[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 2 Issue 8, March 2012].
The draft report from the Commission on Improving Dignity in Care proposes the following ten key recommendations for hospitals.
- All hospital staff should give priority to the person receiving care. Staff should challenge practices not in the best interests of the people in their care.
- Hospitals should recruit staff who uphold compassionate values and provide dignified care (i.e. not just clinical and technical skills). Compassion should feature in appraisals
of staff performance.
- Hospital boards should promote a devolved style of leadership which supports and respects the judgment of staff working closely with older people and their families. Hospitals should enable staff to “do the right thing”.
- The leadership role of the ward sister or charge nurse should be fostered, supporting their authority over care standards, dignity and wellbeing on their ward. These persons should be accountable for acting in the interests of patients and play a leading role in the coordination of services for dignified and seamless care.
- Hospitals should offer older people a comprehensive geriatric assessment at the point of admission, with regular re-assessments thereafter throughout their stay in hospital and before they are discharged, to permit a coordinated care plan to be arranged. When undertaking assessments, time should be allowed to understand and record the needs and preferences of older people, their relationships with family, friends and carers, while also recording physical and mental health.
- Hospitals should view older people’s families, friends and carers as partners in care.
- Maintaining each patient’s independence should be seen as a key measure of hospital performance in delivering care for older people. Hospitals should work with patients, relatives and carers to assess a patient’s independence on discharge from hospital compared with how independent they were before admission.
- Hospital boards should view dignity and patients’ experiences of care as a measure of performance. There should be robust procedures to collate feedback and complaints from older people, their families and from staff, so that any emerging trends come to light. There should be effective whistle-blowing procedures for staff concerned about care standards and poor practice. Hospital boards must respond quickly to any deterioration in performance regarding dignity issues.
- Feedback from patients and their families should be discussed on the ward every day. Hospitals should allow staff time to reflect on the care they provide and how to improve care.
- Hospitals should introduce “facilitated, practice-based development programmes”, (“learning through doing”) to ensure staff develop the confidence, support and skills to do the right thing for patients.
Delivering dignity: securing dignity in care for older people in hospitals and care homes. A report for consultation. London: NHS Confederation, the Local Government Association and Age UK, February 2012.