Leading article: A lethal lack of dignity for the elderly
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It was one of the most distressing details to emerge from the 2005-08 Stafford Hospital scandal: infirm patients were reduced to drinking water from vases of flowers. The NHS promised that the lessons of that disaster, in particular regarding the neglect of patients, would be learned. But today's reports published by the Care Quality Commission suggest they have still not been fully absorbed. The CQC conducted a series of unannounced inspections into the "dignity and nutrition" provided to older people at 100 hospitals. In the first reports released, three hospitals – in Ipswich, Hampstead and Redditch, Worcestershire – are found to be failing.
The reports highlight cases of patients not being given the physical assistance they need to eat their meals, patients malnourished and – in a chilling echo of Stafford – patients not being given enough to drink. In one case, a clinician felt it necessary to prescribe water for a patient to ensure that they got the necessary fluids. Something has gone badly wrong in a hospital when nurses need to be instructed to provide patients with something as simple as a glass of water. The CQC also discovered other evidence of substandard care in these institutions. Some patients complained that their treatment was not explained to them directly. Others said that their private medical information was discussed loudly in wards by staff.
Clearly, the immediate problem is one of substandard nursing care. Some nurses at these hospitals are manifestly guilty of a disrespectful attitude to patients. This is not an issue of resources, as those hospitals that were found to be providing excellent care by the CQC demonstrates. But nor is it acceptable simply to blame the nursing staff. If a nursing team is failing, that means the management of the hospital is failing too.
Dignity and nutrition are not optional extras. They are essential to patient care. And as the case of Stafford shows, when these substandard practices are not picked up on and corrected, the results can be lethal. Those hospitals named and shamed today should be in no doubt about what is now required of them.
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