"Unable to Meet Basic Need"

In May 2024 my dad was admitted via ambulance for urosepsis. He has advanced stage MS and has been entirely bedbound for approximately 18 months. He has all the associated physical disabilities that come with MS. As this is a degenerative illness over a long period of time, he has had numerous assessments to manage his condition safely. Therefore, he has a number of wonderful aids to promote his health and wellbeing and maintain his safety. One of them being an airflow mattress - given he spends 24 hours a day in bed, unable to alter his own position.

On arriving in A&E on a hospital trolley on which he was nursed on for approximately 9 hours. On admission, he was given a pressure ulcer risk rating score as per protocol - this will have indicated his very high risk of developing pressure damage. However, on my asking for an appropriate mattress / bed to be made available to him as per required interventions, I was told they don't order mattresses for here. They had ordered a hospital bed but were unsure how long that would take. Also unsure where he would be admitted to and when this would be - it would only be in these other environments that a mattress would be made available.

Open ended risk of pressure damage as this mattress categorically would not be made available within A&E. This seems to be a massive gap in service - an unnecessary risk to take which did have a negative impact on his pain levels; did cause changes to his skin although thankfully no broken skin which given his immunocompromised state could have had a significant detrimental effect on is life.

On transfer to the ward after a period of another few hours - we had to have this conversation again with a new set of nursing staff- despite the very obvious and documented risk of pressure damage. A further wait ensued and in total he was almost 24 hours without this basic need being met.

The other aspects of care were great, friendly, helpful and approachable staff from ambulance - to A&E, to the ward. Medics involved my Dad in decisions about his care and brought us into conversation too.

This feedback is about lack of provision of a specific basic need, when alerted by both patient and family and assessment tools in place but this was not enough to support access to this intervention. Absolutely unnecessary risk to take with a very vulnerable person. My worry is that this will not be our last visit to A&E, and we will be met with this very real gap in service and lack of provision for my vulnerable Dad.