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Dignity - standards and guidance

Dignity appears both as a principle in codes of conduct and in standards of care from the departments of health across the United Kingdom. This listing identifies the documents where these principles appear.
See also the RCN Older people resource, in particular Older people: standards and guidance

Some of the resources below are in PDF format - see how to access PDF files.

UK

Help the Aged: Dignity on the ward pocket guides
These pocket guides, which originated  from a campaign run by Help the Aged in 1999-2001, were developed by Help the Aged with the Royal College of Nursing. Help the Aged has now combined with Age Concern to form Age UK. These editions were published in 2008:

Nursing and Midwifery Council (2009) Guidance for the care of older people (PDF 662KB)
This guidance is aimed at working nurses and can be used by employers as a benchmark for delivery. It focuses on people, process and place underlining that the process element involves "delivering quality care which promotes dignity by nurturing and supporting the older person's self-respect and self-worth". Throughout the guidance there are cross references to the NMC professional code for nurses and midwives. There is also a leaflet for older people and carers describing what they can expect from nurses and how to challenge poor care. View: Care and respect every time (PDF 210KB)

Social Care Institute for Excellence (2006; last updated 2010): SCIE Guide 15: Dignity in care
The updated guide offers simple, practical tips for managers and frontline staff, as well as updated and expanded examples of what other services are doing to improve dignity in care. Key topics covered include: communication; personal hygiene; eating and nutritional care; practical assistance; privacy; pain management and specialist care including end of life care and mental health care.

Social Care Institute for Excellence: Managing risk, minimising restraint: challenges, dilemmas and positive approaches for working with older people in care homes
Freely available e-learning resources developed by the SCIE aimed in particular at staff working in care homes for older people. The resources include audio, video and interactive technology.

SCIE: Stand up for dignity - legislation
This guide offers a brief introduction to the legislation which supports the rights of people to dignity and respect when using health and social care services. The guide has now been updated to include all recent changes to the law relating to dignity.

England

Care Quality Commission: Essential standards of quality and safety
The guidance provides detailed outcomes for each standard and prompts which indicate what should be done to meet the requirements of the standards.

Centre for Public Scrutiny (2009) Walk a mile in my shoes - Scrutiny of dignity and respect for individuals in health and social care services: a guide
This guide is designed to assist Overview and Scrutiny committees and others in discussing what dignity is, why it matters and how to assess whether an organisation or service treats the people whom it serves with dignity and respect.

Department of Health (2010) Essence of Care 2010
Essence of Care has been updated following a consultation exercise late in 2009. It now contains 12 benchmarks including one on respect and dignity. Essence of Care provides a structured and patient-centred approach to identifying best practice and setting standards for these fundamental aspects of care, and highlights the importance of seeking patient and carer opinion. It acts as a tool for sharing and comparing practice, for developing action plans for improvement and audit, and for identifying education and training needs.

The other 11 benchmarks are: bladder, bowel and continence care; the care environment; communication; food and drink; personal hygiene; prevention and management of pain; prevention and management of pressure ulcers; health and wellbeing; record-keeping; safety and self care.

The Essence of Care (EoC), was first launched in 2001 and emerging from the 1999 nursing strategy 'Making a difference', formed the basis of a Government strategy for improving the quality of care. It became an integral element of the clinical governance agenda. This edition supersedes the previous versions originating since 2001.

Department of Health: Mixed sex accommodation
From 1 December 2010, the collection of monthly Mixed-Sex Accommodation (MSA) breaches was introduced. NHS organisations submit data on the number of occurrences of unjustified mixing in relation to sleeping accommodation.

Department of Health (2009) Delivering same-sex accommodation (DSSA): principles
Seventeen principles have been developed to ensure each organisation delivers the highest standards of privacy and dignity within all areas of a hospital, other trusts and providers.

Department of Health and Social Care Institute for Excellence: The Dignity Challenge
Sets out the national expectations of what constitutes a service that respects dignity, based on what matters most to people.

Department of Health (2001) National Service Framework for older people
The framework sets out a 10 year programme of action " linking services to support independence and promote good health, specialised services for key conditions, and culture change so that all older people and their carers are always treated with respect, dignity and fairness".

NHS Confederation (2010) Delivering same-sex accommodation in mental health and learning disability services
This Briefing summarises existing national policy and good practice on same-sex accommodation, explains what support is available to organisations that need to make improvements. It sets out what both providers and commissioners can do to ensure same-sex accommodation becomes a reality for all.

