"I feel this hospital is badly run"

About: Charing Cross Hospital / General surgery Charing Cross Hospital / Neurosurgery

(as the patient),

Here is a précis of my experience since November 2008 (I have avoided addressing any legal issues that may arise): I was diagnosed with a benign brain tumour requiring removal and substantial cranio-facial surgery to rebuild my face following its removal. I should have been fully recovered within three to six months. In fact, six months after the initial operation my face is currently totally destroyed by infection, with visible bone protruding through and flesh having been removed because of the infection.

I am continuing to have treatment for a damaged eye. I am told that I require at least one more major, seven hour surgical procedure to try to remedy the damage to my face (and if it fails there are no alternatives left to spending my life with a wholly deformed face) and potentially several shorter ones. If I am ever back to leading a normal life, it won’t be for at least another twelve months, by which time my flat will probably have been repossessed and I’ll be considered unemployable by dint of being out of the workplace for so long. Some weeks I have to attend outpatient appointments with various clinics four out of the five working days. The infection has left me largely housebound since April.

In November 2008 I was seen in the private wing of the hospital for a joint appointment with the neurosurgeon and craniofacial surgeon, on a “professional courtesy” basis (i.e. no fee) to receive the diagnosis and prognosis following CT and MRI scans.

I found the receptionist on Floor 15 to be rude, ignorant and discourteous. She insisted that I signed a form saying I’d pay for the appointment. When I said that she was mistaken, and she should check with the consultants, she then started saying loudly and rudely “Well if you won’t sign I don’t know what to do with you. They won’t see you”. Then loudly consulting her colleagues: “I’ve got a patient here who won’t sign the form and says she’s not paying for the appointment as she’s here as an NHS patient, what should I do?” The response, equally loudly, was “Oh they give free appointments in their private appointment time to patients who are seriously ill”. As you can imagine, this was a distressing way to find out that I was seriously ill, given that the two consultants had not yet had the opportunity to discuss this with me.

In January 2009 I was given less than 48 hours’ notice of the date for what the doctors refer to as "very major surgery" and no pre-op assessment. I don’t think this is acceptable for the hospital to allow all the relevant administrative staff to take leave over Xmas and New Year which resulted in there being no cover whatsoever. The consultant surgeon had actually notified the administrator on 22 December of the admittance date of 7 January, but she hadn’t opened the email until 5 January as she’d “been on Christmas holiday” and there was no skeleton staff dealing with such matters in her absence. I enquired about delaying and was told by the neurosurgery that the next earliest date that the joint team could be available would be the end of February. I had already been told that I needed to have the surgery as quickly as possible so felt I had no choice but to proceed.

I was admitted on the evening of 7 January. That night, before seven hour surgery the following morning, I was placed in a private room. The belongings of the previous patient were still there, because the staff hadn’t moved them to the ward she’d been placed on after her surgery. I have no idea if the room had been properly cleaned and sterilised (I was told by the nurse that it had), but I had to ask the nurse to replace one pillow case which had blood stains on it. This is particularly pertinent to me as I have subsequently been seriously damaged by infections picked up in the hospital.

I was placed on a high care ward after my surgery – a mixed gender ward that included a man who kept exposing his penis to female patients and nurses. Several days later I was moved to another mixed gender ward and the staff sister was surprised when I refused to occupy the bed until the area around it had been cleaned of urine left on the floor by the previous occupant. The stink of the urine made its presence obvious – initially I was told “Well this is a hospital, things do smell sometimes”

When I was discharged, no arrangements were made for my follow-up appointments – I had to make the arrangements myself. No-one had told me that I needed to be seen on a regular basis by an ophthalmologist to check the then comparatively minor damage done to my eye by the surgery. Several weeks passed before my outpatients’ appointment with the neurology registrar, who immediately referred me for an urgent appointment with an ophthalmologist. Unfortunately by that time my cornea had been damaged to such an extent that the ophthalmology consultant described it as one of the worse cases of keratitis that she had seen and I was warned I might be left blind in my left eye. (Unfortunately at the initial appointment they were somewhat hampered in following the background to the initial injury during the surgery as my MRI scan results had been misfiled on another patient’s file.)

