"Accident and Emergency care"

About: Dumfries & Galloway Royal Infirmary / Accident & Emergency

(as a relative),

My 90 year old father in law spent 4 hours between 12 and 4 am being seen about haematuria which had been ongoing for 4 days. He has an indwelling catheter and sporadic problems of this nature however he has never had it last so long. At 4 in the morning they sent him home alone. He was going to be admitted however they changed their minds and said he would get an emergency Urology appointment instead. He did not object as he was tired being 4 in the morning. It was now a Friday am and so there was no way that an emergency appointment would be made for him to attend until at least a week after his original complaint which does not seem good patient care on any level. Can I ask you to consider whether it is truly felt that a 90 year old man with relatives 90 miles away was best served by being sent away to an empty home at 4 in the morning?

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Responses

Response from Hilary Butterworth, IPIQ Officer, Patient Services, NHS Dumfries and Galloway

Dear RHAG

I am very sorry to learn of your concerns relating to your father-in-law's tiring and stressful night time visit to the Emergency Department. Having to send an elderly person home alone in the early hours is the kind of experience we would seek to avoid, if at all possible.

I will forward a copy of your father-in-law's story to the team in the Emergency Department to discuss and explore any options to minimise the potential for situations like this happening to patients in the future.

I fully understand the worries felt by anyone relating to vulnerable family members and these worries and concerns are compounded when their loved ones do not live close by.

You will be contacted further once we have explored the situation. In the meantime, if you would like to discuss this experience with me further please do not hesitate to contact me on 01387 244297

With my most sincere apologies and kind regards to you and your father-in-law

Hilary

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Response from Hilary Butterworth, IPIQ Officer, Patient Services, NHS Dumfries and Galloway

Dear RHAG

I have now met with the Emergency Department Staff to discuss your concerns, who are all sorry for any distress or worry to you and your father-in-law. Many staff have elderly relatives and we can empathise and appreciate how worrying and difficult it is for you not living close to your father-in-law. Due to the anonymity of the Patient Opinion website we are unable to identify your father-in-law and ascertain the full circumstances around his visit and which clinical team cared for him and why certain decisions were made. Each patient has unique personal circumstances and their needs are individually assessed. I would like to take the opportunity to discuss some issues you raised and hope it will alleviate some concerns.

Usually patients with catheter problems at night are visited at home by a GP or the Unscheduled Care Nurse. Unfortunately there are a small number of patients if the nurse is unable to relieve the problem the patient comes to hospital to see the on-call Surgical team to avoid being left in pain and discomfort.

Often patients do not want to disturb their loved ones at night and prefer to go home to the comfort and peace of their own bed, avoiding a wait the next day for hospital transport home. When a patient has full capacity of mind and lives independently we honour and respect their decisions only contacting relatives if the patient requests or in life threatening situations.

The nursing and medical teams in the Emergency Department remain very mindful of the needs of older persons living alone and I can assure you we would never send an elderly person home during the night if their medical condition or general well being indicated any concerns. Vulnerable persons going home alone during the night are transported by a two man paramedic crew, who would not transport them or leave them at the house if there were any concerns about safety.

To explore the matter further the Senior Charge Nurse is more than happy to meet with your father-in-law and you to discuss his personal visit to the department.

Kind regards

Hilary

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