"Problems caused by OOH doctor"

About: Hairmyres Hospital / Emergency department Lanarkshire Community Services / GP Out of Hours service NHS 24 / NHS 24 (111 service) Scottish Ambulance Service / Emergency Ambulance

(as a relative),

My Aunt has dementia and had fallen and banged her head last week. She was taken to Hairmyres Hospital where she was checked out given a chest xray. Bloods and a urine test all came back fine.

At the weekend she took a wee turn and an out of hours doctor was phoned for her. He came to see her did not examine her, take blood pressure or anything and stated that she needed to go to hospital.

NHS 24 was called at 5.30 pm and an ambulance ordered. After 6 hours of waiting and a few phone calls later to NHS 24, only to be told there were no ambulances!

I took her to A&E at Hairmyres myself, by this time it was 11.40 am only to be told we had been referred to Monklands but they would see her anyway. She had to stay in overnight but there were no beds.

So I left my 82 years old Aunt, who has Parkinson's and dementia, in an unfamiliar place, sleeping in A&E, because the hospital was full. All this because an OOH doctor did not look at herproperly.

I picked her up today every distressed about the whole thing. If the NHS are going to employ OOH doctors can they please ensure that they are doing their job properly, and probably getting paid a good fee for it, and not passing the buck on to the hospitals. I feel the last 24 hours has been such a waste of everyone's time.

I must stress that the A&E staff at Hairmyers were excellent, very understanding ans compassionate, even they were shocked at how long we had to wait for the ambulance not showing up and the fact he had referred her to hospital in the first place.

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Responses

Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear madmo

Thank you for your posting via Patient Opinion. I am very sorry to learn that your Aunt suffered a fall. Clearly this has been a very worrying time for you all.

Patient Opinion has shared your story with NHS 24 as you have explained that you contacted us and we requested an ambulance to attend, however you needed to chase this up, which I am sure would have been very frustrating.

It may be helpful to explain that once NHS 24 passes a request to the Scottish Ambulance Service for an ambulance to attend to a patient, then ambulance provision is determined by them. Should a patient's symptoms worsen however, we can request a more urgent attendance. It would be helpful to know when the request was made, within what timeframe, and what caused the delay. I note my colleagues within the Scottish Ambulance Service have also been tagged to your story.

NHS 24 would be pleased to explore your story more fully. Please do not hesitate to contact me on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk.

I do wish both yourself and your Aunt well.

With regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

0141 337 4582

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Response from Sharon Hammell, Head of Corporate Affairs and Engagement, Scottish Ambulance Service

Dear madmo

I was really sorry to read your post about your aunt's fall and her distress. And, of course, when her end-to-end care didn't go to plan, this also had an impact on you. I'm really sorry for that, too.

As Shona says above, the Scottish Ambulance Service will have agreed a timeframe for getting to your aunt, with the GP who attended her. The timeframe is normally within one hour, within two hours and up to four hours, depending on the GP assessment of the patient's needs. Six hours does not sound right. Our normal procedure is also to call a patient or the person caring for the patient, on occasions where we cannot meet the agreed timeline, to apologise and to check the patient's condition. I'd like to look into the delay for you, and to check why we weren't in touch with you to explain the delay and check how your aunt was doing.

At your convenience, please give me a ring on 0131 314 0065 or e-mail me at: sharon.hammell@nhs.net

In the meantime, I hope you aunt is feeling more settled and recovering well from her fall.

