"My DVT - a mixed experience of care"

About: Teddington Memorial Hospital West Middlesex University Hospital / Accident and emergency

(as the patient),

I first attended the West Middlesex Hospital last week, being referred from Teddington Walk-In Centre with suspected DVT. I was seen quickly and sympathetically and was in and out of A and E within an hour and a half. The only downside was:

· The information on DVT handed to me as I left was extremely poor – in quality and information content. Whilst on the surface it appears to communicate the relevant information I need, when you look closer it omits vital information, such as what time to attend the Day Unit, how long you might wait for a scan, exactly what will happen each time, etc. This led to my having to ring the Unit twice to establish what I needed to do next and when.

· The staff in the A and E team who gave me an injection were fine, although I noticed a (junior) doctor in the unit sneeze, no tissue in his hand, failing to cover his mouth, then handle notes for me without cleaning his hands. No-one said anything to him and I felt reluctant to do so, even as an articulate health wise individual.

· The first injection of blood thinner was given to me in the shoulder, and then the doctor, who didn’t see it happen, said I had it in the stomach and this would be where it would be given again in future. He seemed surprised when I said it was in the shoulder and he simply shrugged.

I have since twice attended the Medical Day Unit. I note the following which may be of interest and helpful:

The sign posting to the Unit is appalling. The leaflet I was given in A and E does not adequately show where the unit is and once on the first floor the Unit is not, as far as I could see signposted – I was looking for the words “Medical Day Unit”. I had to ask three times where it was and, each time, received a fairly short and uninterested response despite my being cheerful and seeking to make eye contact.

Neither of the two nurses on the Unit made any eye contact with me at all. The Unit was not busy, in fact it was very quiet on each occasion.

Neither time was I offered a plaster to cover my injection site, despite the fact that I might bleed (I am being given blood thinners) and, in fact I did bleed, staining my t-shirt which will not come out.

Only one nurse enquired whether there was any change in my leg size (the DVT is in the calf). I would think that it is basic to simply check for any positive or negative change in my condition, especially as it is presumed DVT and, therefore, potentially life threatening.

On each occasion neither nurse explained what would happen each day following and I had to go out of my way to ask.

On the Thursday I asked what would happen if I did not have a scan at Friday and was told that would mean attending both Saturday and Sunday for further injections, no scan being available at weekend. I asked if I could possibly get this injection done closer to home. I live in Woking, 26 miles away.

The nurse simply said, “No, we have your notes”. I understand having the notes, but surely some kind of conversation could have been had about transferring me, even letting me carry my notes and, if not, then at least a note of “I hope you understand” rather than what came across as indifference.

Six days later and I still await a scan confirming a diagnosis and I have had to resort to Google to find out more about what DVT means and whether I should be concerned.

No-one had any conversation with me about whether I should simply go about my business as normal, so I still don’t know what, if any, the risk is of my possible blood clot moving.

I have felt a distinct feeling of indifference about me as a patient and I wonder how this translates elsewhere for chronically ill patients who often do not feel able to speak up but for whom a focus on them and good communication is critical to their care and outcomes.

I have written to the trust CEO by email (which is publicly advertised, impressive) and to be fair to her I received a good, strong positive reply within thirty minutes.

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Response from Richard Elliott, Communication and Web Development, West Middlesex University Hospital NHS Trust Twickenham Road Isleworth Middlesex TW7 6AF

Thank you for your feedback. We would like to apologise that your experiences do not match the high expectations we have for all our patients. As you say in your feedback, you have been in touch directly with our Chief Executive who has replied to you.

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