Half of English hospitals fail to meet basic standards on care for older people

BMJ 2011; 343 doi: (Published 13 October 2011) Cite this as: BMJ 2011;343:d6645
  1. Helen Mooney
  1. 1London

More than half of England’s hospitals are falling short in providing basic care to older people, the Care Quality Commission has found.

A damning report on the care of older people in acute trusts found what chair of the commission Dame Jo Williams said was “truly alarming and deeply disappointing.”

It found that too many hospital staff fail to ensure that older patients eat and drink properly, do not respect their dignity, and talk to them in a condescending manner.

In the highly critical report the commission concluded that more than half of all hospitals in England were not meeting key standards for dignity and nutrition in older people. The watchdog carried out unannounced visits at 100 hospitals to assess dignity and nutrition standards and identified concerns in 55 cases.

In two cases—Sandwell General in West Bromwich and Alexandra Hospital in Worcestershire—the problems were judged to represent a major problem to patients.

The investigation found several key areas in which hospital trusts were failing to meet the essential standards relating to dignity including:

  • Call bells put out of people’s reach or not responded to in a reasonable time;

  • Staff speaking to people in a condescending or dismissive way;

  • Curtains not properly closed when personal care was given to people in bed;

  • Comments from patients and staff that there were not enough staff with the right training on duty to spend time giving care.

Commenting on the findings Dame Jo said: “Too often, our inspectors saw the delivery of care treated as a task that needed to be completed. Those responsible for the training and development of staff, particularly in nursing, need to look long and hard at why the focus has become the unit of work, rather than the person who needs to be looked after—and how this can be changed.

“Care professionals need to strike the right balance between ensuring that people get the care they need in a safe way—recording how much they have eaten and drunk, what medications they have taken and when—while not prioritising processes over people. Task focused care is not person centred care. Often, what is needed is kindness and compassion . . . which cost nothing.”

Michelle Mitchell, charity director of Age UK, said that the findings showed a “shocking complacency” in hospitals on what should be an “essential part of good healthcare.” He said there could be “no excuses.”

Commenting on the findings health Secretary Andrew Lansley said that it was “simply unacceptable” that some hospitals were not getting the basics right.

He added, “Everyone admitted to hospital deserves to be treated as an individual, with compassion and dignity. We must never lose sight of the fact that the most important people in the NHS are its patients.”

In future the planned new local HealthWatch organisations should be able to carry out their own unannounced inspections, he suggested.

Dignity and nutrition inspection programme: national overview is at


Cite this as: BMJ 2011;343:d6645