"Withdrawal of effective pain relief"

About: Royal Free Hospital / Accident and emergency

(as the patient),

I was admitted a few months ago to the Royal Free Hospital with kidney pains. I was in an A&E ward for 24 hours where, after a rather ineffectual paracetamol tablet, I was given the intravenous form which gave immediate and profound pain relief.

I was then moved to another ward where my requests for more of this pain relief were refused by three different nurses, despite its further use being approved by a hospital doctor. I was given bogus reasons for this refusal – “You won’t be able to have IV at home so you mustn’t have it here”, “We’re weaning you off it”, “Your condition isn’t serious enough to warrant IV”.

The other medications I was offered weren’t very effective and as a result I spent I night in extreme pain for no good reason.

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Response from Royal Free London NHS Foundation Trust

Hi there, we're sorry to hear you're unhappy. If you'd like us to look into this further, please email rf.communications@nhs.net with details of the date and location of your stay so that we can help you. Thank you very much for getting in touch.

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Update posted by Better now but still aggrieved (the patient)

This response is of little help because I would like to have an answer to my complaint whilst retaining my anonymity. I’m still an outpatient at the Royal Free and it’s quite possible that I’ll be back as an inpatient at some stage and I don’t want to risk prejudicing my future treatment by logging an official complaint.

Incidentally, I phoned the Patient Liaison Service who according to the website, will discuss issues in confidence. The phone went unanswered twice, so I sent an email outlining the problem and stating my wish for confidentiality. This email was immediately forwarded, without my permission, to the Complaints Dept and a second email to PLS asking about confidentiality went unanswered. Not particularly impressive.

The sort of questions I’d like answering are:

Is it acceptable for nurses to ignore recommendations on pain relief made by hospital doctors? (There was no issue about safe dosage intervals)

Why would previously administered pain relief ever be withdrawn without clinical indications?

Does each ward have its own policy on pain relief or is one standard applied throughout RFH? (The ward concerned was 5 East B)

The reasons I was given for withholding IVP can’t possibly be genuine – what could possibly be the real reason? Budget constraints, stock shortage?

It seems as though the nurses were obeying orders from above. Who decides which medication can and can’t be given? The ward sister, someone higher or someone junior?

If this happened to me again what could I do?

Response from Royal Free London NHS Foundation Trust

Thank you for your response and we’re sorry that you do not feel it is satisfactory for us to ask you to email us with further details in order to answer your questions. We encourage contact via email so that we can get the details we need without breaching patient confidentiality by discussing the specifics of your case on a public forum. Without knowing personal details regarding your case it is difficult for us to provide an accurate response to your questions – as you can imagine, care decisions are made based on the details of individual cases. If you were to share those with us outside a public platform, the right person who has knowledge of your case would be able to get in touch personally and talk you through the decisions made and why.

We take all comments and complaints about our care very seriously and we can reassure you that neither asking questions nor filing a complaint will affect your care in any way in the future. Feedback is immensely important to us and helps us make changes which benefit many patients.