Drinking water being prescribed by doctors – whatever next?

Today, Age UK has been in the media commenting on the standards of care older people receive in hospital.

Last year, through our Hungry to be Heard campaign, we called on the Care Quality Commission (CQC) to undertake a comprehensive review of hospital mealtimes. In response to this, and pressure from other organisations, the CQC has undertaken spot checks in 100 hospitals to find out if older people are treated with dignity and respect, and whether they get food and drink which meets their needs.

Today the CQC released reports for 12 hospitals which were inspected and the results are not surprising – some hospitals were performing well, while a quarter were failing to meet their legal requirements around dignity and nutrition.

The anecdotal evidence from the hospitals failing to meet their legal duties is shocking and unacceptable within some cases medical staff had to prescribe water to ensure patients are hydrated and patients received treatment with little or no communication as to what was happening and why.

In other hospitals excellent care was observed: nurses ensured that patients’ dignity was maintained and ward staff recognised that nutrition and hydration are essential parts of a patient’s recovery.

So, why the disparity between hospitals? The answer to this question is not easy, but includes a range of factors ; detailed training, strong leadership, the culture of the organisation and staffing levels.

Age UK has been campaigning for improved hospital mealtimes for the past 5 years and it saddens me that we still have so far to go to ensure all older people get the food and help they need during hospital mealtimes. We are calling for all wards to implement our seven steps, to ensure hospital mealtimes are a pleasantand healthy experience for all.

Food for thought

A few weeks ago the Royal College of Nursing (RCN) Congress dominated the headlines as nurses overwhelmingly voted in favour of a motion of no confidence in Andrew Lansley. While NHS reform was the main topic of conversation at the 4 day Congress, it was not the only issue being discussed.

Hospital food by celesteh, via FlickrWe attended the RCN congress to talk about a current problem in our hospitals – older patients becoming malnourished. The statistics show that the number of people entering and leaving hospital malnourished has steadily risen each year – in 2008-09 over 185,000 people left hospital malnourished.

The nurses we spoke to all agreed that this is a problem, but they disagreed over the cause. Many nurses believed that it is caused by the poor quality of food: “Have you seen the food they serve?” “The food looks like slop” are two comments we heard time and time again. Their proposed solution is straightforward – hospitals need to spend more on food so patients can have nutrient rich and appealing food.

While improving the quality of food will help, it will not fully solve the problem. Good quality food is important but hospitals also need to ensure that older people receive the help they need during mealtimes. What’s the point of having a five-star meal if no-one helps you to remove the packaging?

Older people regularly tell us they do not get the help they need at mealtimes – this help could be as simple as ensuring the food tray is placed within reach, to removing packaging as well as assistance with feeding. Without this support older patients go without food and often end up leaving hospital malnourished.

Nurses have told us that the biggest barrier to ensuring patients receive help is time – mealtimes are too short and there are simply not enough nurses to help everyone who requires support at mealtimes. There is no one solution to this; mealtimes could be staggered or extended, hospital volunteers could support patients during mealtimes or more nurses could be employed on wards.

What is clear is that immediate action is required to stop this scandal, otherwise the number of people leaving hospital malnourished will continue to rise.

Find out more about Age UK’s Hungry to be Heard campaign, fighting malnutrition in hospitals.