Why bed sores matter more than reforms

Nurse and patient Bed sores are the most common reason for a serious incident being reported

The complete overhaul in the structure of the NHS is a little over two months away.

From April GP-led groups will take charge of much of the health budget, while day-to-day control will be handed to the NHS Commissioning Board.

To mark the historic change, the BBC's Inside Out programme has produced a series of reports from across the country on the changing nature of the health service.

But as always it is not the structural changes that stand out, rather what the programme has to say about standards of care.

As part of its focus on the NHS, Inside Out has obtained data under the freedom of information act about serious untoward incidents.

These are serious mistakes that hospitals have reported have put patients at risk.

The system by which they are registered was introduced several years ago to help the health service learn from its mistakes.

As you would expect, errors during surgery and outbreaks of infection feature heavily.

But the biggest problem - by far - is something else.

Of nearly 12,000 incidents reported across England, more than 40% related to bed sores.

This issue will be featured on the West Midlands version of the programme as the region has the worst record in the country with one of its trusts - the Dudley Group - reporting that two thirds of its 307 incidents related to bed sores.

A BBC investigation reveals that 42% of serious incidents reported at hospitals in England involve bed sores, a condition that is nearly always avoidable

Of course, an organisation the size of the NHS is bound to make mistakes.

After all, its sees a million patients every 36 hours or so - and most leave happy with their care.

Deeper problem

But what is most telling about this data is that something as avoidable as bed sores is proving such a problem after all this time.

Back in the 1850s Florence Nightingale was complaining about the presence of bed sores, saying they represented a failure of nursing.

Yet still they are an issue.

Bed sores - or pressure ulcers as they are also known - happen when pressure restricts blood supply to the skin.

Some are only small sores, others are open wounds that can lead to serious complications.

Research shows - and the NHS has accepted - that 95% of bed sores can be avoided through regular assessment and turning patients when necessary.

But these figures suggest these steps are not always happening.

In the Inside Out programme, Steve Jamieson, of the Royal College of Nursing, puts it down to inadequate staffing.

National data at a glance

Type of incident Total

Source: BBC Inside Out

Bed sores


Slips / trips / falls


Delayed diagnosis


Surgical error


He says: "If we think of the complex needs of some of these patients we may need two or in fact three nurses to deliver appropriate care to one patient.

"So for example, turning someone who is obese would take more than one nurse and if you've got four nurses who are on duty at one time on a ward of say 36 patients - to take three nurses off to be able to turn one patient on a regular basis, you know, takes time.

"So I think there is something about making sure the staffing ratio is right in areas where people have got complex needs."

Certainly, the squeeze on finances has had an impact. Latest figures show that nurse numbers have fallen in the past two years.

But others believe there is a much deeper problem.

In the past year critical reports by the likes of the Patients Association and Care Quality Commission have raised concerns about the culture that is allowed to develop in some places, leading to failings in basic care.

This is likely to be thrown into sharp focus in the coming weeks by the publication of the report of the public inquiry into Stafford Hospital scandal, where hundreds of patients died needlessly between 2005 and 2008.

Even on the eve of the biggest reorganisation in its history, as always its the quality of care that the NHS stands and falls by.

BBC Inside Out is broadcast on BBC One on Monday, 21 January at 19:30 GMT.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 179.

    The NHS is all about saving money and not looking at the quality of care.I have been told there is no need for a nurse in my service.Today I have talked about nutrition,hydration, urinary function,pressure sores (remove the pressure and the sore goes),pain relief,post operative swelling,wound closure removal,rehabilitation treatment.One visit,One hour.One person.

  • rate this

    Comment number 178.

    Where does the 'national data' come from? Does every hospital have a bedsore monitor?

    The NHS needs a 'functional' complaints system, then they it can put together some accurate data.

  • rate this

    Comment number 177.

    I am not sure how much one can read into this data, given that it is estimated that only 10% of adverse incidents in hospital are actually formally reported. Whilst it is compulsory to report falls and pressure sores, other often more serious, incidents go unreported.

  • rate this

    Comment number 176.

    Only the NHS could spend thousands on an operation, then let the patient die from malnutrition through lack of basic care. Is there a culture of "I'm a degree qualified super medical technician. It's not my job to see than an elderly infirm patient has been able to eat what was put on the tray table".

  • rate this

    Comment number 175.

    The Tories WILL privatise the NHS completely given half a chance. They only need their media to corrupt the minds of the public against the NHS first - it all happens in the blink of an eye.

    Disabled bashing is a taken for granted part of UK society now - their media created it so 'we' wouldn't hold it against them when they cut their benefits making thousands homeless.

  • rate this

    Comment number 174.

