Slight drop in Londoners surviving cardiac arrest as bystanders attempt CPR on 2,500 occasions


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LAS CPR 2,500

Londoners attempted to save people suffering cardiac arrest on almost 2,500 occasions last year, it has been revealed.

The figure is the highest ever recorded by the London Ambulance Service and came as it defended a slight fall in the percentage of cardiac patients alive on arrival at hospital and those who were discharged alive after treatment.

A total of 2,427 attempts at CPR (cardiopulmonary resuscitation) chest compressions were made by bystanders in 2014/15. This meant that a “good samaritan” provided first aid prior to the arrival of emergency crews on 63.1 per cent of occasions  – 460 more attempts than the previous year.

LAS medical director Dr Fenella Wrigley told me: “I think it’s brilliant. From the point of view of helping more people across London, we want to see that figure continue to go up.”

The LAS cardiac arrest annual report reveals that paramedics attended 10,211 cardiac arrests, 406 more than the previous year, and attempted to resuscitate 4,665 patients, up 348 or eight per cent.

The percentage discharged alive from hospital fell from 10.3 per cent to nine per cent – meaning about 30 fewer people survived compared to 2013/14.

This is attributed to life-saving having been attempted on more older, sicker patients and on crews having taken on average about a minute longer to arrive, though waits were still within the eight-minute target.

Resuscitation was not attempted on 5,546 people, either because they were dead on arrival, had a “do not resuscitate” order or their death was expected.
London’s overall survival rate was the fifth best of 11 ambulance services in England.

However the capital was second best at delivering cardiac patients alive to hospital – 31.4 per cent, or 1,465 people, had a pulse.

This rate was even higher among the “Utstein” sub-group whose heart was in a “shockable rhythm” – 55.1 per cent had the return of spontaneous circulation when they arrived at hospital, also the second best figure nationally.

Dr Wrigley credited the spread of publicly-available defibrillators – there are more than 2,600 across the capital – with helping to save lives.

These defibrillators were used by the public on 73 occasions last year, compared to 18 occasions the previous year, with at least 41 people being discharged alive from hospital.

Cardiac patients were most likely to be white men in their sixties, with a Sunday morning in December the time of the greatest number of attacks.

Dr Wrigley praised LAS crews for their performance at a time of “very significant shortfall” in frontline paramedics. She said: “We are continuing to provide a very successful and effective service to the sickest people in London.”

Square Mile holds first ‘safer cycling day’ for women after disproportionate number suffer serious injuries


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The first “safer cycling day” for women in the City of London is being held today after a spate of lorry deaths and concern at the disproportionate number suffering serious injuries.

A total of 30 women cyclists were seriously injured in the Square Mile between 2010 and 2014 and two died in hospital after collisions – Maria Karsa at Aldgate in September 2013 and Janina Gehlau at Ludgate Circus last October.

Ying Tao was killed at Bank in June. A prosecution is underway in relation to Ms Gehlau’s death. City police are continuing to investigate the collision that killed Ms Tao.

Over the same 2014-2014 period, 75 male cyclists were seriously injured and two were killed, despite men making about three times as many bike journeys as women.

The City of London Corporation wants to encourage more women to ride to work as part of a target of having 10 per cent of journeys made by bike. Today’s events include a conference and an “Exchanging Places” event until 4pm in Guildhall Yard that will enable women to experience the “blind spots” that limit the view of cyclists and pedestrians from the cab of a HGV.

The corporation’s officers are also working on longer-term plans to improve safety at Bank, with one of the options understood to involve full pedestrianisation of the area.

Marianne Fredericks, chairman of the corporation’s streets and walkways committee, said: “It’s a real eye-opener as a pedestrian as well as a cyclist to be able to see what the driver can and cannot see when he is perched in his cab. Knowledge is power and if you cannot see him, he cannot see you and you should keep your distance.

“Far too often we have heard about the serious incidents and dreadfully sad deaths of women cyclists across the capital over the past few years. Events like today won’t solve the problem overnight but does serve a dual purpose. It will not only help raise awareness of how cycling can be a great form of transport… but also highlight that unfortunately it is not risk-free.”

