A STUDY into experiences at Stafford and Cannock Hospitals published today saw patient opinion divided on the quality of care they had receieved.
The survey by Staffordshire Healthwatch, which saw 141 patients interviewed about experiences between 1997 and 2013, saw 69 per cent reporting positive experiences, eight per cent mixed and 25 per cent negative experiences, with some reporting serious failings in the care they received and five reporting they were left in their own urine or faeces.
Positive themes of care focused on the hospital staff themselves with one patient saying: “The utmost patience, care, time and dignity were given to both myself and my husband." (2012)
One patient praised post-operative care staff’s skill and dedication while another said: “‘I am cared for, not simply treated, and I never feel like a number.” (2012)
A number of the patients surveyed said their lives had been saved by early diagnosis and quick testing and treatment.
One said: “They did every test which could possibly be done and couldn’t have been more thorough.” (2011)
Other frequently praised aspects of care included cleanliness and good communication.
“Despite bad news the message was delivered in a positive and supportive way,” (2011) said one patient.
One respondent said the reassurance of ongoing care and support at Stafford Hospital was an important aspect of their positive experience.
“If it wasn't for Stafford Hospital I can't begin to think what would have happened long-term to me." (2012)
Negative experiences of care, although significantly less – with only 25 per cent of respondents reporting bad experiences and 47 per cent of those historical complaints – were more complex and diverse, including some extreme cases and some patients experiencing failings in a number of areas, with one relative referring to “not just one thing but a whole catalogue of errors.”
26 patients of the 142 surveyed complained of being treated with a lack of dignity and respect, 22 said nurses were unresponsive to their immediate needs, 17 complained of rude staff, 15 of long-waiting times and cancelled appointments, 15 of a lack of hygiene and cleanliness, 13 of a lack of information or contradictory information given to patients, 12 complained nurses seemed understaffed, 12 of poor coordination between staff including lost medical notes and tests, eight of serious misdiagnosis or late diagnosis and six complaining of under qualified staff.
One respondent interviewed about the lack of dignity and respect her relative received said: “I believe they made her feel worthless and she gave up.” (2007)
Five people reported that they or their relatives were left in their own urine, some historical cases but one as recently as 2012.
Patients reported having to wait long times to be given pain relief or taken to the toilet, with some saying the problem was more likely to occur with night or agency staff.
One patient said: “I should have had my leg redressed three times a day but I was lucky to get it once,” (2012) while another called the agency staff ‘well-intentioned’ but said they ‘didn’t always know what they were doing’ adding “I had to show one member of the agency staff how to make a bed.” (2011)
One major concern highlighted by the report was the rudeness of staff ranging from simple impoliteness to reports of staff behaving in ‘a threatening and abusive manner’.
One patient said: “I was spoken to like a dog.” (2005)
Another said: “A nurse said she wouldn't take me to the toilet as she had ‘too much paperwork’. She said if you have an accident tell them I said that’.” (2012)
One patient told the survey: “When I asked for water I had cotton wool jammed in my mouth.” (2005)
Comparing the reported high standards of care with the extreme negative cases the survey says: “This could suggest that, although for the majority of respondents the standard of nursing care is high, that there are inconsistencies in nursing and a minority of extreme problems which were not adequately identified and addressed.”
One respondent who experience extremes of high and low care said: “I feel the issue is individual instances of nurses and not the hospital as a whole.” (no date available)
Hygiene, cleanliness, poor communication and poor coordination between medical staff were frequent criticisms from negative respondents as was a lack of information and contradictory information.
One patient said: “I saw five locums, all telling me different things. It was like being on a treadmill." (2012)
Another said “He had to be told that my mother was not diabetic by other patients.” (2004)
One respondent said his wife was not properly tested by medical staff.
“Being a retired critical care nurse, she could see the lump and asked to be seen again in three or six months.
“The doctor said no and kept reassuring her it was nothing,” he said. “18 months later it was cancer." (no date available)
The study makes a number of recommendations, including that Mid Staffordshire NHS Foundation Trust individually assess all the negative patient experience in the study should the respondent wish.
It also suggests a ‘mystery shopper’ scheme be considered on an ‘in-house peer to peer basis’ to help staff learn from one another, possibly identifying any inconsistencies in care and replicating those examples of high quality care identified.
Finally the report recommends implementing a number of measures suggested by the Francis report including that ‘Any expression of concern made by a patient should be treated as a complaint” (Francis 1.154), placing a consultant, senior clinician and nurse in charge of each patient’s care so patients and their families know who is in charge overall (Francis 1.211) and not discharging patients unless what is needed to continue their care is already in place (Francis 1.215).