Private Medical Scans – My Experience of Alliance Medical

Private Medical Scans – My Experience of Alliance Medical

NHS England recently awarded a contract for cancer scans to a company called Alliance Medical. This came despite a rival bid from a group of publicly-funded NHS hospitals being £7 million cheaper.

(EDIT  FEB 2016: The contract award was made in January 2015; it has recently been doing the rounds on social media again. The message of this article still stands, however it is a mistake to describe it as ‘recently’ as I originally did. The piece is edited to reflect that.)

The fact that senior Conservative MP Malcolm Rifkind sits on the board of Alliance Medical would clearly have nothing to do with this decision.

The deal was handled by the NHS Strategic Projects team. They helped secure the deal to privatise Hinchingbrooke Hospital. This deal spectacularly collapsed last year amongst damning inspection reports.

All fairly normal for the murky world of NHS private procurement. But unusually, I can actually add something to this news story. I happen to have some personal experience of Alliance Medical and their scanning work. Here it is.

Meeting Doris

During my 2-week placement on a neurology ward, I met a lady, who I’ll call Doris for the sake of this post. Doris had come to our ward after a fall. She  happened to have lost her balance, was a bit confused, and generally seemed ‘a bit off’. This was with good reason.

A CT scan revealed, she had two substantial extradural haematomas, one on the right and one on the left. These are bleeds into the space between the layers that cover the brain and the skull. They are not good news. Quite frankly, it was a miracle Doris was doing as well as she was.

 

Obvious Bleeding

A couple of hours after I’d seen Doris, and after she’d been sent to surgery, I was called into an office by the professor in charge of her care. He showed me a brain scan, not the one I’d seen earlier, and asked me what was wrong with it. Like Doris’ scan, it was an extradural haematoma and, happily for me, I noticed this.

That’s the thing about massive extradural haematomas (or any massive brain bleed/injury). They are a bit obvious.

To prove this to the non-medics reading this, see if you can see what’s wrong with this scan:

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A fairly obvious extradural haematoma.                                                                           Credit:MedPix

Even without the helpful arrows, I’d hope you can notice the massive white blob on the left side of the left picture. Even if you couldn’t say what it was, you’d probably say: ‘That doesn’t look like it should be there, I might tell somebody about it.’

Whoever worked for Alliance Medical and looked at the scan did not think that. They didn’t notify anyone about the massive extradural haematoma, and as a result, that patient went out into the world without being treated.

That patient was Doris. She’d had a CT scan a week before I’d seen her, for a reason I’ve now forgotten. I’m not sure it really matters. Whatever it was, doctors had not thought it serious enough to wait for the report of the CT scan.

That CT scan had been sent to Alliance Medical where three equally bad options await us.

  1. No one looked at the scan in the week leading up to me seeing Doris
  2. Someone looked at the scan and didn’t notice the massive bleed that was obvious enough for a 3rd year medical student to spot
  3. Someone looked at it, noticed what was wrong and didn’t tell either her GP, or the hospital who commissioned the scan, that their patient had a potentially fatal injury.

Actualy, we don’t have three options. It was the last one. The scan had been reported correctly, but no one at Alliance Medical thought it important to tell someone Doris was very, very ill indeed.

As a result, Doris spent a week with a bleed in her brain that could’ve killed her. She then fell and developed a second one.

Unneccessary Harm

Happily, Doris left hospital alive and well. However, it could’ve finished quite differently. She was exposed to a week of serious harm completely unnecessary.

She could’ve easily died if she hadn’t had the ‘luck’ to fall and be ill enough to require a second CT scan.

In this incident Alliance Medical, which  through incompetent management or lack of clinical judegemnt, failed Doris. They failed the NHS, which was required to pick up the pieces of the failure of private healthcare. They failed the British taxpayer who pay them handsomely to look at non-urgent scans so stretched NHS doctors don’t have to.

I imagine my experience is a one-off. I hope it is for the sake of patients like Doris and the NHS as a whole. Otherwise, it seems very unlikely that Alliance Medical will be able to provide a service that’s worth paying an extra £7 million for.

 

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Labour granted emergency debate in Parliament over junior doctor crisis

Labour Shadow Health Secretary Heidi Alexander has been granted an urgent debate on junior doctor contracts in the House of Commons. The debate will take place at 3:30pm on Monday 8th.

The debate comes just two days before junior doctors across England are due to go on strike over proposed new contracts.

Despite several series of negotiations, the British Medical Association and the Department of Health have not reached agreement.

The BMA and the government are clashing over issues such as Saturday pay rates, automatic pay progression and payment for doctors who work on-call shifts from home.

This is the second time Labour has called an urgent debate  on junior doctor contracts. The previous one, on November 20th 2015, attracted some controversy after Jeremy Hunt failed to turn up to respond to Labour MPs.

UPDATE: According to Heidi Alexander, Jeremy Hunt will not be responding to the urgent debate today.

 

Junior doctors to go ahead with industrial action

Junior doctors will be going on strike after the British Medical Association (BMA) and the Department of Health failed to reach an agreement over new contracts.

Junior doctors protesting in London on 17th October 2015. Credit: Rohin Francis
Junior doctors protesting in London on 17th October 2015. Credit: Rohin Francis
For 24 hours beginning at 0800 on Wednesday 10th February, junior doctors in England will offer emergency care only. Junior doctors in Scotland, Wales and Northern Ireland will not be striking.

Johann Malawana, head of the BMA Junior Doctor Committee, said: “We made some good progress. But the Government has made clear, yet again, that they are not prepared to address issues our members have made clear are critical to them.”

The strike on 10 February was originally planned to be a 12-hour walkout from all care – including A&E and other emergency care. Malawana said about the change: “We believe that this balances the need to demonstrate our determination to the Government whilst minimising disruption to patients.”

Junior doctors are concerned about the removal of safeguards to prevent them being overworked; the removal of year-on-year pay progression and the Government’s plan to make Saturday a normal working day.

However some junior doctors online expressed frustration with their trade union. Andreas Leonidou described the move from ‘full walkout’ to ’emergency care only’ as: “A bad move by the BMA. Again.” Debar Rasoul called it: “Nothing less than ridiculous.”

The Department of Health or NHS Employers have yet to comment at the time of writing.


 

Subedited by Kip Dudden.

Previously written for and published on WestminsterWorld.com

WHO to discuss action over Zika virus pandemic

The aedes mosquito - the main carrier of the Zika virus
The aedes mosquito – the main carrier of the Zika virus.   Credit: James Gathany

The World Health Organisation (WHO) is having an emergency meeting today to discuss the continuing Zika virus outbreak in the Americas.  The mosquito-borne virus has spread to 22 countries within North and South America.

Zika virus has been linked to microcephaly, a serious developmental disorder where babies are born with small heads. In Brazil, there have been over 4,000 case of microcephaly since October 2015. Normally, Brazil would see approximately 150 cases a year.

The WHO can recommend placing travel restrictions to and from infected countries, among a wide range of infection control measures. With London as a major business and travel hub, any future restrictions would likely have some impact on the capital.

Those who are pregnant or are planning to get pregnant should seek advice from a medical professional before travelling to countries affected by the Zika virus (click here to find a list.)

Those with chronic medical conditions, or who have a weakened immune system, are also advised to talk to a medical professional. Pregnant women who have recently travelled to any of the countries on the above list are advised to inform their obstetrician or midwife.


 

Subedited by Kip Dudden

Original written for and published on WestminsterWorld.com