The first inquiry into Mid Staffordshire NHS Foundation Trust catalogued extensive examples of neglectful care and appalling patient experiences. Stories of people being ignored, dehydrated, abused were visible signs of an organisation that had forgotten basic principles of care and at worst, wilfully put organisational considerations ahead of patients. Many, if not most, of the patients involved were older people.
The second inquiry reported in February and included 290 recommendations
that could help to avoid the same situation arising again, not just in Staffordshire, but throughout the NHS. You can see what we said about it in our blog.
The government yesterday gave its response to the report in a paper titled Patients first and foremost, and there’s much to be positive about in what it says.
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. Continue reading “Mid Staffordshire Inquiry Announcement”
The first of February marked Dignity Action Day, an annual opportunity for health and social care professionals and members of the public to raise awareness of people’s rights to dignity. There are over 40,000 Dignity Champions across the country who believe care services should be compassionate and person-centred. The Champions pledge to challenge poor care and act as good role models. Dignity Action Day, organised by the Dignity in Care Network, is a time where local communities can come together to hold events and activities that promote and celebrate dignity.
Many organisations around the country marked Dignity in Action day. Just one example is Islington Age UK. Andy Murphy CEO of Age UK Islington was one of the judges for Islington Council’s Care Worker Award. The Care Worker Award recognises and showcases the work of formal care staff and contractors who provide a dignified service to residents. 18 finalists were nominated by Care Managers from across Islington with the winner announced on Dignity Action Day. Continue reading “Dignity in Action Day 2013”
The Autumn Statement announced bleak growth figures and more cuts ahead, reminding us all, once again, we face hard times and unprecedented and prolonged pressure on public services many of which older people rely.
This is why now, more than ever, we all need – the government, public, private, and voluntary sectors and individuals – to work together to meet the challenges and maximise the opportunities our growing ageing population presents.
Age UK, together with our national and local partners, is playing its part. In 2012 we reached over 7 million older people with our information and advice services, our handy person service visited nearly 14,000 homes and we helped more than 65,000 older people keep active and healthy through our Fit as a Fiddle programme. In tough economic times we understand supporting people in later life to make informed choices and maximise their wealth, health, independence and wellbeing is important for the individuals and helps drive down inefficient and unnecessary costs in our public services. Continue reading “Working together to support older people”
Today Age UK along with the NHS Confederation and LGA is hosting an action event on improving dignity in care for older people. The day will give practitioners, commissioners and service representatives from across the health and social care sector a chance to get further involved in ensuring the delivery of dignified care.
Discussions today will help us to ensure that the long-term action plan we are developing with our partners at the NHS Confederation and the Local Government Association is informed by those commissioning, providing or receiving care. This plan will focus on working with our members and partners across health and social care to support delivery of the Commission’s recommendations.
The event will include a keynote speech from Sally Brearley, Chair of the Nursing and Care Quality Forum in the Department of Health. There will also be an overview of the Commission’s recommendations on improving dignity for older people in hospitals and care homes, this will provide opportunities to comment on how the Commissioners believe these now can be implemented. Continue reading “Action event on improving dignity in care for older people”
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.
Death is often said to be the last taboo, despite being the one event that we all have coming to us at some point. Talking about dying can be very difficult for many people, not just the individual and their loved ones but also medical professionals who may be equally uncomfortable approaching such a sensitive topic or regard death as the ultimate failure of their skills.
The NHS has over its lifetime played perhaps a leading role in this country in bringing up life expectancy to the point where of the nearly half a million people who die annually, around four fifths are over 65 and two thirds are 75 plus. The major workload of the NHS has changed from treating working age adults with single acute problems to treating patients in later life – about of every ten patients in hospital around 6 will be over the age of 65. In later life, patients are more likely to be frail or living with more than one serious condition and so require a different approach to their care.
According to the report less than a third of acutely ill patients admitted to hospital got good care when they had a cardiac arrest. Whilst the report did not solely focus on older patients, the vast majority were over 65 and the mean age of people in the study was 77. And most people had at least one co-morbidity.
In nearly half of the admissions, patient assessment was deficient and in over a third of cases did not pick up warning signs that the patient was deteriorating and might arrest. Better training and understanding of geriatric care would, we believe, help medical staff to see beyond the immediate presenting problem and understand that an older person is likely to have other serious underlying medical issues, helping to better anticipate deterioration. All health professionals need to have the skills required to deliver healthcare in the 21st century. Continue reading “The NHS must do more to help patients have a good death”