Guidance on providing dignified care to older people is not always consistently transferred into practice on the ground, but a new partnership is aiming to change that
Looking back over the years, there has been no shortage of reports, inquiries and commissions examining instances where older people have failed to receive proper dignity in care. The Health Ombudsman report earlier this year, for example, provided a catalogue of appalling examples of patients who had their basic needs neglected, becoming malnourished and dehydrated, being left in pain, or receiving inadequate assistance with toileting and personal care. This report made the severity and scale of the problem we are facing crystal clear.
The new Dignity in Care Partnership is about moving on to the next stage and working out what we need to do as a sector
But what has, we believe, been missing up to now is an in-depth look at how we as a sector make the changes to ensure that no older person in future needs to endure degrading or undignified care. The new Dignity in Care Partnership, which launched last week at Age UK’s Improving Essential Care in Hospital event, is about moving on to the next stage and working out what we need to do as a sector to make progress on this problem. This initiative brings together the NHS Confederation, Local Government Group and Age UK to work in close collaboration with professionals and healthcare leaders to improve dignity in care.
We know policy at a national level, such as the national service framework and guidance from the royal colleges, has clearly focused on meeting aspirations of older people, improving the care provided and generally moving things in the right direction. Yet this guidance is not always consistently transferred into practice on the ground and we need to know why.
To do this, we must ask some difficult questions and shine a light into awkward corners of this thorny issue. What are the root cases of the failure to provide appropriate levels of care to older people? We also need to hear what, as the largest group of users of the health service, are the aspirations of older people and their families in terms of care provided.
The Dignity in Care Partnership is starting out by establishing a commission to examine some of these issues. However, we are clear that this is just a first step. After answers we need action.
I cannot pretend this will be an easy process: we need an honest, warts and all approach if this process is to be effective. But it isn’t about pointing the finger at the health and care sector, health professionals or individuals. Instead, to deliver real and lasting improvements, it is vitally important that everyone comes together to discuss how to address practical problems, tackle barriers and change the way we view caring for older people. Patients, professionals and providers must reach a consensus on the underpinning causes of poor care and take responsibility for improving their experiences at every level. We also need to establish what really works by identifying good practice examples across the health and social care system.
Everyone can play their part: we are calling for written evidence via the NHS Confederation website and will also be carrying out a series of oral hearings to collectively develop a series of recommendations to be published in a report in spring 2012. Another report it may be, but I believe it has the capacity to start the journey towards making dignity in care a reality for every older person. Further information on the commission can be found at www.nhsconfed.org/dignity
Margit Physant, Age UK health policy adviser and former nurse