The community health watchdog,
Tameside LINk, organised their 'Hospital Improvement Event' at Ashton Town Hall last Thursday. The LINk or (Local Involvement Network), was set up in 2008 to assist local people to have an input into planning, management, and the delivery of health and adult social care services, in the Tameside area.
Last May (2010), the LINk invited members of the public to a meeting to hear their recent experiences of Tameside Hospital (pictured) as patients and relatives. A report and eight recommendations dealing with - staffing levels, falls and accidents, communication with patients and families, information, organisational leadership, ward leadership, food and drink, bathing and toileting - was
published in September 2010.
Last Thursday`s meeting had been organised to consider whether the hospital had implemented the recommendations and to consider a report from the LINk, following unannounced visits to the hospital in December 2010 and January 2011. Using its right to 'Enter & View', LINk members, visited various wards and asked detailed questions of 91 patients and their relatives who were on wards in the hospital.
Although Tameside Hospital state that they have already implemented many of the recommendations, the LINk report makes clear that many of their recommendations have yet to be implemented and constitute a serious concern which can have a major impact on patient care and wellbeing. Link Co-ordinator, Peter Denton, introduced the report which highlighted a number of deficiencies in patient care.
According to the LINk survey, 64% of people said that they had not been offered a Patients' Handbook even though, it is the policy of the hospital to give them one. Moreover, many patients said that they had not seen nor were they aware, of the Patients` Handbook. Similarly, 90% of patients surveyed said that they didn't have a 'Relatives Shared Care and Communication Sheet' even though:
"the sheet was introduced by Tameside Hospital to improve communication and patients are supposed to be in possession of one at all times."
The report also states that 75% of people surveyed said they had not been offered leaflets about their medical condition and only 31% of people said they had been told where they could get more information. Although the hospital has a health information centre, the report says: "We were disappointed that very few patients or relatives knew about the health information centre based in the hospital." Likewise, 95% of patients said that they had not met their 'Dignity & Care Champion' for the Ward. Very little seems to have changed! The 2010 LINk report, had also stated that most patients at the hospital didn`t know who these people were.
As regards the care of patients, the report highlights a number of serious concerns. Although it is hospital policy that relatives can come in at meal times to help with feeding a patient, the report says that many patients were unaware of this, and one family, was told that they could not come in to help at meal times. The report also says that some patients did not always have a jug of drinking water at the side of their bed or a glass, or its was out of reach, or there was a jug but no glass. The report says that one patient was left unattended on a toilet for 20 minutes while other patients, complained of not getting support with eating, going to the toilet, and bathing. Overall the report says: "One in four patients we asked who needed help at mealtimes told us they didn`t get it."
On Ward 43, the son of a 92 year old patient told the LINk visitors that his mother was incontinent and this had led to a build up of faeces under her fingernails. Ward staff had not cut or cleaned her nails and when he`d asked them to do so, they`d told him, it was not policy to cut patients' nails and he had cleaned her nails himself. On the same Ward, another patient had complained about bathing and said: "they don`t do it properly, they just slosh water over you." On Ward 44, a relative complained that a patient`s hair had not been washed, their toenails had needed cutting and that their request for a chiropodist, had not been followed up. Another relative complained that her husbands eyes were stuck with green gunge and that she`d had to clean his mouth.
The 'Enter & View' visitor`s, say that on their visits to the hospital, they saw overflowing rubbish bins and that some bathrooms and toilets would benefit from deep cleaning. Also, "We did not observe a single member of staff washing their hands or using the hand gel." In the Medical Assessment & Admissions Unit (MAAU) and on Ward 42 they had found patients in soiled bedding. The report also says that the matron`s 'Dignity in Care' audits, do not "seem to be detecting and correcting the deficiencies revealed by our findings.." The visitors also observed that "spills and drinks don`t appear to be cleaned up very quickly."
In the five key domain areas: 'communication and information', 'getting the right care at the right time', 'infection control', 'leadership and complaints', 'feeling well cared for', the hospital was given a 'RED RATING' which signifies serious concern about patient care.
Last May (2010), a significant number of people who attended the LINk event, made it clear that they had little confidence in the Board and the senior hospital management running Tameside Hospital and that improvements, were unlikely, unless there was change at the top. The report published by the LINk in September 2010, also stated: "There are very strong messages that some patients, their families and the public, have very little confidence in the current management at the hospital." And yet, despite this lack of confidence, the report authors stated somewhat bizarrely: "The LINk is more concerned with the care that people receive than with who manages the hospital." Presumably, this equally applies even when the management concerned, are incompetent, or a bunch of nincompoops. Surely, commonsense dictates that the standard and quality of care that people receive at an hospital is inextricably linked, with the type of management that is running it.
Since publishing its report last September, the LINk, now say that they believe that: "effective leadership at all levels within the hospital has a major role to play in both the outcomes the hospital achieves and the reputation it has in the community it serves." Peter Denton, the LINK co-ordinator, did tell the meeting that the health regulator 'Monitor' had said that the hospital management had lacked leadership and he referred to a recent ballot that had been undertaken by consultants, and senior medical staff, concerning a proposed vote of no confidence in hospital management. Hospital management were later criticised by Monitor, for failing to inform them about the ballot.
Addressing some of these concerns, the Rev Tim Presswood, the beleaguered Chairman of the Board at Tameside Hospital, said: "The report highlights some significant areas where the trust needs to improve." But he struggled to answer many of the questions from the floor. "I know we`re not the first hospital of patients choice" he told the meeting, but added: "We`re a hospital on a journey of continuing improvement.". He also told the meeting:
"We`re struggling to find patients who are willing to tell the Board about their stories."
When asked from the floor why he thought people were unwilling to talk to the Board, he said: "I can`t explain it." When asked how he could square on the one hand, the advice given by the hospital (in its patient handbook), that while in hospital patients should maintain cleanliness and reduce infection by keeping their hands and bodies clean, with the LINk report findings, of patients lying in soiled bedding, he said he couldn't square it. When asked what he was going to about it, he deftly avoided the question.
A spokesman for the hospital told the Manchester Evening News (MEN): "The findings of this report are somewhat at odds with the hundreds of letters our wards receive annually from people who have been happy with the care and treatment they have received."