Many of the findings of the Care Quality Commission’s recent report, Dignity and Nutrition inspection programme, are shocking: 20 % of hospitals were non-compliant with legal standards, with a further 35% showing evidence of real concern. One in eight (12%) of inspected hospitals failed to meet standards in respecting and involving service users.

These failures included not respecting patients’ privacy and dignity, and putting call bells out of reach or not responding to them in a reasonable time. Most importantly from an advocacy point of view, 5% failed to involve patients’ views and preferences in their care. Poor communication included being talked about and across rather than being talked to, poor information provision to patients and their families, and even instances of condescension and dismissiveness. Shocking as these findings are, they nonetheless come as no surprise to Older People's Advocacy Alliance.

Our 2006 report, Dignity on the Ward, produced in partnership with the then Help the Aged (now Age UK), sets out in detail what advocacy can bring to the hospital setting, the various ways in which it can be implemented, and why it is so important to do so. The authors visited and interviewed management committee members, officers and volunteers – including older people – involved in the running of 14 advocacy schemes working within hospital settings. The discrimination highlighted by the CQC’s findings is reflected in the barriers, problems and pitfalls that face patients and their families every day:

Older people are discriminated against at an individual and institutional level. This can mean that they are denied access to health care on the basis of chronological age rather than individual assessment, that they receive a ‘second-class’ service and, perhaps most insidiously, that the expectations of older people themselves are lower.

Our report’s recommendations for future development include:

In the spirit of this last point, OPAAL would welcome an opportunity to meet with the Secretary of State and Care Quality Commission to discuss plans for involving Independent Advocacy Support to all older people being admitted to hospital.