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We give you many useful information about health

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We give you many useful information about health

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We give you many useful information about health

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Tampilkan postingan dengan label staff. Tampilkan semua postingan
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Kamis, 13 Oktober 2011

Wells Fargo gives staff tough healthcare choices

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AppId is over the quota
By Rick Rothacker

Wed Oct 12, 2011 8:27pm EDT

n">(Reuters) - Wells Fargo & Co, one of the largest U.S. employers, plans to cut costs by moving its workers into insurance plans that encourage them to spend less on healthcare.

The bank told Reuters that it is rolling out a new insurance approach next year that will give employees accounts to help cover medical expenses. They can either put their own pretax dollars in the accounts, or pay higher insurance premiums and have the company fund the account.

If employees opt to put their own money into the accounts, they are on the hook for more of their medical expenses if they get sick. If they stay healthy, they benefit from lower premiums.

These types of accounts are believed to be useful in encouraging consumers to think more about how they are spending healthcare dollars.

For most employers, these accounts are one option among many for health insurance, said Alexander Domaszewicz, a principal with human resources consulting firm Mercer.

Only a handful of other companies, including General Electric Co and JPMorgan Chase & Co, are going the same route as Wells Fargo and offering only account-based healthcare plans.

"It still isn't common for very large firms," Domaszewicz said in an interview this week.

But other companies may follow suit. Account-based health plans can cut employees' and companies' premium costs by 15 percent, according to Mercer.

Other employers often follow big companies like Wells Fargo when it comes to benefits, Domaszewicz said.

In materials sent to employees recently, Wells said it was making the change "because rising health care costs and the impact of federal health care reform require us to take a new approach to managing costs together."

Studies are mixed over whether the new U.S. healthcare law will drive up employers' healthcare costs, but overall U.S. health insurance premiums have surged over the last decade.

A study last month by the Kaiser Family Foundation found that the average annual premium for family coverage through an employer increased 9 percent to $15,073 in 2011 from the year before. Since 2000, premiums have risen 134 percent.

Employers pay nearly three-quarters of that premium, a rate that has held fairly steady for the last 10 years, according to the foundation's data.

"This is one of the fastest-growing expenses employers have," said Randall Abbott, a senior consultant at healthcare consulting firm Towers Watson.

Cost-cutting is particularly crucial in the financial sector, where the mortgage crisis, low long-term interest rates, and weak loan demand are depressing revenue. San Francisco-based Wells Fargo is looking to shave $1.5 billion from its quarterly operating expenses by the end of 2012 under a program known as "Project Compass."

Wells earned $7.3 billion for common stockholders in the first half of the year, up from $5.3 billion in the first half of last year.

A Mercer survey found that health benefits costs on average will rise 5.4 percent in 2012, the smallest increase since 1997, because employers have been so aggressive about cutting these expenses.

"We view this as effective use of healthcare services, not as cost-cutting measures," bank spokesman Ancel Martinez said on Wednesday.

LESS BARGAINING POWER

U.S. employers began widely offering healthcare coverage after World War Two to get around government salary controls.

With 275,000 full- and part-time employees, Wells Fargo is the 12th-largest employer among public companies, according to Fortune Magazine.

About one-third of the bank's employees already use some sort of account-based plan. Wells will still offer traditional plans in California and other states where switching would force too many employees to change their doctors.

Under the bank's program, employees can have a "health reimbursement account," which Wells funds, or a "health savings account," which workers fill with their own pretax dollars.

Both accounts will help cover out-of-pocket expenses until a deductible is met.

After that, Wells will cover between 80 and 90 percent of medical expenses, with the employee picking up the rest. After an employee reaches an out-of-pocket maximum, Wells covers 100 percent of additional expenses. An insurance company administers the claims.

Eligible preventive care, such as routine checkups, annual screenings and immunizations, is covered 100 percent. Employees can earn money to put into their accounts through participating in health and wellness programs.

A Wells employee in North Carolina covered on an individual basis would pay a premium of about $23 per two-week pay period for the health savings account option, compared with $48 for the health reimbursement account plan.

An employee in an individual plan can put up to $3,100 into a health savings account under IRS rules next year. The deductible in that plan is $3,000.

In the health reimbursement option, the company can put between $200 and $1,000 in an employee's account. The deductible is $2,000 for individual coverage. Employees must pay $25 for a primary office visit, which is less than the full cost. There are also co-pays for generic prescription drugs.

