Alone we can do so little; together we achieve so much!

Older people deserve better care. A Dignified Revolution is a group of individuals, the majority of whom are nurses, who want to improve the care of older people in hospital. It was launched in January 2008. The impetus to establish the initiative was driven by:

• the distress that these individuals had experienced because of the poor care that their relatives had received whilst in hospital, and their concern that others might find themselves in the same situation
• the realisation that the lack of dignity and respect that older people tolerate when in hospital is not a recent phenomenon. The issue was first publicised in 1997. Ten years on, despite extensive media attention and numerous reports and guidance from government, little has changed

Many nurses provide outstanding care. However, the attitude and behaviour of other nurses when caring for vulnerable older people does not reflect the duty of care that they have towards their patients.

The experience of many of us involved in A Dignified Revolution is that:

• many nurses do not consider that basic nursing care is part of their role. Instead, they consider it is the role of the healthcare assistant
• the public do not appear to be aware that registered nurses are responsible for the supervision and care actions of support workers. They have a duty of care to the patient regardless of who provides the basic nursing care and this duty of care makes them accountable in law
• doctors are seen to be more supportive and caring than nurses
• many of the poor experiences being shared are being reported by health professionals who work in various parts of the NHS. The system seems to inhibit them challenging practices which are demeaning their professions

A Dignified Revolution is calling for the NHS to:

• train all their staff in dignity and respect
• train their staff to communicate effectively with older people
• invest in independent advocacy services for older people and their relatives. This is particularly important for those involved in continuing care assessments
• develop an independent mystery visitor service to audit practice at ward level
• provide patient support services in all hospitals and ensure that patients and relatives know how to access them
• involve service users in hospital staff induction programmes so that staff are educated in what the public expects

The deep-rooted and negative attitudes of professionals must change. Older people are the core users of NHS hospitals. Those aged over 65 account for around 60% of admissions and 70% of bed days in general hospitals. By 2025, the number of people over the age of 65 will have increased by 50% and the number over 80 by 80%, with corresponding increases in physical impairment, dependency or multiple long term conditions.

We would all do well to take heed of the Bombay Hospital motto that has been adapted from a quotation made by Mahatma Gandhi. It reminds us that:

A patient is the most important person in our hospital. He is not an interruption to our work; he is the purpose of it. He is not an outsider in our hospital; he is a part of it. We are not doing a favour by serving him; he is doing us a favour by giving us an opportunity to do so

Does your local hospital pass the Gandhi challenge?

A Dignified Revolution produces a monthly update. If you would like to receive this or more information about our campaign please email: info@dignifiedrevolution.org.uk or contact Monica Dennis on 07811 159800

Presentation at SHA Conference June 2008

Writing Guide - how to record concerns in a way which will be useful

Dignified Revolution leaflet - ready to be printed

Compassion in healthcare: The missing dimension of healthcare reform?

Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care

Nurses to be rated on compassion

A true story of a patient with no choice

Dignified Revolution homepage