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Older people's experience of emergency hospital readmission: research report
- Authors:
- LAWRIE Michael, BATTYE Fraser
- Publisher:
- Age UK
- Publication year:
- 2012
- Pagination:
- 41p.
- Place of publication:
- London
Reducing the occurrence of emergency hospital readmission (an unplanned readmission within 28 days of leaving) for older people is a key issue for the NHS. Over the past decade, rates of emergency hospital readmission have risen, particularly for those over the age of 75. The aim of this study was to investigate older people’s experience of emergency readmission to hospital. The study comprised: qualitative interviews with 18 older people who have experienced an emergency readmission (and in several cases their families); a brief review of key policy documents and research; and 4 semi-structured interviews with senior stakeholders. Interviewees were asked to share their experience, beginning from their first admission to hospital through to the discharge and return home, and then their experience of the readmission to hospital. The findings show that emergency hospital readmission is a complex issue with multiple potential causes which range across an individual’s care pathway. However there are particular challenges to be addressed in the transition between secondary and primary care, and ensuring that a personalised care package is put in place in the community. Implications for Age UK both at the local and national levels are discussed.
“Not just grapes and flowers”: older people's perspectives on the role and importance of hospital visiting
- Authors:
- GREEN Bert, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 13(2), 2012, pp.82-88.
- Publisher:
- Emerald
This paper presents findings from a service user controlled research project which sought to provide commentary by older people on their experiences as visitors to hospital or as patients receiving visitors. Nine focus groups were held with a total of 43 older people at 8 different locations in North Lancashire and South Cumbria. The participants were asked about their recent experience of hospital visiting and its value to them, given their individual circumstances and those prevailing at the hospitals. Full transcripts of digital recordings from the focus groups were analysed to identify particular concerns or vivid experiences. These were classified into the following common themes: getting there and back; on the ward; and the value of visiting. The findings suggest that visitors’ needs are not always being met. Recommendations are made that could improve hospital visiting for older people, and consequently their wellbeing, including: times and rules for visitors; the response they get from staff; the potential of older visitors to help improve the welfare of the older patient; and locating older people's wards.
‘To regulate and confirm inequality’? A regional history of geriatric hospitals under the English National Health Service, c.1948–c.1975
- Author:
- GORSKY Martin
- Journal article citation:
- Ageing and Society, 33(4), 2013, pp.598-625.
- Publisher:
- Cambridge University Press
The post-war history of hospital care for older people in Britain in the first phase of its National Health Service (NHS) emphasises a detrimental Poor Law legacy. This article presents a regional study, based on the South West of England, of the processes by which Victorian workhouses became the basis of geriatric hospital provision under the NHS. Its premise is that legislative and medical developments provided opportunities for local actors to discard the ‘legacy’, and their limited success in doing so requires explanation. Theoretical perspectives from the literature are introduced including political economy approaches; historical sociology of the medical profession; and path dependence. Analysis of resource allocation decisions shows a persistent tendency to disadvantage these institutions by comparison with acute care hospitals and services for mothers and children, although new ideas about geriatric medicine had some impact locally. Quantitative and qualitative data are used to examine policies towards organisation, staffing and infrastructural improvements, suggesting early momentum was not maintained. Explanations lie partly with national financial constraints and partly with the regional administrative arrangements following the NHS settlement which perpetuated existing divisions between agencies. (Publisher abstract)
Sexual assault of older people by hospital staff in England
- Author:
- WARBURTON-WYNN Amanda