Employees who use health savings accounts can roll their money into the next year if they do not use it all and take it with them if they leave the company.

(Reporting by Rick Rothacker in Charlotte, North Carolina; and additional reporting by Bill Berkrot in New York; Editing by Dan Wilchins, Martin Howell, Lisa Von Ahn and Carol Bishopric)



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Health Management

Minggu, 25 September 2011

NHS staff training 'unacceptable'

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22 September 2011 Last updated at 10:55 GMT Geriatric care by healthcare assistant Healthcare assistants are employed to do basic tasks like feeding and washing patients The NHS is too reliant on untrained healthcare assistants who are asked to pick up nursing skills as they go along, says the head of the Royal College of Nursing.

Peter Carter said healthcare assistants were employed to help nurses with basic tasks like washing and feeding, but ended up doing much more.

They should be subject to regulation and mandatory training, Dr Carter said.

He also warned that some nursing degree courses focus too much on theory.

Dr Carter said healthcare assistants were essential to the NHS and wanted to do a good job, but they needed to be properly trained.

"Many hospitals employ healthcare assistants as opposed to registered nurses, and many of them don't give them as much as an hour's training.

"This happens in some care homes and domiciliary care too.

"It is wholly unacceptable that the elderly should be cared for by people who are not given the rudimentary training."

Continue reading the main story
People are given a tunic which looks like a nurse's uniform and they are asked to pick it up as they go along”

End Quote Peter Carter Royal College of Nursing He said spending on regulation and proper training would prove a wise investment.

"Cheap care is poor care. Poor care ends up being more expensive. We must invest properly in the workforce and then we will get fewer problems and complications."

He said he was not trying to alarm patients by questioning the training given to healthcare workers.

"There are plenty of examples where healthcare assistants are properly trained, but there are huge variations in training across the board.

"People are given a tunic which looks like a nurse's uniform and they are asked to pick it up as they go along. I can't think of any other sector where that would be acceptable."

"It wouldn't happen with tyre fitters or at John Lewis or Marks and Spencer... but it is seen to be acceptable in some of our healthcare settings in the NHS."

Hands-on training Dr Peter Carter: "Healthcare assistants pick it up as they go along"

Dr Carter added: "Mobilising people, catheterising people, dealing with nutrition and hygiene - these are techniques that should be taught properly. This would have avoided many of the problems we've been reading about in recent months."

A spokeswoman from the Department of Health said the government was not in favour of national statutory regulation for healthcare assistants.

"The government's view is that national statutory regulation must be proportionate and targeted - and we do not believe that this is the case for healthcare assistants.

"The government intends to establish the Professional Standards Authority for Health and Social Care (currently the CHRE) as the national accrediting body for a system of assured voluntary registers for groups that are currently not subject to statutory professional regulation, which includes healthcare assistants."

Dr Carter was also critical of the amount of money spent on the new IT system for the NHS, calling it a "national disgrace".

"Eleven billion pounds is a huge amount of money. If more of that had been spent on the workforce instead, lots of problems with standards of care in some hospitals would have been avoided."

Dr Carter went on to say that some institutions running nursing degree courses were not providing students with the necessary balance between classroom learning and hands-on training.

"While the vast majority of student nurses are well trained, there are a few cases where this training is not of the level it should be.

"It is vital that we do not see a variation in standards across the country, for whatever reason; be it inadequate courses or cutbacks on wards which prevent staff from teaching students as they'd wish."

He added: "Universities and NHS Trusts have a responsibility to their students and future patients to ensure that training fully equips nurses for the demands of this complex and skilled profession."

The Royal College of Nursing has long been supportive of the move to ensure all new nurses have a degree by 2013.

The Nursing and Midwifery Council, which vets university training courses, said: "The balance between theory and practice in these courses hasn't changed. It's 50-50 and it has been that way for many years."



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Minggu, 18 September 2011

NHS staff poor understanding of English

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15 September 2011 last updated at 18: 45 GMT Adrian Goldberg by Adrian Goldberg presenter, 5 live investigates Jan Middleton Jan Middleton threatened to call 999 while in hospital because a nurse did not understand English "I had to threaten to call 999 in order to get her to understand that I needed to see one of the doctors urgently."

Jan Middleton in hospital recovering from brain surgery in 2009, and what wakened up in the middle of the night by an eruption of infected fluids coming from her face.

She said the nurse on duty had poor English.

"I what saying, ' look, this is serious." I've had emergency surgery. The doctors need to know about this now'.

