Why can't the NHS get basic care right?


The relatives of one patient say she went to hospital with a bruised leg and died from a fatal infection

Reading the 53-page dossier on poor patient care put together by the Patients Association, you cannot help but be moved by the harrowing stories.

There is the case of a man placed in a dementia-friendly ward with staff, who were given strict instructions to check on him because he had a history of going walkabout, but was able to escape and subsequently drowned in a nearby river.

There are tales of patients left in soiled sheets, their dignity stripped from them, and others being left for hours in pain, their cries for help ignored.

It is not the first time we have heard such accounts - and probably not the last.

Of course, in an organisation the size of the NHS - it sees 1m people every 36 hours - there will always be cases where standards have slipped.

But what is clear from this report - and others that have been published previously - is that it is still happening far too often.

The wrong patients?

Elderly Hands
  • Two-thirds of emergency admissions are patients with long-term conditions, such as heart disease and asthma. Many of these could be avoided with better support in the community.
  • At any one time a quarter of hospital beds are taken up by patients with dementia when studies suggest most would be better cared for elsewhere.
  • Half of the 500,000 deaths a year occur in hospital despite the majority of people saying they would prefer to die at home or in a hospice.
  • A report last year by a parliamentary group said a tenth of hospital beds should be closed to free up money for better community care.

Organisations, including professional bodies and the government, have been quick to call on staff within the NHS to blow the whistle on poor practice.


But it begs the question: why is it allowed to happen in the first place?

Some have argued the move to degree-level training for nurses - from next year all nurses entering training will have to complete a three-year course - has meant they have lost some of the ability to empathise and show compassion.

But this theory was rejected by the Willis Commission in its comprehensive report a few weeks ago.

Others have said resources are being stretched too thinly. But how much time does it take to place a glass of water within reach?

I recently asked a senior nurse working in a large hospital what she thought had gone wrong.

Her answer was quite clear. She told me: "We have had to become immune, desensitised, to cope with what we do. Every day we see suffering and we can't always help.

"That does not explain or excuse some of the clear examples of neglect we have heard about. But it has created a culture that means these things can happen."

She went on to say that at the heart of the problem was the fact that there were many people in hospital that should not be there.

It is an often-quoted fact that two-thirds of emergency admissions are among people with long-term conditions, which covers everything from heart disease to dementia.

With better care and support in the community, many of these could be avoided.

But that requires a re-think in how the NHS - and the social care provided by councils - is organised.

Mike Farrar, the chief executive of the NHS Confederation, has perhaps put it most succinctly in the talks he has given on the topic.

He describes it as a refocusing of what the health service is there for, saying the NHS of the future "will need to move from a medicinal service with a care dimension to a care service with a medicinal dimension".

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 349.

    Suzanne 341: "Not like when nurses were not University trained, but cared" - I'm sorry but this is arrant rubbish. I'm sure you could find anecdotal evidence from every previous generation about bad nurses and bad nursing care. What has changed is our expectations and the role of nursing which has widened almost beyond recognition. A nurse CAN'T just be a bottom-wiper and hand-holder any more.

  • rate this

    Comment number 348.

    pauljwt - are you trying to say that because a person has qualifications they necessarily aren't caring? People seem to believe that nurses are going into the profession purely for the money. Yes, there are always going to be some poor nurses, but I think in general it takes a caring person to spend 3 years training solely to look after others. Why not get a degree in something else otherwise??

  • rate this

    Comment number 347.

    We need to stop the hypocrisy in our society.At primary level children in assemblies are taught to respect and be polite towards elders.Once they are in teenage volunteering,gaining work experience working in hospitals, care homes their experience is totally different.The children are told not to complain because of the net work,you never know who knows who and obviously you need reference letter.

  • rate this

    Comment number 346.

    @344 oakwoodbank
    Problem is you can't educate anyone to care neither can you pay them to care, people are just caring or they are not, what the nhs is trying to do is replace a caring nurse with a nurse who just has some qualifications.

  • rate this

    Comment number 345.

    It is a compulsory requirement for the sixth form students to volunteer in care homes and hospitals if they want to apply for medicine/NHS services.
    These 16 and 17 years old children are extremely unhappy and sad because of lack of care,abusing language being used,patients and old people calling for help and getting a response after an hour.
    What kind of example are we setting on the youngsters?


Comments 5 of 349



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