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 21.

    The usual banal whining about the NHS being Privatised.

    Private companies have to deliver results or face losing customers or bankruptcy. Its about time the sense of entitlement is eradicated from NHS staff and they are made to show value for money. Poor hospitals will inevitably close, rather than waste millions of other peoples money.

    Governments should NOT be involved in healthcare delivery.

  • rate this

    Comment number 99.

    The NHS used to be the pride of Britain, and now it's the laughing stock of health organisations in Europe.
    The hospitals are filthy, the nurses are overpaid and are not committed to working hard.
    The sooner the NHS is privatised the better.

  • rate this

    Comment number 29.

    Where is the mechanism for it to improve? No incentive to perform better. No one is going to reduce the funding if quality falls - more likely to reinforce failure by adding funding instead. No competition to sharpen their metal. Sacred cow drifting along with no politician seriously going to threaten its closure. Bloated, inefficient, non-competitive. Too big too fail?

  • rate this

    Comment number 123.

    Privatization will be a good thing for the NHS, a radical reform is needed and once it has happened, the quality of care will be improved along with their being no costs for the government. The poor people in society who can't afford private care may start now cutting down on cigarettes and alcohol now realizing that they can't sponge of the state!

  • rate this

    Comment number 129.

    The NHS should be run by successful business people, accountants and economists. Care is unimportant if the books aren't cared for. Balancing the books should be the NHS's first priority, everything else is trivial in the grand scheme. Same applies universally. If the NHS doesn't break even or make a healthy profit then sell it to private companies who will break even/make a killing. Makes sense


Comments 5 of 179



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