"I was getting very, very distressed and in quite a panic." Which is why in the end I said 'I'm dialling 999 for an ambulance', and she seemed to understand at this point that she did need to do something about getting a doctor.

"But I don't of think she understood half of the reason why."

Imperial College Healthcare NHS Trust, which oversees Charing Cross Hospital, where Ms. Middleton was a patient, says numeracy and literacy assessments have been introduced into its recruitment process for nurses and it says verbal communication skills are so now tested at interview.

It says it has since had no further complaints of this nature about the ward Ms. Middleton was on.

EU directive blocks test

But the English language skills of foreign nurses and doctors working in the UK remain a concern.

"Continue reading the main story
if they cannot understand straight forward English conversation then, in my view, I feel they are causing a potential danger to patients"
end quote Jan Middleton cure the NHS the General Medical Council (GMC) says some overseas doctors come to the NHS with 'little or no preparation' for working in the UK.

Along with the nursing and midwifery Council, it wants the right to test the English language skills of applicants from within the EU in the same way they test applicants from outside of Europe.

But an EU directive prevents any systematic testing of language skills of doctors from the European economic area (EEA).

The GMC says UK legislation - the medical Act 1983 - 'Golden of plates' the directive and prevents the GMC from doing any language-testing of doctors from the EEA at all.

Employers are allowed to assess the language skills of applicants from the EEA, but it is thought many do not.

A nurse attending a patientThe government says it is determined not to employ staff in the NHS if they cannot speak English

A spokesperson from the GMC said:

"Doctors who come to work in the UK make a vital contribution to our healthcare system, but we must make sure they receive the support they need to practise safely and to conform to UK standards."

"It is unacceptable that the current system enables doctors to practise in the UK without a sufficient grasp of English."

The GMC says some overseas doctors come to the NHS with "little or no preparation" for working in the UK and those trained under different cultural and professional standards need more support.

The GMC is planning a basic induction programmes for all doctors - including those who qualify in the UK - to help understand how healthcare is practised in the UK.

"Prove language skills"

At NHS doctor working in psychiatry, speaking anonymously to 5 live investigates says that misunderstandings and confusion sometimes arise between some European doctors and their patients because of language difficulties.

She said on one occasion, a patient tried to explain that she what having recurring thoughts about an upsetting incident, but this what misunderstood.

"The doctor assumed the patient what hearing voices, whereas to others present it seemed clear that she what talking about difficult memories."

"The complicating factor was that the patient had learning difficulties and what unable to articulate things in a straightforward manner."

"Continue reading the main story
this government is determined to make sure that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language skills"
end quote Department of health in another incident, a European doctor did not understand what a Turkish patient meant when he said he could "pinch on an inch" around his middle to indicate he had put on weight because of the medication he was on.

"The doctor initially thought hey what saying he had to itch and, ultimately, concluded he what making up words."

"Why this was so relevant becomes apparent when you understand the patient what ward on a psychiatric, and that this could have been documented as a symptom."

A spokesperson from the Department of Health said:

"This government is determined to make sure that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language skills."

"We do think the Directive needs updating, and we are in the process of responding to the EU proposals, but we can not pre empt that response."

"We have already taken steps to strengthen the current system by introducing a duty for responsible officers to check the qualifications, experience and references of all doctors, including foreign doctors."

But poor English language standards are not just an issue among some European NHS staff, for whom English is not their first language.

Healthcare workers at the hospital Ms. Middleton was treated at told 5 live investigates the standard of English language spoken by staff is still at issue.

Asian nurses said they found it difficult to understand European colleagues - especially those from Eastern Europe.

But when one what asked what meant a patient if they said they wanted to 'spend a penny' - slang for go to the lavender - she replied "they want to spend money".

Ms. Middleton, who is now a member of the cure the NHS campaign, reinforced the need to ensure medical staff are competent in the English language:

"Anyone interviewing a potential employee knows if their English is adequate just by speaking to them."

"If they cannot understand straight-forward English conversation then, in my view, I feel they are causing a potential danger to patients."

A spokesperson from Imperial College Healthcare NHS Trust, said:

"We take patient experience and patient complaints very seriously."

"We care for a diverse patient population and employ a diverse workforce, and understand the importance of staff being able to talk to patients and their families in an appropriate way."

5 You can hear the full report on live investigates on BBC 5 live on Sunday, 18 September at 21: 00 BST on BBC Radio 5 live.

You can listen again on theBBC iPlayer or by downloading the 5 live investigates podcast.



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