I have had to have two “day care” eye operations and endless treatment by the ophthalmology outpatients’ team - whom I certainly would recommend - to improve this situation, which in my view was caused by the incompetence of the hospital.

In trying to make my own post-discharge neurology appointment, having been told by email by the lead neurology clinician to do so in the circumstances, I was met with rudeness and resistance by someone working for the section that makes patient appointments. She aggressively and wrongly informed me that I “wasn’t allowed” to do this despite the lead clinician’s instructions and that I wasn’t allowed to speak to the manager of the appointments section – all of which needless to add was not accurate. It was extremely exhausting as a patient trying to convalesce from major surgery, to have to deal with someone who is being rude and who seemed poorly trained. I was on the phone for about half an hour trying to sort this out, whilst suffering post-operative head pain, spine pain and extreme fatigue.

Letters notifying me of follow up appointments for outpatients’ clinics routinely did not arrive at all (I found out about the appointment only when receiving standard letters from the clinics about my “non-attendance”) or arrived the day after the date for the appointment or referred me to mystery clinics such as the fractures clinic or ENT clinic, which seemingly had no connection whatsoever to my treatment but actually contained the sub-clinic which I needed to attend.

In March 2009 I was admitted for emergency surgery as I had developed a brain infection. I was placed on Ward 10 North and the experience was such a nightmare that at one point I had to be dissuaded by the consultant from discharging myself – although still extremely ill, I really could not tolerate the behaviour of some of the nurses any longer.

To sum it up as briefly as possible, this included a staff sister shouting at a doctor that despite the doctors’ instructions she was not going to keep changing my canula as it was a waste of her time and NHS money (I have been paying into the system for over thirty years), some nurses putting inaccurate entries on my file (which I briefly saw before leaving, despite the ward manager appararently trying prevent this) regarding the time that essential IV antibiotics were administered; some nurses reporting on my file that I had refused administration of the IV antibiotics. At one point, I was woken at 3a.m. by a nurse rummaging in the drugs drawer next to my bed, I thought that she was trying to help herself to the drugs I had stored in there for her personal use – when confronted, she admitted it. She was rude, abusive and offensive towards me when I asked her what she was doing.

Until I complained to the consultant, nurses would not respond to the alarm call of the machine which indicates that the IV flow has blocked. Requests for assistance with this were often met with sheer rudeness.

Whilst extremely ill, I was woken out of a deep sleep by one nurse who wanted to interrogate me as to why I was childfree and ram down my throat her views about how I should have had children.

There was no lock on the only shower room on the ward and I was repeatedly disturbed by people opening the door whilst I was showering, plus a heavy and badly constructed screen collapsed whilst I was in there, narrowly avoiding causing me serious injury.

Some of the nursing staff did not seem to have a good grasp of the English language and so they could not understand what was being said to them and would aggressively say “I cannot understand your English”. Having to repeat myself over and over to such nurses was obviously exhausting and stressful.

Additionally, I was sent by doctors in the neurosurgery team for an MRI scan despite having a head full of metal staples (which was only picked up by sheer chance by the registrar going through medical issues -when he asked if I had any metal in my head I replied “Only what the doctors have put there”. He understandably thought I was referring to the titanium screws, and only by chance saw one of the metal staples glinting through the bandage around my head); injected with another patient’s medication; had a nurse check on my blood sugar levels and when I asked why as I was not diabetic, she actually took the trouble to check her sheet and realised she was meant to be checking the poor, helpless stroke victim in the next bed. I was repeatedly prescribed medication to which I am allergic but the doctors concerned had not bothered to check the allergy band that I was wearing throughout. Most seriously, I am dangerously allergic to the contrast material used for scans but I had to raise this myself with the MRI scanning team as they had not been warned by the doctors attached to Ward 10 North.

Visiting hours and the restriction on the number of visitors were not enforced, so there was a constant level of noise and overcrowding on the ward bay; on one occasion another patient's visitor straddled my bed end, rubbing his sweaty jeans crotch along it – just what a patient with an infection really wants. Yes, I was lying in the bed at the time.

