"Our whole experience"

About: Holme Valley Memorial Hospital

(as a relative),

This is our experiences of two operations which my husband had at Holme Valley Memorial Hospital which I hope is never repeated again for any patient in the future whether at this hospital or any other. These experiences probably demonstrated the lack of care and compassion that is the hallmark of our NHS.

This Locala hospital was set up by the NHS to operate the hospital. At times they refer to themselves as part of the NHS and, at others, they will stipulate that they are not.

In April 2014, my husband was due to have an operation on his bunion. We weren't informed of the actual time until less than a week before the event even though we had asked to be informed earlier as it was important to us. This was due to the fact that my husband is also my carer; I have MS, cerebral palsy, asthma and I am very prone to chest infections including pneumonia. Therefore we had a lot of structures to put into place to ensure that things from our end would run smoothly. Given that I don't drive and live in an outlying area where the bus service is not all that regular we asked for hospital transport to be arranged. This was refused. We also asked for a later time of operation if possible given that my medication regime and being assisted to dress etc took, at that time, approximately two hours. This was ignored.

We were informed just days before my husband's operation that he would have to be at the Holme Valley Memorial Hospital ( HVMH) for 8am. We were still without transport and such a time would mean that we would have to get up at 4am to be able to fit in everything. As I was still very ill, this didn't help but we had no choice. The only person who did have a car was my sister who was not well herself at the time and did not live anywhere near us. As she looks after her granddaughter from 5. 15am she had to find someone who could look after the child so that she could run over and pick us up at 7am to run us to the hospital.

When we got there we were told that my husband would be out between 10am and 10. 30am and we had to be there 10am prompt. As my sister had to go back home and arrange more care for her granddaughter before coming back to pick my husband up we asked if we could just arrive at 10. 30am as we had tight arrangements to fit in. We were abruptly told, No! ' Apparently, , my husband could not wait in the waiting room if he was out before 10. 30am as ' the waiting room was for other patients! '

My sister, at last minute - given the total lack of communication by HVMH - had to make a lot of last minute arrangements but did manage to pick me up so that we were back at the hospital for 10am. At 10. 10 am the sister informed us that my husband would be out at 10. 20am and was just finishing off tea and biscuits. My husband however, did not appear until 10. 45 with no explanation given at all. for this delay.

As he was being wheeled out to the car he was informed that he would have to go onto the back seat and keep his foot elevated. It is a pity that this wasn't conveyed sooner as my sister only had a three door car and as my husband's leg was anaethetised he would have been unable to climb into or out of the back seat.

He had also been informed that he would have to have an xray but as HVMH didn't have the facilities my husband would have to make his way to the Huddersfield Royal Infirmary, some distance away. We had chosen the HVMH as it was more convenient given that I didn't drive, and hadn't been informed of this lack of facilities until it was too late. Although my husband was supposed to keep his foot elevated for 55 minutes out of the hour, he had to make a journey on crutches which entailed walking to the bus stop and catching the bus to town, walking to another bus stop to catch the bus to the infirmary, , walking from that bus stop to the infirmary xray department, waiting in the department ( all the while unable to elevate his foot) and then making the return journey which took five hours in all. This makes a mockery of the instruction to keep your foot elevated without explaining how this was to be achieved.

At the follow up appointment he was accused of not keeping his foot elevated and if anything went wrong it would be his fault. I had come down with pneumonia the day following his surgery -which I expected would happen if the stress of not being able to plan anything which would have given me adequate rest periods occurred. I was also repeatedly asked if I was sure that a) I couldn't drive and b) whether we didn't know of anybody who did. My inability to drive is entirely due to having been in a car crash when I was 22 - as the innocent party, I am more than a little fed up of constantly being blamed for not driving some 40 years later as though I was being deliberately provocative.

A little compassion and understanding would not come amiss. it is appalling that the caring professions lack such knowledge and understanding that they cannot see that some disabilities are indeed hidden.

Due to the lack of rest, the hospitals reluctance to either provide transport or point us in the direction where it might be obtained, my husband could not elevate his leg as often as was recommended. His foot swelled to the point where the skin cracked and he unfortunately got an infection in it. This was over the bank holiday period when neither HVMH was open nor my GP surgery. In order to stop the infection, I gave him my rescue antibiotics as they were a good match for this sort of infection ( I have studied immunolgy and infectious disease and molecules, medicines and drugs at degree level)

Recently-this year, my husband had his other foot operated on. We had changed GP's and this time someone at the HVMH informed us that they didn't arrange transport and to go back to the GP. I don't know why this couldn't have been conveyed to us last year. My GP arranged transport for my husband - the operation was scheduled for 12 midday. My husband had been provided with the hospital transport number and his patient number to give to the receptionist should there be any changes. There were, as his operation didn't take place unti 2pm. so his return journey had to be cancelled. Our GP practice had reassured us that if the transport had to be rearranged that the receptionist would do it for us at HVMH if he gave her the details he had on him.

After his operation when he WAS allowed into the waiting room ( unlike last time when this permission was flatly refused us) he gave the slip of paper to the receptionist and asked her to ring up the hospital transport to arrange to pick him up. The older receptionist forbid the younger receptionist to do it and it wasn't until the older person left the reception area that the younger receptionist admitted she could now ring. How appalling that someone felt so intimidated that they dare not fulfil a simple request.

I will say that both operations appear to be successful and we do thank the surgeons for their skill and care. However, most of any basic care, empathy, communication and compassion from most of the other people involved, wasn't in evidence. Not only did it leave us feeling very angry but such behaviour is nothing more tantamount than abuse and has no place in society, never mind in a hospital which is supposed to care for patients.

