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NHS failing older people, ombudsman reports


NHS treatment of older people is “failing to meet even the most basic standards of care” in some areas, a report published today by the health service ombudsman has found.

The report, which details horrific experiences of ten older patients at the hands of hospitals and GPs between 2009 and 2010, reveal “an attitude – both personal and institutional – which fails to recognise the humanity and individuality of the people concerned”, ombudsman Ann Abraham said.

In one case, a woman transferred to a care home by ambulance from a Heart of England NHS Foundation Trust hospital arrived with “numerous injuries”, soaked in urine, and wearing someone else’s clothes held up with paperclips.

At the Oxford Radcliffe Hospitals NHS Trust, a man’s life support was switched off by nurses against his family’s express wishes. His family had not been informed that the man’s condition had worsened and a “do not attempt resuscitation” note placed on his records.

Ms Abraham said that in half of the cases documented, the patients involved did not consume adequate food and water while in hospital.

She said it was “incomprehensible” that the ombudsman needed to hold the NHS to account for basic aspects of care, such as assistance with eating if needed, drinking water, and the ability to call someone who will respond.

“Yet as the accounts in this report show, these most basic of human needs are too often neglected,  particularly when the individual concerned is confused, or finds it difficult to communicate,” she said.

Ms Abraham warned these were not isolated incidents and the NHS needed to undergo an “urgent” widespread change in attitude towards older people.

Of nearly 9,000 properly made complaints to the ombudsman about the NHS last year, 18% were about the care of older people.

Among the other cases detailed in the report are those of:

  • A man discharged from Royal Bolton Hospital NHS Trust with stomach cancer and inadequate pain relief, forcing his daughter to spend much of the days before his death driving around trying to fill morphine prescriptions.
  • A woman who suffered nine falls at Southampton University Hospitals NHS Trust, where nurses “failed to co-operate” with medical recommendations that she be given hip protectors and have a mattress placed next to her bed.
  • A man who was left forgotten for three hours in an Ealing Hospital NHS Trust waiting room, as his wife’s condition deteriorated and the decision not to resuscitate her was made without him.
  • A man whose life was put at risk when Ashford & St Peter’s Hospitals NHS Foundation Trust stopped treating him and discharged him when he was not medically fit.

M Abraham added: “These often harrowing accounts should cause every member of NHS staff who reads this report to pause and ask themselves if any of their patients could suffer in the same way. I know from my caseload that in many cases the answer must be ‘yes’.

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said: “We know that the NHS is expected to save up to £20 billion in England alone, and with 27,000 posts already earmarked to be lost, it is inevitable that there will be an impact on frontline care.

“Where we have seen poor standards of care in the past, we have often found an underlying failure in ensuring safe staffing levels and the right level of skill.”

Nigel Edwards, chief executive of the NHS Confederation, said it was “important to put these 10 examples in perspective”

“The NHS sees over a million people every 36 hours and the overwhelming majority say they receive good care”, he continued. “But I fully appreciate that this will be of little comfort to patients and their families when they have been on the receiving end of poor care.

“NHS trusts need good systems in place to make sure every patient’s experience is the best it possibly can be.

We’re going viral! Have you friends heard about the ‘seat on the board’ petition? Let’s ensure nurses are actively involved in the new commissioning consortia.


Readers' comments (37)

  • How dare Nigel Edwards say that it was ''important to put these 10 examples in perspective”one example is too many.

    i have worked with older people all my nursing career in acute settings and then in rehab. It never ceases to astound me the number of older people who present for rehabilitation from acute areas who are deconditioned and who have pressure ulcers and who transferred in flimsy clothing or made to wait in discharge lounges for hours on end for transport just so their bed can be used, it would appear the NSF for Older People 2000 as everything else has been consigned to the shredder The business model of medicine / nursing has a lot to answer for

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  • Of nearly 9,000 properly made complaints to the ombudsman about the NHS last year, 18% were about the care of older people.

    Why should the public have to make 'properly made complaints'? This is the last thing the sick should need or want to do. They require all their energy to get well again and how about the elderly who are inadequately cared for and have nobody to represent them?

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  • See articles in today's online Telegraph in the health news entitled 'NHS shamed over callous treatment of elderly' for the public's comments on this report. This should be very humbling for many and provides an opportunity for self-examination and improvement instead of constantly seeking aggrandisement of the nursing image and more pay during these hard times even with an expectation of a financial reward for looking after the sick on the day the royal wedding instead of graciously accepting the day off in lieu which is being offered.

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  • when you have wards be shut, reduced bed capacity, staff not being replaced or having proper training. Poor nursing care is the result.

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  • Anonymous | 15-Feb-2011 4:22 pm

    when you have wards be shut, reduced bed capacity, staff not being replaced or having proper training. Poor nursing care is the result.

    There is no excuse for taking it out on your patients! These are sick or elderly people and must be central to all professional concerns and care.

