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Patients Association attacks older people care

Tough action is needed against hospitals that neglect patients, the Patients Association has said.

It published harrowing stories of patients, many of them elderly, left “starving”, told to go to the toilet in their seat because nurses were too busy and relatives largely ignored while their loved ones died.

The charity said for every one of the 16 stories in its damning report, it receives many more detailing similar levels of poor care at the hands of the NHS.

Several of the cases involved patients who died in agony because of inadequate pain relief and one patient, Immacolata Lacovara, who had a “do not resuscitate” order put in her notes without her family’s permission, meaning nurses at Central Middlesex Hospital refused to help when she struggled to breathe.

In another hospital, a family member witnessed a patient accidentally pouring boiling soup over her legs but the nurse saying she was too busy to clear it up, meaning the patient was scalded and a doctor had to be called.

Another, George Taylor, 83, was admitted to Chase Farm Hospital in north London in August of this year.

His daughter Gaynor Marshall said: “On one occasion during his time on the ward dad was sat in a chair by his bed and needed the toilet.

“He asked a nurse to assist him, but was told that she was too busy, and that it would be easier for her if dad relieved his bowels in the chair.”

The nurse promised to clean it up later but never did, leaving Mr Taylor’s wife to do so.

The report said it contained “first-hand accounts of some of the very worst stories of poor care in hospitals that have come to the attention of the Patients Association Helpline.”

It follows earlier reports into poor care of the elderly by the Care Quality Commission (CQC) and the Parliamentary and Health Service Ombudsman.

Today, the Patients Association repeated its call for tougher action, including independent clinical ‘patient safeguarding champions’ to identify those wards where a long-term cultural change is required and oversee them until it happens.

The report also said the CQC inspections may not be enough to ensure long-term change in the NHS.

“It is simply not good enough to allow hospitals to make changes in the short-term to pass follow up inspections, which mask a longer term culture amongst nursing staff who then allow standards to slip once the gaze of the CQC has shifted away to another problem hospital.”

A spokeswoman for the Department of Health said: “Everyone admitted to hospital deserves to be treated with compassion and dignity. Many parts of the NHS provide really good care, but some sadly fall short of what we demand.

“That’s why we asked the Care Quality Commission to carry out unannounced inspections on issues including patient dignity and nutrition.

“So far, 100 inspections have already been carried out and 700 more will be carried out next year.

“Wherever there is poor performance, we will root it out, and whatever the reason for that poor performance, we will tackle it. The Patients Association is right to raise these examples and issues, and we will work with them and with the NHS to sort these problems out.”




Readers' comments (15)

  • The patients association really take a balanced, impartial view with both sides taken into account don't they?

    Why don't they, and the CQC and the DoH actually do something useful for a change and look at, and fight against some of the root causes of these failings, many of which boil down to things like staffing levels or the business/profit culture imposed on us for example. Nurses have been screaming from the rafters that this is the answer for a long time!!! LISTEN TO US!!! Or is it easier to simply attack the NHS and threaten more 'rooting out' and 'inspections' that do or understand nothing?

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  • Could it be that we are being discredited before we go on strike ?

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  • Anonymous | 9-Nov-2011 4:45 pm well there has certainly been a lot of that lately, but this is pretty much on form for the patients association anyway.

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  • Is the Patients Association made up of bitter old retired nurses trying to make a point of university educated nurses?? Because I am trying to understand why their stories are always unbalanced, out of context. Its just another case of nurse bashing and I don't understand why they and the media don't see the bigger picture. Just look at the recent daily mail article:

    Then its comment after comment after comment from public jo agreeing with it all. Why are people so ignorant? I'm not saying none of it is down to bad nursing but really? They would have us all believe that the majority of nurses couldn't give a f***.

    Why are nurses the scapegoats?

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  • I just cannot imagine any qualified nurse including myself or any decent human being letting any of these things happen to a vulnerable patient or anybody else for that matter.

    I once wrote NTBR on my own hospital notes and was surprised when it incurred the wrath of the house officer looking after me. I think he was shocked and did not know how to handle my behaviour hence his angry reaction! I am not sure what happened after that as I no longer had access to my notes but I can guess that he removed it!

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  • Natasha, I think you got three of those words right in your description of the patients association, but I don't think they were Nurses! I think it is about time someone from our side started biting back and started telling them that unless they can come up with something constructive, then they should keep quiet because we go through hell and back to deliver the best care we can, and the majority of the time, we deliver! Frankly I am sick and tired of all the Nurse bashing, and I am very suspect about some of these stories too, refusing to help someone who can't breath??? Please.

