EPCRC guidelines recommend that the enteral route should be used in certain patient groups (eg, to reverse weight loss) in patients with Cachexia
Patient admitted to Royal Blackburn Hospital with a rash to arms and legs. Within 24 hours (and no tests carried out) they are diagnosed with "Terminal Cachexia" - NICE guidelines state that the patient should be enternal fed (tube through nose directly into the stomach).
A. Not tell the family, keep the patient in hospital for a further 2 weeks and continue to try and feed orally (with just 6 out of a possible 30 meals)?
B. As A, then send the patient home, with supply of protein shakes and tell family to try and get them to eat more, the family then has to wait months after the patient's death for the hospital notes before finding out any information about this diagnosis and lack of treatment as set out by NICE guidelines?
C. Follow NICE guidelines for enternal feeding by tube into stomach and notify the family at the first instance this diagnosis was made?
Royal Blackburn Hospital chose B
Royal Blackburn hospital now state, "NICE guidelines are just guidelines and do not need to be followed"
What would you do?
The Royal Blackburn Hospital, in conjuntion with East lancashire Health Trust (ELHT) have so far done their upmost (working with the East Lancashire Coroners office) to refuse to answer questions, look at evidence and reveal requested information, into the action (or lack of) that could have cost an actual human being their life, before it was "their time."
I know these posts will touch many people who pass by here, they may spark outrage, they may be viewed with apathy, they may be denied, ignored or simply dismissed as false, if this be the case, the Royal Blackburn Hospital, East Lancashire Health Trust and the East Lancashire Coroners office, can happily contact myself and answer for their own conduct/action/lack of action.
I have attempted several times, over several months, to obtain information or have them look at the physical evidence in this case, but they ignore all requests to do so and try to fob me off at every turn.
I was pondering on how I could get the information I have across, in the public domain, without a long winded post of endless facts and test results. In my limited capacity as a member of the public, I have decided on a quiz!
This way, I can recall small factors of the case and you get to decide (via multiple choice answers) to decide what should have been done.
I make no apologies for the sometimes uncomfortable questions and answers listed here.
Take a look, see what you think, I'd value your opinion. Thanks.
O2, Lowell Financial Ltd and Bryan Carter solicitors forced to "discontinue court case" but offer no apology?
For the best part of two years O2, then Lowell Financial Ltd via various debt collectors, have been chasing me for a debt that I did not owe.
Late 2014, they instructed solicitors to persue me through the small claims court for an amount of around Â£950.
I received notice from their solicitor (Bryan Carter solicitors) this week, that the case has been "discontinued" for the full amount.
In plain English, they are no longer seeking any payment and the full "debt" and their action in the small claims court has been stopped.
Case won so all's well?
No actually, all is not well!
In the process of this case, I discovered several things:
* In a small claims case put through the Northampton county court business centre, the claimant can attempt to "strike out" the defence, once it receives a copy, in effect winning the case, without any representation for the defendant.
This shows serious bias, in favour of a claimant.
Claimant submits a claim saying you owe them money - you file a defence (thinking it will be sent to an independant local county court, where both sides can be heard) - the claimant then receivesÂ a copy of what you have filed as your defence - claimant can then pick apart your defence and attempt ot have it struck out.
If successful, then the defence will lose the case.
Looks very one-sided to me!
* A national company such as O2 in this case, can keep inaccurate account records of phone conversations on a regular basis and nothing is done about it.
I asked on more than one occasion, for a copy of records, each time I was refused.
It came to light, during my own investigations, that O2 staff promised to transfer across an account to the name of the correct person, once they had reached the age of 18. Over successive upgrades they failed to honour this and failed to record this accurately on the account notes after it had been promised.
* OFCOM (regulator for the mobile phone contracts industry) and the Communications Ombudsman do not know which law applies to mobile phone contracts.
Are people of the UK now only protected if an ombudsman deems a company in breach of "Guidance" and vague regulations, which the ombudsman does not enforce and the regulator (OFCOM in this case) only enforce to ensure the industry works smoothly and doesn't impede the needs of the business?
That both organisations show such little knowledge of common law in England and Wales and fail to display any inclination towards upholding it, which has legal precedent for over 100 years, is deeply disturbing for consumer protection in the UK!
So for all the messing around, the phone calls, etc. I get not a single apology or admission that I was right in the eyes of common law in England and Wales...
After three big bills came in at the same time, see how living week to week can be a struggle. Officially classed as "Working poor" here's my diary (updated through out the month).
