Hospitals need to change to ensure older people are treated with dignity, says commission

BMJ 2012; 344 doi: (Published 28 February 2012) Cite this as: BMJ 2012;344:e1538
  1. Jacqui Wise
  1. 1London

An independent commission has called for fundamental changes so that hospitals and care homes ensure that all patients and residents are treated with dignity and respect.

The commission, set up by the NHS Confederation, Age UK, and the Local Government Association, spent eight months reviewing and gathering evidence. Its draft report, Delivering Dignity, sets out 48 recommendations to stamp out undignified care. These include:

  • Ensuring that hospitals recruit staff on the basis of their compassionate values as well as their clinical and technical skills

  • Giving ward sisters a leadership role, with the authority and responsibility to take action they think is necessary in the interests of patients

  • Providing older people with a comprehensive geriatric assessment when they are admitted to hospital so that a coordinated care plan can be developed, and

  • Making maintaining each patient’s independence a key measure of a hospital’s performance in delivering care for older people.

The commission was established after the publication in February 2011 of a report by the health service ombudsman that exposed a number of failures in the care of elderly people (BMJ 2011;342:d1064, doi:10.1136/bmj.d1064).

Keith Pearson, chairman of the NHS Confederation and a joint chairman of the commission, said, “We have been deeply saddened by reports over the last few years over the provision of undignified care in hospitals and care homes.” He added: “There are some hospitals and care homes which deliver great care, and we need to learn from them to get dignified care for every person every time.”

Heather Tierney-Moore, chief executive of Lancashire Care NHS Foundation Trust, said, “Twenty five per cent of the patients on wards suffer from dementia, some of which is picked up and others not. It is important that the professional and care staff have the knowledge and skills to deal with dementia.”

The report recommends that families, friends, and carers be seen as partners in care, not as a nuisance or interference. “Carers are a crucial part of how care is supported and delivered,” said Professor Tierney-Moore.

The report also recommends that the National Institute for Health and Clinical Excellence’s new quality standard for patient experience in adult services, which includes dignity, be used by providers, commissioners, and regulators across health and social care. And commissioners should set out in their contracts the dignity standards they expect and ensure that the service providers regularly report on progress in meeting them.

The report will be out for consultation for one month, and a final report will be published before the summer. The commission will then produce an action plan that sets out priorities for improving dignity in care for older people.


Cite this as: BMJ 2012;344:e1538