    "The charity said for every one of the 16 stories in its damning report, it receives many more"... well how many stories of EXCELLENT care do you get? Do you want to come and publish a few comments from the thank you cards I have received both as a student and a qualified Nurse? How much of a percentage of these 'bad' stories make up the patient population as a whole?

    Patient care is not perfect in the NHS, but we are trying our bloody best! If you truly have patients interests at heart as your title would suggest, stop criticising and start helping! Start campaigning to the GOVERNMENT for better staffing levels, start campaigning to stop the post cuts, the ward and bed closures, start campaigning for something useful for a bloody change instead of always criticising and coming up with nonsensical ideas like 'independent champions'. Just what we need in the NHS, another clipboard wielding non clinical busy body. Or is that to hard for you all at the patients association to understand?

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  • As a nurse and having been a patient in hospital for a long time I can say that poor care happen across the board. I am certainly not an 'older person' but my care left me shocked and disgusted. However, I also recognise that day after day nurses go to work and do amazing work with and for patients and they do care. It is a small minority that dont care, most do and are disadvantaged by staffing and organisational cultures that promote other things above patients. Just look at our regulatory body
    CEO of the NMC says regarding this report:
    'It is always distressing to read examples of poor care involving nurses'.
    No its is not!!! It is always distressing to read examples of poor care involving ANY healthcare professionals!!! Note the emphasis they put on nurses. Please NMC stop being part of the problem and begin being part of the solution!!!!
    As a nurse you have failed me just as you failed me as a patient.
    It would be interesting to track the number of stories in the press alongside the government agenda for health. Its no coincidence that nurses are slated everyday just as the government wants to downgrade our pensions, demonstrate how bad the NHS is so that there is a stronger rationale for drastic change and is keen that nurses no longer regulate themselves (because we just cant be trusted).
    Sad times. Keep going colleages, most of us do a good (even excellent) job.

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  • michael stone

    I KNEW the Patients Association was going to get 'slagged off' here.

    Please pay attention, because Angela Rippon was talking on behalf of the PA about that report, and the PA's new initiative, just before 9am on Radio 4 yesterday.

    The Patients Association is very clear about 2 things:

    1) MOST nurses are caring and compassionate, and MOST care is good, but

    2) There are TOO MANY 'INEXPLICABLE' EXAMPLES of really poor care and behaviour - such as apparently not noticing that some people are starving because they need some help with eating, or some very distressed patients being ignored 'for an age - hours, not a couple of minutes'.

    Please do not claim that 2 isn't true, on the grounds that 1) is true: the PA insists that BOTH are present, and it is how you can have 2, when 1 is so common, that bothers both the PA and me !

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  • Michael, there are three very important points here, so please pay attention.

    1. The PA hardly ever emphasise the fact they say MOST care is good though do they? No one is saying NHS care is perfect, noone is denying that it does fall short in some areas, but this is by far from the norm, and is often due to circumstances out of Nurses control such as staffing levels. The MINORITY of cases like this are exactly that, the MINORITY. Yet the media and the public pick up on the Nurse bashing bandwagon of 'Nurses and the NHS care is abysmal' when it purely isn't. This is a gross distortion of the facts.

    2. The MINORITY of these cases, and I take just one from above for example ' a family member witnessed a patient accidentally pouring boiling soup over her legs but the nurse saying she was too busy to clear it up, meaning the patient was scalded and a doctor had to be called', perhaps this is a case for an anonymous until proven guilty individual disciplinary rather than attacking NHS care as a whole?

    3. Reports like this are not helpful in any way, as I have said repeatedly above, it simply adds to the baying mob of NHS and Nurse bashing without doing anything to try and get to the core of the problem, which is what we are also trying to do. So why aren't the PA trying to do something constructive? We have said time and time again that where the NHS does fail, it is down to specific things, yet they do nothing to try and improve staffing levels, improve organisational cultures, improve ... oh you get the point. They just periodically release statements like this, which do nothing except anger the MAJORITY of Nurses like myself who are killing ourselves trying to give the best care we can.

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  • Nurses bad
    Nurses rubbish
    Nurses not overworked
    Nurses have enough time
    Nurses are not understaffed

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  • michael stone

    mike | 10-Nov-2011 11:52 am

    No, A R was VERY clear in praising the majority of care - in my view, from 'the other side of the sheets' as it were, the PA is adequately balanced.

    The PA is not in control of selective reporting !

