It’s a sad story in the UK, but one that is all too common. Hospitals neglect the dying.
Death comes to us all, and dignity at the end is the best we can hope for. But for thousands of NHS patients this never comes about. A significant study into the quality of patients last hours on Earth has revealed a shocking and disappointing lack of dignity in many NHS hospitals. This picture of systemic medical neglect arises from inadequate staff training. Too many hospitals fail to support too many people in their final moments. The Royal College of Physicians produced the report.
Only 25% of NHS hospitals have compulsory training in how to handle patients and relatives at that crucial time. 75% of hospitals had no professional palliative carers on the wards at weekends. No wonder then, ‘significant variation’ in quality of care was once again found to be a major symptom of the NHS. Noticeable communication difficulties between carers, the dying and their relatives were also highlighted.
The report found doctors and nurses very capable of knowing when patients were nearing death. Yet in over 50% of cases, where patients were aware enough to have the information, they were not talked to about it specifically. People close enough to visit the dying were told of the closeness of the end, only 30 something hours on average, before the final moment. And 25% of the bereaved, felt totally uninvolved in care regime of the final hours of their loved ones.
The report is telling because it was compiled after a review of over six and a half thousand medical records. The audit involved nearly 150 English hospitals and more than 900 bereaved people were surveyed by questionnaire.
Of course it all depends on your standards and expectations but the UK was recently found to be the one of the best countries to die in, by a World Health Organisation study. Approximately half a million people die every year in England and around 250 thousand do so in hospital. We all have the right to respect and dignity. Relatives should also be consulted, informed and involved in all aspects of end of life care. The RCP report highlights too many unacceptable failings and variations in this area.
There is an inescapable conclusion in the report that states that if some hospitals can do it well every time then surely all of them can. Failure to do so is a form of medical negligence. Of course it all comes down to personal interaction between staff, patients and relatives. Communication is always the essence of quality of care but too many hospitals do not put this as a priority and are thereby letting people down.
We would all like to be reassured that when our time comes to die, we and our families and friends will not only be treated with medical correctness of course but also with compassion and sensitivity to our emotions. A big aspect of the deficient hospitals lies in the social ‘taboo’ of death in the minds of many health professionals.