‘Why was no one being held accountable?’
The Care Quality Commission reports on standards of dignity and nutrition for older people in English hospitals have highlighted some appalling lapses – although it is worth pointing out that the vast majority of hospitals so far have met the required standards.
The finding that shocked me – and probably many other people – the most was that in one hospital, doctors sometimes prescribed water to ensure vulnerable patients do not become dehydrated. Of course it is distressing to think of parched patients looking at a water jug out of their reach and no one thinking to help them. But what is truly shocking is that such a serious systemic failing could be addressed in this way.
Why was no one being held accountable for failures to keep patients hydrated? Prescribing water may be an immediate solution to help an individual patient who is already or is at risk of becoming dehydrated and urgently needs attention, but it does not address the real problem.
Surely someone should have seen that this response is inadequate and that it should be followed up by challenging the staff responsible for ensuring patients receive this vital aspect of care?
Of course it is easier for a doctor to write a prescription for water than confront a ward manager about unacceptable standards. And it is easier for a ward manager to rely on prescriptions ensuring vulnerable patients receive the drinks they need than reading the riot act to their team. Ward are busy places and when you come up against a problem it is sometimes easier to avoid conflict and unpopularity by working round it.
This may solve the immediate problem but does not address the root cause – some problems can only be solved if people are prepared to have difficult conversations with colleagues and risk personal unpopularity.