Review of dignity in care
The number of older people in the population is increasing rapidly. Although many are living a healthy and active life, a substantial proportion of older people often need care in hospital. This need increases with age and their stay in hospital may become more frequent or longer. Maintaining patients’ dignity and treating them with respect while in hospital is of paramount importance to older people, but anecdotal evidence indicates that this does not always happen.
Our 2006 publication ‘Living well in later life’ highlighted the lack of dignity and respect for older people in acute hospitals as a major area of concern. As a result of this, we decided to focus on dignity as a key theme in the annual health check for 2006/2007 and to undertake a targeted inspection programme to assess the extent to which NHS trusts are meeting the Government’s core standards relating to dignity in care for hospital inpatients.
Our assessments highlighted a number of trusts that were at risk of non-compliance with the core standards relevant to providing dignity and respect for patients in their declarations for the 2006/2007 annual health check. We found 35 trusts to be at highest risk and, of these, 12 were already being pursued on dignity as part of other routine follow-up activity. As a result, 23 trusts were identified as requiring more detailed scrutiny, which involved interviews with staff at various levels and observation of one ward for the elderly and one with a mixture of elderly and non-elderly people in each site visited. At least one ward was visited during mealtimes.
The key aspects we observed during our inspection visits were:
- the ward environment, including privacy issues
- mealtime activity
- the behaviour of staff
Following the visits, we assessed the trusts on a five-point scale and we issued notification letters to those trusts that were found to be at risk of non-compliance with one or more standards. These trusts were expected to reflect this in their declarations for the 2006/2007 annual health check.
Based on the scrutiny against standards and the issues identified by other evidence, a number of key themes emerged as the essential elements for ensuring that older people were being provided care in a way that was dignified and that matched their personal needs while in hospital. The themes identified were:
- involving older people in their care
- delivering personal care in a way that ensures dignity for the patient
- having a workforce that is equipped to deliver good quality care
- strong leadership at all levels
- supportive ward environment
Overall, we were encouraged by evidence that acute trusts are making efforts to respond to concerns about delivering care that respects dignity. However, there is no room for complacency and NHS acute trusts must embed an approach to care that ensures dignity for patients. Although we found no major breaches of national standards, there is still a considerable need for improvement in many areas and we have made the necessary recommendations in our report ‘Caring for dignity’.
Report published: September 27th 2007
Read our press release following the publication of the report
Read our press release about the launch of our review of dignity in care
More information about living well in later life
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