    'it simply adds to the baying mob of NHS and Nurse bashing without doing anything to try and get to the core of the problem' - they are launching some sort of 'initiative today', or perhaps yesterday - it was not, however, a simple push for more staff.

    I am not part of 'a baying mob' any more than you are an incompetent or uncaring nurse - so this involves REACTIONS to comments. Nurses probably over-react to criticism of nurses, I probably over-react to criticisms of patients, relatives, etc. For example, just because some patients or relatives are 'aggressive', in my view (as one who isn't) that spate of 'zero tolerance' polcies were unjustified and ofensive !

    I can't comment on that scalding, except that it is unacceptable to not promptly deal with such an incident (my own reaction, if the relative, would probably be to rapidly track down some water, pour it onto the scalds, and then kick up merry hell !).

    But it is the ACUTE DISCREPANCY between the majority good care, and the minority of truly 'unacceptable and HARD TO RATIONALISE' examples of bad care, which bothers the PA (and I agree with the PA, about that).

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  • Michael, okay to be fair I didn't hear that interview, so Angela Rippon herself may have praised the majority of good care, but that isn't the stance that MANY of these reports from the PA, and by extension the CQC take. I understand that they aren't in control of selective reporting, but they are in and of themselves far from unbiased; furthermore I wouldn't call this an over reaction. Anyone, in any profession, trade, job, whatever, can only take so much criticism before it starts to wear really thin, and we have to start defending ourselves at some point Michael.

    Now as for the discrepancy, I understand that occasionally there will be failings, and there will be individuals who do wrong, as there will be in any walk of life, but there are already avenues to deal with that. These 'truly unacceptable' examples that the PA give (and bear in mind no real details are known for obvious reasons so we can't specify or comment too much, except to say I find it unbelievable that a Staff Nurse would not react to a scalding or would not help someone to breath for just two examples,) should have been dealt with on an individual basis in my opinion, through complaints procedures or disciplinary action, there is recourse for patients to take that route already. Again, this system is not perfect, but it is there for this exact reason. To then take these same examples and hold them up as how the NHS and Nurses (who are often singled out as a profession) are FAILING patients, is wrong. The PA is wrong.

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  • George Kuchanny

    Well said Ellie - these failings are most certainly systemic. For the NMC to lay it all on nurses is wrong full stop. I have just read an article (Irish healthcare) where a doctor was eventually struck off for incompetence - could not even take a pulse apparently. So why did she get a job as an SHO? Systemic failure. Because we are in the EU we are not allowed to test the competence of job applicants from the EU.
    Similarly a nuse who is too busy to take someone to the loo and tells them to crap in their bed (so the next shift cleans up the mess?) indicates something very wrong. A brief (10 minute) investigation should be all it takes to get to the root of what is wrong and do something about it.

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  • michael stone

    'Similarly a nuse who is too busy to take someone to the loo and tells them to crap in their bed (so the next shift cleans up the mess?) indicates something very wrong. A brief (10 minute) investigation should be all it takes to get to the root of what is wrong and do something about it.'

    George wrote that, and it is EXACTLY what the PA, and I, can't understand:

    'A brief (10 minute) investigation should be all it takes to get to the root of what is wrong AND DO SOMETHING ABOUT IT.'

    We 'unreasonably moaning members of the public' cannot understand, why that 'if it happens, it must mean something is very wrong - so sort it !' does not seem to ALWAYS happen. If it proves there are too few staff for patient dignity or safety to be maintained, then it needs HIGHLIGHTING and ADMITTING TO THE PUBLIC !

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  • It is very unfair that nurses take the brunt of poor care, although it does exist, but the majority of nurses work their socks of to do their best with what they have got at their disposal. That includes everything from human to equipment resources.

    I think the public and management should realise when other healthcare professionals are short staffed, they cut down on what they do. For example, a patient may miss out on a physio session, or there is no social worker available to come and see them, as promised at a particular time. Porters may be short staffed, and nurses are left to fill their gaps. I don't mean, provide the service necessarily, but may have an extra patient to get up out of bed, as the physio has run out of time; face relatives to apologise for the social worker not turning up, and trying to answer their queries and worries; taking a patient to a dept where portering staff is short or taking bloods to the lab, for example. This all becomes extra work for nurses, often at short, if no notice. Not to mention the unpredictability of patient's conditions, putting extra pressure on nurses time and their ability to do the job properly. They must be very demoralised.

    Like someone else has suggested, lets stop the blame and turn attentions to solving the problems.

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