If you’ve seen the news recently you won’t have been able to escape the torrent of stories highlighting the alarming treatment of older people in the healthcare system.
Following on from the shocking report from the Care Quality Commission last month which exposed unacceptable levels of care, the Patients Association have published a dossier containing "shameful" stories about the care elderly patients receive in NHS hospitals in England.
Are ageist attitudes within the NHS the root cause of this neglect?
As the BBC story details, the dossier reported 16 cases including people being denied pain relief, left to sit in their own faeces and going without food and drink. As well as an increase in the number of calls to the Patients Association helpline regarding care on hospital wards which had already hit 961 this year - a third more than the total made throughout the whole of 2010.
Katherine Murphy, the charity's chief executive, said: "We cannot ignore the fact that some trusts are not even paying lip service to the fundamentals of care.”
"The issues we continue to highlight are human rights issues. They show a lack of compassion and care and a shameful attitude to treatment of the elderly."
Angela Rippon who has signed our Grey Pride petition and been supporting our campaign from the start, is also vice president of the Patients Association.
Today she said: “This report raises serious issues about the quality of care that patients are receiving on our hospital wards. It’s not enough for hospitals to say that they have recognised care hasn’t been good enough in the past and promise improvements for the future.”
We’ve been running a poll on ageism in the NHS for the past few weeks here. We want to know how many of you guys have experienced or witnessed it first-hand. Have you voted yet?
On the homepage the poll features down the right side of the screen.
These reports are disgraceful, but do you believe it is ageism to blame for these cases?
Do older people receive a poorer level of care because attitudes dismiss illnesses suffered by them as "age related" and "just how it is"?
As you've got older, do you feel that doctors still take you as seriously as they did a decade ago?
What everyone knows, but know one admits to within the NHS, is that the biggest barriers to giving good care is the culture we subscribe to, operate in, and indeed as health professionals at every level, we are generally wilfully blind to, and are prepared to sustain and support.
It is common place, and appears to be acceptable to hear stories of the most appalling care throughout the land where patients die and are harmed. The accountable officers, or health workers are paid off and just take up another post elsewhere in the system. The problem is never actually solved, it is moved around.
Good moral leadership is an unknown or at best a very rare commodity in the NHS. The organisations within the NHS fail to respond to unethical behaviours in a way that protects or benefits patients. Rather the systems and structures, including policies, are designed by, and with the intention of protecting staff and the organisation. Patients have little or no say in how the structures around how their care is delivered are formulated.
All too often there is a massive gap between "good care" and the "care being delivered". or, in the documented care and what the patient actually experiences.
The overwhelming perceptions of staff in many NHS organisations, are that balancing the books and meeting targets is the priority over patient's care.
NHS leaders know that poor communication, continuity of care and staff behaviours are behind most medical catastrophes. Some NHS systems and processes appear designed to add to the dangers, disempowering patients and staff alike.
Unbelievable waste is tolerated and ignored, whilst finance is cited as a reason for poor care and lack of resources.
Leaders, nurses, students and all health workers should be recruited, assessed and employed on their ability to understand the need to act with integrity, and deliver the right example and culture , first time, every time. Ethical risk should be identified, and if possible measured. Kindness and compassion should be demonstrable assets (I once had a junior qualified nurse tell me she "didn't like people"!.
A clear statement of an anti-corruption culture, fully and visibly supported at the highest level needs to be the bed rock.Time after time, regulators and Royal Colleges fail to act and support Whistleblowers (I know this from personal experience). Leaders are not always doing what they say.Professional morale needs a national value based and morally led leadership, setting the tone from the top, creating a culture where accountability and responsibility is embrased as necessary and essential tools for the job, and not the too often prevailing culture of rewarding those who "go with the flow" and are prepared to "look the other way".
If you think the shameful practices reported in the press by elderly people's relatives are bad, spare a thought for the patients who have no relatives to speak out, the dementia patients, the confused, the homeless, those with learning difficulties and disabilities! They make up a huge portion of our client group.
