there is no qualification available for a diabetes specialist nurse, which means anyone within the field of nursing could potentially become one.

The trio of senior nurses have already met with Diabetes UK and representatives from Leicester and Swansea universities to discuss the next step. All parties are working together to create a position statement on the subject to be released later this year.

Progress has already been made as NHS England has identified what the role of a DSN should look like and how it differs to the job of a practice nurse, but work still needs to be done in a bid to persuade the Nursing and Midwifery Council (NMC) to back the idea.

A BBC Panorama investigation found private hospitals are not reporting enough data on patient outcomes. Patients may be being put at risk by the failure of private hospitals to report serious incidents, the Royal College of Surgeons (RCS) has warned.

 

This means the private sector “cannot be as robust or as safe as the NHS”, RCS president Derek Alderson said.

The government says new guidelines will lead to tougher enforcement action against failing clinics.

The concerns, raised by the RCS, are focused on reporting serious incidents and so-called “never events” – extreme mistakes that should never happen.

These are not reported to national databases in a consistent way or at all, the RCS said.

It also warned that clinical audit data is lacking from the private sector, such as not submitting datasets on the outcomes of cancer surgery, despite undertaking many cancer procedures.

‘Not good enough’

Mr Alderson said: “We don’t know exactly what’s going on in the private sector.

“It cannot be as robust or as safe as the NHS at the moment for the simple reason that you do not have complete reporting of all patients who are treated.

“It’s not good enough. Things have to change,” he said.

The RCS also points to gaps in reporting on cosmetic surgery, where there is no dataset on the total number of operations.

Much of the private healthcare industry accepts there is a problem with data and transparency.

Brian O’Connor, of the Independent Doctors Federation, said: “It’s up to private hospitals to raise their game and to show the data and the excellence of care, because there is nothing for them to hide.”

Mr O’Connor, whose organisation represents 1,200 private doctors, added: “Those private hospitals which don’t have the data and are not transparent should be closed or not be allowed to conduct complex medical procedures.”

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Panorama heard from victims of rogue surgeon Ian Paterson, jailed for 20 years for intentionally wounding patients.

Although he was found to have harmed patients in the NHS, more than 700 people were harmed by him in private hospitals, including Beryl Parkes.

Paterson removed one of her breasts and she needed further operations to rectnify his mistakes.

Beryl Parkes

Ms Parkes said: “You believe a doctor, don’t you? They take oaths for people to do their best for them.”

But nobody was supervising Paterson.

And when Ms Parkes’s treatment was eventually reviewed, it turned out she should not have had any operations – because she did not have cancer in the first place.

“He should have got life,” she said. “And I think that’s too good for him, because it must have been basically all over money.”

Paterson’s supervisors at Spire Healthcare were criticised for failing to manage their high-earning surgeon.

The company told the BBC it is “truly sorry for the distress experienced by patients”.

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Panorama also learned that some patients are unable to get compensation if they are harmed by a private surgeon.

The hospital might refuse to accept liability because the surgeon is an independent contractor with “practising privileges”.

Lawyer Suzanne White said: “Any patient that goes through a private hospital will assume that they will be covered, and they are simply not. That is astonishing.”

Patients may not be able to get compensation from the surgeon’s insurance company either, because if the insurer decides that the surgeon has broken the rules, they can refuse to cover them.

‘Totally reprehensible’

It is a rare gap in the system, but disastrous for patients.

Mr O’Connor responded: “To say a patient who has had wrong done to them is not going to get proper compensation is totally reprehensible.”

He wants the government and private health organisations to ensure patients are compensated properly.

Panorama has discovered a case where a patient who had been harmed was unable to get compensation from the private hospital or the surgeon responsible.

He successfully sued the NHS instead, because his first consultation was in an NHS hospital.

Even the lawyer who won the case thinks it was wrong that the NHS was forced to pay up.

Suzanne White said: “I feel entirely uncomfortable about it and very cross, because I see it quite often.

“Why is it that a private hospital that has a doctor who has given negligent care – and profited – does not compensate those patients?

“Why is it the NHS has to foot the bill?”

Doctor at computer

Last year, more than 500,000 NHS patients were referred to private hospitals.

But the fastest growing area in the sector is self-pay, where people without insurance fund their own treatment to the tune of almost £900m annually.

Together, NHS referrals and self-pay patients make up nearly half the private health sector’s business.

‘Tougher enforcement’

The Association of Independent Healthcare Organisations said there is strong evidence that the independent sector is safe and patient safety is as much of a priority as it is for the NHS.

It said the Care Quality Commission has rated nearly 60% of private hospitals as either good or outstanding for safety.

The Department of Health said new standards have already set out clearer requirements for the delivery of safe care.

It said tougher enforcement action will be enabled against failing providers.

Cosmetic surgery clinics will now be rated by the CQC, and private hospitals must ensure ratings are displayed both within premises and online.

Was this your experience at the General Election? Or do you think the Government needs to improve the voting process for people with dementia? Our Campaigns team explain how you can share your experiences and help make sure the rights of people to vote are upheld.

The right to vote

The Mental Capacity Act, which provides a framework for making decisions on behalf of people who lack the capacity to make a decision, does not apply to voting. This means that a lack of mental capacity does not stop someone from being able to vote. It is up to the person to decide if they want to vote and if they need it, they should be supported to do so.

Unfortunately, we know this doesn’t always happen in practice.

Even in the most recent election, we heard from people who experienced difficulties when voting, like being asked inappropriate questions about whom they’re voting for and staff not allowing carers to support people at polling booths.

It’s clear that more needs to be done. People with conditions such as dementia should not be prevented from exercising what is a fundamental democratic right.

Make your voice heard

Help change this by sharing your experience of voting.

The Government, in partnership with other organisations, is looking for evidence from people who have disabilities about their experience of registering to vote and voting itself. From filling in the registration forms to the support available at polling stations on Election Day, they want to hear about each stage of the process.

After the consultation is complete, they’ll produce a report of all the findings. This will include recommendations about what needs to change to make sure the rights of people to vote are upheld.

So whether you have experience of registering and casting your vote yourself or you have supported someone else to do so, please do share your experiences and make sure your voice is heard.

Visit the Call for Evidence webpage on Gov.UK for details of the consultation questions and how to respond. This information is available in a range of accessible formats.

The deadline to respond is 5pm on Tuesday 14 November. If you have any questions – or want to share your experiences with us – please contact the Campaigns team at Alzheimer’s Society on change@alzheimers.org.uk