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An ongoing test

NHS care that would never pass the “friends and family test” continues to emerge.

That the Princess of Wales Hospital was in September 2013 the first institution in Wales to implement the test — an NHS England creation — is remarkable given that it is one of two hospitals in South Wales that have since been shown to be under-delivering.

An independent review of Princess of Wales Hospital and Neath Port Talbot Hospital, both part of Abertawe Bro Morgannwg University Health Board, was carried out between December 2013 and April 2014 at the request of Mark Drakeford, the minister for health and social services in the Welsh Government. Concerns about the care of elderly people at the hospitals had been brought to Drakeford’s attention.

Published earlier this month, the review report, entitled “Trusted to care”, describes variable or poor professional behaviour at the ABMU hospitals. Gaps in essential services, shortcomings in the culture of care and problems with clinical and managerial processes are among the issues reported by the review team, led by June Andrews, director of the Dementia Services Development Centre at the University of Stirling, and Mark Butler, director of The People Organisation.

But the picture is “more nuanced”, the authors impress, with examples of exemplary practice observed throughout both hospitals. They describe how their review took place within an environment of public scrutiny and media interest, particularly in the aftermath of the inquiry into standards of care at Mid Staffordshire NHS Foundation Trust, led by Robert Francis QC. The question was being asked: “Is ABMU ‘another Stafford’?”

Drakeford says in a written statement that the present situation “is not, and never has been, the same” as what happened at Mid-Staffs, in England, in the mid-to-late 2000s. ABMU has apologised to patients, families and carers and accepted the findings and recommendations in full, which are surely positive first steps. Andrews and Butler make clear in their report that this “is not ‘another Stafford’”, a point emphasised by the health board.

ABMU pharmacists’ awareness of poor medication practices is described in the report. The Journal believes it is essential that pharmacy teams — indeed all clinicians and support staff at ABMU — are given appropriate support to make the changes to culture and processes necessary to implement the report’s recommendations, which include the introduction of 24/7 pharmacy services. This backing needs to come from managers of the health board at all levels, from the Welsh Government, from regulators, from professional organisations.

These latest revelations should serve as a reminder for all clinicians, irrespective of their country or sector of work, that standards in care can and do slip. Recommendations to address quality and organisational culture are aplenty. It seems that turning these into care acceptable to patients, and their friends and family, is the ongoing test.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138524

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