"Good care for wrist fracture, but more support needed"

About: John Radcliffe Hospital / Trauma and orthopaedics

(as the patient),

In February, I was knocked off my bike and sustained a fracture to my wrist. The ambulance attended and took me to the John Radcliffe A+E. Fortunately, it was early in the morning and the minor injuries unit was virtually deserted so I was quickly sent for an X-ray. The care I received in A+E was mainly excellent and three doctors gave me some anaesthetic and then put my arm in traction to put the wrist back into shape. It was quite a nasty fracture and they were fully expecting that I would need an operation, however their skill in doing this manoeuvre meant that I avoided an operation.

However, I am also being treated by the Community Mental Health Team for anxiety and depression. I repeatedly told staff about this from my arrival on the unit, and asked for some lorazepam to help me deal with what was a very distressing situation (and which I have on hand to take at home, just didn't have with me as I had been cycling to the swimming pool!). Eventually the staff got me some diazepam (after about an hour) but in such a small dose that it made no difference at all. It was not until I was given a further dose that it had any effect.

My experience of the follow up appointments in the Trauma unit had some room for improvement. There is no question that the staff are very busy and that the clinic is routinely overbooked. However, it might be better managed. When you arrive, you are given an indication of the "wait" on a television screen. On the four times that I attended, this was never less than an hour. In fact, it seemed that you had to add at least half an hour onto whatever the screen said. What was frustrating was there was no sense of where you were in the wait, which made it impossible to go outside for some fresh air or even to go to the toilet if you had gone on your own for fear of missing your name being called out. It would be nice if they introduced a system of ticket numbers, so you could see if you were about to be called and so should stay in the waiting room or if you had time to pop to the loo or to get a drink.

Although the consultants are clearly expert in broken bones, I felt that they lacked a holistic approach. At no time did anyone ask me how I was coping with a broken wrist (quite badly in fact, as I was unable to do the usual sporting activities, which help me to cope with my mental illness), and even though I was obviously anxious and tearful (not helped by the extremely long wait and the continued uncertainty as to how long I would be in a cast and whether or not I would need an operation) this was mostly ignored by the staff. There was also insufficient advice given about when it would be appropriate to return to work.

On the other hand, the nurses in the plaster room were exceptional and really took the time to put you at your ease, recognising that I was not coping very well. I was re-plastered twice, and had the cast from A+E over-plastered too, and each time they explained what they were going to do, made a bit of small talk to try to distract me and even found some glitter to put on my cast.

When I came out of plaster in April, the cast was removed at 3 pm and promised physiotherapy before I left. However, by the time I had waited, and the doctor had to send me for an x-ray and had reviewed me again, it was after 5 pm and the physiotherapists had all gone home. I was told that someone would call me the following day to make an appointment for me. This did not happen. As I was very keen to be able to resume my sporting activities and start to drive again, I had to chase this, and fortunately the physiotherapy department were able to squeeze me in a few days later.

The care in the physiotherapy department has mostly been good, although my second physiotherapist has been more knowledgeable and helpful than the first. The department runs like clockwork and you are always seen within a minute of your appointment time. The staff, including the receptionist, go out of their way to be friendly. On my first visit, I was very anxious as I had never had physio before, and the department was extremely busy and noisy, however my therapist offered to treat me in a side room.

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Response from John Radcliffe Hospital

Thank you for your comments regarding your recent admission to the John Radcliffe Hospital. I am very sorry that your treatment was not at the high standard that we expect. We would like the opportunity to investigate the issues you have raised and provide you with a response. If you would like us to do this, please do not hesitate to contact Sue McNiven on 01295 224001 or at sue.mcniven@ouh.nhs.uk who will be happy to discuss the complaint process with you.

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