Monday, January 07, 2013

NHS - No healthy solution

Stafford Hospital isn’t unique, it’s just the most tragic (so far). How anyone can revere the National Health Service is beyond me. It’s a tragic farce. In an ideal world we would dismantle the whole thing and start again. At the very least we should put patients in charge of the way it’s run – instead of the vested interests of doctors, consultants and trade union leaders.

Here’s my latest experience:

e-mail to: sent on Sunday, December 30, 2012

My father was sent to the clinical decision unit at about 2pm today and finally saw a doctor at 5.30. This is, I suppose, what you would class as an acceptable standard of service. I would not.
According to the consultant on duty – who I finally tracked down because nobody was interested in examining my father – the doctors were overwhelmed with work because there had been 37 admissions since 9 am and only five doctors on duty.
By my calculations that is one doctor to just over 7 patients admitted in the course of 8 hours. This works out at better than one patient per doctor per hour. I accept there are other patients the doctors also have to see but even so it does not seem an excessive workload to handle.
One patient per doctor per hour is not overwhelmingly demanding.
That being so, and given that the patients do not all arrive together but over an 8 hour period, how is it possible for a newly-admitted patient to be ignored for maybe two and a half hours and finally only see a doctor once a protest has been made about this neglect?
Why is the system so chaotic? For instance, the consultant said they needed to find my father's notes but they didn't - I was able to inform him the notes were already on the ward and the nurse on duty knew exactly where they were. Did he assume the notes were lost? If so, why? Is that what usually happens?
The planning and deployment of nursing staff was completely chaotic. Why does the hospital provide no doubt expensive computers for staff when everything is done on pieces of paper and - to me quite unbelievably - a white board with various notes in different coloured ink?
To add insult to injury, when he was asked if he’d like some food, he said he could manage some soup. So why was the soup delivered to the patient without anybody bothering to mention it to draw it to his attention? It was left beside the bed for some time before anyone noticed. When they did, it had become cold and congealed. No wonder people starve to death on the NHS.
Finally, my elderly mother was with me in the hospital despite the fact that she, too, is unwell. I asked the doctor, when she eventually arrived, if she would mind examining my mother quickly while she was there because I thought she could do with some antibiotics. This was a request too far. She told me she was not allowed to examine patients who had not been officially admitted and that if I was concerned about my mother I should take her to the Accident and Emergency Department next door. Given the waiting time that would involve, I concluded the best thing to do was to take her home and put her to bed. But, whatever the rules and regulations you feel the need to impose, is this really any way to serve patients and the public? 

Having had no reply, I sent another e-mail: 

24 hours on he has been transferred to another ward but in all that time he has not once been seen by a doctor. Is this usual? Is this reasonable? When will someone be bothered to check if he is OK? 

and a third: 

I am looking forward to a response to my e-mails within the next 24 hours. 

On January 2 I got this: 

Good morning Mr Hastilow
Thank you for your e-mail sent to the Patient Experience inbox, I am sorry that you are not happy with the service provided to your father at the Queen Elizabeth Hospital Birmingham which has given you a need to bring these issues to our attention.
There are several ways in which this can be dealt with, I can forward your concern directly onto our PALS department (Patient Advice and Liaison Services), PALS will be able to look into this issue on your behalf and respond to you once they have obtained information from the relevant management, alternatively, I can pass your information directly onto the manager for that particular ward and department to ask that they feedback to you directly (If you do not require feedback please let me know.)
If you would be kind enough to advise which way forward you would like to go with this that would be most helpful.
I hope the above is satisfactory to you and if we can be of any further assistance in the future please do not hesitate to contact us.
Kind regards
Mrs Sue Higgins
Patient Experience Facilitator 

I replied: I think the PALS department would be appropriate. 

They responded:
Thank you again for your prompt reply and the information that you have provided. I have already forwarded your previous email to the PALS Team who were waiting to hear of your preferred method of communication. I have copied the team into this email so that they will be in contact with as soon as they can.
Mrs. Sue Higgins
Patient Experience Facilitator 

I said: I would prefer to hear from you by e-mail 

They responded: I would like to introduce my self my name is Dawn McKenna and I will be the pals officer looking into your concerns raised by your email on Sunday. I have escalated your original email to the Matron and Ward Managers of CDU, would you be kind enough to let me have a direct contact number for you that I can pass onto Matron who will be wanting to speak to you direct.
Dawn C McKenna
Patient Advice & Liaison Officer 

I sent them a mobile number but said I would prefer communications to be in writing as I was a journalist and may wish to report on the situation in due course. I then got this: 

I am writing in relation to your recent emails regarding the care received by your father. I was sorry to learn of your concerns about the service at QEH. 
The matter has been passed to me as you have requested a response in writing and we will therefore be dealing with this as a formal complaint. We are obliged to seek your father’s consent, both to the complaint and to the sharing of his information with you. Ahead of our writing to him, I would be grateful if you would confirm that he is aware of your contact to us and that our letter will be on its way to him.
Once we have received consent, we will be in a position to complete our review and respond to you. Please let us know if you have any questions regarding this email.
Dave Beech
Patient Services Co-ordinator

I said: He does not know of my complaint and is far too ill (still) to be bothered with this. Please do not communicate with him and only communicate with me. I am asking for some answers to questions; I cannot believe you need a formal procedure for that. 

They said: Thank you for your reply. In the circumstances you have detailed we will not make contact with your father, although the Trust’s response to you will be limited.
We are dealing with your enquiry through the Complaints Process as it is the Trust’s mechanism for investigating and responding formally to concerns raised about its services. We will contact you again as soon as possible.
Dave Beech
Patient Services Co-ordinator

I asked how long this would take and so far I haven’t had an answer, though it is amazing that so far three people have been involved in my complaint – two more than the number of doctors who could be bothered to care for my father.

Later... answer arrives:
We are hoping to receive information from the clinical team very shortly, following which there will be a review of the information at a senior level prior to the Trust responding to you. We hope to be able to finalise this matter within the next few weeks, but will contact you if for any reason there is an unforeseen delay
David Beech
Patient Services Co-ordinator


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