This blog was contributed by Dianne Jeffrey CBE DL, Chairman of Age UK and Joint Chair of the Commission on Dignity in Care.
After many years’ service in health and social care I have seen much in both to be proud of. I have witnessed excellent examples of compassionate care, met many dedicated staff and seen how high-quality services have transformed lives.
Yet I have also been deeply saddened by the knowledge that in too many cases care has fallen short of these standards, letting people down when they are vulnerable and most in need of help.
That is why I have been delighted to co-chair the Commission on Dignity in Care; an independent commission established by Age UK, the NHS Confederation and Local Government Association to bring together expertise from right across the care system, including nursing, social care, medicine and commissioning with the voices of older people and their families.
Our aim was to help health and social care sectors to find long-term solutions to tackling poor care that work on the ground. We recognise that this is a difficult task, there are no silver bullets. Instead we wanted to understand the roots of poor care and find ways to support people to take action in their own organisations.
Today, just a little under a year since we began, we publish the Commission’s final report Delivering Dignity. The report’s main message is clear. Leaders in the health and social care sector must drive a “major cultural shift” to tackle the underlying causes of poor and undignified care of older people throughout care homes and hospitals.
The NHS already has ‘never events’, things that are considered so serious they should never happen, like operating on the wrong part of the body. The Commission has recommended ‘always events’, things which should never be forgotten and should be considered as basic rules for the delivery of dignified care in every hospital and care home.
This may all sound a bit theoretical at first glance. However our report has made 37 clear recommendations for steps that could practically be taken by people at every level from front line staff to board members. Ultimately it is the individual actions of people in the system doing the right thing which adds up to major change.
Delivering dignity will mean changing the way we design, pay for, deliver and monitor care services as the numbers of older people in care continues to grow. Alongside the consistent application of good practice and the rooting out of poor care, we need a major shift in the system to ensure care is person-centred and not task-focused.
This will require empowered leadership on the ward and in the care home, as well as a lead from boards and senior managers. It will also mean changing the way we recruit and develop staff working with older people.
We have to work with older people to shape services around their needs, and listen to patients and residents and their families, carers and advocates so we learn from their feedback and continually improve dignity in care.
We are also clear that it is the leaders of health and social care who are responsible for driving better quality care. Regulation and government action has a critical role to play, but it cannot alone deliver the cultural and organisational change that may be necessary.
In February we published an interim report to consult on our proposed recommendations. We were overwhelmed by the hugely positive response it received, with over 230 responses from across the health and social care sector, patient groups, members of the public and professionals. This clearly demonstrated to me just how passionately people feel about getting care right for older people.
Our next challenge is harnessing this passion and commitment to drive forward implementation of our recommendations.
I don’t underestimate the scale of this task and know we won’t see changes overnight. But from the very beginning we were determined that this wouldn’t be just another report that sat on shelf gathering dust.
In the autumn we will be launching an action plan. We will be seeking to work with people from across the health and care system, professionals and older people to make sure change happens.