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"Care for Renal colic"

About: NHS 24 / NHS 24 (111 service) Queen Elizabeth University Hospital Glasgow

(as a friend),

Partner suffering Renal Colic one evening in December. Called NHS 24 - endless call options to get through before speaking to an operator. Thereafter, endless questions, put on hold, told a nurse would call back within the hour. They never did. Called again, same call options, then through to operator. Fobbed off with "yes, the nurse was just about to call you back". Put on hold again. Advised to see out of hours GP at QEUH, put on hold again, then advised to go to A&E. Advisor then said "can I close this case down now as it's your responsibility"!

Go to A&E - 4th in line - seen fairly swiftly and the new hospital's A&E facilities actually fairly pleasant. Seen by doctor after 90 minutes - despite two doctors chatting at the nurses station for over 10 minutes about their domestic arrangements for the upcoming holidays - seriously bad use of time there doctors (! ) and you could have seen us earlier and quicker. Blood tests done, results back in an hour, pain relief given. Gold standard CT Scan to see size and location of stone never done, despite the Radiography facility being right next to A&E.

I went to the atrium to get some refreshments - a couple of times - the doctor said I could, as the other way to reception was controlled by door entry systems. On my return to the A&E unit, I was aggressively approached by a porter, loudly shouting at me saying "you either stay in, or you stay out - you cannae keep wandering in and out like that, Right? " I told him I'd been given permission. His response? "I couldnae care less, now go in or go away". Charming. If not rude and unacceptable.

Prescription for pain relief had to be given as they'd ran out of supplies. Referral to urologist - 4 to 6 weeks wait.

Get home, call private medical and get an appointment for first day after the public holidays - consulted, tested, bloods and CT scan all done within 30 minutes.

QEUH call during holidays to arrange appointment for catheter insertion. Never mentioned at A&E, and certainly not required. Called back to say there was an error.

Experience at the QEUH A&E was better than expected, although there were a few failings and bad manners on behalf of the staff evident before, during and after.

The NHS can't afford to keep up with the demands placed on a free service. Private medical care works and more should be widely available to those willing to pay. Kidney stone diagnosis and treatment, when the stone is active, can't wait in a 4-6 week waiting list system the NHS provides - otherwise the patient will keep returning to A&E time and time again, with symptoms, clogging the system up. Diagnose and treat the symptoms of the patient properly at the beginning, to reduce all the factors that burden the system. Simple. Logical.

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Responses

Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 8 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24
Submitted on 11/01/2016 at 09:08
Published on Care Opinion on 12/01/2016 at 12:31


picture of Shona Lawrence

Dear mcghk

Thank you for your posting via patient opinion. I note that you have logged this as the friend of a patient. I was sorry to learn that your friend was suffering from renal colic and I appreciate that this can be a very painful condition.

I have read your posting with interest. Thank you for detailing the story which assists our understanding of the whole patient journey. I am concerned at the detail you have logged in relation to the contact with NHS 24 and I am keen, with your friend's permission, to explore this further.

I note that you have referenced the options heard upon contacting NHS 24 and I am sorry if this caused frustration. We do monitor our introductory message frequently and this is set up to effectively manage the types of calls received by NHS 24. Your comments regarding this will be shared more widely with key clinical staff.

The role of the NHS 24 Call Handler is to capture the patient details and the call reason, which again enables us to priortise calls depending on the symptoms being displayed by a patient. I am sorry that you feel the questions asked were excessive however these are asked to ensure patient safety. I note your friend's call was awarded a one hour priority which is a high priority and means that we were aware of the acuity of the symptoms. However, I am concerned that you state the return call was not made within this timeframe. I would like to establish why this was the case as we do always endeavour to achieve the indicative return call time. From what you have detailed in your posting, NHS 24 arranged face to face clinical assessment for your friend which, from the symptoms described, would be an appropriate outcome.

As explained earlier, I am keen to fully investigate this contact to establish if there is anything that NHS 24 could have done better. I would be pleased to hear further from you to enable me to do so. I can be contacted on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk.

