"Appalled by emergency care at the New Queen Elizabeth Hospital"

About: Queen Elizabeth Hospital / General surgery

(as a relative),

A few days ago the GP secured an ambulance admission for the Mother In Law (age 74) for a potential upper bowel obstruction (pre existing Diverticulitus) and she was admitted to the Clinical Decision Unit.

My partner met her at CDU when she arrived and she was placed on a trolley/bed and the ambulance crew offered a handover and were told that the staff were too busy.

My mother in law had not had any fluid intake for over 5 hours and after an hour my partner had to try and find some staff, walked past two empty desks and when some staff were found manning a desk I was curtly told to go back and wait as this was not their area.

On returning to CDU my partner found a nurse and explained that my mother had been there an hour without triage or any assessment.

An hour later a male nurse explained they were very busy, there were no staff and they were uncertain who the surgeon on take was, or if they were in, and following a very cursory tick triage he left.

My partner, concerned about her mother's dehydration, was about to get water and then the nurse came back and said "oh by the way she is nil by mouth".

After the lady in the next bed told my Mother in Law she had been there from 10:00 am waiting for a surgical review we called the on call manger.

We asked why there was not a proper triage, why an elderly lady who has had hours without fluid was not on a drip or offered water and where was the surgeon?

20 minutes later, the on call manager arrived to explain that they were very busy and that there were people in A&E in a great deal of pain and they were the priority and she could not advise when a surgeon would be available.

Mother in Law aged 74 was admitted with a great deal of pain, abdominal distension and suspected bowel obstruction and was dehydrated and had had a triage, so we are unsure why the sicker people "guilt card" was played and that we viewed as making a fuss whilst other people were more deserving.

Evenutally the surgeon came, apologised, explained he had just come on call and she had a thorough exam. He took her off nil by mouth, planned some x-rays, sorted a drip and if by the morning no bowel movement, it would be strong laxatives.

My partner stayed, pushing fluids on her mother as no drip arrived and there was no support from nursing staff to ensure her mother took on board fluids.

My partner was there on Friday for the morning surgical ward round, where the surgeon explained x-rays were clear and the fluids had shown that there were bowel movements and said a dynamic contrast CT needed to be planned but not on saturday as needed done properly.

She suggested she was kept in a further night for observation.

Only the surgeon realised my mother in law was well known locally and active in the community, and it was the first time she had been treated as an adult and with dignity.

Mother in law has had no further interventions, just basic observations, and on Saturday we tried to contact the ward she been moved to.

After calling for 30 minutes and having the ward phone picked up and hung up, and trying all three numbers on UHBs web site for the ward which routed to a fax and to admin offices with answer phones, we called the On Call Manger again.

Once more we were getting the impression an undue fuss was being made and she would contact the ward and someone would get back to us.

40 minutes later we are preparing to go the hospital in person.

We shall be complaining formally about what is percieved to be a dumping ground for the elderly who are not seen as a priority, because they do not complain or make a fuss. Our complaint will be to the PCT Cluster (the commissioner) and not the in house PALS team paid by the Trust.

As we both work in healthcare, knowing about on call managers, on take surgeons, etc, we have the advantage of making things happen albiet slowly but others are not so fortunate.

The new supersized round wards with side rooms means the nursing staff seem to be chasing their own tails over considerable distance to do even the basics. The second surgeon was great and treated Mother In Law as a person. I don't think the nursing staff are responsible for staffing levels or missing surgeons but it is worrying that the care at the new super hospital does not match its shiny glossy modern finish - and is it best clinical pratice to refuse the ambulance crew's handover?

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Responses

Response from University Hospitals Birmingham NHS Foundation Trust

Thank you for taking the time to provide feedback on your mother-in-law’s experience at Queen Elizabeth Hospital Birmingham.

We were very shocked to read your comments about the experience your mother-in-law had on our Clinical Decision Unit (CDU). This is certainly not the type of experience we would want anyone to have as a patient under our care. We strive to provide the highest standard of care possible and we are very sorry that we have not achieved this on this occasion.

Your comments have been forwarded to the senior managers responsible for this department and we will shortly be posting a more detailed response to the issues you have raised.

We welcome all feedback and would like to assure you that all comments are taken seriously and acted upon as part of our ongoing commitment to improving patient experience.

Response from University Hospitals Birmingham NHS Foundation Trust

Thank you for your patience following our earlier response to say we would be looking into this further.

Your comments were forwarded to the relevant senior clinical and managerial members of staff and an initial investigation of your concerns has taken place. As the issues raised are quite complex and personal to your mother-in-law’s care it is difficult to address them properly over a public website. In order to ensure that you are able to discuss the issues raised in more detail and for the team to take action to ensure that future patients have a more positive experience they would welcome the opportunity to meet with you. If you would like to do this please contact the Patient Services Department who will make the necessary arrangements. You can contact Patient Services by phone 0121 627 2950 or by email complaints@uhb.nhs.uk.

Thank you again for taking the trouble to post your comments on the Patient Opinion website.