Tuesday, 15 February 2011

Proof at last

I’ve been banging on for ages about the poor treatment of our elderly at the hands of the NHS. I've heard first-hand reports from patients’ families who've told me how their loved ones were often left untended and unfed. Tales of dehydration, of being left in soiled bedlinen and denied kindnesses the rest of us take for granted meant their final days were spent in misery. The families’ complaints were brushed aside with callous disregard as the NHS damage-limitation machine cranked into action.

Since raising the matter on my blog I’ve also had a few abusive posts from NHS supporters or people who work for our health service, but the truth remains that some of our elderly are treated worse than animals when admitted to some of our hospitals. There is an endemic culture in some sectors of the NHS that sees the elderly as simply not worth saving or worthy of dignified and caring treatment.

Fortunately, at last, the establishment is grudgingly admitting the truth. The Health Service Ombudsman has published a report today that says 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. NHS provision is failing to meet even the most basic standards of care.

It goes on to say: “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.”

According to the Ombudsman, Ann Abraham, the patients in the ten cases that she studied had all been loving, active people of a generation that didn’t like to make a fuss. She goes on: “They had simply wanted to be cared for properly and die peacefully – but they all suffered unnecessary pain, indignity and distress while in the care of the NHS. As a result, they were transformed from alert and able individuals to people who were dehydrated, malnourished or unable to communicate.”

Shocking examples of lapses in care contained in the report include:

• An 82 year-old who died alone because staff did not realise her husband had been waiting to see her for three hours.

• A woman was not washed during 13 weeks in hospital, did not have her wound dressings changed and was denied food and drink.

• A woman who was discharged from hospital covered in bruises, soaked in urine and wearing someone else’s clothes.

•  The life-support system of a heart attack victim was switched off despite his wife asking to leave it on while she contacted the rest of the family.

In response to the report, Nigel Edwards, chief executive of the NHS Confederation, said: “It is of course 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. 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.”

He still doesn’t really get it, does he?


  1. I'm working as an intern on a geriatrics team in Sydney Australia and this makes me feel ill. I'm willing to bet that money is the root of this: more and better trained staff costs money.

    My department has quite a bit of funding, which might explain why each geriatrics consultant has their own registrar, resident/intern, dietician, social worker, physiotherapist and occupational therapist. Yep that's right, there's one for each team! (And there are 3). And there are enough nurses that everyone gets looked after properly, although the government has just agreed to nurse: patient ratios of 1:4.

    As a result our patients are fed, nursed, mobilised, their families get social supports, and we send them home either at their baseline or as close to as possible. If they do die (and two of my patients have) they do it with all the palliative measures we can give and their loved ones around them.

    The NHS has no excuse. It can be done properly, but they'll have to be prepared to make the geriatric service a priority and fund and manage it properly... I'm not holding my breath.

  2. The NHS has been hosed with money by the previous government but I'm not sure what's happened to it. A large chunk has gone on wasteful PFI schemes and no doubt they've found other ways of wasting it. THere's something wrong with the NHS recruitment process. There's an incredible amount of homogeneity in certain grades of workers. A lot of the basic nursing is done by demotivated and poorly paid orderlies who probably don't enjoy their work all that much. Structurally there's something seriously wrong with the way the NHS is staffed and managed.

  3. Good lord, I'm not surprissed by the report, just surprissed its taken this long to get it into the public eye.
    But its not new, its been going on for years, and its not just the elderly that are suffering its children too.I'm looking forward to seeing the report on hospital food next week on TV, and of course thanks to you TM for your continuous reports and involvment.
    When I see an old friend going into hospital these days I dont expect to see them alive again.
    And what will be done? nothing. the likes of Nigel Edwards are blind to the facts because of there own ignorance, they get paid thousands of pounds to manage, but the only thing they manage is there salarys.

  4. Let`s hope after the report from the ombudsman, that the NHS will be investigated and checked.

    What i would like to know is , what are the nurses being taught in nursing school these days, it is quite obvious they are not taught health and hygene standards, basic care and wellfare of patients and the needs of patients.

    As for the catering side, put me in charge of it, i will create nourishing food menus that would cost as little as possible.

    To budget a buisness especially in catering, find a good deal from local farmers market, willing to supply daily fruit and veg regularly at a good price.

    Then find a meat retailer, bargain with them for a good price on regular meat deliveries.

    no hidden extras and no supprise hike up of prices, contract if possible for a year.

    Get rid of these catering packs of powdered cack, and get back to good old fashioned home cooked meals full of nutrition.

    E.G ...Beef stew.

    one kilo of lean beef (cost near a tenner),

    two kilo of potatoes (cost about 1-50 ).

    two kilo carrots (cost about 1-50 ).

    two kilo swede (cost about 2-00 ).

    kilo of onions (cost about 1-50 ),

    6 OXO cubes ( cost about 1-50)

    500 grams barley (cost about 1-00 )

    500 grams chickpeas (cost about 1-00 )

    The whole lot makes 12 kilos when cooked.

    Total cost 20 quid........ Prices are a guess as i don`t know what the prices are in UK now, but i guess they are the same as Crete at the moment.

