This blog was contributed by Dianne Jeffrey CBE DL, Chairman of Age UK and Joint Chair of the Commission on Dignity in Care.
What happened in the Mid-Staffordshire Foundation Trust was a truly sickening and extreme example of when training, professionalism, management, and structures all individually and collectively failed very vulnerable frail patients.
Few in the health sector could claim that Mid-Staffordshire Foundation Trust was an isolated case. Most of us have heard accounts of similar failures in care in our local hospitals or care homes, some relating to individual wards, others more widespread.
Today is a watershed moment for the NHS: 31 months after the Francis report was commissioned the final report was published on the 6th February. The report makes 290 recommendations on how to improve the system and we must once and for all take this opportunity to make the deep and lasting changes that are required. A ‘sticking plaster solution’ is not going to be acceptable and will certainly not be enough to reassure millions of older people and their families.
The initial inquiry into Mid-Staffordshire marked a crucial moment in exposing undignified and poor care and was a major factor in the decision by Age UK, the NHS Confederation and the Local Government Association to establish the Dignity in Care Commission. Our remit was to make sure that our older people are treated in a way that not only helps them to get better but that also values their individual dignity.
It is, of course, important for us to remember that there is a huge amount of good care delivered by caring staff across the system. But we urgently need a comprehensive plan of action to transform culture and practice, as well as policy and systems, to ensure good care is delivered to every patient every time.
This is what we heard throughout the Commission’s work too. We listened to hours of evidence from both professionals and families about poor care they had experienced but crucially also about how good care can be encouraged and supported.
Our final report, Delivering Dignity, sets out a blueprint that will help the NHS and care homes make the real and enduring changes needed to consistently deliver dignified and compassionate care.
However there must be true accountability and leadership to drive change – without that, what hope can we have for the future of the NHS and social care system?
There are also wider and uncomfortable questions for us all. At some level are the events at Mid-Staffordshire due to our sometimes negative societal attitude to older people? Have we collectively stopped listening as attentively to the needs of our oldest members as we should?
Our society is ageing and clearly the NHS is struggling to adapt. Around 65% of people admitted to hospital are over 65. Yet despite the growing number of older service users, geriatric medicine is still treated as a niche subject by many medical schools and it is possible to qualify as a doctor having experienced only around 30 hours of bed-side geriatric medicine. We must ensure that better initial and follow-up training happen from now on.
So much about providing dignified care is not to be found in text books or lecture halls but in seeing beyond a medical condition to an older person’s humanity and treating them as we would wish to be treated. It is about making sure that compassion and empathy are part of care at every level of hierarchy and in every situation. It is often about something as simple as placing a glass of water just that little bit closer so that a patient can actually reach it.
In partnership with the NHS Confederation and the Local Government Group, Age UK launched the Dignity in Care Commission to drive improvements in the levels of care provided to older people in hospitals and care homes. Find out more about the work of the Dignity in Care Commission