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Are lives at risk in Intensive Care units because of cost cutting?
Are lives at risk in Intensive Care units because of cost cutting?
The philosophy that doctors are here to save lives, not money, has been undermined by the Royal College of Anaesthetists (RCA). They say that a cheap device, commonly used in most operating theatres throughout the UK, would save more lives were it to also to be installed in intensive care units. However, it seems that the onus is being put on how much money can be saved rather than on the benefits of these devices to patients.
The capnograph is a small and relatively inexpensive device that measures how much carbon dioxide is present in a patient’s breath. From analysing these results, a medical professional can get a quick and advanced warning as to any potentially life-threatening situations that may be about to occur. The capnograph is non-invasive, provides constant assessment, is physically unobtrusive and can even be used to test any breathing apparatus that a patient might be using. The RCA suggests that the introduction of capnographs into intensive care wards could reduce the instances of breathing-related deaths by more than 70%.
Airway complications
Between 2008 and 2009, there were 184 recorded instances of ‘airway complications’. Of these, 39 resulted in patient death – 18 of which occurred in intensive care. The majority of these deaths were attributable to the fact that the patients had other medical conditions that affected their respiratory systems, such as obesity. Monitoring their respiratory rates with capnographs could well have prevented any fatalities.
Nicolas Jervis, Managing Director of claims specialists 1stClaims, says that: “the NHS’ apparent concern in saving money over a patient’s well-being is another blow at the bond of trust between the public and medical professionals. It is easier to understand that accidents happen and that medical negligence usually occurs through human error than to consider that people are dying because of cost-cutting exercises.”
He believes that the continued refusal to use this simple piece of equipment could be increasing the risk of medical negligence claims to the NHS. “Although there are no legal precedents in this type of situation, it wouldn’t be a surprise to see someone challenge the medical authorities in a court of law. If that claim were to be successful, it would only be a matter of time before the dam broke and other claims were launched. The NHS might be better protecting itself financially by installing capnographs, rather than waiting for the first medical negligence claim of this sort to come and bite them,” he says.
Is a life worth the price?
To put this in perspective, the retail cost of a capnograph in the UK, is little over £1,500 per unit. As of January 2011, the number of intensive care and high dependency beds was totalled at 3,747. Assuming the cost of capnographs is around £1,500 per unit and discounting any discounts for bulk orders, the total cost is £562,500. Nicolas Jervis believes that the numbers add up. “Of course, there would have to be the cost of training to be factored into the equation but, even so, when you consider that the National Health Litigation Authority is currently anticipating a payout of £319million in compensation for maternity blunders, half a million pounds looks like a reasonable investment,” he comments.
Until the NHS looks at pro-actively protecting itself, through pro-actively protecting its patients, the statistics for medical negligence and compensation payouts look set to rise.
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