Lots of explanations are being offered for the scandalous treatment of frail, mainly elderly, patients, which has been exposed by the Care Quality Commission. But whatever the deeper issues of ageism, organisational culture or bureaucratic neglect, the proximate cause is easier to identify: absence of voice; most of these patients were neither able to demand decent treatment themselves nor did they have friends or relatives to make this demand on their behalf.
Arguably, therefore, the underlying cause is social isolation; too many people without anyone to fight for them. And, while changing cultures or reengineering bureaucracies may take a long time and ultimately be unsuccessful, surely there are relatively simple community-based ways of addressing the isolation of vulnerable patients.
My policy proposal would be that any patient in hospital for more than 48 hours who does not have at least one regularly visitor should as a matter of right be allocated a volunteer friend. Of course, it is not easy to recruit volunteers and there is no evidence of its getting any easier. So I suggest forming links between hospitals and school sixth forms and FE Colleges.
The hospital would provide the young people with a short course – it need not take more than a few hours – covering basic hospital procedures, the standards the hospital is committed to meet, and how best to know whether someone who may be unable to use conventional communication is comfortable or in distress. The pupils would then volunteer to be patient friends.
On a rota system they would be called up by the hospital to visit a patient –they might go on the way home from school. There are more sixth formers than elderly patients in hospitals so if most students signed up they would probably only be called on every few weeks, but they would be encouraged, once attached to a patient, to try to stick with visiting them until the end of their stay.
A simple password restricted on-line space would be created for the students to log any concerns they had which had not been met by staff on hand (the students could text from the bedside).
All the students who participated would get some kind of award showing they had done the course and delivered the service. Universities would commit to taking these awards into considering student applications for places.
I wonder if there is anyone out there interested in scoping such a scheme? If you are an RSA Fellow or can get a Fellow involved you could apply for a Catalyst grant.
If the idea is any good (and it may be pants for reasons that just haven’t yet occurred to me), then the indirect credit goes to Acland Burghley School.
I went there on Monday as part of a new Speakers for Schools initiative and was incredibly impressed by the sixth form group I spoke to (memo to Speakers for Schools: ‘the best part of your scheme may not be what the kids learn from the speakers, but what the speakers learn from the kids). These young people seemed to me to have the values, energy and the ambition to change the world. It just needs to be channelled.
Indeed, it wasn’t just the sixth form that impressed me. Acland Burghley is a great school. Its intake is diverse in every social sense but it manages to combine a really strong sense of community with very good and improving exam results. And for all of us trying to promote greater public sector collaboration how about this? The head teacher told me the school has successfully run combined post-16 provision with four other – quite different - schools for 30 years!
It’s only a pity that the school is in an increasingly decrepit building (it was as victim of the scrapping of BSF) and, as one of the those most unfashionable of institutions - a genuine and proud comprehensive community school - it won’t be expecting public plaudits from Government ministers any time soon.
Fabian Wallace-Stephens (Foresight Lead)
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