    165.The Bloke - "Some people forget just how crap the nationalised utilities were, and the likes of BA and BL, telephones pre-BT.... Not a bit crap. Really spectacularly crap."

    One example - our railways now have fully 600% more tax payers cash thrown at them than pre-privatisation.

    BR were never given sums like that to work with - so we cannot say privatisation worked in that industry....

  • rate this

    Comment number 173.

    Re 165. Some of the nationalised companies weren't sold off because they were bad. If that were the case, there wouldn't have been a mint to have been made when the shares of these companies came to the market. They were sold to provide money for the economy and now all the 'crown jewels' have been sold, we are left in this sorry economic state.

  • rate this

    Comment number 172.

    If any of you people knew what really goes on in some hospitals ... as an NHS worker in a trauma centre in East London I can assure we we pick up the pieces of many people's lives and then some. The are mistakes and issues, yes, and those should be dealt with, but outsourcing the NHS will result in less service and quality you watch!

  • rate this

    Comment number 171.

    165@ The Bloke

    Excellent Bloke. So true better crap than the very crap nationalised industries
    My opinion is that the British are generally incompetent in most things they do. We are getting better but our skill and education levels are poor.
    Mix that with a 'cant do' and 'more than my jobs worth' attitude and a lack of ambition and vision = crap
    Fundamental basic of life: crap in = crap out

  • rate this

    Comment number 170.

    Privatisation of the NHS is just over two months away you mean!
    Shame on you BBC for spinning it any other way.

  • rate this

    Comment number 169.

    155.sprout_2001 - "More and more paperwork (often just a convoluted box ticking exercise) and less and less staff...."

    We the public oculd help there - people ar so quick to sue these days
    they have to keep a record of EVERYTHING to prevent dodgy claims....

    ...the paperwork also helps see where things go wrong when they do.....

  • rate this

    Comment number 168.

    When will a political party appear which upholds basic human values? I don't mean 'Old Labour' or their soft-Marxist agenda for Utopia, or the xenophobic rants of the nationalists. 'This thing is bigger than the both of us', as they say. But surely there must be a viable alternative to the current utterly corrupt servants of the highest bidder. Or maybe not - hey, who's on X-Factor this week?

  • rate this

    Comment number 167.

    Re 164. When you have nothing constructive to say, bash the BBC. Just because one entity exists in the same entity as another, that is not a reason to support it. The same ethos goes for the private sector - they don't all rally round each other if one of them is exposed. It is possible to highlight anything anywhere; it is how you decimate the information that is the crux of the matter.

  • rate this

    Comment number 166.

    I am just waiting for all the failures to happen, as is common outcome of starting something from scratch.

    All those years of experience & of correcting thousands of issues/problems, chucked away & starting again, which I am sure many faults/issues will not even be reported properly or at all.

    The only guaranteed outcome will be necessity of more oversight- QUANGOS

  • rate this

    Comment number 165.

    Some people forget just how crap the nationalised utilities were, and the likes of BA and BL, telephones pre-BT.... Not a bit crap. Really spectacularly crap.

    Doesn't mean their replacements are perfect, but they're not as stand-out crap as their nationalised predecessors.
    I'd actually argue against privatising the NHS. Making it less crap, and its staff less crap, is the priority.

  • rate this

    Comment number 164.

    157@Global Yawing

    You cannot highlight problems with the public sector (which in my opinion are endemic) on this HYS because the BBC is part of the public sector. It wants to keep the myth going that the public sector is all rosy and the private sector all those bad guys who want create wealth (to pay for the public sector)
    Propaganda programs based in hospitals and schools were they are so good

  • rate this

    Comment number 163.

    "a million patients every 36 hours". Bear this in mind when you factor in that to cut costs you have the minimum clinical staff working and the fact that many of them are working 12.5 hour shifts (often with no breaks) and have done for 4+ days at a time and you should be bloody grateful for the excellent service that is provided for the majority of the time.

  • rate this

    Comment number 162.

    In reply to the comment by Mike earlier you really should be a manager in the NHS. The NMC code states you are responsible for your actions and omissions and this is certainly used against Nurses when staffing levels are decided. The NHS is chronically short staffed and Nurses can only do so much. Nurses are taught to prioritise and if this means leaving a bedsore to perform CPR so be it.

  • rate this

    Comment number 161.

    Hospitals need to sort out the bed sheets rather than administrating sheets of paper. Matron would never of accepted it 50 years ago, so why is it acceptable now? The government need to look at what changed from then to now to find the answer.

  • rate this

    Comment number 160.

    Another article on the BBC news is about 3D printed food replacing farming animals. I look forward to the day that technology can replace our beloved UK politicians, then we might get some decent policies out of them.


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