"Upset by communication about my brother's care"

About: The Great Western Hospital / Older people's healthcare

(as a relative),

Having believed in the NHS for all of my life it is with dismay that I now find myself in the position of having to complain vigorously about an appalling episode which occurred whilst I and other family members were visiting my 76 year old brother at Woodpecker ward in early February, after he had earlier in the week been admitted with Pneumonia.

Three of the family including myself, my brother’s wife, and my 14 year old son, visited during the afternoon between 14:30 to 17:00 hrs. We were all extremely worried and anxious as the ward had been trying to contact us that morning, to tell us that my brother had been given a bowl of soup which he may have not swallowed correctly, although they could not confirm this as the cause, he may have choked on it and had turned blue, and had to be resuscitated after his heart had stopped beating for three minutes.

He was taken for an x-ray or scan shortly after we arrived, and at that time we were told by the staff nurse that was attending him that the doctor would be along to speak with us in an hour’s time, after they had more results, and so when my brother was returned to the ward a short time later we waited to see the doctor who duly arrived at approximately 16.45. My brother was fully conscious and lucid at the time, and knew who each of us were, even though he had a very loose rattling cough, and was obviously very ill.

The Doctor introduced herself, and then went on to speak with us whilst at my brother's bedside, saying that there had been an episode that morning where my brother had possibly choked on some soup that he had been eating and some could have gone down into his lungs. She then went on to say that because of his condition, if it were to happen again for any reason, then they wouldn’t consider resuscitating him, because he could end up with even more damage in the way of possible broken ribs, and may end up in a worse condition in ‘intensive care’, and because of the his quality of life, to be frank it wouldn’t be worth it.

This was said to me, and his wife, and also in front of my fourteen year old son who has a autistic condition, and at the time I stood there in shock as I could not believe what was being said, with my brother who was fully conscious and lucid had been listening to it also.

When it was time to leave after visiting hours, I had had time to recollect and get over the shock of what had been said to us in front of my brother, and I thought to myself that it was similar to what one gets told by a Vet when a treasured pet is coming to the end of its lifespan, but this was my brother that she had been speaking of, who is my sole remaining blood relative on this planet.

I then went to the ward reception desk as I felt that this event should not be overlooked for the sake of my brother, and others at the GWH, where I saw the Doctor concerned with her back to me over the far side of the desk, and I asked a nearby colleague to draw her attention to the fact that I would like to speak with her.

She duly came over, and I expressed my concern about what she had said to my family whilst at my brother’s bedside and I told her that I was not happy about what she had said, and her response was that I had not understood, and anyway she had received instructions from two consultants, one whose name was McKinley, and another one who she mentioned at the time but I can’t recall. I then got rather angry, saying I thought that you people were here to save life, and then considered that I was wasting my time by raising the subject, and proceeded out of the hospital.

The next day my son was in tears and highly distressed at the thought that he may never see his uncle ever again, and it was at this point that I decided to make a complaint to the PALS at the GWH which is the Patient Advice Liaison Service, who told me that they needed to speak with my brother to see if he was willing for me to raise it as a complaint, but then went on to say that there was indeed a policy of non resuscitation in place if it was considered by the powers that be, and in this case the two consultants that the quality of life in their opinion would not make such action worth it.

It seems to me that PFI hospitals under Cameron’s coalition government need to save money no matter what the means may be, and it would appear it is happening by letting the elderly die, or possibly helping them on their way, as there has been reports of starvation with food not being given, and more importantly fluids not being given. I remain far from happy with this state of affairs, especially in the light of the treatment of my brother, and furthermore I am not satisfied with my dealings with PALS, which has only compounded my fears, and will now consider taking the matter further, for the sake of elderly patients that deserve the right to expect both their life and dignity to be heeded at any age.

However I would like to commend the ordinary nursing staff, who were outstanding whilst telling me in detail what was happening concerning my brothers treatment, and they are in no way to blame for the perceived short comings of their clinical seniors.

However I still feel anxious and worried knowing that my brother is still resident in Woodpecker ward at the GWH, as I have now lost completely my faith in the senior clinical staff, as having the welfare and the life of my brother, along with that of other elderly people before that of cost cutting, and therefore looking at the big picture I have never felt that the NHS was safe in PM David Cameron’s hands, and have now had it confirmed in no uncertain terms.

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Response from Great Western Hospitals NHS Foundation Trust

I am sorry that are unhappy with the care your brother was given at our hospital. I am aware that you have been in contact with the Patient Advice and Liaison Service (PALS) to complain about the issues highlighted in your comment above which is the right process to follow. I have been assured by the PALS Team that the investigation into the issues you have raised is underway and an acknowledgment of your complaint has been sent to you.

It is very important that we investigate issues of concern so that we can provide reassurance to patients and relatives, and if necessary make changes to practices if the care provided falls below the standard we all rightly expect. Given the issues of patient confidentiality, it would be inappropriate for us to go into detail about the case on this website but I would like to assure you the issues are being looked into and have been raised with the clinical and nursing team on the ward.

The issue of resuscitation is a very sensitive one. All hospitals have a policy in place detailing in the process that should be followed if resuscitation is considered by the Doctor in charge not to be in the best clinical interest of the patient.

In your second post, you highlight concerns about the use of the Liverpool Care Pathway (LCP). The LCP uses the experience and the expertise of hospices in caring for people at the end of their life and aims to raise the standard of end of life care in hospitals. The focus of the LCP is to have a plan for the end of life which is designed around the needs of each individual supporting them to have a dignified and comfortable death. The issue that matters most is the care of the patient and not finances or other factors of that nature. Clearly with these very sensitive issues it is important that staff clearly communicate with relatives about the LCP and what support is provided to the patient and additional information to support relatives has been ordered for use on the wards. We also have some useful information for relatives on our website here: http://www.gwh.nhs.uk/wards-and-services-a-z/a-to-z/palliative-care/liverpool-care-pathway outlining what the LCP is designed to achieve.

I understand from the nursing staff that you had the opportunity to speak to them about your concerns whilst your brother was under our care and we would encourage anybody who has cause for concern to raise issues immediately with the staff on the ward or department. This enables them to address them there and then rather than through a formal complaints route which, by its nature takes time to properly investigate.

Do not hesitate to speak to the ward staff or to the PALS department if you need to chat through anything, in the meantime a full response will be sent in the near future once the investigation is complete.