"Mostly very good but some areas could be improved..."

About: St Richard's Hospital

Hospital at over capacity with lots of people stacking up in A and E corridors (but all comfortable even if lacking any sense of privacy). Staff in A and E under resourced for the busiest weekend of the year ( which should have been anticipated). Staff mainly working very hard to meet needs of huge number of patients and generally keeping smiling face whilst dealing with some very rude and ungrateful relatives. SECAMB patient co-ordinator sat and gossiped and distracted staff with little obvious work related effort. A and E doctor was fabulous and pragmatic just getting through work really efficiently and kindly. Porters were excellent and sweet. Nurse in majors nearly snapped once but not surprising given the workload she faced; she managed to overcome frustration and regained smile quite quickly though. Worse about A and E was dreadful HCA on reception - totally inappropriate to allow an unqualified HCA to make clinical decisions and to be so dismissive of relative and patients concerns. They need to know patients presenting as struggling to breathe need priority over splinters and sore wrists and should receive immediate attention when a relative asks for it rather than carry on typing through four separate requests and a final demand that we would go and find someone clinically competent ourselves. A more appropriate algorithm might help or a ANP on reception doing initial triage and dismissing some people to GP/Pharmacist. AMU staff all delightful in difficult circumstances. Night staff particularly brilliant with confused and quite abusive/challenging very frail elderly patients. GP trainee was lovely and reassuringly competent. Consultants that listen too! Only comment re AMU was that it was freezing. I was cold and will bring my own bedding if admitted in future. Elderly patients all complaining of cold and not sleeping because of this. Other younger patients sleeping wrapped in dressing gowns. Bedding inadequate, hard, thin and not providing much in way of comfort at all. Nurses spent considerable time tracking down basics like pillows and blankets. Decent bedding and ambient temperature would reduce nursing workload in longer term and might prove cost effective. Increase number of HCA's to reduce need for RNs to make cups of tea and run backwards and forwards between tasks to care for wandering confused elderly. An HCA per bay would reduce the nursing costs and reduce falls risks. Give them no other tasks but to sit and encourage elderly to eat/drink/go to loo/wash/take tablets and to hold hands and reassure etc. More expensive initially but might reap benefits longer term.

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Response from St Richard's Hospital

Thank you very much for your very detailed feedback, which really does give a very full snapshot of a patient's experience. Thank you for kind and appreciative comments and also for the constructive criticism, which we shall pass to the relevant managers of A &E and AMU to address.

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