"They would leave food out of reach"

Good morning columbabr58,

Thank you for taking the time to share your valued feedback. We are always grateful to those who share their experiences of the services they have received. I am sorry to hear that you father has been unwell, though it was heartening to learn how amazing the ambulance staff were. As an organisation we are committed to consistently show compassion, professionalism, and respect for the patients we care for.

I hope your dad is recovering well.

Kind regards,

Maggie

Good afternoon columbabr58,

My name is Colin Patterson. My position is Governance, Experience and Involvement manager, with a leading role in improving the service user experience - this includes stories on Care Opinion.

Can I thank you for taking the time to post your fathers recent experience of 3C and the Transition Ward, I am very sorry to learn of this experience and the impact it has had on him and your as a family. Both the fall downs in communication you describe and the inconsistencies outlined, particularly the feeling of lack of compassion are not in keeping with what we would expect as a Trust.

The managers from these areas are aware that you have posted this experience on behalf of your father, however a few key members of staff to get a complete picture and understanding are currently on leave until next week. Following their return, we will review your fathers and families experience and look to explore the elements for change and improvement opportunities.

Following this we will publish a response on this platform learning and plans to improve.

Again, I apologise to you for the elements of your fathers journey that fell below the expected standard and I thank you for sharing.

May I wish your father and entire family well.

Best wishes

Good morning coloumbabr58,

My name is William Stritzel. My position is Ward manager of Ward 3C Coronary Care Unit in the Ulster Hospital. My role involves the day to day management of the ward and includes addressing issues which arise from patient experiences on the ward including stories on Care Opinion. I apologise for the late response as I have been on leave.

Firstly, I would like to thank you for taking the time to share your father’s story and his experience on Ward 3C. I am deeply disappointed as the ward manager that your father and your family have had the experience you describe. I would like to assure you that your feedback is warmly welcomed, taken very seriously and will be used to improve the service moving forward.

From reading your experience I can see that there are a few issues that need to be addressed:

1. The standard of care and attitudes of the staff

2. The communication between the ward and the family

3. Food and drink being left out of reach

In relation to the standard of care being “OK” I can only apologise for this experience. I assure you that an “OK” standard of care is not the standard I expect of the staff on ward 3C and that I hold the staff to the highest standards of care for our patients. OK care is not what I expect or strive for patients on 3C and your feedback will be shared with the staff to ensure we improve the experience of the patients and families on our ward.

In regards to the staffs attitude (not being respectful and ignoring people), again I can only apologise for this! I expect all my staff on the ward to be caring and compassionate towards everyone; patients, relatives and colleagues; in line with the trust values. Your experience is far below what I expect of the staff in 3C and I will use your experience to highlight to the staff the need to be more self-aware when communicating with other.

In relation to the communication between the ward and yourselves, the decision around TAVI treatment is complex. There are a number of diagnostic test that need to be completed which sometime can take some time and then the decision is taken by the multi-disciplinary team (The Heart Team) at a meeting; a group of cardiologist from here and different trusts across northern Ireland (specialist who discuss each case individually and come to a consensus on a treatment plan). Often these discussion are complex and the staff on the ward are not involved in this process and therefore do not have the reasoning for the final decision, but are given the outcome (decision on treatment). Usually on the ward the staff will relay the outcome to the patient and family as soon as we are given the information. Any further information is often followed up with the patients’ consultant on the next visit. I apologise that this isn’t the experience you received when your father was on the ward and that you were not given a clear reason as to why the decision was taken not to undertake the TAVI procedure. I would direct you back to your fathers consult to gain clarity on the reasoning as to not undertake the TAVI procedure. You can contact then cardiologist through their secretary and I am more than happy to assist with this.

In relation to the communication around reasoning and decision to transfer your father to the Transition ward, I can only apologise this was not clearly communicated. We utilise the Transition ward for patients who are fit to go home however require further assessment for social care such as packages of care at home or placements to further care such as nursing homes or rehabilitation placements. This allows us to admit patients from the emergency department who are awaiting admission and who are acutely unwell. Your experience of the communication on Ward 3C is not what I expect! I will share your experience for learning and I will endeavour to ensure staff communicate clearly, compassionately and in an empathetic manner and provide rationales for the decision making process on the ward.

Lastly, in relation to the food and drink being left out of reach. This is not what I expect on the ward and if patients require assistance for any reason this should be provided by the staff and I will endeavour to ensure staff are providing consistent support throughout. In relation to the Fluid, your fathers condition and the question around TAVI procedure would lead me to believe a fluid restrict was required to help the reduction of the amount of fluid retention. This would mean the nurses looking after him would be required to monitor the amount of fluid taken on by a patient. So although the fluid may have been out of reach the nurses would have been giving him regular drinks and strictly measuring what fluid he was taking and this hopefully should have been communicated at the time. Food trays are sometimes put out and then the staff come back to assist patient or the patient have refused meals but they are left to be collected on the way back. If a patient requires assistance this should be given and I would expect the same. Without knowing the direct details it is difficult to respond to this. However, I assure you that meals are offered to every patient at all mealtimes. I will look at changing how we give meals out and collect meals moving forward based on your experience. If meals are refused or assistance has been given then the tray will be taken away immediately, preventing people from feeling trapped under a tray.

Again, I would like to apologies for the aspects of your fathers care that did not meet your expectations or the level I expect and thank you for sharing. Again I assure you your concerns have been taken on board and shared with the staff to improve the service moving forward.

If you would like to discuss your concerns further I am more than happy to meet with you and discuss these at a time convenient to you, with your fathers consent of course.

I would like to take this opportunity to wish you and your father well in the future.

Best wishes.

William