I am sure my colleagues within NHS Greater Glasgow & Clyde will respond to your comments regarding the provision of service at the Queen Elizabeth Hospital.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manger

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Update posted by mcghk (a friend)

Thanks for your response Shona. The NHS24 call menu option is excessive and frustrating when in times of urgent need. No further discussion on that one. The one-hour callback did not happen, hence my second call to NHS24, to go through the same process again.

Your response is timely, as I have just finished a phone call with a rude, condescending member of staff to cancel yet another unnecessary appointment. This kind of attitude I make no apology for, is yet another reason why we have gone private. They demanded to know what type of appointment we were cancelling - clinical or surgery. The letter provided gave zero indication. Therefore, I replied giving a full account of why we were cancelling. I felt that the whole approach to me, on behalf of a patient, was bluntly disgusting and I unashamedly explained why.

I feel that the system in my partner's instance has failed and is affecting other patients. We cancelled all NHS healthcare, in the immediate week after our A&E visit. This included cancelling a 4-6 week wait for a CT Scan. We received further phone calls arranging for a catheter to be fitted - never discussed at A&E and medically uneccesary. We then received an admission letter. Again unnecessary. From what I gather today, after having the telephone conversation, my partner was going to be taken to theatre tomorrow morning. We have no idea what for! Again unnecessary and never mentioned to us at A&E.

I say it again. In our experience and in my opinion, the NHS system is failing patients at all stages. All these errors are of poor communication and work-flow systems, which could all be better deployed in helping patients that need and use the service.

Response from Lorna Fairlie, Patient Experience, Public Involvement Project Manager, NHS Greater Glasgow and Clyde 8 years ago
Lorna Fairlie
Patient Experience, Public Involvement Project Manager,
NHS Greater Glasgow and Clyde

I work in a small team in NHS Greater Glasgow and Clyde which seeks to involve patients and carers in the work of the NHS. The biggest part of my role is in managing feedback projects across the Board area, one of which is Patient Opinion. It is my job to give our patients and carers the opportunity to give us feedback, and to make sure that this is passed to the right people to help us improve the services we provide.

Submitted on 12/01/2016 at 17:05
Published on Care Opinion at 17:21


Dear mcghk,

Following on from Shona's comments above, I wanted to get in touch about the experience you and your partner had in A&E at the Queen Elizabeth University Hospital.

Although I am glad to hear that overall the experience was a positive one, there are certainly some issues you have raised which we can improve on to make this even better. This of course includes the way you were spoken to by a member of staff, which of course is far from what we would expect from any member of staff. I will pass this on to my Facilities colleagues as a reminder to all staff about the impact that the way they interact with patients, relatives and friends can make.

I have also noted your comments about the waiting time to see the Urology specialist and will pass them on to the appropriate service for reflection. I appreciate you sending in your detailed thoughts, as it is really important to us to be able to understand what the patient journey is really like, and how we can make this as smooth as possible for those using our services.

I hope that your partner is doing much better now, best wishes to you both.

Lorna

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Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 8 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24
Submitted on 13/01/2016 at 10:35
Published on Care Opinion at 10:39


picture of Shona Lawrence

Dear mcghk

Thank you for your response and please be assured that I have shared your comments in relation to the NHS 24 call menu options with relevant senior clinical staff.

I note your comments in relation to a conversation with a rude staff member and I am very sorry that this was your experience. I would advise you however that NHS 24 do not manage patient appointments, nor do we provide appointment letters to patients, therefore this aspect of your feedback would require to be addressed by the relevant Health Board.

I am sorry to read your general comments overall in relation to the NHS. Health Boards do seriously consider all patient feedback and are keen to learn from the experiences of service users as this does ultimately assist in improving the service. From what you describe in your story, it would appear that communication has been an issue and I agree that good communication ensures that patients, their friends and their relatives, are fully informed at all times.

As explained in my previous response, NHS 24 are keen to explore any contact with our service to establish if there is anything we could have done differently or better. I am especially keen to explore why the 1 hour call back was not achieved. I reiterate my offer for you to contact me directly should you wish us to explore the service provided by NHS 24 to your friend.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

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