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.54-56.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to highlight the findings of this research. A research paper was published in October 2021 highlighting results of freedom of information (FOI) requests sent to National Health Service (NHS) Trusts in England. The FOI requests asked for the number of incidents of sexual assault reported by hospitals where the victim was aged over 60 and the alleged perpetrator was a member of staff. Design/methodology/approach: The methodology involved sending FOI requests to all 206 NHS hospital Trusts in England requesting information on reported incidents of sexual assault against patients over 60 years old from 2016/17 to 20/21, where the alleged perpetrator was a member of staff (including agency staff). Along with the number of reports, the FOI request also asked for the sex of the victim and alleged perpetrator, whether the incident was reported to police, the outcome of the police investigation and whether any internal disciplinary processes were followed. Findings: Of the hospitals that responded with some data (others were nil return), 56 individual reports meeting the criteria of the FOI were identified. A further 19 hospitals advised that they held reports of such incidents but, under general data protection regulations, they were unable to disclose exact numbers, but they were less than 5, some hospitals said less than 10, so the research can only count one for each of these. The resulting findings are that there were at least 75 reports of sexual assault on patients over 60 by hospital staff in the past five years. The findings also show that whilst the majority of victims were female, 30% were male and that a disappointing number were reported to police - only 16. Of these, 14 were closed as "No Further Action" by the police. Originality/value: Whilst there has been some research into sexual violence against older people, most notably by Dr Hannah Bows, the issue of sexual assault happening whilst in hospital perpetrated by hospital staff has not been studied. (Edited publisher abstract)
Older people's experiences of dignity and nutrition during hospital stays: secondary data analysis using the Adult Inpatient Survey
- Authors:
- VIZARD Polly, BURCHARDT Tania
- Publisher:
- London School of Economics. Centre for Analysis of Social Exclusion
- Publication year:
- 2015
- Pagination:
- 210
- Place of publication:
- London
The report uses the Adult Inpatient Survey 2012 to build up an in-depth quantitative evidence base on older people’s experiences of dignity and nutrition during hospital stays in England. It shows that just under one-quarter of inpatients reported that they were not treated with dignity and respect, or were only sometimes treated with dignity and respect during their hospital stay. The analysis estimates that this is equivalent to around 2.8 million people on an annual basis - of whom about 1 million are aged 65 or over. Inconsistent and poor standards of help with eating during hospital stays were also a key concern. In 2012, about a quarter of all survey respondents indicated that they needed support with eating during their hospital stay. This is a substantial proportion and points towards the issue of support with eating being a major issue for significant numbers of inpatients – just under three and a half million each year - rather than being a marginal or specialist issue. Of those who needed help with eating, more than 1 in 3 reported that they only sometimes received enough help with eating from staff, or did not receive enough help from staff. Logistic regression analysis suggests that, after other factors are controlled for, the risk of not being helped with eating is significantly higher for women rather than men and for individuals who experience a longstanding limiting illness or disability such as deafness or blindness, a physical condition, a mental health condition or a learning difficulty, or a longstanding illness such as heart disease, stroke or cancer. Perceptions of inadequate nursing quantity and quality, and lack of choice of food, stand out as having consistent, large associations with lack of support with eating during hospital stays. The report concludes that there was a widespread and systematic pattern of inconsistent or poor standards of dignity and respect, and help with eating, in hospitals in England in 2012, and these were a significant general problem affecting inpatients in the vast majority of NHS acute hospital trusts (Edited publisher abstract)
Changes in falls prevention policies in hospital in England and Wales
- Authors:
- HEALEY Frances, TREML Jonathan
- Journal article citation:
- Age and Ageing, 42(1), 2013, pp.106-109.
