BackIn a new report Health Service Ombudsman Ann Abraham says the NHS is failing to treat older people with care, compassion, dignity and respect. The report, Care and compassion?, is based on the findings of ten independent investigations into complaints about NHS care for people over the age of 65 across England. It serves to illuminate the gulf between the principles and values of the NHS Constitution and the felt reality of being an older person in the care of the NHS in England.
The Ombudsman’s findings show how ten older patients suffered unnecessary pain, indignity and distress while in the care of the NHS. Her investigations highlight common failures in pain control, discharge arrangements, communication with patients and their relatives and ensuring adequate nutrition.
The Ombudsman explains: ‘The findings of my investigations reveal an attitude – both personal and institutional – which fails to recognise the humanity and individuality of the people concerned and to respond to them with sensitivity, compassion and professionalism. The reasonable expectation that an older person or their family may have of dignified, pain-free, end of life care, in clean surroundings in hospital is not being fulfilled. Instead, these accounts present a picture of NHS provision that is failing to meet even the most basic standards of care.’
The ten investigations covered in the report are not isolated cases. Of the nearly 9,000 properly made complaints to the Ombudsman about the NHS last year, 18 per cent were about the care of older people. The Ombudsman accepted twice as many cases for investigation about older people as for all other age groups put together.
Care and compassion? recounts the Ombudsman’s investigation into the care of Mr D, who had advanced stomach cancer and wanted to die at home. When his daughter arrived to collect him from hospital, she found him sitting behind a closed curtain in distress. He had been left for several hours, was in pain, desperate to go to the toilet and unable to ask for help because he was so dehydrated that he could not speak or swallow. The emergency button had been placed out of his reach, his drip had been removed, fallen and had leaked all over the floor. At home, the family discovered Mr D had not been given the right pain relief and spent the weekend driving around trying to obtain the correct medication before he died.
Also included is the story of Mrs H, who was admitted to hospital after having a fall at home. She suffered further falls while in hospital and broke her collar bone, but her niece, who was her only relative, was not told. Mrs H was transferred by ambulance to a care home. When she arrived at the home, she had numerous injuries, was soaked with urine and was dressed in clothing that did not belong to her and that was held up with large paper clips.
The Ombudsman concludes: ‘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”. The NHS must close the gap between the promise of care and compassion outlined in its Constitution and the injustice that many older people experience. Every member of staff, no matter what their job, has a role to play in making the commitments of the Constitution a felt reality for patients.’
