Elderly care in disarray (again)

Posted by Alexander Hay

A new report by the Care Quality Commission is damning about some of the worst examples of neglect and incompetence in the NHS, which has taken root in one way or another in more than half of our hospitals

In many hospitals, this level of care is common, but in others...Sometimes the power of understatement can be devastating. For example, the use of the word, 'alarming' in this news story:

Too many hospitals in England are falling short in the most basic care they are giving elderly patients, inspectors say.

The Care Quality Commission carried out unannounced visits at 100 hospitals to assess dignity and nutrition standards.

It identified concerns in 55 cases, describing the findings as "alarming"...

We have been here before, with bad nursing and even worse treatment of elderly and vulnerable patients. What is interesting is the ratio of good to bad care based on the report's random sampling:

...The 100 sites inspected - representing more than a third of the total number in England - were chosen through a combination of random selection and because previous research had flagged up concerns about standards...

...In total, 45 were judged to be fully compliant, 35 met both the official standards on dignity and nutrition although there was room for improvement and 20 were failing on one or both...

So, the largest number of hospitals sampled were acceptable, meaning that the worst cases are still a minority. Still, 55% of hospitals have some or considerable problems, which suggests a picture that is complex, but also still rather disturbing.

Some of the cases cited are also disturbing:

"...The patient constantly called out for help and rattled the bedrail as staff passed by... 25 minutes passed before this patient received attention..."

"...The person did not have any assistance and the food was left on their table for over half an hour before they were assisted to eat..."

And so on. It fits a pattern not of malice but apathy and casual neglect. The humanity of the patient is overlooked in favour of an abstract workload. That is the problem here - patient care is divorced from the nature of human interaction and empathy. One shouldn't need to have a conversation with one's surgeon (especially midway through an operation) or have more than a formal relationship with whoever launders the bedsheets.

But part of what nursing is about is actually aiding the patient's recovery, which plainly isn't happening in the worst cases. What's missing is the human contact and interaction that seems to still be happening in 45% of our hospitals. But why not the others? Perhaps it's a lack of professionalism, or an erroneous belief that academic qualifications immediately translate into competence. Or simply not enough nurses aren't being sacked for negligence. In the meantime, a large number of elderly patients will continue to suffer.

There is one disturbing implication here however. Given the nature of news media, only unusual cases tend to get reported. "Grandmother, 62, goes in for ingrowing toenail - makes full recovery" hardly sells newspapers after all. But how likely would the grimmer stories be reported if the majority of patients had to endure them? Perhaps it's fortunate that the worst cases are coming out now, before the problem became truly endemic.


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Alexander Hay

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