Hospitals 'are medical factories'

Hospitals are medical factories which churn patients through without treating them with enough kindness and respect, a leading think-tank says.

The King's Fund said the problem is not so much with medical care, but the way patients are treated personally.

And it called for a re-think as it launched a series of trials aimed at revamping attitudes to patients.

It is a theme that featured heavily in the recent Darzi review of the NHS published during the summer.

Health minister Lord Darzi called for a more personalised health service in his report which was drawn up to coincide with the 60th anniversary of the NHS.

A FACTORY SERVICE?

• "I'm saying 'Who's the person that has the lead responsibility?' and they said they could not say that because it was a different person each day" - daughter of NHS patient
• "She was treated like a parcel. In one of her moves, she was taken by a porter in a wheelchair to the door of one ward. The nurse in charge came to the door and barred the way, telling the porter: 'You're not bringing her in here'. My mother felt anxious she would be lost inside the system" - patient's son
• "I used to dread the nights when agency staff were allocated to look after me. Not knowing me or much of my history, they would also tend to be inflexible and suspicious, doggedly insisting that I should be given drugs that I hadn't taken for days because ‘you're still written up for them on your chart'" - hospital patient

The government has responded by strengthening the emphasis placed on patient views in rating NHS trusts.

But the King's Fund report, based on an analysis of previous research and in-depth interviews with patients and staff, suggested it was much more complex.

The report, to launch its Point of Care programme, said that while recent surveys showed more than nine in 10 patients rated their care as good or better, many felt concerned about the lack of respect, dignity and kindness they were shown.

The King's Fund put this down to the "churn" of patients going through the system.

Hospital admissions have doubled in the past 25 years with the NHS seeing 30m people as outpatients, 13m as inpatients and more than 5m through A&E.

Jocelyn Cornwell, director of the Point of Care programme, said: "As with any large organisation, there is a lack of personalisation in the service being provided.

"Staff come to work intending to provide the quality of care they would want for themselves and their families.

"But today's hospitals are vast, time is at a premium and in these busy medical factories care of the person can unfortunately get squeezed out."

Problem

Joyce Robins, of Patient Concern, agreed there was a problem: "The NHS has become a conveyor belt. Patients are sent into hospital and then rushed out before they are ready."

To try to rectify the problem, the King's Fund is working with hospitals over the coming years to help change the way care is delivered.

London's Royal Free is piloting a US initiative known as Schwartz Center Rounds, where staff from all parts of the hospital come together for an hour each month to discuss the problems affecting care.

Meanwhile, Guy's and St Thomas' and King's College, two trusts which are also in London, will be trialling experience-based design which involves working groups of patients and staff helping to redesign services.

The think-tank will be monitoring progress and attempting to recruit more hospitals to take part.

But care services minister Phil Hope said steps were already being taken.

"In future, more NHS funding will also go to those hospitals and GPs where patients are most positive about their experience," he said.

"This will act as a strong incentive for everyone to perform to the standards of the best."

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