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Leaders in the health and social care sector must drive a "major cultural shift" to tackle the underlying causes of poor and undignified care of older people throughout care homes and hospitals in England. 

That is the main message contained in 'Delivering Dignity', the final report from the Commission on Improving Dignity in Care for Older People, an independent group set up by the NHS Confederation, Age UK and the Local Government Association (LGA). The report received widespread support following a month-long consultation with feedback from over 230 health and social care organisations, patient groups and individuals across the country. 

The NHS already has ‘never events',  things that are considered so serious they should never happen, like operating on the wrong part of the body. The commission recommend a number of 'always events',  things which it says should never be forgotten and should be considered as basic rules for the delivery of dignified care in every hospital and care home. These include introducing formal and informal feedback from older people and their carers to improve practice. 

The commission also urges the Government to ensure that every person receiving care is protected under human rights legislation. Currently only those people whose care home place is arranged by their local authority are granted this protection. 

The commission will now promote its recommendations, which have resonated with NHS and care home leaders, to encourage change in the way the system designs and delivers care for older people. 

A copy of the final report will be sent to every NHS and care home chief executive in England. 

A joint action plan from the three organisations will follow the report later in the year. It will provide practical solutions to the recommendations to help support NHS and care home leaders and to encourage change in the way the system designs and delivers care for older people. 

In a joint foreword to the report, the commission co-chairs, from Age UK, NHS Confederation and the Local Government Association say: 

"We set up the commission because older people and their loved ones deserve so much better. 

"Delivering dignity will mean changing the way we design, pay for, deliver and monitor care services as the numbers of older people in care continues to grow. Alongside the consistent application of good practice and the rooting out of poor care, we need a major cultural shift in the way the system thinks about dignity, to ensure care is person-centred and not task-focused. 

"This will require empowered leadership on the ward and in the care home, as well as a lead from boards and senior managers. It will also mean changing the way we recruit and develop staff working with older people. 

"We have to work with older people to shape services around their needs, and listen to patients and residents and their families, carers and advocates so we learn from their feedback and continually improve dignity in care." 

Other recommendations include an evaluation of the way staff assess patients' needs to allow adequate time to understand and record preferences of older people. 

The report also recommends commissioners, providers and regulators use new NICE quality standards for patient experience in NHS adults services to help provide a consistent approach when defining and measuring the care provided to patients. 

A copy of the report can be found on the NHS Confederation website: 
NHS Confederation

 Notes to editors 

1. The commission aims to complement the work of the public inquiry regarding Mid-Staffordshire NHS Foundation Trust. The public inquiry's terms of reference focus on regulatory and supervisory issues where as the commission has focused on organisations providing and commissioning care.

2. The commissioners are:

Sir Keith Pearson JP DL, Chair, NHS Confederation (co-chair)

Dianne Jeffrey CBE DL, Chair, Age UK  (co-chair)

Councillor David Rogers OBE, Chair of the LGA's Community Wellbeing Board (co-chair)

Hugo Mascie-Taylor, medical director, NHS Confederation

Lise Llewellyn, Chief Executive, NHS Berkshire East

Professor Heather Tierney-Moore OBE, Chief Executive at Lancashire Care NHS Foundation Trust

Jenny Owen CBE, Deputy Chief Executive/Executive Director Adults Health and Community Wellbeing, Essex County Council

Martin Green, Chief Executive, English Community Care Association (ECCA)

Professor Trish Morris-Thompson, Chief Nurse, NHS London

Dr Elizabeth Kendrick, GPwSI Older people and Chair End of Life Clinical Innovation Team NHS North East, County Durham & Darlington NHS Foundation Trust

Gillian Buck, service user representative

Catherine Westcott, service user representative

 3. Further information on the commission can be found on the NHS Confederation website: NHS Confederation

 4. The NHS Confederation represents all organisations that commission and provide NHS services. It is the only membership body to bring together and speak on behalf of the whole of the NHS. We help the NHS to guarantee high standards of care for patients and best value for taxpayers by representing our members and working together with our health and social care partners. We make sense of the whole health system, influence health policy and deliver industry-wide support functions for the NHS.

 5. Age UK is the new force combining Age Concern and Help the Aged, dedicated to improving later life. We provide free information, advice and support to over six million people; commercial products and services to well over one million customers; and research and campaign on the issues that matter to people in later life. Our work focuses on five key areas: money matters, health and wellbeing, home and care, work and training and leisure and lifestyle. We work with our national partners, Age Scotland, Age Cymru and Age NI (together the Age UK Family), our local Age UK partners in and local Age Concerns. We also work internationally for people in later life as a member of the DEC and with our sister charity Help Age International.

 6. The Local Government Association is made up of six organisations that work together to support, promote and improve local government. These are Local Government Leadership; Local Government Association; Local Government Improvement & Development, Local Government Employers, Local Government Regulation and Local Partnerships.

 7. Contact Francesca Reville: Telephone: 020 7074 3312 (NHS Confederation); Cherie Willers: Telephone: 0207 664 3120 (LGA); or Natalie Owen: Telephone: 0203 033 1438 (Age UK)  For out-of-hours media enquiries, please call the NHS Confederation duty press officer on Telephone: 07880 500726.