The corporation has faced criticism from cycle campaigners for the failure to improve safety at Bank and for failing to implement in full Mayor Boris Johnson’s “quietway” routes.

But officials say that have been working for 18 months drawing up proposals for Bank to put to Transport for London. If approved by City politicians, the proposals could be put to public consultation in a year. There is also hope of interim changes being introduced “sooner rather than later”.

Changes to the road layout at Holborn Circus are believed to have contributed to a recent  reduction in cyclist injuries, while safety improvements at Aldgate are due to be completed by Autumn 2016.

A crackdown on rogue cyclists by City of London police, codename Operation Atrium, saw 502 fines issued in the last six months for red-light jumping and cycling on the pavement. More than 300 of the fines were rescinded when the cyclists attended an Exchanging Places event.

Alarm raised at use of face-down restraint of patients at Broadmoor hospital



Patients at Broadmoor hospital and its sister units are being subjected to an alarming degree of face-down restraint despite Government attempts to curtail the practice, the NHS watchdog reveals today.

A “very high” level of about 30 cases a month were reported at Broadmoor, the country’s most famous high-security unit, and medium- and low-security facilities for men, including St Bernard’s hospital in Southall.

Broadmoor and the West London Forensic Service were today rated “inadequate” by the Care Quality Commission, while their parent organisation, West London Mental Health NHS Trust, “requires improvement” overall.

According to the CQC, patients were physically restrained on 432 occasions between last July and December – though the true total is higher as some staff failed to record arm restraint of elderly patients.

Of the 432 most serious cases, 179 involved use of the potentially dangerous “prone position”, which involves trapping a patient face-down on the floor. At least 31 patients required “rapid tranquilisation” to bring them under control, though this was also “under-reported”.

Several months earlier, the Department of Health published a two-year plan limiting the use of “outdated” face-down restraint as part of an overhaul of the treatment of people with mental illness.

Dr Paul Lelliott, the CQC’s deputy chief inspector of hospitals, said: “We were concerned at the apparent overuse of physical restraint, and the failure to keep proper records.

“Staff must use restraint only as a last resort, and minimise the use of restraint in the prone (face-down) position. They must also make the necessary physical health observations to ensure the safety of patients who have been given an injection to manage disturbed or distressed behaviour.”

A total of 113 serious incidents were recorded between March 2014 and February this year. A quarter involved a patient attacking another inpatient. Between April 2014 and April this year, there were three patient deaths, including two at Broadmoor. A further 17 community patients died in apparent suicides.

The CQC inspection, over five days in June, involved a team of 75 inspectors and spoke to 381 patients and relatives. The trust was found to have a “substantial” problem with staff recruitment and retention, with to few to guarantee safety and quality in high-security and forensic services and in the community.

Some staff complained of poor morale and a bullying culture. But inspectors praised staff at Broadmoor for showing a “real concern” for patients and a desire to help them progress towards recovery. A redeveloped site at Broadmoor, in Berkshire, is due to open in 2017. It has about 240 inpatients, of which 37 were in long-term segregation at the time of the inspection.

Cyclists using Boris ‘Crossrail for bikes’ superhighway ‘at risk’ from drive-thru McDonald’s


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Cyclists using Boris Johnson’s new “Crossrail for bikes” superhighway would be placed in danger if a new McDonald’s drive-thru restaurant were built alongside it, a planning inquiry was due to hear today [Weds from 10am].
Ealing council and the Mayor’s cycling commissioner Andrew Gilligan fear that drivers heading to the proposed fast-food takeaway on the A40 at Gypsy Corner in Acton would cut across the cycle route at high speed.

The council initially granted permission for the two-storey restaurant in February but revered its decision a month later when the Mayor confirmed the east-west superhighway, which links Acton and Barking, would be built.

McDonald’s appealed to a planning inspector against the council’s refusal, though there were hopes today that a compromise could be struck by creating a different entrance route off Western Avenue.

It is believed the restaurant franchisee, Atul Pathak, supports the cycle superhighway but McDonald’s corporate headquarters wants to win approval for the original scheme.

