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Start with ward 'atmosphere', says former nurse Betty


The “atmosphere” on a ward is the first factor to consider when assessing standards, according to a retired nurse turned hospital inspector.

This week will see the first set of results from the government’s patient-led inspection programme on ward cleanliness and safety, privacy and dignity, and food. More than 4,600 inspections have been carried out since the programme started in April. 

Former NHS nurse Betty Smithson, 82, was a volunteer inspector at St James’ Hospital in Leeds. Since retiring at 60, she has experience as a patient, having had orthopaedics surgery and treatment after a heart attack.

She said: “Seeing the wards as a patient, you see them in a very different way. The first thing I always notice is the atmosphere – is the ward a happy place, are people smiling, what are the expressions on patients and staff faces?

“You can usually pick up the atmosphere very quickly,” she said. “Then you look at particular issues, such as watching the food being served and testing its temperature, or checking whether the wards are clean.”

She added that staff had been “wonderful at listening to us”. As a result, St James’ has improved signs to help patients to find their way round and installed benches in corridors for older patients.

“I know from my time working on the wards that you don’t always see the little things when you are there day-in, day-out. But they make a big difference to patients,” she said.

Detailed results of the first inspections are due to be published by the Health and Social Care Information Centre later this week.

Hospitals will receive a rating on each area at the end of their inspection, and the results will be published online. Hospitals are also required to publish what they will do in response to the results.

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Readers' comments (3)

  • Perhaps a little insight into what contributes to a happy ward atmosphere might be helpful, nurse Betty. It STARTS with good staffing levels, good staff skill mix, good and supportive management. A positive atmosphere is much more likely to exist when the other things are in place.

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  • Yes, this is hardly something we can control. A lot of us work on wards that are like a runaway train. If the Savoy had half the staff and twice the diners, does Betty think the atmosphere would still be the same?

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  • A good starting point could be to have senior management staff, directors + inspectors and run each unit / ward for a fortnight. Make their changes, then work again for another week to see if it works.

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