NHS Confederation (2009) Same-sex accomodation: your privacy, our responsibility
This briefing provides a background to the Department of Health’s same-sex accommodation: your privacy, our responsibility initiative, launched in January 2009, to provide clearer guidance and support for hospitals.

NHS England (2013) Compassion in Practice – our culture of compassionate care
This page within the NHS England website contains the Compassion in practice three year vision and strategy for nursing, midwifery and care staff, which was launched in December 2012. The strategy, which focuses on the delivery of high quality compassionate care is based around six values – care, compassion, courage, communication, competence and commitment – known as the 6C’s. It sets out six action areas for delivering the vision. The page also has implementation plans and other resources to support putting the vision into practice. See also the 6C’s Live: Communication hub.
See also: Compassion in practice implementation plans.

NHS Institute for Innovation and Improvement (2007) Privacy and dignity: the elimination of mixed sex accommodation
This guidance outlines 11 key principles to support the achievement of good physical separation of the sexes in hospital accommodation and includes a self-assessment checklist.

NHS Institute for Innovation and Improvement (2010) The Productive Series: Delivering same-sex accommodation (DSSA)
The central theme of The Productive Series is that great care processes (in this case around privacy and dignity) do not just evolve, they need to be designed. This supplement pack on delivering same-sex accommodation is designed to complement the existing programmes in The Productive Series and provide improvement tools and case studies to support delivery (You will need to register and log-in to access the full-text online).

Northern Ireland

Department for Health, Social Services and Public Safety (2008) Improving the patient and client experience. A set of standards aimed at improving patient care
The five standards relating to respect, attitude, behaviour, communication, privacy and dignity set out what the public should expect from staff in the health service. This statement has been produced for DHSSPS by Northern Ireland Practice and Education Council (NIPEC) in partnership with the RCN. Testimonies of patient experiences are included in a pocket version. See: Improving the patient and client experience (PDF 3.48MB).

Department for Health, Social Services and Public Safety (2008) Safety, quality and standards: Care standards
These standards focus on the safety, dignity, wellbeing and quality of life of service users and are designed to address unacceptable variations in the standards of treatment, care and services and to raise the quality of services. There are standards for nursing homes, residential care homes, nursing agencies and domiciliary care agencies.

Scotland 

Scottish Government: National Care Standards
The underlying principles for all standards are: dignity; privacy; choice; safety; realising potential and equality and diversity. There are generic standards as well as standards for different settings.

NHS Education for Scotland: Little things make a big difference: Valuing the patient experience
This resource has been developed by NHS Education for Scotland for frontline NHS staff. It is designed to act as a gateway for staff to support the enhancement of patient experience. It provides access to audio and video resources and key documents and tools to support continuous professional development or to be used as a resource with patients and carers.

Wales

Care and Social Services Inspectorate Wales: Care for adults
This section of the Care and Social Services Inspectorate Wales (CSSIW) website introduces the regulatory and legislative framework and links to the national minimum standards for social care.

Welsh Government (2011) Giving voice to older people - Dignity in care Welsh language toolkit
The toolkit was commissioned as part of the Dignity in Care Small Grants programme. The aim of the toolkit is to raise awareness and understanding of the implications of the Welsh language in establishing dignity in care for older people living in Wales.

Welsh Assembly Government (2010) Doing well, doing better - standards for health services in Wales
This updates and replaces the healthcare standards published in 2005 and Healthcare Inspectorate Wales will continue to use these standards to undertake a level of testing and validation against the standards each year. The onus though is on organisations and services to demonstrate they are using and meeting the standards on a continuous basis. Standard statements are arranged under 26 standards and a key change is the inclusion of a new standard (Standard 10) specific to dignity and respect. This is a section within the NHS Wales Governance Manual website.

Welsh Assembly Government (2006) Older People - National Service Frameworks
The NSF for older people in Wales set the context for the framework in relation to the Strategy for older people in Wales. This area of the Welsh Assembly Government website brings together the NSF standards and related documents and tools.

Welsh Assembly Government (2003) Fundamentals of Care (PDF 577KB)
Provides guidance for improving fundamental aspects of health and social care for adults. Quality statements and practice indicators are provided for 12 key aspects of care one of which is 'Respecting people' which addresses basic human rights to dignity, privacy and informed choice.

Further guidance focused on improving the patient experience

A range of key guidance and tools is featured in the Patient Focus section of the RCN Clinical Governance resource. See: Patient experience - guidance and tools.

This page was last reviewed 15 July 2014.