"Poor Practice"

About: Queen's Medical Centre / Accident and emergency

(as a service user),

Two friends had taken me to A&E because I was experiencing really low mood and had plans to end my life that evening and they felt unable to cope and keep me safe. When I was initially seen and asked by I had come to A&E the nurse asked me why I was there if I wanted to die, and what I wanted from being there. This was unhelpful and only fueled my ambitions as well as reducing the little hope I felt. After several hours waiting I was assessed by a mental health nurse. I don't really remember a lot of that meeting and rely on my two friends who came in with me to tell me the smaller details. One bit I do remember distinctly is at the end. My friends had asked on several occasions if I could be admitted. The nurse went for sometime to discuss this with her team. She came back and that they didn't have enough room and she thought think it would be pretty likely that they would be writing a coroners report in the morning but that I would have to go home". I remember this because I understood it as a positive thing - I could be free to act as I wished but my friends received it very differently. Now, thanks to other excellent professionals I have recovered sufficiently to be able to see how appalling such comments are. I, friends and family have been told so many times hat I should go to A&E if I am experiencing an acute episode outside the hours of the GP.

After several similar experiences I am put off. It has been some time since I have visited A&E without a high level of persuasion or an element of mild physical force on behalf of friends or family.

I just can't understand why some 'professionals' feel it is appropriate to speak to someone experiencing mental illness like that - would they speak to someone who was as unwell as a result of a physical illness? I can't imagine a nurse questioning or sending a patient home despite there being a risk to their life. Having no beds is not an excuse. Would it be acceptable to send someone home with an open fracture because there was no beds?

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Responses

Response from Nottingham University Hospitals NHS Trust

(Posted on behalf of Nottinghamshire Healthcare NHS Trust by Nottingham University Hospitals NHS Trust))

Nottinghamshire Healthcare NHS Trust, who provide the mental health liaison service in the Emergency Department, find it is most helpful for us to hear about patient experiences in order to learn and develop as a new service. It is regrettable that in this instance your experience was not a good one.

The concerns surrounding the staff’s communication with you had already been brought to our attention by the people who came with you to the Emergency Department at NUH. In response to the comments we received we have undertaken a comprehensive investigation.

We agree that you did receive a substandard service and want to assure you that we are going to learn from these findings at an individual clinician level, team level and indeed service wide.

We apologise wholeheartedly and wish to thank you for taking the time to feedback to us your concerns. We’d welcome any further feed back if you choose to contact us again.

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Update posted by PaS (a service user)

I checked with both of the people who were with me when I attended A&E at that time and they have both said they had not shared their 'concerns' with anyone. I believe they would be honest so I am concerned that an issue very similar has also been raised.

Fortunately, other services such as the county crisis team have been much more helpful- literally life savers.

Response from Queen's Medical Centre

Thank you for taking time to share your experience with us. We decide whether to admit patients into our care based on clinical need. Patients who require hospital care for their illness or injury are admitted to hospital. If you would like to discuss your experience with us in greater detail, please do contact us on 0115 9249924 ext. 67184 or email sarah.kennedy@nuh.nhs.uk and we will arrange a meeting with you to fully look into your individual case.

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