Poor practice must never be tolerated, says Ruth Marks, the older people’s commissioner for Wales Care of some elderly hospital patients is “shamefully inadequate”, according to a review for Wales’ older people’s commissioner.
It found some patients degraded and humiliated and the commissioner, Ruth Marks, is calling for “fundamental change”.
Health Minister Edwina Hart said the findings will be considered as part of work to “improve patient care”.
Recommendations include improving discharge times and patient privacy.
The review was carried out following a public consultation and a poll of 1,500 people which found that one in five either knew someone who had a negative experience of hospital care, or had one themselves.
The panel, chaired by Dame Deirdre Hine, a former chief medical officer for Wales, gathered evidence through hospital visits and written evidence.
The report highlights as unacceptable a “lack of timely response to continence needs” which it found widely reported.
“Attitudes and practices that assault the dignity and self esteem of older people at a time when they are most anxious and vulnerable must be stopped”
Dame Deirdre Hine Review panel chair
It said the sharing of patients’ personal information within earshot of others “should cease wherever possible”.
The report said that “too many older people are still not being discharged in an effective and timely manner and this needs urgent attention”.
The review panel also heard that older people have low expectations of what to expect in terms of dignity and respect while in hospital.
“Attitudes and practices that assault the dignity and self esteem of older people at a time when they are most anxious and vulnerable must be stopped,” said Dame Deirdre.
The report, called Dignified Care? details recommendations, including the need to change the culture of caring for older people by empowering ward managers to run wards in a way that “enhances dignity and respect” as well as “prioritising continence care”.
Some of the findings in this report make for uncomfortable reading – and in many ways, that’s the point.
It draws attention to issues like avoidable incontinence, when people are denied the right to go to the toilet.
It says the effect is degrading and humiliating for patients – “an assault on their self respect”.
The report highlights the contrast between the good, compassionate care many thousands of older patients receive every day in Wales, and basic failures which erode the dignity of older patients.
Some of the problems – such as delayed discharges from hospital – are long standing.
Others, like the sharing of personal patient information could be addressed with very simple changes. But the need for change is becoming more acute.
The number of frail, elderly patients is increasing year on year – within 20 years, the number of people aged 85 and over is set to double.
At the same time, the Welsh NHS faces a shrinking budget in real terms – making improving patient care more difficult than ever.
Ms Marks said: “Fundamental change is needed to prevent what is sometimes shamefully inadequate care and treatment. Poor practice must never be tolerated.
“The attitudes, behaviour and sensitivity of staff on the wards are crucial.
“We need strong, positive leadership at all levels and a system which builds in dignity and respect as the cornerstone of high quality care.
“There are examples of effective leadership and good practice and it is vital these are built on and become the norm.”
Health boards and trusts which runs the hospitals concerned have three months to respond to the recommendations.
Mrs Hart said: “We are taking action in these areas but we will consider the report’s findings and recommendations as we continually work to improve patient care.
“Every day the health service cares for thousands of patients and the vast majority of patients are satisfied with their care.
“However, there will be occasions where the standard of care does not meet our high expectations and we must to all we can to reduce this.
“That is why it is so important that patients or relatives raise concerns to the hospital ward sister or other members of staff to ensure action is taken to address any issues.”
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