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NHS chief says improving patient dignity is top priority next year

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Improving the dignity of older patients is “probably the most important” priority for the NHS next year, its chief executive has told Nursing Times.

Sir David Nicholson’s comments marked the publication of guidance on how the health service should be run during the next financial year, beginning in April.

NHS providers must “systematically” improve standards of dignity and care for patients, including ensuring staff are appropriately trained to do so, according to the NHS operating framework for 2012-13.

The document, published this afternoon, sets out the government’s priorities for the health service during 2012-13 and how they should be achieved.

The operating framework specifically identifies dementia and care of older people as an area “requiring particular attention during 2012-13”.

It said this was in response to “worrying examples” of unacceptable standards in the Care Quality Commission’s report on dignity and nutrition standards published last month.

In an exclusive interview to coincide with the release of the guidance, NHS chief executive Sir David Nicholson told Nursing Times that “dignity in care of vulnerable people” was “probably the most important [priority] for us”.

He said: “There’s been some criticism of the NHS over the last period. There is quite a lot of evidence around that some of the care is variable and not up to the standards we’d expect.

“We need to do a whole series of things to help people provide care for vulnerable people,” he said.

The operating framework stated that “caring for patients with dignity and humanity goes to the heart of the purpose of the NHS”, and that there was a “systematic set of things” the NHS needs to do to improve services for older people.

For example, it said commissioners – currently primary care trusts but which in future will be clinical commissioning groups – should ensure NHS service providers are compliant with National Institute for Health and Clinical Excellence quality standards relevant to older patients and dementia.

Additionally it stated: “PCT clusters should ensure that all providers have a systematic approach to improving dignity in care for patients, to giving staff appropriate training and to incorporating learning from the experience of patients and carers into their work.”

It also said commissioners should work with GP practices to “secure ongoing improvements” in the quality of primary care and community services, so that “patients only go into hospital if that will secure the best clinical outcome”.

Additionally, the framework restated the government’s goal of a two thirds reduction in the use of antipsychotic medicines, but it suggested there had been a softening on this aim.

In October last year, health minister Paul Burstow said the DH was committed to reducing the use of antipsychotics prescribed to people with dementia by two thirds by November 2011.

The operating framework said the NHS needed to engage in “initiatives to reduce inappropriate antipsychotic prescribing for people with dementia…. with a view to achieving overall a two thirds reduction in the use of antipsychotic medicines”, but set no new deadline.

The framework also said the NHS service providers would be required to continue their “drive to eliminate” mixed sex accommodation, and ensure they participated in national clinical audits relating to services for older people.

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Readers' comments (4)

  • BAsically good but give more nursing staff so this is achievable

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  • Why not ths year? Patients ahve waited long enough!

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  • What a ridiculous statement. Of course patient dignity is really important, but how about getting the fundamental things right first so that staff can ensure all patients are treated with dignity? Little things like staffing levels for example? Isn't ensuring patient safety and care just as important? No mention of that though I see.

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  • The NHS will not improve until respect and dignity is addressed in society as a whole starting with child rearing practices and social policy. For example, Organisations, including many hospitals are breaching human rights to bodily privacy in their toilet cleaning practices.The Equality & Human Rights Commission (EHRC) are currently monitoring the use/misuse of opposite sex workers in toilets and changing rooms where it is proportionate and legitimate to use a same sex worker without being accused of discrimination-for reasons of privacy and dignity/decency.

    Policies for opposite sex workers are largely absent or being ignored in many multi cubical/urinal single sex toilets and washing/showering/changing room facilities where permanent warning signs eg 'male and female staff work here' are being used to allow free access to female facilities by male workers and vice versa by gaining implied consent from unsuspecting service users. This breaches privacy laws, potentially meets with the principles of harrassment for many people (especially those who have been sexually abused), and puts women, children and other vulnerable groups at increased risk of both dignitary and physical harm. Such policies may also be derpriving women of cleaning jobs or exploiting staff (eg sending female staff to clean around men using open urinals). There should be a robust alternative to a gender based policy ie one which does not compromise either users or cleaners-eg signs giving times of cleaning/checking. Knocking/opening the door does not allow users chance to object before cleaners enter. Choice and control is a key factor relating to the concept of dignity. Depriving people of choice by inappropriate operational policies can be perceived as sexual abuse.

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