Poor Patient Care @ Bridlington Hospital


Church Meadows,
Toddington,
Glos
GL54 5DB

27 February 2007

Mr Iain McInnes
Chief Executive (Interim)
Scarborough & North East Yorkshire
Healthcare NHS Trust
Scarborough General Hospital
Woodlands Drive
SCARBOROUGH
N Yorkshire YO12 6QL

Dear Sir

Mr Leonard Randle (deceased) – Patient Ref. No. S32662

With the NHS currently in such disarray, your own finances stretched to the limit and Bridlington Hospital under threat of closure, I regret to add to your problems, but felt compelled to write to express my utter dismay at the way the NHS treated my father during his final days.

On Saturday, 20 January, the staff at Pinfold Lodge in Hunmanby, where my father was a resident, were unable to rouse him for breakfast, so they rang NHS Direct to ask for a doctor to come out to him. They were made aware that my father was 101 years old and had been suffering from heart failure for a couple of months. He was well aware that ‘Father Time' was catching up with him and had strongly expressed the wish not to be taken into hospital, but to spend his final days at Pinfold Lodge in his own bed. Yet despite this information, NHS Direct were unable to find a doctor to attend him.

Therefore, the paramedics from Scarborough Hospital were called and as they were unable to say what was wrong, they took him to that hospital where he was X-rayed and assessed by a Dr Gupta. By this time my father was responding more to stimulation, but his left leg was beginning to turn blue, which apparently indicated that he had had a minor stroke that morning and a blood clot had lodged there – his legs had been checked daily at Pinfold Lodge and there had been no sign of a problem the day before. My father's heart was also not beating regularly, so the staff advised my sister over the telephone that they felt it was necessary to transfer him to a ward temporarily just to ensure that his heart rate was stabilised. Only when my elder daughter rang the emergency ward at Scarborough on her way to the hospital, to find out where she had to go, did we find out that they were transferring him by ambulance to Kent Ward in Bridlington!

Needless to say, this left my father very confused and disorientated as to his whereabouts, but fortunately my elder daughter and her husband were able to be there just after he arrived in Bridlington to explain what had been going on. When they first arrived, they were told that a doctor was with him and checking him over. The Ward Charge Nurse, Paul Smith, was very helpful and explained things as far as he knew as the doctor that saw my father did not explain anything to them at all. By this time my father was quite lucid, aware of his surroundings (not very impressed) and asking to go back home.

When they went back again in the evening, complete with some pyjamas and wash things, they asked (with my permission and that of my sister) if they could they speak with the consultant, Dr Pond, on the Sunday morning to clarify what was exactly wrong with my father and the future plan of action. This was agreed to. They also asked if my father could be made more comfortable as he was still complaining of pain in his foot. The staff also promised to put on the pyjamas for him.

On the Sunday morning my daughter and son in law duly arrived at 10.00 a.m. , as requested. As the consultant was still on his rounds, they spent some time with my father (my father still hadn't been changed into his pyjamas, and it was upsetting him that he had not had a wash or anything since he had been there). After a while Paul Smith asked to talk with both of them, confirming the very difficult news that my father had multiple complications, none of which gave any hope of recovery. Thankfully, he was kind enough to prepare them for the worst. A little while later, they were asked to see the doctor. Although they had expected to see Dr Pond, he had delegated the responsibility of going through everything with them to his Registrar, although the latter spent a long time going over the problems with his leg, seemingly reluctant to give them the whole picture. Therefore, they were very grateful that Paul Smith had already done so as it enabled them to ask the right questions. It also transpired that the doctors in Scarborough actually knew the full extent of the problems before they sent him to Bridlington.

