No-one could fail to be moved by the accounts given in “Dying Without Dignity” the report on the end of life care just published by the Parliamentary and Health Service Ombudsman. It is a sad reflection of the very patchy nature of the NHS. In some cases, it seems, end of life care epitomises the dehumanisation of health care. The emphasis on process rather than compassion is very clear from the case studies. In one of them, Mrs N is quoted and her complaint is familiar
“I needed someone to say “right, let’s get together in the same room, and here’s the plan, we will all work together so that we can help Mr N”, but no one thought that it was necessary to do that. They were all interested in their own “bit” and not the person in the middle of it.”
The report identifies key themes:
- Not responding to people’s needs
- Poor symptom control
- Poor communication
- Inadequate out of hours service
- Poor care planning and delays in diagnosis and referrals for treatment
All of these issues are illustrated with case studies. It makes for painful reading.
When confronted with these key themes I am left thinking that they actually summarise well the short comings that I, as a clinical negligence lawyer, encounter on a daily basis. This list may not be a completely comprehensive “how not to” list but it is certainly a good start.
Does this mean that the problems identified by the Ombudsman with end of life care is simply an extreme version of the problems that the NHS have to tackle across the range of all treatment? I think it is.
The way that we treat the elderly and dying as a society reflects the way that we treat all vulnerable members of society. If the NHS really devotes resources to tackle the issues identified in this report and succeeds in overcoming the problems it would be a significant step towards not only improving care for the dying but care for all. Assuming the NHS follows its own promise of sharing all positive learning from its own mistakes that could translate into the NHS becoming an organisation that treats everyone with more dignity.