"Lack of urgent advice to a known patient with specialised care on a Bank Holiday"

On New Year ’s Day, Friday 1st January, I rang the Royal Free Hospital at the request of my adult son who had an issue with the medication they had prescribed for his long-term treatment. My son (who attends 3 departments at the Royal Free) was due to take a weekly dose of immunosuppressant medication on that day. Nevertheless, he had flu symptoms and a fever, so he was very apprehensive about taking the next dose of something designed to lower the response of his immune system. At the same time, he was worried about missing his dose of prescribed treatment. I rang the department concerned and they were closed. I then rang the switchboard and asked to be put through to the doctor on-call for that department. I was eventually connected to a junior doctor not related to the department who was extremely officious and unpleasant, refusing to listen to my son’s issue and saying it was “inappropriate” for me to ring and I had to contact the GP or A&E. I tried to speak with him but he continually spoke over me repeating the same thing. He did not want to know why I was ringing.

I was already worried about my son’s condition and feared it getting worse and now I was very upset by this doctor’s response. I knew that an on-call GP would not have access to my son’s complex notes as neither would our local A&E department (neither do they usually have the specialist knowledge required). After a while I rang the Royal Free again to speak with PALS to see if they could access some informed medical advice for my son about his medication, but was disappointed and frustrated to discover there was no PALS officer on duty or on-call that day, as it was a Bank Holiday.

Eventually, I rang NHS Direct and was informed by their pre-recorded message that they were extremely busy and were only dealing with emergencies, I was warned that if I did continue with the call there would then be a 4 hour wait for someone to ring me back. At this point, I put the phone down, near to tears. I did ring again though, and my son and I spoke with a very helpful call handler who said she would get a doctor to call us back. After only about 20 minutes a doctor from Bromley EmDoc called. He was extremely pleasant and helpful, and with the caveat of not having access to the notes or understanding my son’s case, he gave me two pieces of sensible (holding) advice which I was able to relay to my son. On the basis of this advice my son made a decision what to do regarding the medication (which of course may not be what the Royal Free might have advised/ wanted).

I find it strange and disturbing that the Royal Free (whose care of my son has always been good) has no provision for crisis/emergency advice to known patients with complex needs and their carers on Bank Holidays (and I also presume this pertains to weekends).