Two reports reveal sad state of affairs in some UK hospitals

By Dr. Ananya Mandal, MDSep 16 2011

Care Quality Commission report

According to a new report half of UK's hospitals and care homes are failing to look after patients.

Nurses at some institutions are serving up people’s evening meals at 3pm – just because it is more convenient, inspectors found. And several hospitals do not have enough nurses on wards to feed or wash patients, or help move them to prevent bedsores. Nurses arrive unannounced at elderly patients’ bedsides and strap blood pressure monitors round their arms without telling them what they are doing.

The report by the Care Quality Commission watchdog found that, in some hospitals, patients are even wheeled away to have major surgery without doctors properly explaining details of the operation and the potential risks. It was noted that pills may be dumped in front of patients but nobody tells them what the medication is for or why it must be taken.

Campaigners warned that the basic care of the most vulnerable in society was being ‘cast aside’ as it was deemed ‘too costly or difficult’. This latest report is yet further evidence of the poor treatment and neglect of the elderly in hospital wards and care homes.

Of the 137 hospitals visited by inspectors at the CQC in the last year, 49 per cent were found to be failing basic standards of care and wellbeing. In a handful of cases, investigators found that ‘do not resuscitate’ orders had been placed in patients’ medical notes without informing them. Medical guidelines insist these orders – which tell doctors not to carry out CPR if someone’s  heart stop beating – are issued only following discussion with a patient or their family.

Similarly, 49 per cent of 799 care homes inspected were deemed to be failing basic standards of care and wellbeing. Some 39 per cent were not protecting patients health and safety, the report found.

Michelle Mitchell, charity director of Age UK, said, “It’s not acceptable that NHS hospitals and care homes with  nursing are not complying with basic minimum standards required for the wellbeing and welfare of older people. It’s shocking to see that only half of NHS hospitals and care homes with nursing are meeting their obligation to provide effective, safe and appropriate treatment which meets their needs and protect their rights and that 30 per cent fail on nutrition,  welfare and safety. The demand for high quality of health and social care will only increase as our population continues to age. The care of the most vulnerable in our society is one of the most important issues facing the country and too important to cast aside and be labeled as 'too costly or difficult'.”

Earlier this year, another report by the CQC found that doctors in hospitals had resorted to prescribing patients drinking water alongside their medications because nurses had allowed them to become so dehydrated.

Report by Professor Paul Corrigan

In yet another report produced by Professor Paul Corrigan, Tony Blair's former special adviser on health, and healthcare business expert Caroline Mitchell, warning was issued that up to 40 hospitals will fail by 2013 without radical reform of their working practices. Britain could face a £5 billion bill to rescue the Trusts unless the NHS adopts more innovative and “factory-style” working, the think-tank Reform has claimed.

The report reads, “NHS hospitals currently try to be all things to all people and deliver every healthcare service to everyone. To achieve scale we will need to close down under-performing units so that activity can be concentrated in centers of excellence. By applying the lessons from assembly lines, aviation and service industries, managers can introduce a 'factory' mode of production offering streamlined 'value added processes' for patients.”

Prof Corrigan added, “Unless something drastic happens to the nation's NHS hospitals, we predict that by 2013 the Government will have to find an extra £5 billion to secure the continuation of all hospitals. As a proportion of the overall NHS budget, this does not seem to be unmanageable but for other Government departments, this is a significant amount of money. It is difficult to see any Chancellor simply giving the NHS that quantum of money to spend on inefficiency. The root cause of the problem is that acute hospitals are sick and need to heal themselves. To thrive in the present and future environment they need to focus on a radical change - on overall transformation. They need to focus on developing a successful business model and not try to be everything to everyone.”

Reacting to the report, Health minister Simon Burns said, “Few now deny the NHS must change to meet future challenges. But we believe the NHS should be the opposite of a factory-style operation and instead offer patients high quality, tailored care. That is why our plans give freedom and control to doctors and nurses, puts patients at the heart of everything it does, and safeguards the future of our health service.”

The former chief executive of the NHS, Lord Crisp, made similar points recently while the Health Secretary, Andrew Lansley, won praise from the medical profession this week for finally agreeing that some services should be lost at Chase Farm, a long-threatened hospital in north London.