In a joint statement in advance of the hearing, Mr Gilligan and Ealing leader Julian Bell said: “The franchisee who will actually be operating the new restaurant is perfectly happy to accept an entrance that does not compromise the new cycle superhighway.

“McDonalds corporate headquarters, however, has insisted on aggressively fighting for an entrance which both of us believe to be unsafe.”

A McDonald’s spokesman said: “We are excited about our plans to invest and create jobs in North Acton. Over the last year we have worked alongside all of the parties involved to ensure that a new restaurant supports the plans for a new cycle superhighway. We are confident that this is the case and look forward to the inquiry’s decision.”

London’s deadliest road gets new junction to protect cyclists from left-turning vehicles


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The UK’s first junction designed to protect cyclists from being hit by left-turning vehicles was unveiled today on London’s deadliest road.

Transport for London has introduced the changes on the Mayor’s Cycle Superhighway 2 on Whitechapel Road, at its junction with Cambridge Heath Road.

The new layout uses traffic lights to hold back traffic wanting to turn left, while allowing cyclists and vehicles heading straight on to go first. Cyclists are held at a red light when vehicles get a green light to turn left.

The chosen junction is not one of the most problematic but CS2 has been the location for a number of fatalities, including at Aldgate and Bow. Victims have included Philipine de Gerin-Ricard and Brian Dorling.

All 11 major junctions along the superhighway – currently being segregated from vehicles along almost its entire length – will feature such “early release” junctions for cyclists by next year. The junctions will also be introduced elsewhere in London.

London mayor Boris Johnson said: “I made a firm commitment that we would upgrade cycle superhighway 2 to ensure that cyclists get the time and the space they need to cycle safely. That’s exactly what’s happening here in east London.

“The innovations we’re using at Cambridge Heath are a fantastic taster of the raft of improvements that are coming down the track, ensuring that people can cycle safely and more confidently in our city.”

There is also a two-stage right turn for cyclists. About 85 per cent of cyclist collisions happen at junctions, mostly involving turning traffic. TfL hopes the new system will reduce the number of cyclists injured in London. A total of 5,146 were injured last year – the highest figure since 1989.

Work to upgrade the superhighway began in February and is now half complete. Once finished, the vast majority of the route will be separated with a kerb. Where space is tighter, flexible poles or “wands” will keep cyclists separate from vehicles.

TfL said the work at the Cambridge Heath junction was “co-ordinated” with improvements taking place at Aldgate – where the route narrows and becomes one of the most terrifying routes in the capital due to the number of lorries, coaches and taxis – to minimise inconvenience to riders. At present, much of CS2 is being dug up – making it hazardous for cyclists and pedestrians.

Caroline Pidgeon, Lib-Dem transport spokeswoman on the London Assembly, said: “While it is regrettable that serious mistakes were made with the initial superhighway 2 it is very welcome that such innovate designs and safety measures are now being adopted.”

Copenhagen-style bike lanes in Camden Town will create Swiss Cottage to Canary Wharf cycle route


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Plans were unveiled today for a major cycle route linking Swiss Cottage to Canary Wharf and Barking that will include Danish-style segregated lanes in Camden Town.

It copies a design pioneered in Copenhagen, one of the world’s most bike-friendly cities, that builds the cycle lane higher than the road but lower than the pavement to keep cyclists, pedestrians and vehicles separate.

Camden council has proposed the layout for Delancey Street and Pratt Street, currently the “missing link” in the route via Swiss Cottage and Regent’s Park to King’s Cross, where riders will be able to connect to Transport for London’s new north-south King’s Cross to Elephant and Castle cycle superhighway and a number of other protected routes.

Copnhagen-style bike lane in Pancras Road (Pic via @PhilJones79/Twitter)

Copenhagen-style bike lane in Pancras Road (Pic via @PhilJones79/Twitter)

Andrew Gilligan, the Mayor of London’s cycling commissioner, said: “This outstanding scheme will break one of north London’s main barriers to cycling.

“Once the links are complete, cyclists will be able to ride from Swiss Cottage and Camden Town to Canary Wharf, Barking or Elephant & Castle entirely on separated cycle tracks or low-traffic streets. It’s testimony to the power of the relationship between TfL and a borough genuinely committed to cycling.”