We have mentioned these difficulties to which the response was that they did ask if there was a 'responsible person at home to look after my husband. As a person who has been in healthcare all my life until illness took over, i would say - as would others - that I am a very responsible person as is my husband.

However, it is difficult to plan anything when there is such lack of communication or indeed any recognition by the health care service of our individual needs which could have easily been met if they had chosen to do so.

What could have been better

Communication

showing some humanity

Signposting us to sources of transport

Recognition of the difficulties that carers face and that some people do have hidden disabilities and not judging on what you cannot see.

Lack of suitable xray post operative equipment

The receptionist who refused to ring for hospital transport

The skills of the surgeon and Tracey's compassion was good.

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Responses

Response from Louise Thornton, Customer Engagement Manager , Adults Planned and Health and Wellbeing Business Unit, Locala Community Partnerships

picture of Louise Thornton

Hi GladysConstance

My name is Louise Thornton, I am the engagement manager for the business unit in which day surgery at HVMH sits. I would very much like to chat to you personally regarding your husband’s experience in our podiatric surgery department. Please can I ask you contact me either via email louise.thornton@locala.org.uk or ring me on my mobile 07814665526 Unfortunately I will be on annual leave until Monday 9th March.

Louise Thornton

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Update posted by Constance Gladys (a relative)

Good afternoon Mrs Thornton,

Thank you for your response. I prefer not to meet at this stage but I am willing to supply any information you request regarding the review above.

Gladys Constance

Update posted by Constance Gladys (a relative)

Our further response/follow up review

Our first follow up appointment went very well, apart from when we approached reception and asked them to organise the transport back (we had arrived by hospital transport – both journeys had been requested by our GP surgery, beforehand). Both receptionists initially refused but did rectify the situation quite quickly.

My husband has his post operative x-ray soon and his second follow up appointment, the day after. We would both like to thank Alison (surgeon) and Tracy (nurse)

for their kindness, care and exemplary instructions on post operative care which could not be faulted.

The receptionist was polite and efficient and on our request for an appointment six months hence, she did add that she would also telephone for the transport we required for which we also extend our thanks.

We would also like to thank the wonderful volunteers in the café at HVMH who are always so cheerful and helpful. Both my husband and I would like you to know that we appreciate what you do very much. (as I am sure many others, do).

We would now like to offer our suggestions for enhancing patient care

• Patients may choose HVMH for its geographical convenience therefore they need to know, when making their choice, if a lack of post operative equipment means that they will still have to travel to another hospital for x-ray. My husband was only informed of this requirement after his first operation.

• Many patients will need to know more than a few days in advance, the time of their operation. We were informed of the date in reasonable time but not the actual time. We were dependent on other, very busy people, to help us out who not only were ill themselves and had to organise child care for a grandchild they looked after but also had a disabled daughter to look after.

• If you don’t organise transport then at least point patients in the right direction. We had just changed GP’s prior to being referred to HVMH so our current GP did not know of our difficulties at the time neither did we know that they arranged transport.

• Patients need to know of the requirements to elevate their foot on the back seat of the car well in advance of their operation – not after the operation on the way down to the car, which in our case was unsuitable, since it was only a three door hatchback and as my husband’s leg was anaesthetised, he was unable to access.

• Patients need to know that their crutches are going to be abruptly taken off them at their two week appointment. Nobody told my husband the first time around that this was going to take place and he had gone to his appointment without his normal shoe. His crutches were withdrawn and he had to go home with one ordinary shoe and one post operative shoe on and without the support of any stick which he did need at the time. At the follow up for the second operation, he asked if he still required the post-op shoe for which we again extend our thanks for their consideration in giving him a choice. My husband, after all, has the knowledge of whether he can cope or not. Every individual is different.

• Please give consideration to the fact that sometimes infections do occur when it is a Bank Holiday and both HVMH and the GP’s surgery is closed. This happened to my husband and could have had much worse consequences if my rescue antibiotics had not been a good match. In such eventualities, there needs to be guidance as to what steps should be taken.

• Please try and understand that a patient does not exist in isolation from their environment which will impact on their recovery. Not everybody drives, not everyone has children who can do the running around – our son died a while ago. We would have loved it if he could have been here to run us around. We are more or less the youngest in our family with the majority of our relatives in their nineties living in the Midlands and the few who do live nearer – still in their 80’s and 90’s - we provide the support for, not the other way around. My husband will be 70 soon.

• Communication needs to be better. My husband’s second operation was scheduled for 12 midday but he didn’t have his operation until 2pm and yet nobody rang me up to inform me that there would be a delay.

It would have been helpful for us to have a written idea of what to expect at each stage – for example:

 at the second post operative appointment, your crutches will be withdrawn and you will be required to bring along your normal shoe. Some people find a walking stick useful for the following few days after withdrawal of crutches.

This is the end of our response which we hope will be useful. Thank you!

Response from Louise Thornton, Customer Engagement Manager , Adults Planned and Health and Wellbeing Business Unit, Locala Community Partnerships

picture of Louise Thornton

Many thanks for the above suggestions all of which are really valuable. Myself, the operational manager and the clinical team leader are meeting in the next few weeks to look at all the points you have raised and hopefully reflect and prevent them happening again.

I will pass on your thanks and appreciation to the surgeon, nurse and café volunteers and thank you once again for taking the time to post on Patient Opinion.

Louise Thornton

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