"Praise ... and concern"

Elderly mother with multiple medical problems called local practice requesting help for chest infection and did not get past reception staff - was not even  put on call back list. My mother had COPD and had worked as an NHS nurse for 40 years! 

I live 50miles from my mother and due to the Covid restrictions had reluctantly not visited since before Christmas, but called daily. 

She struggled on for a couple of days saying she felt better, but in Jan, I called NHS24. I cannot praise the care and attention given highly enough, from speaking to the call handler through to Paramedics attending  -all within 2 hours. Medication was sent over that night and Mum did start to improve.

The following day, I requested a follow up call from her local practice in case further treatment was required and also aired my concern that other issues had not been followed up  and through persistence, a GP call was arranged for  the following day -  

Unfortunately, a week later, Mum slipped while getting out of bed and could not get up. She triggered her Medical Alarm and a local responder came to help. As a precaution he called 999 and an A&E consultant triaged her by phone and ascertained that there were no fractures , however he did raise concern about her breathing and suggested calling NHS24 again , 

Again someone responded within a short while and arranged for medication to be dispensed. She advised Mum that she would arrange for someone from the local Community Nursing team to call on her the following day .

On 18th January, I contacted the Community Nursing Team and spoke to their lead. 

-told no visit had been arranged

- when I requested a visit re my concern of Mum's age and multiple health issues and felt that she required assessment for medical reasons was told that they did not do visits ! Did not do assessments ! (Care of the elderly was part of my mother's duties as a 'district nurse' may years ago)

- was left that she would at least receive a telephone call (which she did not receive)

Mum told us she was feeling better, but unfortunately her condition deteriorated and I arranged a call from the doctor. She was given an appointment and consequently admitted to Dr Gray's Hospital in Elgin pending diagnosis of pneumonia.

Unfortunately, despite all efforts , Mum passed away on 31st January .

PRAISE - NHS24 and 999 service  - care, compassion and attention on both occasions. 

                Dr GRAY'S Elgin - attention and care from A&E assessment , AMAU and HDU - kept informed of changes. Their compassion in last 24 hours and knowing that someone was with Mum at the end.  It must be a very tough unit to work in knowing that most patients are in a critical condition. The professionalism of all staff I spoke to or met was exemplary. 

                 For GP on 28th Jan who recognised that she was ill.

CONCERN - Duty of Care - the adage of my working life in a related profession - to look after patients and ensure they are treated to best of my ability.

Unfortunately I feel that this has been non existent in the local practice.

Since Covid lockdown started, we have been continually reminded that the doctor is there to deal with all ailments, not just Covid. 

In fact, the moment  'cough' is mentioned the receptionists immediately tell  patients to call elsewhere, regardless of the patient's history. Statistically in this area Covid is a small percentage of respiratory cases compared to the chronic problems especially at this time of year.  

Many times I heard Mum say that she felt that the local health centre did not care especially for the elderly, She was frustrated on a few occasions especially  in the past year while trying to get advice -like many older people she did not want to be a bother  eg a lump appeared on her hand and she was told that it would be dealt with once Covid was over. It grew rapidly and necrotised and 3 months later  thanks to a community nurse reporting it back, surgery was arranged within a month of the consultant appointment . (Histopathology report indicated squamous cell carcinoma which was not reported back to her until the call on 12 th Jan- Mum was told by hospital that she would be advised by doctor when received..)

She contacted them re a weakness in her leg and fell resulting in a damaged shoulder which persisted - at same time mentioning she felt she had 'lost time' - again felt there was no concern given.

I have enough clinical experience to know that had my mother been accorded medical care earlier it might not have made any difference to the final outcome. 

She was proud to have worked for the Health Service, working from that particular location for around 25 years. She felt let down .