"Occupational therapy for adult care in Hertfordshire"

About: Hertfordshire Community NHS Trust

(as a relative),

Mum developed a pressure sore, adult care services provided a mattress but the only size they had did not fit Mum’s bed. The result was mum could no longer get herself onto the centre of the bed, but had to sleep right on the edge and so started to fall out.

I contacted the occupational threrapy service for assessment of her needs to enable her to get in and out of bed safely and to help with leg raising (oedema due to heart and circulation problems) and back raised (breathing probs due to COPD).

The OT came and referred Mum to local authority OT for bed assessment. care coordinator came round with what appeared to me to be a bit of string on a stick (leg lifter) to solve the problem. I quickly realised that, due to Mum’s lack of strength and coordination difficulties following stroke, the bit of string on a stick was not going to do it and left to discuss with the OTs.

In the meantime we contacted the British Legion to see if there is any possibility of their help to fund a bed to meet mum’s needs. They allocate a case worker within the week, however, he needs to see an OT assessment on which to build his case. I go back to the named care coordinator who had said I could get back to her at any time to discover, because she came out with the bit of string on a stick, the case is now closed with the only conclusion ‘no equipment provided’.

The only way we can re-access the system to get the professional assessment we originally asked for is for me to spend nearly an hour on the phone with the call centre giving them all the information that is taken each time we have to contact them and then to wait 8 weeks for the OT assessment that should, I believe, have been carried out two months ago.

When I ask for the name of a head of OT Service as I would like to discuss the fact that the duty of care to provide an assessment was not delivered and my concerns about access to the service. The call centre are happy to give me the name, but are not allowed to give me a contact number, I then return to the health OT to check that she did indeed refer for a bed assessment rather than a limited bit of unhelpful kit. Get through to a phone message that says ‘the single point of access is unavailable’!

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Responses

Response from Peter Gibson, Associate director, public affairs, East and North Hertfordshire NHS Trust

We are grateful for the opportunity to respond as occupational health services in Hertfordshire, whether provided in people's homes out in the community or as part of someone's care whilst in one of our hospitals, are not provided by us, but a different NHS organisation called the Hertfordshire Community NHS Trust in conjunction with the local authority, Hertfordshire County Council.

We are in the process of contacting Patient Opinion to ask for your comment to be moved to their pages as they are best placed to respond to your concerns.

In the meantime, we do hope that your mother continues to get the care she needs and that you get access to the people looking after her.

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Update posted by Willing but disabled by the system (a relative)

Many thanks for this response. I do apologise for attributing this experience to the wrong provider organisation and am grateful that this be corrected.

This error illustates the lack of any written information, in the form of contact details or, more importantly, a written record of the outcome of the visit that was provided. This may have helped us to reaccess the service when no outcome from the visit was forthcoming.

I will also contact Patient Opinion to have this error corrected.

Response from Stroke Association, Stroke Association

Dear 'Willing but disabled by the system',

We saw your post about the care your mum has received from the local occupational therapy department. I was sorry to hear of your mum’s stroke and the concerns that this has raised.

It sounds as though you are upset and frustrated about the difficulties you have faced in trying to obtain a suitable bed for your mum. The Royal College of Physicians (RCP) produce guidance on stroke care – you may find it helpful to read about the stroke care pathway and the support that should be available. These guidelines are not legally binding but most hospitals and GPs try to follow them. I have attached a link to this document below:

http: //www. rcplondon. ac. uk/sites/default/files/documents/care_after_stroke_or_tia_booklet_0. pdf

It might be helpful to speak to the Patient Advice Liaison Service (PALS). They provide confidential support and help to resolve problems and concerns with the GP and hospital. In addition, they can provide information on complaints procedures. They will also be able to direct you to an advocacy service in the area. It is really important to raise your concerns to the NHS so that they can improve their services and resolve problems. To find out the number for your local Patient Advice and Liaison services you can contact NHS Direct on 0845 4647.

PALS are part of the NHS, but if you wished to complain with the assistance of an independent body you could contact ICAS, an advocacy service for people who wish to make a complaint about health and social care.

http: //icas. org. uk/default. aspx

You may also wish to make a complaint to your local authority - sometimes this is where the occupational therapy department is. You can find out more about this from your local authority – they should have details of their complaints procedure on their website.

At the Stroke Association we have support workers across the UK, providing information, advice and support to people affected by stroke. Our services are funded by PCTs or social services and we receive referrals from hospitals, social services, friends and family and self-referrals; this helps us to support people affected by stroke from the moment of diagnosis. Sadly, not all areas provide funding for these services so we also campaign to raise awareness about stroke, demonstrating the need for our services, and encourage people to understand more about the long term effects of stroke.

Our current campaigns include the Life after Stroke campaign, which challenges some of the barriers to recovery, such as social care, benefits, NHS care and rehabilitation. We are also involved in campaigns against cuts to benefits and services, and we produce Stroke Care Reports which highlight positive and negative aspects of local stroke services. You may wish to join our campaigns - this can be done on our website:

http: //www. stroke. org. uk/campaigns/signup

You may also wish to contact Patients Association, which is an organisation dedicated to campaigning about issues with healthcare services. They have a helpline where you can provide your views about a service; they undertake regular surveys of patient opinions about services; and they produce a newsletter called Patient Voice which contains recent news and opinion about the NHS. I have included their contact details below:

Patients Association

PO Box 935

Harrow

Middlesex

HA1 3YJ

Helpline: 0845 608 4455

I hope this is helpful. If you have any questions or would like to discuss anything further, please do not hesitate to contact us again. The Stroke Helpline is open Monday to Friday from 9am to 5pm on 0303 30 33 100. Please note you can download our full range of leaflets and factsheets free of charge from our website http: //www. stroke. org. uk

Yours sincerely

Eliza Hakes

Stroke Information Service

info@stroke. org. uk

Stroke Association staff are not medically trained and the information provided does not replace information given to you by your own healthcare provider.

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Response from Hertfordshire Community NHS Trust We have made a change

Response from Chris Badger, General Manager, Adult Services, East and North, Hertfordshire Community NHS Trust

We are very sorry to read about the difficulties you experienced when trying to get the right assessment and equipment for your mother following her return home from hospital. We are also sorry that you had cause to raise concerns after being unable to contact the Trust Occupational Therapist through the Single Point of Contact system used by Hertfordshire Community Services NHS Trust

The Trust has recently applied improvements to The Single Point of Contact system by asking professionals (for example GP’s) to make referrals to a different number, in order to free up the line and make the service more accessible to patients and carers when they call in. In addition, work has started to implement a new system to make it much easier for patients to contact our services.

Hertfordshire Community Services NHS Trust welcomes comments on the services it provides in order to resolve problems and improve the patient experience. For further information, or to make a comment about the services provided by us, please contact Hertfordshire Community Trust PALS service on 0800 011 6113.

e-mail: pals.hchs@nhs.net

www.hertschs.nhs.uk