"A&E ambulance destination fail"

About: Royal United Hospital / Older people's healthcare South Western Ambulance Service NHS Foundation Trust / Emergency ambulance Southmead Hospital / Older people's healthcare

(as a carer),

My 87 year old father fell overnight at his home and the ambulance staff were forced on pain of disciplinary action to take him to RUH Bath where he has never received care and which is completely inaccessible without a car both from his home and from mine. There is no direct bus service to the hospital, I have no car and no-one who can take me, taxis are outside my financial means and I cannot hire a car, which is just about affordable, until Monday.

He is in the process of being assessed for dementia and I usually stay with him throughout such incidents to ensure that he is calm and as oriented as possible and to minimise the risk of falls. I know that I am an important element of his care and save staff a lot of extra pressure. I am beside myself with distress that he is alone. Southmead Hospital (and prior to that Frenchay Hospital before it closed) have always been the hospitals where he has received care in the past and I simply cannot understand why there is no provision for frail elderly people in need of support during A&E care to be an exception to the new rule. This incident will undoubtedly accelerate his deterioration and is frankly unforgiveable.

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Response from Sara Coburn, Patient Engagement Manager, Governance, South Western Ambulance Service Foundation Trust

Good afternoon Candy56,

Thank you for taking the time to provide our service with feedback. I hope your father is recovering well after his fall.

I’m sorry to hear that you were unhappy with the decision to take him to RUH Bath. Our goal is always to provide the most appropriate care to our patients.

It would be difficult for me to comment on the possible reasons behind this decision without some specific information from you but we would be happy to look into this. If you would like us to do so, can I ask you to please contact our Patient Experience Team on either swast.patientexperience@nhs.net or 01392 261585 and a member of the team will take you through the next steps of the process.

Thank you, again, for sharing your experience with us.


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Update posted by Candy56 (a carer)

Thanks for the response Sara. The matter is in hand with the ambulance trust. I am delighted to say that I have also had feedback which enabled me to see my father's GP and have a flag put on his file that he should be taken to Southmead unless the A&E was unable to take patients or his condition required an alternative hospital. I am very grateful for this practical solution that will enable me to help save NHS resources and spare my father the distress and undue delay in discharge that being in hospital on his own inevitably leads to.

Response from Southmead Hospital

Dear Candy56 - Thank you for taking the time and trouble to post your views. I am sorry that your father was not able to be admitted at Southmead when he fell. The hospital is able to accept patients of any age in A&E and I suspect it was pressure on emergency beds that resulted in him being taken to RUH Bath. The criteria used in making this decision would have considered where he was most likely to be quickly seen and treated. I hope that by the time this response is posted appropriate arrangements have been made for your father to be transferred to nearby Geriatric Services for his ongoing care. However, if you have continuing concerns please advise us at Complaints@nbt.nhs.uk and we will do everything possible to assist.

Kind Regards – Steve Sykes

Advice and Complaints Team

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Update posted by Candy56 (a carer)

Hello, Steve.

Yes I got a full and frank explanation of the circumstances from the ambulance service and arrangements are in hand for any future eventualities. I now know that if Dad is taken to RUH I can stay with him, which is a major relief as deconditioning, even in a two night stay, was a major issue. Thanks for the response and a big thank you to all NHS staff who continue to provide excellent service under extremely trying conditions.