After shaving more monthly costs off our household bills (already low) I wore a smile on my ugly mush, which lasted for all of a day.
My Â£48 a year saving, was wiped out the next day when a statement from the bank we are forced to have came in, which revealed the 20 day per month cap for charging Â£1 a day for our small overdraft was being "lifted"
As a result, we now have to pay Â£1 per day for 30 days instead of 20 for all the time we are in our overdraft.
Our Â£48 a year saving vanished into the bank's pocket, along with an extra Â£72 per year.
I asked Santander to comment on twitter, but they don't even have the courtesy to reply.
A poached egg on two slices of toast for dinner, then frankfurters rolled up in bread with fried onions for our Sunday tea (higher percentage of meat and not "mechanically reclaimed" as hotdogs are) so a rare treat.
Supper was a few broken chocolate fingers with a brew, picked up from the cheap cake stall on the outside market (2 for Â£1).
Rock and roll in our house...
The value of eggs and spuds can never be under estimated.
The number of meals that can be made with these two ingredients is staggering and gets us through another week.
Caught our outdoor market green grocer as he was closing up, for a quid, picked up almost half a sack of washed whites, not the best, but good enough for baked spuds, a plate of chips and some roasties.
A tray of eggs picked up last week from the same place (Â£3 for 24 eggs) is lasting well. Should have enough to use for pastry, maybe knock up a cheese and onion pie tomorrow if I get the time.
Nipped into Morrisons for their "box of crisps for Â£3" offer - I can use them for crisp butties when the cheese runs out later in the week - of course they had none left. All 8 boxes went first thing in the morning, not the first time an offer has been blasted all over the tv, but none available when you turn up at their store.
That said, I did spot some tunnocks marshmellows and caramel wafers going on sale, grabbed a pack of each, went to the till, was overcharged. Price label didn't match the higher price at the till, another common occurance. It took 15 minutes to get the difference refunded. I wonder how many others have been caught like this?
PolishedÂ my footyÂ boots, sprog's shoes and monkey boots for her indoors and burned another three "burn bags" of useless but confidential paperwork on the burner, great way to pre burn the fire ready for the logs coming in a couple of weeks.
Wanted to wash some ofÂ my footy kits ready for all the training next week, but no joy as we are now out of washing powder. Just my luck.
Only another twelve days until payday...
I've been keeping track of my "5 a day" intake over the past couple of weeks.
5 a day - 0 days
4 a day - 0 days
3 a day - just once (inc. homemade apple pie)
2 a day - a few times
1 a day - most times
We lost a family member recently, a real blow to all of us.
Made me look at things a little differently, I tried to help in a practical way sorting out paperwork, etc.Â but their passing has left us all shattered, in a kind of daze. Memories will liveÂ on in our hearts for ever. For me, I miss them dearly. Always there for me for over 30 years, helping me with advice and practically without effort.
Work mates have been fantastic, supporting me throughout. They all helped more than they realised.
Have a small claims case to deal with also, Â£75 of my already over stretched working poor budget if I want to attempt to strike it out. A judge could have decided to strike the claim out, but has chosen to refer it to mediation, with which if I don't comply, will rule against the defence.
I'll post more soon, suffice to say without any proof, no contract and the company concerned revealing information that would close the case down, but failing to record it accurately on the account notes, I'm left in limbo.
Ombudsman and regulator have admitted they do not know the law that applies to what the case concerns, a full post is coming soon.
Managed to get to the end of the month with Â£7.40 to spare.
Wasn't enough to buy any fireworks for sprog2 this year, we managed to get some sparklers though, bless her, she loved all 10 minutes of them.
For those that know me, being unable to celebrate Bonfire night hurts, especially where little ones are concerned.
It's a tradition, one that I've always celebrated.
This year it has passed without valuable memories being made, terrible parenting on my part.
Maybe those with money to burn should use the "working poor"Â not celebrating bonfire night (because they cannot afford it) with their childrenÂ as a tear jerker for their Christmas advert... which of course is a tax deductable (for them) as it's marketing.
Sprog2 is already making extravagant plans for Father Christmas' coming, let's hope we are in a position to do something about it!
The boiler is on the way out, hot water stopping for no error message.
Our old back boiler system needed a good clean out (stripping down and cleaning inside) just once in 19 years, within 3 years this new fangled glory boiler (which has cost MORE to run, because it no longer heats water as it heats the home) has now developed a fault.