Doing nothing is not an option, We are all complicit if we do not act. I am that Whistleblower that knows, the reality is, there is no policy that will protect you when you stick your head above that parapet.
What is reported in the press is the tip of the iceberg.
I think you are very courageous to speak out as you are doing.
I totally agree the most vulnerable old people are unable to speak out for themselves. I was in hospital and had a catheter left unchanged for hours. It felt so heavy...I didnt appreciate how full it was and i should have been observed periodically. Fortunately I was able to speak up but imagine if I had been confused or had learning difficulties or had dementia. It is so frightening. Could volunteers go in and "buddy" a patient? I suppose each one would have to be vetted and checked and it would then get to be an enormous beaurocratic undertaking. But that may be one way forward.
My experience of having bowel cancer in 2004 showed me there was a lack of care towards elderly patients. I was in a ward where an elderly lady was never provided with a commode at night, although she and other patients constantly buzzed nurses to get her one. (We couldnt sleep for her cries). She was left to defecate in the bed and then they changed the bedding. This happened several times. I was appalled I complained but was told they didnt have sufficient commodes. When I left hospital I told my work colleagues and between us we raised money to provide another commode for the hospital...They thanked us for this but never acknowledged they had been at fault.
Ten years ago I was a volunteer taking the sweets trolley around the wards at Queen Mary's Hospital, Roehampton. In the wards for the elderly I found it very upsetting to see patients unable to feed themselves and having their food removed untouched, patients calling for a nurse and being unattended, patients with medication in the form of large tablets they could not possibly swallow, and the worst thing was an old lady who was not in bed but sitting in a chair and her cardigan was wet, from what liquid I didn't know, but she was cold and uncomfortable and asking weakly for help. No one came; I went up to a group of nurses and other staff who were standing talking and laughing nearby; they treated me as if I had a great cheek to ask them to attend her, and otherwise ignored me. She was not attended to before I left the ward. IT IS NOT TRUE THAT THIS TREATMENT IS DUE TO UNDERSTAFFING OR CUTS OR EVEN TRAINING; IT IS DUE TO PEOPLE IN THE JOB WHO DON'T CARE. These people should be weeded out and not be allowed to start work in a hospital for the elderly. Those who have the right attitude should still be given proper training: a friend of mine, who will willingly corroborate this if you wish, told me she saw nurses shouting at old people because they couldn't move for bedsores, and other cruelties which I will ask her to tell you herself on this same page. I applaud Angela Rippon because she said so rightly on tv the other day we KNOW this is happening; we need no more reports; we need ACTION and we need it NOW.
Cardiac Arrest Procedures: Time to Intervene? (2012)
To ensure that a wide variety of medical and surgical studies are undertaken, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is currently running four projects, covering very different topics but all with the underpinning aim to review the quality of care received by patients in hospital. The areas being studied include the care of patients who undergo resuscitation in hospital; bariatric surgery for weight loss, death following a diagnosis of alcohol-related liver disease and hospital treatment following a subarachnoid haemorrhage.
NCEPOD is an independent charitable organisation that reviews medical and surgical clinical practice and makes recommendations to improve the quality of the delivery of care for the benefit of the public. They do this by undertaking confidential surveys and research covering many different aspects of care and making recommendations for clinicians and management to implement.
Independent Advisory Group for the Medical and Surgical Programe
As the commissioner for this programme on behalf of the funding bodies, HQIP will be guided by an Independent Advisory Group on topic selection for the programme as well as progress and programme outputs.
Of interest, Elderly denied NHS care 'can sue'
Age discrimination by NHS hospitals is to be outlawed, ministers have announced.
From October, elderly patients will have the right to sue if they have been denied care based on age alone, says Care Minister Paul Burstow.
This will not mean patients can demand any treatment they want. Care decisions will still be judged according to clinical need by doctors.
But NHS staff will have a legal duty to consider wellbeing and dignity.
Michelle Mitchell Age UK
It sends a clear message to service providers that discrimination law will in future also protect older people”
The decision, which applies to hospitals in England, Wales and Scotland, follows a consultation exercise on the issue by the Home Office.