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Update posted by madmo (a relative)

Thankyou both for responding so quickly. I maybe didn't explain that we had been in touch with NHS 24 within the 6 hour period. When 3 hours was approaching they contacted us to let us know that an ambulance was on its way and when the time went over 4 hours the priority would be changed to urgent this was about 7pm. We waited an hour and a half and I phoned them back to ask where it was but it had been diverted to an emergency, fair enough that takes priority, but one would be with us soon. At 11pm I phoned again to ask if one was on it's way and if not could I cancel the request and take her myself. Eventually they agreed I was responsible enough to take her as there were no ambulances available. We eventually got to A&E at 11.40 pm. What my problem is that when I asked nhs 24 earlier could I cancel the ambulance and take her myself they said no because the OOH doctor had ordered it. I don't understand why I could not cancel it. So really we waited and felt helpless for 6 hours when if I had been able to cancel it, she could have been at hospital much earlier. She was checked over and there were no other health problems apart from what she has already, unfortunately her experience in A&E was a little traumatic for her.

Response from Lise Axford, Senior Nurse, Emergency Medicine, Hairmyres Hospital

picture of Lise Axford

Dear madmo

Thank you for sharing your recent experience. I am sorry to read your account of this distressing time. I hope that your Aunt is recovering after her fall.

I would like to apologise that your Aunt had to stay in the Emergency department overnight. Staff make every effort to ensure that each patients needs are addressed and I was pleased to hear that staff were compassionate and understanding. I will share these positive comments with staff. You mentioned that your Aunts's experience in A&E was a little traumatic for her and I would like to discuss this further with you in order to address your specific concerns. I would be grateful if you could call me on 01355 584725 to discuss.

Thank you for sharing your concerns.

Lise

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Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear madmo

Thank you for the additional information and I can completely understand your frustration at the time taken for your Aunt to receive care.

It may help your understanding if I explain that NHS 24 would not cancel an ambulance which had been arranged by an Out of Hours GP. We would consider that the Out of Hours GP had assessed the patient's symptoms and circumstances and concluded that ambulance attendance was the safest and most appropriate way for the patient to be transferred to hospital. We would, in some circumstances, arrange for further contact to be made with a patient by an Out of Hours GP to establish the current situation.

I note my colleagues have also responded to your posting and are keen to explore this more fully. Please do not hesitate to contact me on 0141 337 4582 should you wish NHS 24 to undertake a review of the contact with our service. We would require some additional detail for us to look into this further.

With regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

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Response from Sharon Hammell, Head of Corporate Affairs and Engagement, Scottish Ambulance Service

Dear madmo

Thanks for posting more information yesterday. Just to let you know I've shared your experience with a colleague in our Ambulance Control Centre (ACC) to see if there is some learning around the options available, in the event that we are unable to make the time frame requested by the patient's GP. I'll get back to you once I have heard from him. It'll most likely be next week, but will post an update as soon as I can.

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Response from Laura Jack, Patient Affairs Manager, Primary Care Division, NHS Lanarkshire

picture of Laura Jack

Dear Madmo,

Myself and the General Manager responsible for our Out of Hours Service, Tom Bryce, have read your post and the replies posted by our colleagues and we would like to join them in saying how sorry we are that your experience of accessing our services was not as good as it should have been. This must have been very distressing for your aunt and your family.

If, having read the others posts, you still have concerns in relation to the Out of Hours GP who saw your aunt I would be more than happy to look into this further for you and update you directly. Perhaps you could let Lise from Accident and Emergency know when you contact her and she will pass these on to myself or my colleague Tom Bryce. Or you may wish to contact me directly via laura.jack@lanarkshire.scot.nhs.uk or by telephone on 01698 858 292.

Many thanks

Laura

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Response from Sharon Hammell, Head of Corporate Affairs and Engagement, Scottish Ambulance Service We are preparing to make a change

Dear madmo


I'm just following up on my last post about how we will learn from your experience with your aunt. My Ambulance Control Centre colleague has reviewed how we managed our part in your aunt's care. As you might expect, healthcare partners such as the Scottish Ambulance Service, NHS 24 and Out of Hours GPs meet on a regular basis. We will share your experience with your aunt at these meetings, with a view to applying a bit more collective common sense, when a situation such as the one you were in, arises in future.
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Update posted by madmo (a relative)

Thank you so much for listening, your responses have been great, very encouraging. This is a great service, thank you.