Hospitals still don't do enough for patients' privacy and dignity
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《英国医生杂志》
Care in hospitals in England and Wales has improved significantly over the past four years, but the quality of service received by patients still depends too much on where they live, the Commission for Health Improvement (CHI) has said in a report.
The report says that hospital care is now more focused on the needs of patients and that progress has been made in reducing waiting times in emergency departments and for outpatient appointments.
"Significant improvements have been made in hospital trusts in the four years since CHI began reviewing the services they provide," the commission抯 acting chief executive, Jocelyn Cornwell, said in a statement. "Trusts are taking the involvement of patients more seriously and we are more regularly seeing care being organised around the needs of patients, rather than around the convenience of the NHS."
But in some areas that really matter to patients, such as safety, cleanliness, privacy, and dignity, there is still disparity between trusts, she said. "We are most concerned that there is still too much variation in the care provided within hospitals and across hospitals, depending on where a patient gets treated."
More trusts than previously have a three star rating, but the number of trusts with zero stars has also increased, Dr Cornwell added. "Not enough is being done to ensure patients have privacy and are treated with dignity, and some services are of an unacceptable quality."
The report also says that there is an urgent need to address a lack of clinical leadership in acute trusts and to tackle continuing problems with the accuracy and quality of data.
Furthermore, the commission says that the health service needs to concentrate on redesigning its services with quality in mind. "Performance targets have driven improvements to care but should not replace local response to patients?needs," Dr Cornwell said.
The commission抯 report drew on assessments of acute services, including the more than 300 clinical governance reviews it has conducted since December 2000. It is also based on information about progress on related action plans, investigations into service failures, reviews of progress on national service frameworks, the national patient survey programme in England, and performance ratings.
The Tory shadow secretary of state for health, Andrew Lansley, said the improvements noted by the report were due to "the dedication of hard working NHS staff . . . rather than this meddling government."
"The report is hugely revealing, showing how little progress has been made in areas that we were led to believe were in hand," he said. "Although the government had assured us that mixed sex wards were a thing of the past, they, and unassigned toilets, were found in around a sixth of all acute trusts."
This report is one of the last that the commission will make before it is incorporated into the new Commission for Healthcare Audit and Inspection at the end of March. The new body will also replace the National Care Standards Commission (in respect of private and voluntary health care) and some functions of the Audit Commission relating to national studies of efficiency, effectiveness, and economy of health care.(London Stephen Pincock)
The report says that hospital care is now more focused on the needs of patients and that progress has been made in reducing waiting times in emergency departments and for outpatient appointments.
"Significant improvements have been made in hospital trusts in the four years since CHI began reviewing the services they provide," the commission抯 acting chief executive, Jocelyn Cornwell, said in a statement. "Trusts are taking the involvement of patients more seriously and we are more regularly seeing care being organised around the needs of patients, rather than around the convenience of the NHS."
But in some areas that really matter to patients, such as safety, cleanliness, privacy, and dignity, there is still disparity between trusts, she said. "We are most concerned that there is still too much variation in the care provided within hospitals and across hospitals, depending on where a patient gets treated."
More trusts than previously have a three star rating, but the number of trusts with zero stars has also increased, Dr Cornwell added. "Not enough is being done to ensure patients have privacy and are treated with dignity, and some services are of an unacceptable quality."
The report also says that there is an urgent need to address a lack of clinical leadership in acute trusts and to tackle continuing problems with the accuracy and quality of data.
Furthermore, the commission says that the health service needs to concentrate on redesigning its services with quality in mind. "Performance targets have driven improvements to care but should not replace local response to patients?needs," Dr Cornwell said.
The commission抯 report drew on assessments of acute services, including the more than 300 clinical governance reviews it has conducted since December 2000. It is also based on information about progress on related action plans, investigations into service failures, reviews of progress on national service frameworks, the national patient survey programme in England, and performance ratings.
The Tory shadow secretary of state for health, Andrew Lansley, said the improvements noted by the report were due to "the dedication of hard working NHS staff . . . rather than this meddling government."
"The report is hugely revealing, showing how little progress has been made in areas that we were led to believe were in hand," he said. "Although the government had assured us that mixed sex wards were a thing of the past, they, and unassigned toilets, were found in around a sixth of all acute trusts."
This report is one of the last that the commission will make before it is incorporated into the new Commission for Healthcare Audit and Inspection at the end of March. The new body will also replace the National Care Standards Commission (in respect of private and voluntary health care) and some functions of the Audit Commission relating to national studies of efficiency, effectiveness, and economy of health care.(London Stephen Pincock)