'Critical' Hospital Ward Rounds Neglected

Hospital staff are being stretched so thin that critical ward rounds are being neglected, leading clinicians have said.

Fewer members of staff, tighter budgets and a rising tide of admissions have led to a deterioration of ward rounds in hospitals, the Royal College of Physicians (RCP) and the Royal College of Nursing (RCN) said.

The quality of rounds must improve to ensure that patients are seen as people and not conditions, they said.

Ward rounds are "critical" to patient care and should not be curtailed by hospital managers, they added.

The Colleges said there has been a gradual erosion of "good ward rounds" and have launched new guidance to ensure that there is a standard of practice across all hospitals.

Dr Mark Temple, acute care fellow at the RCP's Medical Workforce Unit, said: "Hospitals are under more pressure now than they have been in a very long time. There are huge pressures in terms of staffing, in terms of a rising tide of inpatients and emergency admissions and particularly the financial constraints on the NHS at the moment.

"There is a danger that busy clinical staff have become too task orientated and less patient orientated in relation to the tasks that they are doing.

"If you are a manager in a distant part of the hospital you may see a ward round as something that could be shortened and may not be able to measure the value of it compared to activity going through an outpatient department."

Dr Linda Patterson, clinical vice president of the RCP, added: "We have heard from patients that care can be fragmented and not holistic.

"Despite being a key component of daily hospital activity, ward rounds have been a neglected part of the planning and organisation of patient care.

"There are no national guidelines or templates on how to run a ward round, there is still considerable variation across hospitals.

One of the recommendations set out by the Colleges is to ensure that a nurse participates in each ward round.

The Colleges also said that patients should be given a clear summary after each ward round, the multidisciplinary teams should use check lists to ensure that they have not missed anything and that patients records should be kept centrally to avoid errors.