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"Availability of emergency surgery"

About: Altnagelvin Area Hospital / Trauma & Orthopaedics Northern Ireland Ambulance Service / Emergency ambulance response South West Acute Hospital / Emergency Care and Medicine Services

(as a relative),

My elderly Dad fell and broke his already replaced hip in Sept 2023.

He was attended by a paramedic in a fast car and then it took 4 hrs for the ambulance to come and collect him to go to South West Acute Hospital (SWAH).

In the Emergency Department (ED) in SWAH he was kept on the corridor most of the time as due to be transferred to Altnagelvin. They were waiting for a bed for him for over 24hrs and he was in a lot of pain. He was put in a side room for a sleep but quickly moved out of there as someone else needed the room.

The overstretched staff in ED were doing their best for him, despite there supposedly being protected beds in Altnagelvin for SWAH emergency surgery patients none were available until later the next day. He was then placed in a transport ambulance in pain, no access to pain relief and no family member able to accompany him there. I though that was disgusting as my elderly Mum & myself had to say goodbye to him not sure how the journey would go. He was so frightened.

Recommendation- Patients clearly in pain should be transported with full access to pain relief & with a family member to accompany him there.

Little did we know this was just the beginning of a very long journey and many long journeys to Altnagelvin & back.

He waited nearly a week for his Operation on the Trauma ward as the Trauma team needed to sort a plan which was understandable. There were daily journeys 2hr return journeys from South Fermanagh. The road infrastructure is not even 2nd world standards in some places and clearly this is due to years of neglect and underfunding for various reasons.  

Recommendation- Patients need a dedicated team who look after them if they must go for treatment in Altnagelvin. 

 - Family members need access to affordable accommodation where they can stay over

My Dad had his op and that went Ok the staff were very kind and facilities excellent on the Trauma ward. They were very keen to get him into rehab and home. Perhaps too keen as my Dads hip procedure failed within 2 weeks of discharge. Everyone (Omagh Rehab, SWAH, Altnagelvin & Community team was passing the buck to each other- this was very poor care. If the procedure was completed in SWAH this could have been avoided.

Recommendation-A dedicated team is needed to follow the pathway of SWAH patients needed to receive treatment in other hospitals.

My father & the family were back to square one, in Altnagelvin, he had more surgery & despite his age and infirmary, time in ITU he recovered through his sheer determination, the kindness of staff & love of his family. 

He got home just before Christmas and is now walking on one stick again.

Recommendation-Improve communication between teams as it can be very poor at times. 

Recommendation- staff organising appointments need to factor in traveling time for the elderly to avoid long journeys. 

I honestly believe that if emergency surgery was available in SWAH then his 1st procedure would not have failed & would have not needed to return to Altnagelvin.

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Responses

Response from John Kerr, Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care, WHSCT 11 months ago
John Kerr
Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care,
WHSCT

assess and treat

Submitted on 06/09/2024 at 10:06
Published on Care Opinion at 10:09


Dear Olivia24

My name is John Kerr, an Emergency Nurse Practitioner, based here in the ED at the SWAH. I would like to take this opportunity to respond on behalf of the ED department, to thank you for taking the time to post your opinion, about the care your father received while a patient with us.

I am sorry to read that the level of care, your father received, appears to have fallen short of what your and our expectations would be. Please accept my apologies.

The Emergency Department, is an extremely dynamic ever changing environment, with huge pressures placed upon it of recent times. We will always attempt to place patients in the most suitable environment where possible base on clinical need. Unfortunately, clinical need can become a priority to space, and we as a department have to work with the resources available to us. Our aims remain the same however, to provide excellent levels of medical care and support throughout the patient journey.

I am sorry the hear you felt your father was in a lot of pain while in the department and for his transfer to Altnagelvin. I cannot comment on individual cases, however, we do have a pathway for pain management in fractured hips. Our medical and nursing staff are all aware of this. Once again, I would like to take this opportunity to apologise if your father pain was controlled successfully.

I have read your comments and recommendations, which will be considered. A number of other concerns you have highlighted, in time will be addressed by the relevant departments.

Finally once again, on behalf of the ED, I would like to apologise for any upset caused by us, in the treatment of your father while a patient of ours.

In conclusion, I hope this finds you and your father well, and that steady progress is being made.

Kind regards

John Kerr

Emergency Nurse Practitioner

SWAH ED

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Response from Neil Gillan, Co-Production & Partnership Lead, Quality, Safety & Improvement, Northern Ireland Ambulance Service 10 months ago
Neil Gillan
Co-Production & Partnership Lead, Quality, Safety & Improvement,
Northern Ireland Ambulance Service
Submitted on 04/10/2024 at 09:47
Published on Care Opinion at 09:51


picture of Neil Gillan

Good afternoon Olivia24.

My name is Neil Gillan, and I am the Co-production Partnership Lead with the Northern Ireland Ambulance Service, where I lead on the development and delivery of an organisation wide approach to Patient Client Experience. I would like to begin by thanking you for taking the time to share your experiences of the Northern Ireland Ambulance Service.

From the outset, I would like to apologise to you and your family for any distress caused by both the delayed response and the challenges with your dad’s transfer to Altnagelvin Hospital. Please be assured that we are reviewing resources internally within the organisation. We are also working closely with the Department of Health and the Strategic Planning and Performance Group to increase our available resources. We are also working with the local EDs to try to ensure that our patients can be handed over to hospital clinical teams as quickly as possible so that ambulance are able to respond to further emergencies.

I would like the opportunity to discuss this matter further with you, if you are able and when the time is right for you, please contact me directly on 07880022791 or neil.gillan@nias.hscni.net.

I wish your dad a speedy recovery.

Yours sincerely

Neil

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