    So by batch baking the above, and allowing half a kilo per patient, or a decent soup bowl full, the NHS would save thousands, patients would be getting nutritional food.

    I have volumes of recipes for nutritional food, good budgeting and common sense is needed for NHS catering, i bet there is a hell of a lot of waste food thrown away every day, which does not help the land fill situation , does not make sense dishing out crap food that is unpalatable and is a money strain on the NHS.

    There must be hundreds of willing ,out of work chefs on the dole, willing to replace the seemingly non chef types employed in the NHS hospital kitchens.

  5. One reason the food is so unpalatable is the guidelines on salt, sugar and fat levels. The food Nazis insist on a very austere diet to fit in with their warped view of healthy eating. The food manufacturers claims these limits make hospital food bland and unappetising and not as tasty as food eaten at home or in restaurants. I have to agree with them. Most patients are in hospital for short stays so normal sugar, salt and fat levels won't hurt them. Indeed, some patients such as cystic fibrosis sufferers need high fat, high calorie meals.

  6. Hi Mark -

    Just been pointed towards the blog by Lucy - something through various experiences that is close to my heart. One of the most interesting points of view was from an experienced nurse today - she said that there is a "new breed of nurse" these days that are not trained, or care less in the actual provision of care itself. It's a hard quality to define, "care", but with the target driven environment, it's about getting jobs done, not doing them properly and with respect. It's too tempting to treat the condition, not the person.

  7. Very true, Andy. Once nursing drew in girls ( and they were mostly girls) because they cared and wanted to nurse. I remember as a small boy my female cousins nursing their dolls and teddys. Now nursing is a degree profession taught in lecture theatres rather than on the wards. Nursing recruits seem to be joining up as a step on the first rung of a career ladder. Nurses of old were just happy to be nurses. We've made a career out of what used to be a vocation.

  8. It is only when the public kick up a fuss that there is any chance of increased funding for the elderly. There is a limit to what can be done from within. Some of us try.

  9. My Mum was killed by a major hospital last year and I am still awaiting the inquest. She was in hospital for a quick procedure which should have meant an overnight stay. To cut her excruciating story short, she was in for a week, she was not fed, water was out of her reach, her skin on her arms, legs and backside was ripped off her by the use of incorrect dressings and her bed was constantly wet from the weeping wounds. She was 94. On the date of entry to this hospital she was completing the Telegraph crossword and knitting booties. I was at the hospital from 8am to 8pm every day. It made no difference. The ward severely hastened my Mother's death with neglect and cruelty. I have appeared on Look North - BBC and am happy to talk to anyone else appropriately about this particular atrocity. What the UK public needs to realise is this is a daily occurrence in our beloved NHS hospitals and there seems to be no accountability. If I had left and treated my Mother as they did I would be in prison now.

  10. I have only had two relatives in hospital- both were neglected by staff. Both relatives lost weight - to the point where they were classed as anorexic- and were left in appauling conditions.

    On one occasion my under weight father was given a tomato and a thin piece of ham as his main meal.

    I work in a Vets and we provide the best level of nutrition for our cats and dogs. We also change their bedding constantly to prevent urine scalds- a level of care my father and grandmother did not experience before they died.

    Complaints were ignored by the NHS.

  11. For a period of time my wife worked for a branch of the NHS based in the East Midlands. This branch was catered too by Sodexo. The food they were given was of a very high standard and yet when my wife ended up in hospital for an on going medical condition she was given food that I would not have given to my dogs. In fact I would have been surprised if the dogs would have even shown any interest in it any way. Also on continuing I was unfortunate to have to spend most of last year visitng my wife in hospital because of a major error in her treatment where they almost killed her. In that time I have seen firsthand how bad the whole state of the care system is. I have witnessed the poor food and hygene. I have seen the results of the general lack of interest by many members of the nursing staff and some doctors. I have been told by nurses that ''they do not dress wounds because it is something they are not trainned to do''. This is not a joke. I have seen people wait for hours for medication. My wife on a number of occasions when admitted has had to wait for days to get medication she is supposed to be on,on a regular basis. I have seen toilets covered with feces and no one has cleaned them for hours. I've seen cardboard bed pans left on bedside tables for so long that they have been leaking when finally removed. The amount of crap I alone have witnessed could fill a book. I myself have decided that if I am unfortunate enough to end up in a terminal state then I will end my own life rather than be left to wittle away in a corner of one of these death factories.

  12. My friend who is 60 years old has been in the hospital since thursday. She has pnemonia and coughs so hard she pees on herself. They waited a day and a half to give her antibiotics. She has sat in soiled depends for hours, til we come up and raise hell. They were not putting anything on her rash down there til I did for 3 days she was clearing up. I couldn't get up there for a day and a half and she's right back where she was raw because they didn't put anything on her. She is hoping to come home today but the doctor hasn't been in yet, she says my as well go home they aren't really doing much for me anyway. I think it's because she's at that senior age now, they just don't care they know medicare will pay for her to be there for however long so they just let her lay there and get worse. I'm planning on going to my local news media about this and we will see some heads roll.