"A day in A&E to forget"

About: Lincoln County Hospital / Accident and emergency

(as a carer),

My wife suffers from a heart condition that causes her to collapse without warning. She also suffers from a chronic back condition following a fall which has damaged her central nervous system so that when she collapses the jolt to her neck causes severe pain in her neck and back, which goes into spasm and causes her legs to go numb so that she cannot mobilise. These collapses happen periodically so we are familiar with the situation and know what medications and dosages she needs to effect recovery in the shortest time. We always call an ambulance when she collapses and the paramedics always take her to A&E.

Recently my wife collapsed and was taken into Lincoln A&E by ambulance. The paramedics gave her Entonox for the journey which helped with the chronic back pain.

When she got to A&E about 10am she explained everything to the doctor including the medications and dosages that she needs in order to overcome the back pain and enable her to go home in a few hours. The doctor ignored her advice and gave her minimal doses which were totally inadequate. As a consequence her chronic back condition deteriorated. She was in extreme pain and she lost sensation in her legs and feet so that she could not mobilise. She was ignored for hours on end. At around 7pm it felt like the doctors suddenly decided that they wanted my wife out of the treatment bay which she had occupied all day while A&E filled up with casualties waiting for treatment.

They asked what treatment she needed in order to go home. As before she told them the medications and doses she needed to start recovery which this time they gave her. She told them that she couldn't mobilise and therefore couldn't go home so eventually after 11pm she had to be admitted to the hospital proper where she spent the night.

I collected her the following day by which time sensation had returned to her feet and legs. However, the constant chronic pain she suffered for in excess of 12 hours had taken its toll and she spent the next 3 days in bed.

When we lived in Suffolk we had a care plan for my wife's treatment in A&E so that the staff and doctors knew what to do and she could be discharged home in 4 hours.  Lincoln hospital has so far refused to grant one. They do not believe it is necessary.

We feel totally let down by Lincoln County Hospital A&E department.

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Response from United Lincolnshire Hospitals NHS Trust

Dear Disappointed99,

I am sorry to hear that you felt your experience in Lincoln A&E was so poor.

I am aware of the circumstances surrounding the events and previous attendances and can reassure you that a great deal of work has been put in by the Emergency Department to try to resolve this and create a plan to go forwards.

Unfortunately I am aware that there are certain processes that need to be undertaken. This has been discussed with and agreed with your wife’s GP.

It is not the case that the hospital or the Emergency Department is unwilling to do this or has refused to grant one but need the input of other teams to ensure that the plan is correct. If you would liaise with your wife’s GP to ensure this process is happening.

Please contact the trusts PALS department on (01522) 512512 if you wish to discuss any aspects further.

Dr David Flynn MB ChB FCEM
Clinical Director Medicine and A&E/Consultant Emergency Medicine

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Update posted by Disappointed99 (a carer)

We attended the pain clinic at Grantham last Friday and put it to the doctor that we needed his input and recommendations regarding my wife's treatment in A&E when she is admitted after a fall. We explained that effective treatment for her extreme pain was the prime objective in achieving an early discharge from A&E.

He said that he could not possibly provide any input because he would not presume to tell doctors in an emergency situation what they should be doing. All he did was review her regular medications. He said he could not help us further. As pain control is the issue we cannot see how the cardiac or neurology departments can contribute to the matter. Her heart never shows any adverse signs by the time we get to A&E and her neurological situation has never changed. The problem is effective pain control. The only way forward, in our opinion is to do what we did at Ipswich Hospital namely have a face to face meeting with the doctors responsible for clinical practice in A&E so that the issues can be discussed and resolved. If you believe that other departments need to be involved then we think that the onus is on you to put the problem to them and for them to say whether in their opinion they can usefully contribute. If they do, then we will go to the clinics concerned for my wife to be examined.

So far all we have achieved is a tour of satellite hospitals in Lincolnshire. Recently we went to a cardiac appointment in Grantham only to find that my wife's notes weren't there. We went to a cardiac appointment in Worksop only to find that we had been allocated the wrong day. At this rate it will take months only to find that in the end the whole exercise is futile and in the meantime my wife will collapse again and our last experience of A&E will be repeated.

This is simply not good enough. It means that my wife will suffer pain and distress unnecessarily and the department will find a bay taken up for hours unnecessarily while doctors who have never met my wife before proceed with treatment which for her is totally inappropriate.