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"Services provided to my father"

About: General practices in Lanarkshire Lanarkshire Community Services / Community Nursing Service Queen Elizabeth University Hospital Glasgow University Hospital Monklands University Hospital Wishaw / Day Surgery

(as a carer),

He was diagnosed with a cancerous tumour in his mouth at QEUH Glasgow in July this year and everything moved very fast after diagnosis. He had a lengthy op, and throughout the whole process (diagnosis, pre-OP, post-OP, to discharge) he and the family were treated with dignity and respect by every single member of staff we came across. They kept us fully informed and were very approachable and honest which we really appreciated. He was discharged to home with the support of district nurses, homecare and we his family. Again, the service was faultless. 

Whilst we have almost overall had a fantastic service, there are a couple of areas we have found difficult. Firstly, we have twice had an issue with the GP surgery issuing for notes and referring us back to the hospital, even though he had been discharged and we passed on the discharge letter to the GP. On the 2nd occasion, the receptionist advised that as the GP hadn't seen my dad they couldn't confirm he was unfit for work. They refused to arrange a home visit to assess (I understand this, but he was housebound). Also as the district nurses were visiting on a regular basis to assist with tracheostomy and peg feeding care, they would have been able to discuss with gp to confirm he indeed is far from  ready to be able to work. But the receptionist told us to contact the hospital and refer them to DWP guidelines re issuing of fit notes. The hospital in fairness did so, and lo and behold, the GP was indeed responsible for issuing the fit note. We were round in circles before getting this resolved.

The second, more worrying issue we had was my father's peg feed became blocked due to a granulated antibiotic and after myself, the district nurse, and the Abbott nurse all trying to clear the blockage, it was confirmed he would need the tube changed. As it hadn't been in place for 12 weeks the Abbott nurse confirmed this would have to be done at hospital but there were limited people who would be able to do this. After establishing that there is a head/neck unit at Monklands DGH, we thought they would assist but were told they were unable to and referred us to a&e. By this stage, my father had been without pain relief or peg feed for over 20hrs. Only by contacting Rosemary at Wishaw General (who was at the day unit) were we able to be given an appt for 2hrs later and Rosemary indeed changed the tube for us. She was more than helpful, but agreed that it was surprising that my dad could not have been seen and dealt with at the head and neck unit at Monklands. The whole situation was stressful for us and him, and also painful for him not being able to have any medication. 

I would like clearer guidelines on who we should turn to for urgent assistance with peg feeding at a local hospital. 

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Responses

Response from Lesley Allan, Rota Governance manager, Clyde Sector, NHS Greater Glasgow and Clyde 4 years ago
Lesley Allan
Rota Governance manager, Clyde Sector,
NHS Greater Glasgow and Clyde
Submitted on 27/09/2019 at 13:22
Published on Care Opinion at 15:04


picture of Lesley Allan

Dear Mary5678

Thank for your feedback regarding your fathers care during and after his operation.

I am pleased to hear that the staff at The Queen Elizabeth University Hospital treated your father and the family with the dignity and respect that you all deserved at such a difficult time.

If you wish we can look the issues that you have mentioned but we would need some additional information. With your dad's permission can you forward his name and date of birth to lesley.allan7@ggc.scot.nhs.uk to allow me to look into this for you.

Kind Regards

Lesley

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Response from Lesley Allan, Rota Governance manager, Clyde Sector, NHS Greater Glasgow and Clyde 4 years ago
Lesley Allan
Rota Governance manager, Clyde Sector,
NHS Greater Glasgow and Clyde
Submitted on 02/10/2019 at 15:15
Published on Care Opinion at 15:15


picture of Lesley Allan

Dear Mary5678

Thank you for getting in touch with your Father’s details.

I have contacted one of the Nutrition Nurse about your Father’s blocked gastrostomy tube. In NHS Greater Glasgow and Clyde, we have community enteral feeding nurses who can assist the local district nurses to resolve issues such as your father experienced. They can attend and replace a primary gastrostomy tube if it has been in place for over 4 weeks. Abbott nurses are separate from the NHS and deliver care in the community within Lanarkshire.

Our understanding is that if they cannot resolve any issues they should refer either to the patient's local emergency department or the Queen Elizabeth University Hospital. We apologise for the additional distress and worry that this caused.

If there are any other issues, in the first instance contact your local district nurses, Abbott contact or the Nutrition nurses at QEUH as detailed on the guidance issued to your father when an IP in ward 62 (Guidance if your gastrostomy tube accidentally falls out). If it is out of hours contact your local A&E department.

Kind Regards

Lesley

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Response from Rick Edwards, Service Manager Surgical & Critical Care, University Hospital Hairmyres, NHS Lanarkshire 4 years ago
Rick Edwards
Service Manager Surgical & Critical Care, University Hospital Hairmyres,
NHS Lanarkshire
Submitted on 03/10/2019 at 08:14
Published on Care Opinion at 08:14


picture of Rick Edwards

Dear Mary 5678,

It appears your persistence and perserverence won the day; I'll be sure to pass on your thanks to Rosemary at University Hospital Wishaw, but I'd like to apologise for the discomfort and distress your dad experienced whilst trying to access appropriate services.

I note Lesley's response above which I hope clarify's the pathway for you for the future. I'm not personally familiar with the process for obtaining fit notes, but it was clearly both challenging and frustrating for the family. GP practices are independent contractors and are responsible for investigating and responding to any concerns a person may have about their service; could I ask you to contact the Practice Manager to share your experience so that they might learn from this and consider if they can make any changes to improve the process for others in the future.

Best wishes to you and your family.

Rick

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Response from Lynn McTavish, Interim Surgical Service Manager, University Hospital Monklands, NHS Lanarkshire 4 years ago
Lynn McTavish
Interim Surgical Service Manager, University Hospital Monklands,
NHS Lanarkshire
Submitted on 03/10/2019 at 12:52
Published on Care Opinion at 12:52


picture of Lynn McTavish

Dear Mary 5678

I can see from the above that you now have information on a clear pathway for your father should any further issues with his feeding tube arise.

I am sorry that your experience in NHS Lanarkshire regarding this did not go as smoothly or straightforward as we would have hoped.

If you have any further concerns please do not hesitate to get in touch with me directly on 01236 748748 x4135 or via email lynn.mctavish2@lanarkshire.scot.nhs.uk.

Kind Regards

Lynn

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