Having been unable to travel up to Yorkshire on the 20 th , I did so the next day, arriving later that morning – again it was left to Paul Smith to put me in the picture as to exactly what was wrong with my father, although I understand that Dr Pond was on call all over that weekend. My father was still asking when he could go home, but we explained that Dr Pond and a (vascular) surgeon had planned to see him on Monday morning, after which he should be able to go home on the Tuesday – we had been advised by the nursing staff that this could not be any sooner because of the booking system for ambulances, i.e. this had to be done by 12.00 noon for the following day. At the time there were only three trained nursing staff on duty for a ward of nearly 40 acute patients. We had to ask for help in lifting my father into a more comfortable position, which we received, but when he still couldn't sit up properly to eat his evening meal and we again asked for help, no one came. Had we not been there, his food would have remained out of reach with no one to assist.

Before we left the hospital that evening, we asked if we could speak to Dr Pond the next morning and were advised to be back on the ward by 10.00 a.m. when he would be able to talk to us after examining my father on his round. Indeed, alongside the Nurses' Station is a notice “ Consultants are happy to speak with the next of kin on their morning ward rounds. Please discuss with Ward Staff to arrange when to come .”

My daughter and I arrived back at the hospital at 9.45 a.m. the next morning (22 nd January) to be told that Dr Pond had had to go to Scarborough Hospital to attend an emergency and would not be back until the afternoon. As this would have meant missing the 12 noon cut-off for ambulance bookings, we asked if this could be booked for the Tuesday morning, even if it had to be unbooked. The nurse in charge, Denise, agreed this would be no problem and booked it there and then. My father was greatly relieved by this news. As requested, we returned to the hospital at 2.00 p.m. , and although we watched Dr Pond progress down the ward, he made no attempt to approach and speak to us. When he had turned the corner towards my father's room, I stood in the doorway of the Day Room where we had been asked to wait, at which point the nurse in attendance pointed me out to him, so I fully expected him to speak to me at the end of his round. When we had not seen him by 5.15 p.m. , we went into my father's room and were told by the other patients that Dr Pond had not even examined him and had left by another door. At the same time, they also told me that a surgeon had examined him around 1.00 p.m. and overheard him say that there was nothing he could do about my father's leg and, in his opinion, he could return home. Again, there were only three trained nursing staff on duty and we had not been advised of this visit or the outcome. Of course, we did not mention any of this to my father, but again assured him that he would be going home the next morning as planned - he was overjoyed to be reassured on this point. However, I would also mention that my father was obviously in pain and had developed a large bed sore. The staff advised us that they were aware of this and that he would be placed on an air mattress that night to make him more comfortable.

Arriving early on the Tuesday morning to help get my father's things ready, as requested, naturally our first question was to ask if the staff had any idea just when the ambulance would arrive to take my father back to Pinfold Lodge, but all they could say was that it could be any time up to 11.45 am . As my father had deteriorated significantly during the night (there was still no sign of the air mattress), we felt it best to let him sleep and went downstairs to the Reception area. Having watched numerous ambulances arrive and then leave empty, at 11.00 a.m. I asked the Receptionist if she could find out just when one was to arrive to collect my father. She rang Ambulance Control to be told that ‘he was down for an afternoon discharge'. We immediately returned to the Nurses' Station on the ward, at which time the staff were just returning from their break. None of the nurses had been made aware of any change regarding my father's discharge, and all of their records indicated that things were still on track for a morning discharge. When they checked, it was confirmed that the ambulance would not be coming that morning and no time could be given as to just when it would arrive as there had been a very slight snow fall overnight, apparently leading to road accidents and more ambulance call-outs than usual. At this point I should mention that I had to drive my daughter, who has severe rheumatoid arthritis, back to South Northamptonshire that day so that she could attend a long-standing appointment on the Wednesday. We could also see that my father was deteriorating rapidly and, naturally, we were extremely anxious to get him back to Pinfold Lodge, just as he wished, before it was too late.

