"The pathway that’s in place to get help and the care I received"

About: Maternity care / Maternity Assesment/Triage New Victoria Hospital / Out-of-hours GP service

(as the patient),

I have already emailed a formal complaint however thought i post on here.

Some background about me, I’m 33 years old and have been pregnant twice before suffering both times with Hyperemesis gravidarum. ( I am happy for you to look up my medical history relating to these pregnancies)

We were planning to have a 3rd and wanted to be prepared. My GP had my prescription ready for when I got a positive pregnancy test.

We happily found out I am pregnant last month, I called up for my prescription and had it ready and waiting.

The nausea hit at 5 weeks 1 day ( earlier than previous pregnancies) I started taking my medication however still struggled to keep down fluids and food.

On the Wednesday I called my GP to say I wasn’t coping and he increased my Ondansetron dose to 16MG per day. At this point I was 6 weeks pregnant.

This didn’t really help and by Friday I was unable to eat or drink.

On Sat I called maternity assessment at 1.20pm as I had tested my urine and it was showing 3+ ketones, I could barely stand, was constantly dizzy and extremely shaky and lethargic . I had not kept anything down for over 24 hours (from around 10am on Friday)

I was told that I couldn’t self-refer for dehydration and would have to call NHS 24, I called them at 1.27pm.

The call handler advised a doctor would call me back within 4 hours, a doctor called me at 1.54pm and asked me to head down to The new Victoria out of hours. I arrived around 2.30pm and was taken almost immediately which I was very grateful for, the doctor was lovely and a total credit to the NHS, I can’t remember their name but they are a very sincere warm person.

They tested my urine and my ketones were now 4+, and did a few other tests and was advised I would need admitted as I was dehydrated. This doctor called mat assessment however they said they didn’t want to take me as I wasn’t pregnant enough?, called the gynaecology department but they were in surgery and said they would call back within the hour. I had to sit back in the waiting room for which he was very apologetic for.

At around 3.40pm the doctor called me back in and said in fact I did need to go to mat assessment, they knew I was coming and gave me a letter with the findings advising I needed fluids as I was dehydrated.

I think we arrived at mat assessment, the queen Elizabeth formally the southern general at around 4.30pm. I was taken into a side room and asked for a urine sample which I managed to give a tiny one. I was told to leave it outside the door which I done and then we waited.

We waited an hour and a half.

A midwife then walked in and said “well you’re not dehydrated, your fine”!

I was not fine, no one had examined me in this department, I hadn’t kept anything down for over 24 hours, I could barely stand. She then advised my ketones were only 2+!!

This is not possible and I don’t want to call her a liar but these results were just not possible, I had pictures on my phone of the previous tests taken in which she just shrugged her shoulders and said they are going by their test.

I was extremely upset and extremely angry, I tried to argue my case in between being sick however she said some untrue statements which included:

Hyperemesis can only be diagnosed by a blood test

Your too early on in pregnancy to have Hyperemesis

GPs are too quick to diagnose Hyperemesis

You have a urine infection and that’s what’s making you unwell

I’d like to point out that testing ketones is an outdated method and is not an indicator of dehydration. Discussions on this can easily be found online with medical evidence.

She gave me some antibiotics for a urine infection that I have no symptoms of so pretty sure I don’t have one and had never complained about one, and cyclizine anti sickness tablets to work alongside my ondansetron.

This whole process took 4 and a half hours!!!!

So my complaint is split into 2 categories.

1 – The absolute ridiculous steps I had to take to get tested for dehydration. If you are just going to use ketones as an effective way to test for dehydration wouldn’t it have been more effective for me to have popped down to matt assessment, peed on a stick to be told 30 seconds later I was fine instead of wasting countless NHS resources!!! Previously in my other pregnancies that’s exactly what I did and every single time I was admitted for at least 24 hours yet this time it took 4.5 hours with no fluids at the end.

2- Maternity assessment, Whilst I don’t specifically want to complain about the midwife as I realize their job is hard and shes maybe only following orders, I do want to complain about the department. It’s clearly overstretched, perhaps that’s why my care was inadequate. No one asked me my symptoms, how I was feeling, how many times I had vomited, when was I last able to keep anything down. I was not given any other diagnostic testing for dehydration and no physical examination. I was made to feel like I shouldn’t be there because I’m under I do not believe my ketone result.

As per the NHS website dehydration symptoms include:

•feeling thirsty

•dark yellow and strong-smelling pee

•feeling dizzy or lightheaded

•feeling tired

•a dry mouth, lips and eyes

•peeing little, and fewer than 4 times a day

I had ALL of these symptoms.

Having had the condition twice before I’ve tried to be as prepared as possible. I do not want to go into hospital, I do not want to waste precious NHS time and resources but I do want to receive adequate care for something I know I have and has been diagnosed by a doctor!

I have now lost faith, even when I do get very ill I won’t phone, I cannot sit in waiting rooms for that amount of time, I cannot go through that long winded process again for what appears to be 30 second test they are doing to diagnose.

;