"Please sort out the A&E registration process"

About: Lincoln County Hospital / Accident and emergency

(as the patient),

I am 60 years old and its the first time that I have used A&E. Unfortunately my experience was all the bad things that I have heard people say about Lincoln hospital. I banged my head in an accident giving myself a deep skin cut and by self assessment knew that I would need help to hold it together whilst it heals.

My wife took me to hospital and the first stage was an inquisition for 8 minutes where a computer operative showed complete apathy. She could not find the correct surgery for my local doctor. In the 2 hours that followed I watched the same system incompetence be repeated several times. Just give the reception an ipad to resolve that problem! Its easy to resolve and unacceptable that people in a university city should wait to register their attendance, because the system can't find local doctors surgery.

Triage was within half and hour and I saw a doctor (I think this was unnecessary, a nurse would have done fine) after one and three quarters hours. 10 minutes later I was sorted.

What was shocking was that I observed a high proportion of patients and accompanying people continually left A&E to stand outside smoking. This, even though the hospital is a non-smoking site. This would not happen in a cheap hotel or on a train, or in an office or factory workplace, so why would the hospital endure smoking on their site without taking action?

Within A&E there are 3 vending machines encouraging patients and accompanying people to further their obesity journey by drinking coke and eating chocolate. There was a constant flow of people serving the machines and the floor was littered with debris from the machines.

The environment is so poorly managed that it exudes ill-health and the staff that work there exude apathy. Please bring enthusiastic management into the department to turn it around and begin by getting the registration process sorted because A&E are probably not including waiting to be registered in the waiting time statistics.

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Responses

Response from United Lincolnshire Hospitals NHS Trust

Dear Sad Forpatients

Thank you for sharing your feedback with us. I am very sorry that you experienced a delay when booking in with our A&E receptionist. I will investigate this with the reception supervisor and look at what is causing this delay. We do have Advanced Nurse Practitioners on duty who see patients with head injuries instead of the doctor when appropriate and is dependent on the nature and severity of your injury.

I agree that smoking outside the department is unpleasant and gives a poor impression. The Trust does have a no smoking policy in place across each of the hospitals sites although we do have designated smoking areas which are clearly signed and are located away from entrances to the hospitals. Whilst signage is in place, our managing smoking is also about the messages and positive direction given to patient and visitors in wards and clinics regards the site Smoking Policy. We employ a single Security/Car Park person during days; their constant reminding smokers and pointing out the arrangements in place is at best not practical. It requires promotion of changed behaviour through the wider hospital community.

I have spoken with our catering manager regarding the issue of the vending machines. He has said "in the past we have trialled a food vending machine that had snacks and healthy choices in such as fruit etc. Due to the lack of use and the wastage, it was decided to have the machine taken out. There is limited space in the A&E to offer a full range of products. So it was decided from a food wastage point of view to have the best-selling options available in the department. During the day up to 7pm there is catering facilities on site that offers healthy choices along with a full range of other products. So in A&E the vending machines are there to offer waiting visitors some to have as a drink or light snack".

Regards

Tracy Bell

Matron for A&E, Lincoln County Hospital

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Update posted by Sad Forpatients (the patient)

Dear ULHT

The reason that I am Sad Forpatients is summarized in your reply. The response epitomises that of an organisation with a culture supporting systemic apathy. It offers no reassurance that the hospital is committed to improving its service for local people. It is somewhat unusual that there was no "lessons have been learned" and "changes are already underway" which is the stock response from a public service that continues to fail.

With regard to smoking on a strictly no smoking site, can I invite Lincoln County Hospital to visit every other large business in Lincoln to see why they succeed and our health trust fails. The current local policy is obviously not working.

With reference to chocolate & coke machines in A&E because that is what is wanted by a majority, it is irrational to feed the causes of obesity in a service that exists to make people healthy.

Please, please change and improve.