OVER the past few weeks, has been asked by some constituents to investigate the standard of care their elderly relatives received at Maidstone Hospital.

She was so concerned by what she was told, she contacted the Kent Messenger. In a special report, she explains those concerns and , director of nursing at the hospital, responds.

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'Why I must speak out about a fall in standards'

by Ann Widdecombe

I DO not wish to be alarmist but my confidence in the standard of care being offered by Maidstone Hospital to elderly patients has declined to the point where I feel obliged to urge those who have elderly relatives there to be alert and, if they have any misgivings at all, to pass them on not merely to the medical staff but also, always and automatically, to PALS (Patient Advisory Liaison Service).

It hurts to write this as I have always had a terrific relationship with Maidstone Hospital but the welfare of my constituents is paramount.

The last Conservative Government undertook what was then the biggest capital building programme in the history of the NHS and new hospitals sprang up everywhere. Maidstone was one of those and when I became the MP in 1987 it was still only a few years old.

Since then it has expanded to include oncology and again for ophthalmology. It has more consultants and nurses and equipment than ever.

In the late Eighties I was proud to join a nurses’ demonstration from Maidstone to Westminster to campaign for more money.

Each Christmas I visit the hospital and hardly ever hear a bad word from the patients about the care they have received. Even now I am fighting hard to keep services at Maidstone which the trust wants to move to Tunbridge Wells.

Yet I cannot avoid the increase in correspondence complaining about the care of the elderly and also the absence of hygiene.

In one case a de-hydrated patient was left with an empty drip. Food is brought in on trays and removed again without any attempt to record what has actually been consumed meaning that families are not given accurate information when they enquire and old folks can become dangerously undernourished.

In another incident an elderly man with Clostridium Difficile phoned his brother to say he was sitting in his own diarrhoea and wished he were dead.

Complaints abound: requests for assistance are not answered, relatives clear up mess, bowls of blood lie around unremoved. One complainant even sent me a video.

Younger patients cope. They make their voices heard. The elderly and confused do not notice empty drips or remember what they have or have not eaten. They are hugely vulnerable.

Why on earth is it happening? The answer is a complete collapse of authority, line management and responsibility, especially among the nurses.

Our hospitals are full of people with clip boards ticking boxes and devising action plans but nobody bosses, disciplines or sacks. Matron no longer exists. Oh, certainly, we have "modern matrons" but they lack the authority of the old style ones.

Ward Sister needs to understand that the standards of everyone beneath her are her direct responsibility. She needs to know not only that everyone is doing his or her job but also how well it is being done.

Ward Sister should be asking "what did Mrs X eat today and how much?" Ward Sister should notice the empty drip. Ward Sister should be demanding "why is that elderly gentleman sitting in his own mess?"

Because if her nurses knew she was checking up on them every five minutes they would do their own job far more conscientiously, and especially if the disciplinary procedure was less cumbersome and they knew they would be held to account. No amount of government money is a substitute for that.

Of course it might help if nurses had greater clarity about the role they play. We demand A-levels and then wonder why they are not content with the traditional roles of bedwashes, wiping backsides, cleaning up sick and fetching cups of tea.

The modern culture of excessive egalitarianism and employee rights - centred employment law has drained the NHS of the order and discipline which once made it great. No wonder so many of my constituents scrimp and save to afford the private sector. It is not snobbery which drives them but fear.

Florence Nightingale must be turning in her grave.

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'I'll investigate any claims'

by Bernard Place

THE vast majority of the 40,000 plus patients admitted to hospital in Maidstone and Tunbridge Wells each year are well cared for and go home having had a good experience thanks to the efforts of our dedicated staff.

If standards dip below what we all expect to see, however, we will take swift action to ensure any improvements that need to be made are made straightaway.

I would personally welcome the opportunity to hear from elderly patients and their relatives about their experiences, good and bad.

I will also personally investigate any claims where a named member of staff has failed to provide proper standards of care, and take any necessary action.

We have met with and written back to Ms Widdecombe outlining some of the further improvements we are making to ensure all of our elderly patients consistently receive the very best care possible.

These include:

* Running a mandatory development programme for ward managers that focuses on the quality of patient experience, emphasising the kinds of issues Ms Widdecombe has described.

* Developing an internal 'turnaround team' of Senior Nurses to visit wards and review both the standards of care and attitude and culture they observe. Action will be taken where shortcomings are found.

* Introducing a new monitoring system where ward sisters and senior nurses are required to publicly account for the standards of care on their wards.

* Sharing ward structures and daily routines with patients and holding ward managers to account for sticking to these regimes. To help fight both infection and to enable more direct patient care work to be done visiting hours will be reduced to a more traditional restricted schedule.

* Hospital site matrons freed up to work more on improving the experience of patients and the cleanliness of the hospital environment.