The older people's czar has called for a financial reward for trusts that uphold patient dignity.

National director for older people's services Professor Ian Philp suggested using payment by results to encourage trusts to tackle the issue.

Speaking at a Royal Society of Medicine event called 'Dying to be Heard' last week, he said: 'We need to get away from the idea that it's down to heroic individual leadership or bad people.

'Good systems move bad people out of areas where they pose a risk to people. I want to use the tariff to reward dignity if, for example, 95 per cent of patients are saying their dignity was respected.'

NHS Confederation policy director Nigel Edwards told the audience it would be difficult to build a dignity reward into the tariff but an overall bonus could be used instead.

However, he added: 'If you pay account to dignity, [then] lengths of stay fall and services become more efficient so there's a reward in itself. I worry we need bonuses to reward initiative and intelligence.'

Justin Varney, president of the Royal Society's epidemiology and public health section, said: 'Dignity isn't an add-on. It's about human rights.'

He said an elderly man had been left in his local hospital for three days in soiled underwear because the trust claimed buying new underwear was not included in the tariff. 'Patients have a right not to be left in their own excrement,' he said.

'There are pressures on people to perform against targets, and increasing demands from the public, but trusts have a corporate responsibility.'

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