Poor ward care is harming patients, warns a senior doctor in this week's BMJ.

Recent figures show that three of the four commonest causes of delayed discharge are associated with inadequate care on the ward: pressure sores, healthcare acquired infections, and medication errors.

This crisis is the result of lack of trained staff, lack of continuity of care, and poor leadership, and it is directly harming patients, argues consultant anaesthetist, Katherine Teale.

Common complaints include never seeing a nurse except when drugs are being handed out, days going by without any contact with senior medical staff, having to virtually beg for help moving up the bed or getting to the toilet, and repeated requests for pain relief.

It's these experiences, and not the skilful surgery, that patients remember and tell their friends about. And it's these that make patients, especially elderly patients, dread being in hospital, she says.

It's easy to blame the nurses, but we doctors have to take our share of the responsibility, she adds. If the senior medical staff are rarely on the ward seeing what goes on, if they don't act as role models for their trainees, and don't make themselves available to support the nursing team then patient care suffers.

Ward care is just as important as complex surgery and can be just as difficult but unfortunately it is not so glamorous, nor is it appreciated by peers. This is tragic, not only for the patients but also for the future of the hospital.

"It's madness to spend thousands of pounds on fancy surgery if the patients are then allowed to develop avoidable complications," she concludes.

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Contact: Emma Dickinson
edickinson@bmj.com
44-020-738-36529
BMJ-British Medical Journal
11-Jan-2007