"In A and E frustrating and exhausting; on the..."

About: Wythenshawe Hospital

What I liked

Two member's of my family, a toddler and an elderly gentleman with a terminal condition have been admitted to the hospital this year. The treatment and care of both on the wards was good.

The treatment of the elderly patient in A and E fell short of acceptable. Overall we were in A and E for 6 hours much of it on hard seats in the waiting area, this despite a GP referral. The GP had rung ahead to request a bed. I appreciate that emergency medicine is a difficult area to manage, but this does not excuse staff not introducing themselves or explaining what and why they are doing things. Coming into a cubicle stating I'm doing your blood pressure and then another nurse stating I need bloods is not respecting the patient as an individual. Nor are discarded bandages from a previous occupant of the cubicle being on the floor under the bed acceptable. What a relief when the ward manager arrived with a smile on her face addressed the patient by name and introduced herself, little things really do count.

Incidentally the information displayed on screen in A and E contains a number of basic errors ( I had several hours to digest the information content ) take a look such errors do not inspire confidence if care is not taken in one area maybe it is not in others ( hence discarded dressings) e.g. one of the errors ' are consultants are ' instead of our consultants are.

Again I do appreciate A and E is difficult to manage and I am sure stressful for staff I did however feel on this occasion things could have been managed far better.

What could be improved

At Leighton Hospital my grandchild was taken straight to an assessment ward following a GP referral, why does this not happen at this Hospital? Better by far for the patient and releases capacity in A and E.

Refer none emergencies back to out of hour GP services after triage and/or charge for misuse of the emergency services ( at point of access not from the GP's budget).

The bays in A and E were full due to shortage of beds on wards, this is not a situation that occurs instantaneously but over a number of hours monitor bed occupancy more closely and respond by opening up wards before blockages occur. Mathematical modelling of bed use should allow for reasonably accurate prediction and best value use of resources.

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Responses

Response from Wythenshawe Hospital

Can I apologise for your experience within the emergency dept on your recent visit. Unfortunately at the time of your attendance the dept was very busy and experiencing high levels of attendances and admissions.

When patients are brought into cubicles to be assessed it is expected that the rooms are clean and tidy and prepared to receive a new patient. Unfortunately this did not happen which I can only apologise for, having discussed this with the unit manager it appears that due to the busyness of the dept, staff may not have had the time to ensure this. I have reiterated the importance of ensuring this occurs in the future before patients are brought in.

When a GP refers a patient to the hospital it is for a medical assessment to determine whether the patient needs to be admitted into the hospital. This assessment can take place in one of two places either on the GP assessment unit or within the emergency dept. On this occasion the GP assessment area was closed for assessments due to bed pressures within the Trust. Therefore you were sent to the emergency dept to be assessed by the medical team. At this time although we were aware of expected number of admissions for the day, the Trust had bed capacity issues due to the number of unwell patients currently in the hospital and the emergency dept who required a bed.

All staff are expected to meet and greet patients appropriately, introduce themselves and explain to patients and relatives what is happening. I apologise this did not occur and this has been feedback to the individuals and the senior team are working with the staff to improve this.

The ED screen in the waiting room is owned by an external company and we have discussed the errors contained in their information and rectified the situation. In future we will be completing regular reviews of the information to ensure this does not occur again and provides useful appropriate information for patients and relatives attending the dept.

Thank you for your comment

Thank you for bringing the issues to our attention, the Nurse Manager for Accident and Emergency Department will take action to rectify the issues you have raised.

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