Essence of Care

Essence of care is a department of health initiative which provides guidance on standards of care which should be delivered to patients. The standards include:

  • Communication
  • Nutrition
  • Privacy and dignity
  • Record keeping

Since beginning the campaign, we have been swamped with calls from people with relatives in hospital, some in tears for fear of their relative’s welfare, all these people reporting the same problem. Neglect.

A similar theme too, is the response from the hospital to each of these complaints – often something along the lines of “Issues are being addressed as part of the Essence of Care benchmarking”.


Time and time again we witnessed staff who didn’t communicate with the patients. They didn’t seem to care if some patients go better they never asked “how are you feeling” or even “hello”. Meal trays would be placed and returned unopened without the patient ever knowing she could eat. Patients were often washed in silence apart from their protestations when their hair had been caught or they had been knocked when being hauled into the chair. When two staff was needed they would chatter above the patient to each other (usually ward politics). This happened one day whilst a patient was being sick. She’d been really poorly all night and on waking and being got up she was violently sick. It was terrible I have a really queasy stomach for vomit and felt terrible too. I’d had no sleep myself and felt really groggy. The staff continued with their conversation after passing the poor patient a bowl. They then left her, the bowl full of vomit, chair bound. Off they hurried to the next room to carry on with dragging older people out of their beds and making the bed. If they had one aim it was to make the beds by a certain time to some, it was their priority for the day.

Some of the nurses on the ward were the opposite. Their priority was to care, the Florence Nightingale School of nursing. After eight weeks on the ward we met all the staff and I can assure you there was a lot of very poorly trained and uncaring staff in that hospital. You could tell there had been several staff members who had once cared, but they had given up. Others didn’t give a damn they took their moods out on patients and it was common to hear certain staff shouting at elderly confused patients. I wasn’t sure if they knew other people could hear them, or if they didn’t care. What was evident was that communication was a real problem.


I cannot begin to tell you how often patients went without meals and were denied fluids, in those eight weeks. If patients needed feeding, they weren’t. Relatives helped, but the staff who cared enough to help feed, were often too busy. Intravenous fluid lines were left for hours and hours without being replaced. My Mother amongst others, waited hours for lines as the procedure or should I say palaver to get intravenous fluids administered was farcical at times. I haven’t the energy to expand on this, but let’s just say a hospital manager and a light bulb come to mind.

Privacy and Dignity

During our stay confused patients wandered the ward exposed. The poor souls were oblivious to it. Staff, sometimes senior staff, passed them in the corridor unbothered.

Patients rang for 30-40 minutes for toileting, they often had an accident and apologised. Some staff told them not to be so daft, a few apologised for being so long (the nightingales), and others ignored rushing them back to bed. On some occasions patients were returned back to a wet bed and you could then hear them moan and repress the buzzer, for another 40 minutes wait. I never quite understood this, as the staff then had to return and make the bed. I suppose some particularly the confused elderly slept in the soiled bed not bothering to disturb them again. I dread disturbing some staff and often tried to distract Mum to wait a little longer. Another patient, her daughter, Abi, and I often helped to toilet a couple of the other patients on the ward. You couldn’t not, before we helped out they would often end up on the floor and it was only a matter of time before they hurt themselves. We would try to distract them, but it often didn’t work and you had to help.

Record Keeping

I’m not sure how they intend to improve on record keeping. I would like an improvement in the truth of their record keeping. When a complaint is made there is an investigation and honest and accurate records are used and not altered to distort evidence.

I’m not quite sure what the response I received means. It certainly hasn’t helped the poor souls who are now on the ward as I have had relatives on the phone in tears. I believe it means nothing; senior members of staff are aware of the poor standards and have done nothing. Letters I have received tell me that other people have reported the same things to senior staff for months and nothing has yet been done.

We can do nothing alone but together I believe we can help to improve the care of our older members of Staffordshire.