No Dignity For Older Patients On NHS Wards

Health inspectors are to mount spot checks on NHS hospitals after finding hundreds of older people being treated without dignity or adequate privacy on wards across England.

In a report today on conditions in 23 hospitals, the Healthcare Commission said only five complied with all the government’s core standards for dignity in care. Others were found to provide degrading treatment, including making incontinent patients wear nappies and placing older women in mixed-sex bays shielded by skimpy curtains on insecure rails.

The commission included Barts and the London NHS trust among eight hospitals that failed the dignity test and were issued with a formal warning. Another 10 trusts were told to make improvements, including seven of the government’s flagship foundation hospitals, which were supposed to be among the best in the country.

The commission appealed to patients, carers and relatives to blow the whistle whenever they have concerns about the treatment of vulnerable older people.

Anna Walker, the chief executive, said: “Where there is evidence that the right care is not being provided, we will use all our powers of assessment and inspection. Patients and the public do not want us to let this issue go – and we have no intention of doing so.”

The commission had suspicions about the 23 hospitals after analysing patient surveys and intelligence data. All had declared themselves in full compliance with dignity standards in this year’s self-assessments, but seven were found to be failing to provide adequate privacy and 11 were below par on the standard of nutrition.

The commission said many trusts were finding it difficult to provide single-sex accommodation for older patients, as the government requires. People who had suffered a stroke or had MRSA were placed on mixed-sex wards because staff found it easier to care for them.

Inspectors found toilets without locks or with faulty engaged signs. A few toilets were unclean, with an unpleasant smell.

All the hospitals had procedures to weigh older patients to find out if any were losing weight from malnutrition. But staff in one trust were encouraged to guess the patient’s weight if it was difficult to weigh them. Many hospitals found it difficult to provide hot meals outside normal hours and some paid insufficient attention to the eating requirements of people from ethnic minorities.

The commission did not identify which hospitals were responsible for these shortcomings.

It noted evidence from the National Patient Safety Agency of an older patient being left for seven hours without the prescribed fluid resuscitation. Another with a wheat allergy was fed Weetabix. The agency said 300 patients were harmed or put at risk of harm over the past 18 months after mistakes involving eating or drinking. Incidents included patients being given food they were allergic to, choking on food and diabetic food being unavailable out of hours.

The commission issued formal warnings to eight trusts of failure to comply with the dignity standards. It told 10 others to make improvements, ranging from providing adequate staff training to ensuring meal times were not interrupted by doctors’ rounds and tests.

The report included examples of best practice around England, including one trust which introduced a new gown to protect patients’ modesty.

Paul Cann, policy director for Help the Aged, said: “Older people are human beings, not objects or numbers. It’s nearly 10 years since we first exposed the shortcomings in hospital care and dignity for older people, yet we are still hearing all the time about shocking abuses of dignity.”

Ivan Lewis, the social care minister, said: “Dignity and respect should be at the heart of services for older people. This is why I launched a national dignity campaign and asked the commission to make dignity central to its inspections.”


The eight trusts formally warned for failing to meet core standards:

Barts and the London NHS trust

Hull and East Yorkshire Hospitals NHS trust

Luton and Dunstable Hospital NHS Foundation trust

Oxford Radcliffe Hospitals NHS trust

Princess Alexandra Hospital NHS trust, Harlow, Essex

Queen Elizabeth Hospital NHS trust, Greenwich, south-east London

West Dorset General Hospitals NHS trust

West Hertfordshire Hospitals NHS trust