"Acute Medical Rapid Assessment ward at Queens…"

Arrived at Amra at 9am, left at 8pm. In the intervening time, saw doctors and had tests between 9 and around 2pm. There then followed 6 hours of waiting to be discharged (without a prescription- that would have taken even longer).

The doctors changed shifts at 4pm, and did no handover at all for my dad. When a consultant came to see us at 8pm, we had to brief him. Cannot believe we waited so long and don’t understand why the original doctors didn’t finish their work and discharge my dad at 4pm.

Between 4pm and 8pm, the nurses did observations, handover and huge amount of chasing of the doctors - all of it time that would have been saved if the original doctors had started the discharge before leaving shift. A huge waste of time, and back tomorrow to pick up the prescription, as couldn’t face waiting longer today.

There are not enough doctors on a ward that is mainly General practice referrals. Surely in a ward where general practice don’t know the answers, there should be a lot of doctors and consultants? This ward is mainly staffed by nurses with a handful of doctors - so how can that lead to rapid assessment?. I heard one nurse tell a patient ‘ I tell everyone to expect to spend at least 6 hours here’. If patients were processed quicker, less nurses would be needed to keep doing their observations, and fielding the constant demands from patients and relatives (myself included) asking where is the doctor, and when can I go home?

This department needs someone to manage the doctors, have them complete their work, and spend time with the patients to get them out of the door quicker it is basic process management and ownership that is needed to avoid wasted time and associated expense. Treating patients quicker and having consistency of doctor between asking for tests to discharge would also improve patient outcomes. As I said to the doctor finally discharging us, when he asked me why the other doctor had paused certain tablets ‘I am not a doctor’. What I do know is a poor process when I see one and a staff mix (doctor vs nurse ratio) that isn’t set up for successful outcomes or efficiency. As we left the hospital, we walked through A&E which was packed out, and with ambulance drivers queuing with patients. Not right that my dad was in a bed in Amra desperate to leave, whilst others were needing it.

One final point, why, why do both ambulance staff wait with the patient? Surely one could wait with 2 patients, leaving 3 others to go back on the road?