Human Rights Of Patients Need To Be Improved - Report

Over 100 findings and 26 recommendations into emergency healthcare in Northern Ireland have been made to improve the human rights of patients, families, carers and staff, following a report published by the NI Human Rights Commission (NIHRC).

Chief Commissioner Les Allamby said: "With around 700,000 visits each year to emergency departments in Northern Ireland this is an issue which touches almost everyone’s life. Public participation was at the centre of this Inquiry and throughout we heard from patients, families, staff, management and the Department.

"The Commission considered quality, accountability and governance of the service. We visited emergency departments throughout Northern Ireland during the day and night. We heard from dedicated staff striving to maintain patient dignity in an often challenging and crowded environment. In such circumstances there were reported instances where patients did not receive assistance with personal care needs, no pain relief, and no access to food and fluids. Of particular concern were cases involving end of life care, the inappropriate transfer of older patients from nursing homes and the experiences of those presenting to A&E in mental health crisis, with dementia or disabilities.

"The Commission heard individual cases which amounted to inhuman and degrading treatment but, did not discover evidence of systemic violations of human rights. The importance of human rights are most obvious when we are at our most vulnerable. The right to the highest attainable standard of health is a standard that must be strived for and the respect for dignity and other human rights principles must be adhered to."

Inquiry Key Findings include:

• There were reported instances where assistance with personal care needs was not provided, no pain relief, and no access to food and fluids for patients.

• While interactions with staff were often reported to have been positive, person-centred care was, at times, undermined by a perceived disregard, lack of attention or kindness from health professionals.

• Concerns were raised about the practice of older persons, particularly those with dementia, being transferred alone at night in taxis.

• A lack of physical provision for blind and partially sighted persons. A lack of buzzers and braille information, made Emergency Departments difficult to navigate. The online version of the 10,000 voices survey was not accessible to blind and partially sighted persons.

• A number of patients, staff and community and voluntary sector organisations expressed concerns about the lack of privacy for persons experiencing mental health crisis, such as self-harm and attempted suicide, presenting to Emergency Departments. The PSNI identified that 21% of all persons reported missing were from hospitals and predominantly Emergency Departments.

• The 'Card Before You Leave' scheme which instructs that a patient presenting with mental health crisis is given a written appointment with specialists before leaving ED was regarded as critical. Concerns were raised, however, about inconsistencies in its implementation.

• The Inquiry learned that £25 million of the funding assigned to Transforming Your Care (TYC) has been spent on resettlement of long term patients with mental health and learning disability patients into the community. This is an important issue to be tackled, but, was not what the TYC transition fundings were designed to achieve. In effect, the TYC proposals have been parked and emergency care departments have continued to struggle to meet the demands placed on them. The Commission recommends that the Department should urgently revise and implement Transforming Your Care.