The charity Age UK said it was long overdue but good news.
Age discrimination in the workplace is already unlawful, but until now there was no equivalent legal requirement on public and private services.
This has led to inconsistent practices and unfair treatment, with the needs of older people in particular being ignored, the government says.
When Kenneth Worden, from Chester, was diagnosed with an aggressive form of bladder cancer he was told by doctors that he was too old at the age of 78 to have surgery.
But his daughter Michele Halligan, who is trained as a midwife, disagreed. She was determined that her father should have the treatment in a bid to ease his distressing symptoms - he was in a great deal of pain and had disturbed sleep because of he had to use the toilet every half hour.
After more consultations Kenneth was eventually treated by surgeons at the Queen Elizabeth Hospital in Birmingham.
Three years on from his surgery he is fit and well with no signs of the cancer returning.
An investigation by The King's Fund recently found treatable conditions such as incontinence and depression were sometimes ignored in older patients.
Last year the Health Service Ombudsman accused the NHS of failing to meet "even the most basic standards of care" for the over-65s in England.
The Francis enquiry into Mid-Staffordshire NHS Trust uncovered failings at all levels of care provision. Most alarmingly the regulators were found wanting at every level too. The Trust was awarded 3 stars, foundation status and went uncritised by local and national regulatory bodies during the period of poor care and above national average deaths.Alarm bells from patient groups, relatives and staff went unheeded.
Front page headlines in the Times newspaper on Friday 13th August 2004 said that medical errors and accidents cause the deaths of 72,000 patients a year in Britain with 40,000 directly attributed to ones we know about. 9 out of 10 preventable deaths go unreported.
Whistleblowers save lives. So why does the NHS insist on systematically destroying them when they attempt to put put things right? To change the dire culture that keeps all patients at risk we have to change how we view and treat Whistleblowers in the Health Service.
The enquiry recommends a duty of candour and how to support people to exercise it. Plus protection of Whistleblowers. Evidence is emerging from many Trusts that "Mid-Staff's lessons to be learned fatigue" is now an emerging phenomena!. "Shoot the messenger" remains the status quo in many areas. The unacceptable appears to have become the acceptable norm.
The Health and Social Care Information Centre (HSCIC) has today released further data onto the National Adult Social Care Intelligence Service (NASCIS) http://www.nascis.ic.nhs.uk.
These data and standard reports support the Official/National Statistics provisional reports that were published on the HSCIC website at 9.30am today, and are therefore available on an unrestricted basis to all users.
The Official/National Statistics provisional reports are:
Adult Social Care Outcomes Framework 2011-12 Provisional
Release is at: www.ic.nhs.uk/pubs/adultsocialcareoutcomes1112
Adult Social Care Survey, England 2011-12, Provisional
Release is at: www.ic.nhs.uk/pubs/adultsocialcaresurvey1112
Community Care Statistics: Social Services Activity, England 2011-12, Provisional
Release is at: www.ic.nhs.uk/pubs/ccs12socialservicesactivity
The updated standard reports are:
I Have spent time in hospital for array of things IE:stroke,heart attack,Prostrate op and now my latest a tripple A aneurisme I take so many tabs i rattle ,but the treatment i received is excellent always been on the ball with me,although i do feel they could use a bit of common sense when it comes to peaple who are suffering from dimensioned don't know where they are or what they are doing ,on my last visit an old lady was put in the ward and kept uncovering her self I put the tv between me and her so as not to see her and give some dignity
I have, in the last couple of days, heard about THE PATHWAY. This is, when the patient is considered beyond help, a method of hastening death by methods such as the removal of liquids etc by drip. I understand that this is common practice in many NHS hospitals.. Allowing a patient to die of thirst does not seem very kind to me, but my main concern is that relatives are not consulted. When my elderly aunt was in hospital her drip was removed and, when I queried it, was fed a story about her being overhydrated. The next day it was back. It is possible, of course, that this explanation was correct. It is also possible, although I would not dare to suggest such a thing, that these elderly patients are seen as bed blockers and their departure is hastened for that reason.