Page last updated at 05:02 GMT, Tuesday, 30 December 2008

Compassion 'key to good health care'

By Jane Dreaper
BBC News health correspondent

Amanda Platt
Amanda Platt is furious at her father-in-law's treatment

Amanda Platt still burns with indignation when she recalls her late father-in-law's dying days in the care of the NHS.

Aged 101, he was sent home from hospital on an hour-long journey in a taxi, wearing ill-fitting pyjamas.

After a five-day stay on a mixed ward, his clothes that were soiled with excrement were put in the same bag as his clean ones.

Salisbury Hospital in Wiltshire says it has apologised to the Platt family.

But Mrs Platt wept as she said: "You just don't do that to people. All he had left was his dignity.

"His hearing aid was squashed and his false teeth were lost. The teeth were brand new - he had insisted on having new ones and they had cost him a lot of money, but he didn't want to ever be seen without his teeth in.

"I was so furious. I think respect in that situation is the same as compassion."

War hero

Brigadier John Platt had led his men in a heroic assault across a river in Italy during the Second World War. He was awarded a Distinguished Service Order.

I felt they didn't acknowledge he was an old man of 101 who deserved respect
Amanda Platt
Mrs Platt added: "Everybody's got to die. He was obviously going to die and he wanted to die.

"It wasn't because he was a heavily decorated soldier - but I felt they didn't acknowledge he was an old man of 101 who deserved respect."

Salisbury District Hospital said: "Clearly some aspects of Brigadier Platt's discharge in 2006 were unacceptable and the Trust apologises for any distress that this caused the patient and his family.

"In apologising, the Trust also acknowledges the concerns raised about some of Brigadier Platt's personal effects.

"The Trust takes all complaints seriously so that it can learn from these experiences."

Deterioration

The head of the King's Fund think-tank has told the BBC he is convinced there has been a deterioration in the level of compassion that staff have shown patients in recent years.

Charlotte Wilkinson
When I was a cancer patient, I felt like I'd finally graduated from nursing school
Charlotte Wilkinson
Various projects in the NHS are trying to address this issue - especially since Lord Darzi's review emphasised the importance of quality in care.

In a simple exercise at one of London's busiest hospitals - the Royal Free - ward sisters are being encouraged to take 20 minutes to sit and observe what life is like for patients.

Caroline Cahill, from an acute medical ward for older people, has taken part.

She said: "It was interesting to sit and listen - to hear the noise levels and conversations.

"You realise it can be quite aggravating for a patient to sit in a chair and hear this stuff all day."

Other measures include special pegs or warning signs, so that a patient's privacy is maintained when curtains are drawn around a bed.

Burn out

The nurse running the Royal Free project, Mary Flatley, admits having experienced burnout several times in her career.

You shouldn't be there if you don't think the humanity of medicine is as important as the science
Sir Cyril Chantler
Retiring paediatrician
A particularly stressful time was when she returned to the wards after a spell in research and was in a busy area, constantly surrounded by death.

She said: "I came back into clinical work again in 2002 and found a very different health service - much more complex and faster.

"There were times when I felt I didn't get support, and that made me feel I was losing my compassion.

"Hospital work has changed dramatically over the past 25 years.

"I was a ward sister in the 1980s and at that time people were in hospital longer. Some patients used to even help on the ward by giving out the tea."

A nurse doing similar work at Barnet and Chase Farm hospital in north London, Charlotte Wilkinson, said: "When I was a cancer patient, I felt like I'd finally graduated from nursing school.

"It made me really appreciate the impact that small things can make on an experience in hospital."

At Great Ormond Street Hospital in London - where the country's sickest children are treated - the chairman, Sir Cyril Chantler, is retiring from the NHS after 45 years.

Experience as a patient

He has had a new heart valve fitted - and agrees with the theory that being a patient makes for a better doctor.

Sir Cyril, who was a paediatrician, said: "I'd have been a much better doctor, during my time as a doctor, if I'd been a patient a bit earlier in my life.

"You've got to like people to be a nurse or a doctor. Our job is to serve the patient.

"You shouldn't be there if you don't think the humanity of medicine is as important as the science.

"Vocation is an old-fasioned word but I believe it's still very important.

"In fact, my experience of interviewing large numbers of young people to go to medical school is that vocation is as alive and well now as it was when I qualified."

The government is developing measures to define quality in the NHS, and ideas about compassion will be included, though pilot schemes have not yet begun.

Privately, ministers say a change of culture is still needed in some parts of the health service.

Staff themselves believe compassion requires the basics to be in place - such as adequate staffing levels.

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