The route through Delancey Street and Pratt Street will create a contraflow for cyclists on 2m-wide tracks and better crossings for pedestrians. This will link to Camden’s widely-praised cycle lane in Royal College Street, and a new route in Pancras Road. The work is part of the Mayor’s central London cycling grid.

Phil Jones, Camden’s cabinet member for transport, said: “These new plans are for some of best cycling facilities that London has seen and will open up a network of safe and attractive routes for the growing number of cyclists who want to cycle through Camden.

“Camden already has some safe and attractive cycle routes and by the end of 2015, we are on track to have doubled the amount of segregated cycle lanes in the past two years.

“By the end of 2016 we plan to have over 10km of new and improved segregated cycle lanes in the borough linking many of our town centres to each other and to the West End and City.”

Full details of the consultation:

Mayoral hopeful proposes free Boris bikes for pensioners and expansion of scheme



Pensioners would be able to ride Boris bikes for free, under an expansion of the Mayor’s cycle hire scheme proposed today by a prospective Labour candidate.

Christian Wolmar would allow older Londoners to use their old-age Freedom Passes, which provide free bus and Tube transport, instead of paying the £2-a-day bike hire.

He vowed to expand the scheme across south London and the parts of north London, such as north Camden and Islington, where there are no docking stations. Suburban boroughs would be able to bid for hubs in their town centres. He wants bikes to be hired and returned at mainline train stations.

Mr Wolmar said: “At the moment this is very much a Zone 1 and 2 scheme aimed at ABC1s. I want to turn it into a mass form of transport that will help to reduce congestion and encourage all Londoners to get on their bikes.

“In Paris, people are able to hold onto their bikes for up to a month by paying a higher fee. That would mean they would not use expensive docking space and probably many will then eventually buy their own bikes.”

Students offered £2,000 annual bursaries to train as London Ambulance paramedics


Students reconsidering their options after receiving their A-level results are being offered a £2,000-a-year university bursary to encourage them to become paramedics.

London Ambulance Service has increased from 250 to 600 the number of annual places it will offer to students in a bid to plug a long-standing shortage of frontline staff.

The places are available at four universities – with one partnership between St George’s, University of London and Kingston university boasting high-tech simulation rooms to make the training as realistic as possible.

The recruitment plan is a key part of LAS’s long-term strategy to attract and train Londoners. It has been forced to hire hundreds of Australian paramedics as a short-term solution to solving its vacancy crisis, and will return Down Under next month for a third visit.

LAS places on £9,000-a-year paramedic science BSc courses are available at St George’s, Greenwich, Hertfordshire and Anglia Ruskin universities. London paramedics currently start on a salary of £31,456.

Jane Thomas of LAS said: “I see it as a real positive. It’s very exciting for us and it’s good to bring new blood into the profession. We will have more people on the road and high-quality staff who will be able to treat Londoners.”

Daniel Ryan: started work as LAS paramedic this week

Daniel Ryan: started work as LAS paramedic this week

Daniel Ryan, 23, a former nurse living in Streatham, started work as a London paramedic on Monday after completing his paramedic training at St George’s.

He said:  “It’s something I have always wanted to do. I have always been attracted to the diversity the role offers, being out and about and being able to treat a non-specific group of patients. The course itself is run by paramedics who have a wealth of experience.”

Chris Baker, paramedic science admissions tutor at St George’s, said it had about 50 places left. “I think this campaign is so necessary,” he said.

“There is this national shortage of paramedics. We need to get people working in ambulances and urgent care centres to make sure the public have got what they need. This is a fantastic job.”

Victoria line upgrade will create ‘most frequent Tube service in Europe’, says TfL


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Work to upgrade the Victoria line will make it the most frequent Tube service in Europe, Underground bosses said today.

They said it would set the “gold standard” for public transport, with 36 trains an hour – double the number when it first opened in 1968.

An £11 million programme to replace a “scissors” track-crossing outside Walthamstow Central station has forced the closure of the northern end of the line for three weeks and disruption for thousands of east London commuters.