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  • It is ironic that 2 days prior to this report coming out I had to remind two members of staff that because and elderly person had shouted at them and refused to come to the dinning room for lunch was no excuse not to take this person a meal. I as a nurse who had just started the late shift took it upon myself to make sure this patient was given a meal. My personal opinion is no matter how angry we are with managers, government cuts, job loses etch this should not be taken out on patients. All of us has a duty of care to patients honestly they are some people who work in the NHS who are so uncaring should be dismissed immediately but this will never happen unless something drastic happens.

    I remember when my dad was terminally ill in hospital I approach a nurse for an extra blanket for him this nurse was so rude to me ask if I could not see she was busy go see an HCA at this time I was seething but I counted to 10 and said to her there was no one around so if she could direct me to the linen room I would happily make the bed myself with the required linen needed. This nurse proceeded to be rude to me again this was done in the presence of a doctor and a student. At this stage I asked for her name she showed me her name badge, I requested the name of the manager of the ward which she relunctantly give then I obtain the other people who were witness to this name then I informed miss rude I will be reporting her to the NMC, and will also be writing a letter of complaint to the Trust. I had no intention of doing this but the look on her face give me the satisfaction I needed. But I did raise my concerns about this nurse's attitude to the Trust I will not say what the outcome was but changes were made on that particular ward .

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  • I believe this report is true. As a student Nurse I have seen poor practice. I have reported it to the relevant people . I feel the government cannot afford all these elderly patients so it is easier and cheaper to let them die.
    I have seen tablets dumped on tables, drinks taken away cold and food not being encouraged and thrown in the bin . Lets be honest how many people are losing weight and going into renal failure due to lack of food and fluids.
    This treatment is discusting and often bad leadership from the top breeds Nurses who fall into the same social group as their peers , giving out the same shoddy care.
    In my opinion not even pain is controlled correctly. Someone has to stand up for frail patients who have given up and cant care for themselves and I applaud this report.

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  • In some countries in Europe where the care for the elderly was previously good the danger is now that with the baby-boomer generation more nurses are going into retirement at once than was previously the case and the elderly population is rapidly increasing as this was a very large generation born just after the last world war and people are living longer including the number of people now living until 100 or more. The fear is that there will be a lack of places and lack of staff to cope with these increasing demands and that the younger generations find more attractive careers to go into. Is this also the case in the UK and despite these alarming reports will measures be taken to improve standards of care or will they simply continue to deteriorate as demands carry on outstripping the available resources?

    Urgent and immediate measures need to be taken to improve the quality of care offered to the elderly who are currently in care, resources need to be made available, training in gerontology, a challenging and interesting field which can be highly rewarding, needs to be made available and staff need to be attracted and retained with improved working conditions and adequate renumeration. Facilities and equiipment need to be improved and made readily available to meet increasing future demands. New models and an infrastructure for social care and nursing care of the elderly needs to be re-examined such as retirement villages with wardens and nursing staff, flats or cottages where more independent can live together with some support or supervision, dementia villages where patients can be cared for safely and with some degree of freedom, etc. so that they can have the quality of life and respect they deserve to enjoy retirement until the end of their lives. Hospital facilities and care with specialist staff also need to be made more attractive with greatly improved standards for this age group who have the right to be patients and cared for with respect like all others with their very special and indiviudal needs adequately and willingly met.

    Younger generations also need to integrate better with every generation and understand that the elderly have their rightful place in the community just as everybody else does and there is NO social exclusion for anybody regardless of their age, handicap, beliefs or skin colour.

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  • Just a quick note to say how glad, relieved and proud I am to read these comments. I used to nurse decades ago and left because I couldn't care the way I wanted to. Nothing would draw me back to this honourable profession now so kudos to those of you who actively care - because you're a decent person rather than because your an angelic, untouchable martyr.

    More nurses voices need to be heard, saying that you won't ignore the cruelty of some of your peers, promising that your whistleblowing won't result in you being bullied.

    Your good work results in respect and affection. Bad work tarnishes you all.

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  • clare slaney | 16-Feb-2011 8:37 am

    Thank you, I wrote four of these comments above and spent the whole of yesterday blogging on the Telegraph following the articles on the same subject which are well worth reading and I am so furious at what is being allowed to happen. Among the blogs was a wonderful and inspiring poem which I have sent to the editor in the hopes she will publish it in
    I was so furious at today's article in the telegraph where one trust said they would evict elderly patients no longer requiring medical care that rational arguments in defence of the elderly momentarily fail me and I have turned to emotional and irrational responses instead!
    Unfortunately other priorities now press and I have no time to paste the refs. to the articles here but recommend that as many people as possible read the comments with give insight into the public perceptions of nurses so eager to create 'an image' for the profession. These articles are easy to find in Telegraph (online) in the news section and under health.

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