"Problem of pain and length of wait at A + E"

About: Russells Hall Hospital

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1] My daughter was experiencing acute abdominal pain last Monday 25 March. We arrived at A + E at about 7 pm. Not only was she in great pain, she looked it: very pale, listless, almost in a state of collapse. Despite the notices on display about pain, no member of staff seemed charged with observing patients to see if rapid assistance was required. Eventually my other daughter, who was with me, pointed this out to a member of the triage staff, but they should have been much quicker off the mark. 2] An official 3 hour (!!) waiting time for A + E is far too long!! Far more resources seem to be urgently required. 3] When my daughter was discharged (the following afternoon) I had to seek out a verbal 'debrief'' on her diagnosis. The doctor I spoke to did not seem 'rushed off her feet' - it obviously just did not seem to occur to anyone that a (brief - 2 minutes) face-to-face debrief is re-assuring and informative to both patient and (in this case) parent, and could prevent the same thing happening again! 4] A more general thought: On all my visits to RH over the years (my own parents came here a number of times as they got older) I have never seen anyone obviously 'in charge' keeping 'an eye' on things - a kind of Matron figure - as often happens in Schools. Such a person is re-assuring, especially to people who aren't very well!! 5] I notice that several other reviews address the problem of pain and some of them say the problem is greater at night, as was the case with my daughter. - Overall I think RH needs to give far more thought to what it must be like for patients at A + E (in this case) and adjust their practice to the 'other side of the counter'.

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Responses

Response from The Dudley Group NHS Foundation Trust

Thank for taking the time to comment on your experience of our hospital. We would like to assure you that all comments are taken seriously and acted upon as part of our ongoing commitment to improving patient experience.

We are sorry to hear you and your daughter had a negative experience of our A&E Department. It is very distressing to see a loved one in pain. Timeliness of pain relief is very important; every patient who attends A&E is booked in and triaged (assessed) by a trained member of staff and analgesia is prescribed and administered, where appropriate.

A&E is an extremely busy department – in 2011/12 more than 98,000 patients attended. We do our utmost to offer the best possible care and aim to see every patient within four hours of their arrival. Patients with major injuries are triaged first – and in order of priority I.e. the sickest patients and those with life threatening conditions will, and must, be seen first. This can lead to other patients with less serious conditions waiting to be seen.

You have mentioned feeling that nobody was in charge on the day of your visit. A&E is run by a team of experienced and skilled staff including a senior emergency consultant called a medical service head and a matron who is in charge of the A&E nursing staff. Each shift, whether in the day or at night, has a lead nurse with responsibility for the smooth running and safety of the department. All those mentioned report to the clinical director of emergency medicine.

It is difficult to comment further on your daughter’s particular experience without reviewing the record of her attendance but if you would like us to do this, please get in touch with our Patient Advice and Liaison Service (PALS) on free phone 0800 073 0510 if you would like us to look into your concerns.

Response from Russells Hall Hospital

Thank for taking the time to comment on your experience of our hospital. We would like to assure you that all comments are taken seriously and acted upon as part of our ongoing commitment to improving patient experience.

We are sorry to hear you and your daughter had a negative experience of our A&E Department. It is very distressing to see a loved one in pain. Timeliness of pain relief is very important; every patient who attends A&E is booked in and triaged (assessed) by a trained member of staff and analgesia is prescribed and administered, where appropriate.

A&E is an extremely busy department – in 2011/12 more than 98,000 patients attended. We do our utmost to offer the best possible care and aim to see every patient within four hours of their arrival. Patients with major injuries are triaged first – and in order of priority i.e. the sickest patients and those with life threatening conditions will, and must, be seen first. This can lead to other patients with less serious conditions waiting to be seen.

You have mentioned feeling that nobody was in charge on the day of your visit. A&E is run by a team of experienced and skilled staff including a senior emergency consultant called a medical service head and a matron who is in charge of the A&E nursing staff. Each shift, whether in the day or at night, has a lead nurse with responsibility for the smooth running and safety of the department. All those mentioned report to the clinical director of emergency medicine.

It is difficult to comment further on your daughter’s particular experience without reviewing the record of her attendance but if you would like us to do this, please get in touch with our Patient Advice and Liaison Service (PALS) on free phone 0800 073 0510 if you would like us to look into your concerns.

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Response from Laura Broster, Head of Communications, NHS Dudley CCG

Thank you for your feedback. We would encourage you to pass your details onto Russells Hall as requested, so this can be looked into in more detail. We aim to commission the highest quality of services for our patients, and this feedback is always useful, to inform commissioning decisions going forward.

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