"Emergency surgery pathway"

On behalf of my mother, myself and my brothers, I would just like to praise the overall healthcare experience of my mother at Royal Cornwall Hospital (Treliske) earlier this year.

Finding my mother in agony one morning, struggling to get around and very nauseas, she said she needed to get ready to see GP when it opened, due to a problem with her hernia. Seeing the problem and suspecting a strangulated hernia (turned out to be incarcerated with an associated infection), explaining to her that this is a medical emergency and will require urgent surgery, and a stern telling off for not informing anyone much earlier overnight and not listening to us over preceding days, I rang my brother and said she needs to go to the emergency department immediately.

As I'm unable to travel due to health issues, he was concerned about driving with her alone when she was in so much pain and it would have meant hitting rush hour, which would extend the journey to an hour or more. We didn't like to call for an ambulance so rung NHS 111 first. I'm so glad we did.

The lovely operator, after asking relevant questions, said a clinician would call back and this was almost immediately. After obtaining information, the wonderful paramedic informed us that he would contact the hospital directly and if she was able to get into a car, it would be quicker to get her there than waiting for an ambulance, but if problems were encountered with this, or on the journey, to phone for an ambulance. He said to set off immediately and he would get back to us in a few minutes with details.

On calling again he'd arranged for her to go direct to SDSA/ESU (Same Day Surgical Assessment/Emergency Surgical Unit). None of us were aware that such a unit/service existed, hence wanting to head straight to the ED initially (although I'm sure after assessment they would probably have redirected her there in the end anyway). What a fantastic service.

On arrival, they were expecting her and knew the details the paramedic had relayed, and she underwent surgery that afternoon. My brother was updated whilst with her and informed that she may require a colostomy depending on what they find, and when she went for surgery was well informed on the contact details to keep up to date and what time to call and thus was able to relay information to myself and other brother.

The medical and nursing staff were superb both on the SDSA/ESU and on Pendennis ward, where she went afterwards, both in their care for her and their interactions with whichever one of us called (being mindful that a busy unit does not need us to interrupt their work by enquiring individually) or, because of the extra day on the ward than expected, due to the infection, visited. Furthermore, every other non-clinical member was excellent too.

Luckily, because of the extra day, her drainage tube had been removed prior to discharge but an appointment at the "hot clinic" on the following Monday was arranged. A problem occurred with this as no appointment time was given and being discharged late on a Friday afternoon, the outpatient booking department phonelines were all closed. It sounded to us like "Hot clinic" might have meant an open appointment, so we were going to presume this but, with doubt setting in, to be sure, I decided to ring the unit on the Saturday to check. The staff member I spoke to informed me that it was appointments and to ring again the next day, when she would be working again, if no appointment arrived by post.

None arrived, and the fantastic ward clerk I spoke to was able to get someone to access the system and informed us of the appointment time early on Monday, which otherwise my mother would have missed. That was the only slight issue encountered but no complaints, as it was dealt with politely and professionally with no trouble by the staff members I spoke to.

All in all, despite the slight hiccup, the pathway worked extremely efficiently and effortlessly from the first call made to 111 to the discharge following the follow-up hot clinic appointment. Everyone in the teams encountered by my mother and us as her offspring, were superb and a credit to the healthcare systems in Cornwall they were work for. Our heartfelt thanks go to them all.

I only wish more people were aware of these pathways as I'm sure there must be more families than just us, realising that urgent surgery would be required, would have headed straight to the Emergency Department first. Although, if we had, I'm sure we wouldn't have been told we shouldn't have been there but, it would have probably added extra time before surgery to give her some relief from the pain.

All in all, despite the slight hiccup, the pathway worked extremely efficiently and effortlessly from the first call made to 111 to the discharge following the follow-up hot clinic appointment. Everyone in the teams encountered by my mother and us as her offspring, were superb and a credit to the healthcare systems in Cornwall they were work for. Our heartfelt thanks go to them all.