At this point I became very upset, not only for disappointing my father, but also for the total lack of any first hand information. A very helpful nurse offered us a cup of tea and came to talk to us, the outcome of which was that he asked Dr Pond's SHO, Lucy, to come and speak to us. She advised us that she had not been aware of our wish to speak to Dr Pond and had not been directly involved with my father's case. As she had no knowledge of my father's situation, she left to check his notes and X-rays. Later she came back to advise us that Dr Murthy would come and speak to us. After listening to our concerns, he went away to examine my father, came back to say he would check on his notes, and a little while later came back to speak to us. He could not have been more understanding of our plight. He advised us that indeed there was nothing that could be done about my father's leg now, and that the hernia that my father had expressed concern about to me on the Sunday was, in fact, cancerous. Apparently the X-ray taken in Scarborough had shown that my father's liver was enlarged with shadows in his lungs, and that this was most likely due to cancer and secondary cancer. He said that he had informed Dr Pond of our concerns and that although he was in a clinic near the Ward, Dr Pond had apparently just said that he would come and see us on the Wednesday. We explained that we could not wait any longer as we were expecting an ambulance to take my father home that afternoon, as we had promised him, and in any event what was the point in prolonging my father's discomfort. Dr Pond could not be bothered to see my father or talk to us the day before, and we had already been told on the Sunday that there was really nothing that could be done to help him.

Whilst all this was going on, my daughter had contacted her husband at home. He immediately contacted PALS in Scarborough and spoke at length to a lady called Yvonne. After being fully informed about my father's situation, she kindly contacted the ambulance service in the office next door, despite the fact it was not her area. Thanks to her efforts, we were able to extract a promise that there would be an ambulance for my father at Bridlington Hospital by 3.00 p.m. This duly arrived at 2.45 p.m. Through the efforts of my son-in-law and the various people that he spoke with, it was also interesting to learn that as far as the ambulance service was concerned, the ward could have requested transport for my father at any time, rather than the advised need to book by 12.00 noon the previous day. So, in theory, my father could have been transported home much sooner.

By the time he was finally able to leave hospital, my father's health had deteriorated to such an extent that all he wanted to do was sleep, but on arrival at Pinfold Lodge he opened his eyes and with a smile and a great sigh of relief, greeted many of the staff by name. Once he was safely tucked up in his own bed, he looked so much more comfortable and we were able to say our farewells, each of us receiving a thank you and kiss ‘goodnight'. This is the lasting memory of him I will carry for ever. He died in the early hours of Thursday, 25 th February 07.

Was this really the way to treat a 101 year old gentleman who had had hardly a day's illness in his life and very little need to call on our National Health System?

Yours faithfully

Linda Cheshire
(Next of Kin)

PS: When my daughter queried the lack of staff on the Ward, she was told that some of them were away sick and that they had been told that they could not have any Bank nurses as the Trust could not afford to pay for them. How on earth are three trained staff supposed to cope with so many very sick patients? And why is Bridlington Hospital under threat? The nursing staff work so very hard and deserve more support.

Furthermore, while we were waiting around to see Dr Pond on the Monday, the afternoon tea was being prepared, and it transpired that a cleaner had been made to do this although he had not been trained to do so!

cc:

Tony Blair, Prime Minister
Patricia Hewitt, Health Secretary
Greg Knight, MP
PALS, Scarborough
Ms Sue Wellington, Manager, Bridlington & District Hospital
Dr Ian Holland, Medical Director
Mr Andy Brook, Transport Manager
Professor Rajan Madhok, North & East Yorkshire & Northern Lincolnshire (Strategic Health Authority)
Mrs Catherine Reay, Corporate Affairs Business Manager, Complaints Department
Mrs Jayne Barnes CBE, Chief Executive, TENYAS
Mr Mick Pilling, ‘ Save Bridlington Hospital ' Campaign
NHS Direct
Daily Mail – ‘Dignity for the Elderly' Campaign
Scarborough Mercury
Hull Daily Mail
The Bridlington Free Press
The Rt. Hon Mr David Cameron, MP
The Rt. Hon Mr Menzies Campbell MP



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