But Tube bosses said insist the long-term gain will be worth the short-term pain, with passengers seeing train frequencies increase from 24 to 36 trains an hour when a new signalling system is installed next summer.

David Waboso, capital programmes director at London Underground, said: “We are renewing the ironwork, track, foundations signalling and power so we can get trains to come in faster and leave faster.

“Because of that, we can get more trains per hour into Walthamstow, which will mean we can increase the number of trains in this section of the line from 24 to 36 an hour from next year. It will be a massive improvement for our customers.

“We think 36 trains an hour will make it the most frequently used line in Europe, apart from Moscow, which runs 40.

“I think the Victoria line now sets the bar for where we want to take our next lines. Thirty-six trains an hour is really pushing at being the best in the world.

“Across most of our modernised lines now, we are pushing the barrier to 30 trains an hour on the Jubilee line, the Central line and increasingly the Northern line when we get the next section of the upgrade finished.”

The three-week closure has taken three years to plan. About 300 contractors are working round the clock to complete the project by August 30, with services resuming for the August bank holiday and Notting Hill carnival.

The Standard was given access to the tunnels and saw how a new interchange will allow trains to be “turned around” at Walthamstow Central much more quickly.

As a driver gets out of the cab at one end of the train, another will be ready at the other end of the platform to drive it back towards Brixton. At peak times, trains will be about only 50m apart.

Programme manager Mark Maher, 42, is continuing work started by his father Harry, now 81, who helped dig the tunnels for the Victoria line in the Sixties.

Mark Maher said: “When the original tunnel was being dug from 1964 onwards, him and a few other parts of my family were working here as tunnel minders and pit bosses for the duration of construction.

“He would probably like to come down here and check my work to make sure the quality was there.

“People of today’s age don’t really understand the complexity of the work there was to build it.”

Investigation launched after NHS attempts to win back £72 million contract from private sector


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An investigation has been launched into a London hospital’s bid to win back a £72 million contract from the private sector to treat thousands of patients.

The NHS regulator Monitor is checking whether having “low risk” day surgery performed by NHS doctors is in the best interest of patients.

It is Monitor’s first probe into patient choice, competition and the “tariff” charged for each procedure, and shows how the NHS is “fighting back” in a bid to secure lucrative work to offset the huge cost of providing A&E care.

The investigation was prompted by a complaint from Care UK after it lost the contract to perform about 15,000 operations a year, such as hip replacements and cataract removal, at the North East London NHS Treatment Centre in Ilford.

Care UK had run the centre since it opened 10 years ago. But GPs from four east London clinical commissioning groups instead awarded the five-year deal to Barking, Havering and Redbridge NHS trust, which runs the adjacent King George hospital and Queen’s hospital in Romford.

Catherine Davies, executive director of co-operation and competition at Monitor, said: “This complaint raises important questions for patients about how elective services are commissioned and paid for.

“Our investigation is at an early stage and we have not yet reached a view as to whether there has been any breach of the rules. We are now seeking further information from the organisations involved.”

Matthew Hopkins, chief executive of Barking, Havering and Redbridge, said: “Being named as preferred bidder shows that commissioners have real confidence in the quality of our services and the care that we provide to our patients.

“It’s great news for the communities of North East London – some of the most deprived in the country – and for the health economy. Importantly, it also shows real commitment to the future of King George hospital.”

The CCGs said: “Barking and Dagenham, Redbridge, Havering, and Waltham Forest Clinical Commissioning Groups are disappointed that this investigation has been launched. The CCGs remain confident that our arrangements to select a provider of these services were in the best interests of patients.”

A Care UK spokeswoman said: “We welcome Monitor’s announcement of an investigation into the procurement process for the operation of the existing NHS North East London Treatment Centre, run successfully by Care UK since 2005.

“Care UK confirms that it has raised concerns with Monitor and the local CCG regarding the appropriateness of price competition for NHS tariff services, the loss of patient choice and the weighting and evaluation of clinical quality in the procurement process.

“Care UK is committed to continuing to operate the service to the highest possible standards and continuing to support the local NHS in addressing its performance challenges during the period of Monitor’s investigation.”


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