A quick look around the plumbing forums reveals it's a common problem involving a thermostiser? which is a small attachment to a pipe, measuring resistence through a small electrical charge, to gauge how much heat to use to heat the water to a given temperature, is going.
The part to replace is just Â£7.80 for a new one.
To fit it, British Gas would change a minimum Â£75... scandalous!
Yet another job to add to my long list.
I was working out roughly how much we recycle or reuse in our gaff, it would take some beating!
We burn plastic cartons (ideal for firelighters)
We have a constant supply of newspapers from family to use
We burn all the bills in our "bill bag"
We burn potato and carrot peelings as they simmer slowly and give off heat
We buy and cook all veg fresh
We make our own pies and pastries
The most luxurious thing we buy seems to be crisps and broken biscuits from the market!
The annual Christmas party has had to be cancelled this year, we just don't have the funds to spare.
Â£30 for a barely touched turkey dinner, plus drinks and a taxi home, can buy a lot of Christmas presents!
It shouldn't be a problem though, as I don't drink most of the year.
I end the month with (what I hope) is a ripped muscle in the back of my leg, I don't actually know if it is as I was unable to get a doctors appointment, as I couldn't convince theÂ receptionist my injury was bad enough to warrant the precious time of my GP, she demanded I explain to her what was wrong so that SHE could make the decision that a GP should have been making.
She made it clear it was too much trouble for them, so I put the phone down.
Her time is obviously more important than mine.
This was highlighted in a letter that came today, from the tax office, by complete coincidence, revealing that only more than a fifth of our tax paid last year was spent on the NHS.
Finally a response from santander, regarding their increased overdraft charges.
They tell me they will kindly "feed back my concerns" - to exactly where, no one knows.
Will my complaint fall on deaf ears... I suspect so and no doubt they will continue to take from a family pot that shrinks by the month.
I just hope we get the shed load of snow this winter that the "experts" have been telling us about, then the corporates can lose money and put our bills up again once it's all passed.
Ignored on twitter this week - ICO, Food standards agency, EDF energy, Caroline Flint MP, OFGEM and Persil.
Information Commissioners Office (ICO):
EDF were in the news this week, for failing to record accurately, customer's complaints.
OFGEM ruled against them, but EDF kept their "Compliant" status and licenses with the regulator by setting aside Â£3 Million for the Citizens Advice Bureau. (A "fine" of Â£3 million would be against the Hampton principles of light touch regulation and could have led to a court case had EDF chosen to defend it!)
I asked the ICO if they would be taking action against EDF, as by not recording customer complaints accurately, EDF was in breach of data protection law?
The ICO had no answer.
Caroline Flint MP (Shadow minister for Energy):
All over the news with the Labour party's latest gimmick - removing trading licenses for energy companies that flout the laws of the land. I also asked about Labour's "tough new regulator" they propose to bring in to replace OFGEM.
I asked the MP a number of questions, especially after the OFGEM - EDF story broke the next day.
* Would Labour's tough new regulator have removed EDF's licenses for breaking data protection laws?
* Would Labour's tough new regulator have deemed EDF to be "compliant" and let them keep their licenses and carry on trading?
* How many corporate businesses lost their trading "license" under Labour from 2005 (introduced Hampton principles of "light touch" regulation) - 2010?
Not a single answer came back.
It seems like the shadow minister (and her social media team) only want to promote her work, instead of answering in a public forum.
One final question for Caroline and the Labour party's twitter account, why, if they advocate tough regulation, do they not campaign against the trans atlantic trade agreement (TTIP), which is watering down regulator powers via the small print?
Again, they have nothing to say on another important issue.
(For the record, I advocate no political party, they are all as bad as each other. Kick out unelected civil servants who are pulling the strings behind successive governments!)
Why do EDF remain "compliant" with their regulator and keep their licenses to trade, after breaking data protection law?
Nothing, Nada, Nowt...
On to the Food Standards Agency (FSA):
Big twitter campaign, regarding barbeque weekend coming up and food safety on "not washing chicken as it spreads bacteria."
Does marinating not spread bacteria on chicken?
No reply, good to see they care!
Asda sold Persil washing powder for Â£11 (70 wash box) which weighed in at 5.9kg
Asda now sell Persil washing powder for Â£11 (70 wash box) weighing in at only 4.9kg
KatyGooner also spotted it.
Persil stepped in with a reply, saying that as the powder was "now more concentrated" they could offer the same number of washes in less powder.
I asked Persil to prove it!
Persil did not reply.
I asked Persil to send Katy a box of each and let her test it.
Persil again, chose to say nothing.