There are numerous other examples I could give of poor care during this stay.

In April 2009 I was again admitted to the hospital for urgent surgery related to the infection, this time staying on the Riverside ward. I found the admitting sister to be exceptionally unpleasant, rude and aggressive to me, and in my view better suited to working in a prison than a hospital.

I was ordered by her to undress, put on the hospital gown and lock away all (her emphasis) my property in the locker located to me, as there would not be time to do this once the porter came to take me to the theatre. She then said that if I walked around or needed to visit the lavatory whilst waiting, I must wear my shoes. In response to my comment that I couldn’t understand her instructions, as if I locked away all of my belongings then how was I meant to keep out my shoes, she snapped at me “All of your belongings except your shoes, of course”.

I was then given a form by her and instructed to sign it. I asked what it was for and she sighed loudly at my request for an explanation. Only when I insisted that I would not sign anything without knowing what it was for, so if necessary I’d read through all its small print myself despite my limited and damaged vision, did she explain – in a rude and aggressive way – that it was a patient disclaimer, and by signing it I was agreeing that the hospital had no responsibility for any property of mine that went missing when it was transferred from the locker to the room that I would be in after the surgery. I refused to sign this form – in my view it is wholly unacceptable for the Trust to attempt to coerce patients into signing such a disclaimer.

I explained this to her and also asked her how I would be able to unpack anything if I were unwell after the surgery. She responded dismissively that if I were too unwell to unpack then I wouldn’t need anything. This turned out not to be true and caused problems after the surgery when medication had to be obtained urgently from the hospital pharmacy as I was too unwell to unpack what I had brought with me, and confusion when I was seen by the SHOs the following day as the medication I had brought in with me had not been written up on the chart.

This young woman became increasingly abrasive and bullying towards me in her manner. She accused me of interfering with hospital procedures and of stopping her from dealing with other patients efficiently. She then said that as I refused to sign the disclaimer, an inventory would have to be taken of every single item I had brought with me, so that I could not claim after the surgery that something I had not brought had been taken. I got very cross at this point, explaining to her that as a lawyer I found particularly offensive the suggestion that I would lie and wrongly accuse someone of theft in order fraudulently to obtain compensation. I would expect that all patients find such suggestions offensive. I refused to make a list of everything I had brought as it was a ridiculous and time consuming idea, and in any event there would have been no time to unpack and repack every item as I was the only patient on the consultant’s operating list and would be taken to theatre shortly. Her behaviour caused my blood pressure to go through the roof, and left me feeling very stressed immediately before being taken to the operating theatre.

I then handed her some medication I had brought in with me which had to be kept refrigerated. She did not arrange for this or any of the other medication I had brought in with me to be listed on my medication sheet.

The morning after the surgery, I was seen by two SHOs, one of whom was particularly rude and aggressive. He made rude and unprofessional comments about the other doctors who had dealt with me, then gave ophthalmology advice which totally contradicted what I had been told by the ophthalmology team – he became very abrasive when I pointed this out.

He failed to arrange for the drains to be removed from my head, these were not removed until 10pm that night following repeated complaints by me, and thus I was prevented from leaving the hospital until the next day.

One of these doctors claimed to have telephoned the consultant for advice on a medical issue that I had raised and he had said this and that. When I discussed this with the consultant the next day, he was clear that he had not been phoned by anyone about my case and would not have given such advice.

On top of everything else, there was no ward sister on the ward from 3pm until the next morning. “Bank” nurses felt confident that they could get away with no wearing identification badges. Other staff were unable to identify them.

I have made three formal complaints to the Managing Director of this hospital and am singularly unimpressed by the way that they have been investigated to date. I also have complaints about the behaviour of two nurses going to the Nursing and Midwifery Council and complaints about three doctors going to the GMC.

I feel that the way this hospital is run is atrocious. The management of this hospital does not reflect the skill, care and professionalism of many staff who have the misfortune to work in such a badly run organisation, whose dedication is overshadowed by the behaviour of some rude and seemingly incompetent colleagues who seem confident that they can get away with such behaviour. Ultimately, I feel it is the patients who pay the price.

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