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: Britain
Five-fold increase in deaths from drug prescription errors
in Britains hospitals
By Mike Ingram
3 January 2002
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A report by the Audit Commissiona government-appointed
watchdog that monitors health and local government standardsnotes
that 1,100 people died in hospital from medication errors and
adverse effects from medicines in 2000. This was more than a five-fold
increase on the 200 deaths in 1999.
The commission paints a devastating picture of the way medicines
are managed in Britains hospitals. In addition to the tragic
human costs, the problem is costing the National Health Service
(NHS) £500 million a year in longer hospital stays.
In one hospital, a cancer drug was over-prescribed by 1,000
times the correct dose. Other errors detailed include a woman
with breast cancer who was prescribed the sleeping tablet temazepam
rather than the correct drug tamoxifen.
As well as the increase in such accidental deaths,
the report says the most common cause of problems with patients
is complications arising from medication. Most errors are
caused by the prescriber not having immediate access to accurate
information about either the medicineits indications, contraindications,
interactions, therapeutic dose, or side effectsor the patients
allergies, other medical conditions, or laboratory results.
Recommending the increased use of computer technology, the
report says hand-written prescriptions or patients notes
contribute to the errors, as they can be illegible, incomplete
or use inappropriate shorthand. Many errors could be eliminated
through the use of computer technologya national approach
is needed to introduce these systems, the report states.
Also pinpointed is insufficient medical training regarding
drugs; errors were most likely to happen when new doctors began
work in hospitals. The report states that 7,000 individual drug
doses are administered each day in a typical hospital, and estimates
that spending on medicines runs at £1.5 billion a year46
percent of total hospital running costs. Pharmacy costs amount
to a further £300 million per year.
The commission insists, Medicines are now so central
to patient care that pharmacy services need to be seen as a core
clinical function, not a technical support service. But
as with every other area of health, the NHS is extremely short
of pharmacists. The report found that one in six posts were currently
vacant and one half of all hospitals in the UK are unable
to provide all their intended pharmacy services because of staff
shortages.
The report is only the latest in a string of such documents
highlighting one or another crisis in the NHS. Whether it is longer
and larger waiting lists, rising deaths from mistakes in surgery,
or drug errors, the underlying cause is one and the same. Firstly,
the NHS was systematically starved of funds throughout 18 years
of Conservative governments and, secondly, nothing substantial
has been done to reverse this trend since Labour came to office
in 1997. Rather the problem has been compounded by the governments
insistence on imposing targets for the numbers being treated at
a time when services are being either starved of funds or sent
out to tender in the private sector.
To reverse the spiralling trend in unnecessary deaths in hospitals
and provide an adequate health service for all requires the massive
injection of public funds. This would mean launching a programme
of recruitment and training, to substantially increase the number
of doctors and nurses, as well as enabling the building of a modern
IT infrastructure, with a patients medical history available
to all medical staff at the touch of a button. Instead, the commission
proposes to tackle staff shortages through the introduction of
more flexible working patterns and redesigning
and enriching jobs to focus on clinical pharmacy. However,
the prerequisite for this is that the present low wage rates within
the NHS are raised substantially.
The report also calls for the introduction of automated dispensing
and the outsourcing of non-core services, such as manufacturing.
Outsourcing invariably means further privatisation, eating into
NHS budgets and placing the onus on private health care corporations
to cut costs in order to maximize their profits, often at the
expense of patient care and safety.
See Also:
Britain: Government
suppresses report showing hospital patients face danger from Human
BSE
[29 November 2001]
Britain: Inquiry reveals
role of NHS cuts in deaths of child heart patients in Bristol
[31 July 2001]
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