Of all the complaints we receive about the NHS, around 18 per cent are about the care of older people. Older people can face a particularly unique set of issues when they need hospital treatment: Inadequate personal care At risk of dehydration Needing support with eating Picking up healthcare acquired infection Poor communication between hospitals and families – listening and consulting, particularly on DNR capacity Lack of integrated care Fear of, or problems following, their discharge from hospital The NHS constitution has ‘care and compassion’ at its heart and most of the time it does a very good job of this. But we still receive too many complaints about older people being treated with a lack of dignity.
These are real-life quotes taken directly from some of our cases. The letters can be heart-breaking to read. I’ll pause to let you take them in. We were so concerned about the treatment of older people in the NHS that in 2011 we published a report highlighting some of the worst cases. ‘ Care and Compassion’ received considerable media coverage and I am delighted to say resulted in The Commission on Dignity and Care, of which, of course Age UK was a founder member. This shows that complaints CAN make a difference. But too often we find the same mistakes from hospitals when it comes to complaint handling: Poor explanation 33% No acknowledgement of mistakes (including cover up) 32% Inadequate remedies 26% Failure to learn So how do we make this better? [ref research] Competence Confidence Culture
When a patient expresses a concern or complaint – either on the ward or to a complaints team – the first question asked should be: ‘How can this be put right?’ The next should be: ‘How can we learn from this?’ From ward to Board, complaints should be at the heart of improving the NHS I often use the mnemonic GRASP [talk though each point] G overnance R ecords A ccountability S tandards P ractice In summary, care can be improved by listening and learning in a complaints driven culture. This has to be led from the top downwards. Thank you.
1. Culture Change in CareThe role complaints can play in improving care of olderpeopleDame Julie Mellor DBEParliamentary and Health Service Ombudsman
2. The issues older people can faceInadequatepersonal carePoorcommunicationwith familiesDehydrationLack ofintegrated care‘The NHS touches our livesat times of basic humanneed, when care andcompassion are what mattermost’Opening lines of the NHS ConstitutionMalnutritionDischarge fromhospital
3. Care and compassion?“They took awayeverylast ounce ofdignity myhusband had left”“It was as if hedidn’t exist – hewas an old man andwas dying.”“They decided thatenough was enoughwithoutbothering to include me”“I was quite frightened.I was recovering from minorsurgery. I am 82 years old and didnot know how I was to get home. Iasked the nurse if he could phonemy daughter. He told me this wasnot his job.” “When she arrived at the carehome, she had numerousinjuries, was soaked with urineand was dressed in clothing thatdid not belong to her which washeld up with large paper clips”“His tongue waslike a driedpiece of leather”“Our dad was not treated as acapable man in ill health, butas someone whom staff couldnot have cared less whetherhe lived or died”
4. Listening and learningGRASP•Governance•Records•Accountability•Standards•Practice