- Publisher:
- Oxford University Press
Background: In 2007, the National Patient Safety Agency (NPSA) published ‘Slips trips and falls in hospital’ and ‘Using bedrails safely and effectively’. Objectives: This observational study aimed to identify changes in local policies in hospitals in England and Wales following these publications. Method: policies in place during 2006 and 2009 were requested from 50 randomly selected acute hospital trusts and their content was categorised by a single reviewer using defined criteria. Results: Thirty-seven trusts responded. Trusts with an inpatient falls prevention policy increased from 65 to 100%, the use of unreferenced numerical falls risk assessments reduced from 50 to 19%, and trusts with a bedrail policy increased from 49 to 89%. It was concerning to find that by 2009 advice on clinical checks after a fall was available in only 51% of trusts, and only 46% of trust policies included specific guidance on avoiding bedrail entrapment gaps. Conclusions: The observed changes in policy content were likely to have been influenced not only by the NPSA publications but also by contemporaneous publications from the Royal College of Physicians' National Audit of Falls and Bone Health, and the Medicines and Healthcare products Regulatory Agency. Most areas of local policy indicated substantial improvement, but further improvements are required. (Publisher abstract)
Person-centred dementia in acute settings
- Author:
- CHAMPION Elizabeth
- Journal article citation:
- Nursing Times, 110(37), 2014, pp.23-25.
- Publisher:
- Nursing Times
Introducing a dedicated dementia activities coordinator into an acute ward for older people improved patient care and reduced costs incurred in use of agency nurses. This article reports on the findings from a six-month pilot on an acute elderly care ward at Maidstone Hospital. The dedicated coordinator was able to provide activities that boosted patients' mobilisation also provided social and cognitive stimulation. The role also reduced the wards' reliance on agency staff to provide on-to-one care. Following the pilot the atmosphere on the ward had changed, staff morale improved, challenging behaviour on the ward has decreased and length of stay on the ward reduced. (Edited publisher abstract)
The Mid Staffordshire NHS Foundation Trust public inquiry: volume 2: analysis of evidence and lessons learned (part 2)
- Authors:
- FRANCIS Robert, chair
- Publisher:
- Stationery Office
- Publication year:
- 2013
- Pagination:
- 668p.
- Place of publication:
- London
Volume 2 of the final report of the Public Inquiry into the failings in the Mid Staffordshire NHS Foundation Trust. It builds on an earlier report, published in February 2010. The final report considers the evidence of over 250 witnesses and over a million pages of documentary material. The inquiry found a found a lack of care, compassion, humanity and leadership. This volume look at issues concerning the governance and culture of the Trust. There is then an examination of the role played by local scrutiny and patient and public involvement groups, the commissioners, the Strategic Health Authority, and the regulators with a view to establishing what went wrong, followed by a consideration of the involvement of other agencies.
The use of the Mental Capacity Act among hospital patients: findings from a case study of one Acute Hospital Trust in England
- Authors:
- PHAIR Lynne, MANTHORPE Jill
- Journal article citation:
- Journal of Adult Protection, 14(6), 2012, pp.259-270.
- Publisher:
- Emerald
This paper presents findings from a review of hospital policies and practices in one NHS Trust in England. The focus of the review was hospital staff policy and practice in safeguarding the rights of vulnerable patients. A sample of 42 staff members was surveyed to investigate their knowledge of the Mental Capacity Act 2005 in 2010. Analysis revealed limited confidence and knowledge about the Mental Capacity Act 2005 and uncertainties about its relevance to clinical practice. In relation to safeguarding, there was limited realisation of the potential of the Act to uphold the rights of patients lacking capacity and staff responsibilities. MCA training had not made a great impression; hospital policies were inconsistent and lacked coherence. The authors concluded that the findings of this case study may be applicable to other hospitals and to other providers of health and social care services. The relevance of the MCA could be highlighted and used on several induction and training programmes. The study identifies features of policy and practice that could be investigated in other organisations.
Homing in on improved care in the community
- Author:
- IMISON Candace
- Journal article citation:
- Health Service Journal, 20.9.12, 2012, pp.28-29.
- Publisher:
- Emap Healthcare
People over the age of 65 continue to experience high rates of emergency bed admissions. Often the admission is avoidable or the length of stay in hospital longer than necessary. Recent research from the King's Fund found a fourfold variation in emergency bed use by people over the age of 65. The article reports on the reasons for this variation and the lessons that can be learnt from Torbay, who now uses less emergency beds per head of the population (for people over 65) than anywhere else in England.