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Elderly patients 'experience poor hospital care'

Published 15/07/2015

Older people were often not given the help they needed to eat meals in hospital, the study found
Older people were often not given the help they needed to eat meals in hospital, the study found

Elderly hospital patients are experiencing poor care, a lack of dignity and little help with eating when they need it, according to a report.

Researchers found a million over-65s are experiencing poor or inconsistent standards of dignity and respect during hospital stays.

Of patients who needed help eating, more than one in three said they did not receive enough assistance - equivalent to 1.3 million people a year, and 640,000 aged 65 and over.

The report, which was carried out by the Centre for Analysis of Social Exclusion at the London School of Economics (LSE), found that amongst older people, poor or inconsistent care was more likely to be experienced by women, and those aged over 80.

The risks were also higher for those with a long-standing illness or disability such as deafness of blindness.

Those in hospital for a long period, or who stayed in three or more wards, had an even greater risk.

The report was compiled using evidence from the Adult Inpatient Survey 2012, which covers people aged 16 or above who stayed in hospital for at least one night.

"There was a widespread and systematic pattern of inconsistent or poor standards of care during hospital stays in England in 2012," the report found.

"Patient experiences of inconsistent or poor standards of dignity and help with eating do not appear to be limited to isolated 'outlier' providers.

"Rather, this appears to be a significant general problem affecting the vast majority of NHS acute hospital trusts."

About a quarter of all respondents said they needed help with eating during their hospital stay, amounting to just under 3.5 million patients a year - a "substantial proportion".

Of those who needed help with eating, nearly two fifths (38%) said they only sometimes, or did not, receive enough help from staff.

The quantity and quality of nursing care, and whether there was a choice of food, appeared to have a large and statistically significant effect on the probability of patients experiencing poor standards of help with eating.

The LSE team found 23% of patients reported experiencing poor or inconsistent standards of dignity and respect - equivalent to 2.8 million people a year, of whom a million are aged 65 and over.

"Levels of inconsistent or poor standards of dignity and help with eating are too high in the vast majority of trusts," the report said.

"There has been remarkably little change in the percentage of individuals reporting inconsistent and poor standards of care over time."

The report authors said while there has been increased attention to the area in the wake of the Mid Staffs scandal and the subsequent Francis Inquiry, further improvement is clearly needed.

Dr Polly Vizard said: "It's the first time we have analysed an NHS patient survey in such detail and the findings are very disturbing.

"What really stands out is not just the large number of patients who say they aren't always being cared for in a dignified way or helped to eat - but also that there has been remarkably little change in the percentage of individuals reporting inconsistent and poor standards of care over a substantial period of time.

"An important message arising from the Francis Inquiry into the tragedy at the Mid-Staffordshire NHS Foundation Trust concerned the need to make 'better use' of patient experience data in the future.

"Treatment with dignity and respect, and help with eating for those who need it, are key markers of quality of care.

"Our analysis across NHS hospitals suggests that experiences of poor or inconsistent standards of dignity and help with eating during hospital stays are endemic across the vast majority of trusts."

Caroline Abrahams, charity director at Age UK, said: "This new in-depth analysis of older people's reported experiences shows just how big the challenge is in ensuring every older person in hospital receives the dignity they deserve and help with eating if they require it.

"It must be recognised that the data this research is based on is two years old now and that the newest figures suggest some welcome improvement, especially as regards older people's experiences of dignity, but this sobering report certainly shows that hospitals need to redouble their efforts.

"Above all it is really worrying, if perhaps not altogether surprising, that the more vulnerable an older person is, the greater their risk of not being treated as we would all wish for ourselves or our loved ones. Turning this situation around ought to be a top priority and no hospital can afford to be complacent."

A spokesman for NHS England said: "One of the critical tests of a modern health service is how well it looks after older patients.

"As hospital nurse staffing has risen in the years since this report's baseline data was collected, we should expect to see widespread improvement in compassionate and dignified care for older and vulnerable patients across the NHS."

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