'Basic care' lacking in hospitals

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A patient lobby group is demanding an urgent review of hospital care after issuing a report detailing first hand accounts of "appalling" NHS standards.

Elderly people and the seriously ill being left soiled, and help not being given with eating and drinking feature in the Patients Association report.

Its president Claire Rayner, a former nurse, called for "bad, cruel nurses" to be identified and struck off.

The government said the cases were unacceptable but not representative.

The report includes 16 stories from relatives, which the association says are just a few of the many reports it has received. It says all accounts were reviewed critically prior to publication as it was aware that complaints do "not necessarily reflect the reality".

But it stressed that common themes emerged throughout the accounts, with nearly all focusing not on treatment but basic nursing and domiciliary care.

It also said one trust had "raised the spectre" of legal action if it went ahead with the publication.

All the reports related to cases in England, but the association said it received similar stories from across the UK.

'Wake-up call'

The Patients Association did note that the latest inpatient survey found 43% rated the service they received as excellent, a significant increase from the previous year.

It is important to note this is not representative of the picture across the NHS. The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care Chris BeasleyGovernment chief nursing officer

But it also stressed that the 2% who deemed the service poor had not changed between 2002 and 2008, and that while the proportions were small they still represented thousands of patients.

Earlier this year, a report from the Healthcare Commission - now replaced by the Care Quality Commission - detailed grave lapses in standards of care at the Mid Staffordshire NHS Trust.

Families described "Third World" conditions, with some patients drinking water from vases and lying for hours in soiled bedding.

"Whilst Mid Staffordshire may have been an anomaly in terms of scale the Patients Association knew the kinds of appalling treatment given there could be found across the NHS," said Katherine Murphy, the association's director.

"This report removes any doubt and makes this clear to all. Two of the accounts come from Stafford, and they sadly fail to stand out from the others."

"We hope this report is a wake up call for the Department of Health and the Care Quality Commission-we've made a number of recommendations to try and prevent these kinds of things happening to other patients.

"We hope this report also encourages other people to get in touch with us and tell their stories-we plan to continue publishing accounts until we can be confident that every patient is secured dignity in their care."

Two percent is too many but we are concerned that this might undermine the public's confidence in the world-class care they can expect to receive from the NHS DR Peter CarterRoyal College of Nursing

Relatives described how they found their loved ones dehydrated or lying in faeces, blood and urine, and detailed the difficulty in obtaining assistance from nurses. They described how patients were left with sandwiches or drinks in packaging which they could not open.

"I am sickened by what has happened to some part of my profession of which I was so proud. These bad, cruel nurses may be - probably are - a tiny proportion of the nursing work force, but even if they are only one or two percent of the whole they should be identified and struck off the Register," said Claire Rayner.

Good 'overshadowed'

Government chief nursing officer Chris Beasley said: "All patients deserve the highest quality of care from the NHS and the poor care received in these cases is simply unacceptable.

But she added: "It is important to note this is not representative of the picture across the NHS. The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care - the Care Quality Commission's recent patient experience survey shows that 93% of patients rate their overall care as good or excellent."

The CQC itself said the registration system it was introducing for trusts next year would ensure they met key quality standards.

"It is absolutely right to highlight that standards of hospital care can vary from very good to poor," said chairman Barbara Young.

"Many people are happy with the care they receive, but we also know that there are problems. Matters related to the dignity of care are of particular concern to patients and their families. And poor basic nursing is a recurring theme in organisations that perform badly.

"I am in no doubt that many hospitals need to raise their game in this area."

Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said it would not condone nurses who behave in ways "that are contrary to the principles and ethics of the profession".

But he added: "This report is based on the 2% of patients who feel that their care was unacceptable.

"Two per cent is too many but we are concerned that this might undermine the public's confidence in the world-class care they can expect to receive from the NHS.

"Furthermore it could also dampen the morale of the millions of staff who work tirelessly to help their patients."