"Integration of Health and Social Care"

About: Raigmore Hospital / Trauma & orthopaedics

(as a relative),

My elderly mother was recently admitted to hospital A & E following a fall. She broke her hip.

She remained in the hospital a little longer than necessary in my opinion mainly due to the fact that there wasn't a bed available in a local community hospital. There are two community hospitals in her area but the one that she finally was transferred to is the furthest away from her family and makes travelling that little more difficult. She has I believe had three estimated dates for discharge since being admitted to the community hospital but two dates have gone by the way and then she fell in the hospital and had to be sent to A & E.

She has now returned to the hospital but is not doing too well and is very unsettled, has been put on medication - anti depressant - and is not doing too well. If she had been sent home earlier then I believe that she would have been coping a little better than she is at present.

I have a number of concerns about what is going on - and to me it feels that health and social care is less integrated now than it was before it was introduced.  In my opinion Patient centred care is not happening. and integration of health and social care is not happening. There are some good professionals out there but the system is not working and certainly not for the patient in this case.

Maybe this is an isolated case but I am sure that this is not so. I will not go in to all the details but someone out there has to take stock of what is going on and be prepared to listen.

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Responses

Update posted by Little Mac (a relative)

One month later mother is still in hospital - my understanding is that she shouldn't be there but it would appear that there is no services or a residential placement to offer mother yet. Is this not bed blocking? No response received to date from anyone.

Response from Maimie Thompson, Head of Public Relations and Engagement, Chief Executive's Office, NHS Highland

picture of Maimie Thompson

Dear Little Mac

I am so sorry for you not receiving a timely response and for the difficulties you are experiencing. I do apologise

Can you get in touch to provide me with some further details and I will ask the director of operations for Raigmore Hospital (Katherine Sutton) to look into this as a matter of urgency.

You can call me on 01463 704722 or email maimie.thompson@nhs.net

I look forward to hearing from you and hopefully assisting you.

Thanks for getting in touch

Maimie

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Update posted by Little Mac (a relative)

Another month has passed and mother is still in the community hospital. I visited the Highlands following the response that I had received and I made contact with a number of staff in social care. I learned a great deal about what had been happening and following this after I had returned home made a request for a comprehensive care needs assessment and enquiries about direct payments. My visits to mother in hospital were also enlightening and spoke with a number of staff with mother present about her situation. They too I would imagine are frustrated by the inactivity and the fact that it is preventing others from being admitted to this hospital. They were extremely helpful and understanding. It must however affect their morale the fact that people who are ready for discharge are not being discharged. It certainly is impacting on my mother's well being and mine! I think Social Care's Plan A and B need to be reviewed and maybe it is time for Plan C!! I think many questions need to be asked about my mother's 'treatment', for example are her human rights being violated? The Scottish National Action Plan on Human Rights identified these issues as being of major concern.

Response from Pat Tyrrell, Deputy Director of Nursing and Midwifery, NHS Highland, Nursing and Midwifery, NHS Highland

Dear Little Mac

Thank you very much for updating us on the ongoing issues in relation to your mother's care. I am so sorry that this has not been resolved and that it is having an impact on your and your mother's wellbeing.

My colleague, Maimie Thompson, who responded to your earlier posting is currently on leave. Please can you contact me on 01463 704980 (or on my mobile 07789650992) to discuss further so that we can help deal with the issues that you are facing?

I look forward to hearing from you.

Many thanks.

Pat Tyrrell

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Update posted by Little Mac (a relative)

Four months in the community hospital is fast approaching! Still not had the Care Needs Assessment. Still no word of a residential placement nor an alternative package, not even a temporary one. This is totally unacceptable. No more spin, no more excuses. Time for an appropriate placement for my mother even if it is only a temporary one until something long term is found.

Update posted by Little Mac (a relative)

20 weeks since admitted to the Community Hospital and mother is still there! Nursing staff are looking after her very well but it is not where she should be. Person centred care it is not.

Response from Maimie Thompson, Head of Public Relations and Engagement, Chief Executive's Office, NHS Highland

picture of Maimie Thompson

Dear Little Mac

Thank for your postings. As you know we continue to liaise with the local team and yourself to ensure that everything that can be done is being done.

I know my colleague Pat Tyrell spoke to you last week and in discussion with you, agreed that the best way to handle this is for you to submit a formal complaint which will allow us to more formally investigate. Clearly we wish to protect patient confidentiality and so it is not appropriate for us to report this through PO but very important to reassure you around the steps we have taken.

The best route, on this occasion, will be through a formal complaint. If you require any help in putting together your formal complaint then our feed-back team will be able to assist.

I hope this is helpful

Best wishes

Maimie

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Update posted by Little Mac (a relative)

I didn't find the response from NHS helpful because a formal complaint had been made at the beginning of June and followed up with a further phone call to the complaints section and a further telephone call to a senior officer in NHS. I also wrote again detailing my complaint (with a number of further issues being raised!) in August. I contacted the Complaints section again (adding to my previous complaints) and learned that the investigation had yet to commence. I wrote to the Head of Public Relations and Engagement following the last post to clarify the situation but as of today had no response. My mother remains in hospital and her condition I believe is deteriorating. There is no word of her being discharged.

Response from Pat Tyrrell, Deputy Director of Nursing and Midwifery, NHS Highland, Nursing and Midwifery, NHS Highland

Dear Little Mac,

Many thanks for submitting your complaint in August folowing our discussion. This complaint has now been logged onto our system and the investigation has commenced. Our Feedback team will be in contact with you to let you know the likely timescales for completion of the investigation. We will work hard to cover all of the issues that you highlighted and respond to you as quickly as possible.

Please do not hesitate to contact me if you require any additional information, or if you have any further concerns, in the meantime. My mobile telephone number is 07789 650992.

Many thanks

Pat Tyrrell

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Update posted by Little Mac (a relative)

I don't find response at all helpful as I have already stated the complaint was made in June. No mention of this in response. Furthermore I have been told that the investigation is to be made by the person who is responding and had been delayed and once started would take at least 40 working days. Personally I believe that there should be an independent inquiry in to what is happening in the Highlands.

PS My mother is still in hospital awaiting a placement

Update posted by Little Mac (a relative)

49 working days have now passed since I lodged my complaint for the second time, the first being in June. Still no response from investigating officer. Mother is still in hospital. More and more issues have been raised about my mother's case since then. Not a satisfactory situation but am at a loss as to what further action I can take.

Update posted by Little Mac (a relative)

Mother was finally admitted to a care home, her first choice late last week. She has settled in remarkably well. Thanks to all responsible for this and a special thank you to all nursing staff who looked after her while she was in hospital.

Still no response about the investigation in to complaints and what action is to be taken.

Update posted by Little Mac (a relative)

61 working days have now passed since written complaint submitted. Response awaited.