"Hospital food"

About: Hairmyres Hospital / Ear, Nose & Throat Southern General Hospital / General Medicine

(as a relative),

My wife has been in hospital since 2013 with a degenerative brain disorder (undiagnosed) which has left her unable to communicate with us in any meaningful way. One of the many side-effects of her condition is dysphagia, which caused the hospital to put her on a texture B dysphagia diet. Earlier this year she was transferred to a hospital closer to us. I was informed by a nurse, 6 weeks in to her stay at the new hospital, that my wife had been given the same meal (lunch and dinner) for 6 weeks. It was a kind of chicken gruel. When I asked the ward nurses why they had not acted on this I was told to contact the dietician, which I duly did. The Dietician was appalled and apologised, but hinted that this one meal could be the only texture B meal available at the hospital. Speech Therapy were called in to do a swallow test and it was decided that my wife could move up to a texture C diet. I did find this odd, particularly following the conversation with the dietician, and the fact that the first hospital had my wife on texture B for some 10 months.

My wife has been on a texture C diet since early spring this year. There is a set menu for this diet, which consists of 7 meals for lunch and the identical 7 meals for supper. The same 7 meals have appeared on the menu now for some 6 months. I am occasionally given these menus to fill out for my wife as she is unable to do so. I always put a line through all the meals for lunchtime as they are far too large for that time of the day (I write underneath, “Soup, if possible”). I am not at the lunches, but I am lead to believe that the large meals come up more often than not, and very occasionally my wife gets soup or a yogurt. Of the 7 meals, I routinely score out two which my wife has found particularly distasteful - this leaves 5 choices, which I rotate to try and make it more pleasing.

Two things to mention: the menus I fill out are routinely ignored; the last three nights have all seen the SAME meal arrive. Secondly, is it acceptable in the 21st century to be limited to a choice of the same 5 meals EVERY day for nigh on 6 months?

And, why is it not the case that when concerns are raised with nursing staff that they do not simply take up your case? I get sympathetic nods and I am given phone numbers, or a complaints form. These are my immediate professional contacts, and they should know the system better than a lay person like me. They should sort the matter out. The dietician recently informed me that she would look into the matter, and I should contact catering. I work full-time in extremely stressful circumstances, why is the onus on me?

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Response from Paul Cannon, Head of Administration, Acute Services Division, Greater Glasgow & Clyde NHS

Dear Disheartened

Thank you for taking the time and trouble to provide your feedback. We are sorry to hear you are not happy with the service. We have in the first instance shared your comments with our Head of Nursing for this Service as well as our Catering Manager.

In order to progress your concerns further, I would be grateful if you could contact me (paul.cannon@ggc.scot.nhs.uk) with your wife's personal details.

Kind Regards

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Response from Susan Friel, Chief of Nursing Services, Hairmyres Hospital, NHS Lanarkshire

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Dear Disheartened

I am so sorry that you and your wife have had such a bad experience. Like my colleague from NHS Glasgow, I too would be keen to look in to how we can improve our care of your wife, and our support for you also.

To allow me to do so, could I ask that you get in touch, not only to provide your wife's personal details, but also so that I can provide updates to you directly. I would be grateful if I could ask that in the first instance you contact Christine McNeill, Patient Affairs Manager, at Hairmyres Hospital Tel: 01355 585 000 with this information.

Kind Regards

Susan Friel

Chief Nurse, Hairmyres Hospital

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Response from Joan James, Divisional Nurse Director, Acute Services, NHS Lanarkshire We are preparing to make a change

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Dear Disheartened,

Thank you for getting in touch. I too was disheartened when I read the account of your experience and I can only apologise for the lack of communication and support you received initially.

Your story has been shared widely with nursing staff throughout NHS Lanarkshire as it highlights the key role that nurses have to play in caring for and supporting their patients’ and families, as well as their responsibility for linking with other specialties and services.

I know you are now in contact with one of my Senior Nurses. I hope she has been able to address your concerns and I understand she has arranged for a few additional choices of the Texture C diet for your wife.

I would like to let you know what we are doing as a direct result of your feedback about the Texture C diet. Your story was discussed at the NHS Lanarkshire Food, Fluid and Nutritional Care Group, which has doctors, nurses, dietitians, catering staff and public representatives as members.

We are currently discussing our texture modified menus to explore the possibility of having a choice of three courses, a soup, a main course and a pudding available at each meal for Texture C, D & E.

We are also going to introduce a system so that texture modified menus can be reviewed to accommodate likes and dislikes of patients that will be in hospital for some time.

I hope your experience of the ward has improved and your wife is more comfortable. Please speak to the ward staff if you need anything in the first instance. If you do not feel you are being supported please ask to speak with the Senior Nurse.

Kind regards

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Response from Craig White, Divisional Clinical Lead, Directorate of Health Quality and Strategy, Scottish Government

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Thank you so much for taking the time to highlight such an important issue, one which I sense will be relevant across the NHS in Scotland.

I will make sure that colleagues here in Scottish Government are made aware of your feedback and the responses from colleagues in NHS Lanarkshire. It is vital that there is now support for the learning and change that might be required across the country to improve things for anyone else with the same needs as your wife.

Best regards,

Craig A White

Divisional Clinical Lead, The Quality Unit

Scottish Government Health and Social Care Directorates

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Response from Pauline Downie, Professional Lead, Speech & Language Therapy Services, NHS Lanarkshire We have made a change

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Dear Disheartened,

It has taken some time and numerous meetings but I am now able to tell you about the changes we are making.

I’m sorry to say that the companies that supply us with Texture Modified meals can only provide soup for the Texture B diet.

We have increased the range of choices available for main courses and introduced a pudding option for all textures.

We are also producing local guidance which will clearly define staff responsibilities for patients requiring a Texture Modified Diet.

Kind regards

Pauline Downie

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