"Accident and Emergency/CDU, Queen Elizabeth Hospital"

About: Queen Elizabeth Hospital / Accident and emergency

(as the patient),

I recently attended the Accident and Emergency department at The Queen Elizabeth Hospital Birmingham.

I was seen quite quickly by a doctor and had blood tests and x-ray examinations.

The staff in A and E were all very helpful and professional, explaining what they were doing and why. When I had the x-rays the radiography staff were also very professional and made me feel at ease. I was referred to the surgical team and spent an hour in CDU before being sent home.

Overall I experienced very high quality treatment and I would like to thank all staff involved in my care.

I am an insulin dependent diabetic and this was my first experience of A and E or inpatient care since diagnosis. I did detect a degree of uncertainty amongst some staff about whether I should continue to inject insulin as normal or not.

The prospect of relying on someone else to control my insulin dosages was one that concerned me. Some of the ward staff seemed unsure about allowing a patient to self medicate.

As it turned out, much to my relief, my stay was very short and I was sent home within a few hours. So my question is: does the hospital have a clear policy regarding insulin dependent diabetics and their medicine management?, I. e. when and how their insulin therapy is taken over by hospital staff? Are all clinical staff aware of this policy and when they should allow patients to self manage their insulin injections?

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Response from University Hospitals Birmingham NHS Foundation Trust

Thank you for taking the time to provide feedback on your experience of the Emergency Department (A&E) and CDU at Queen Elizabeth Hospital Birmingham. We welcome all feedback and would like to assure you that all comments are taken seriously and acted upon as part of our ongoing commitment to improving patient experience.

We would like to thank you for the positive feedback you have provided. It is a real morale boost for staff to receive feedback like this from patients. It means such a lot to know that the hard work, dedication and commitment of our staff is recognised and valued in this way. It is also very satisfying for staff to hear they have made such a difference to patients and made sure your experience under our care has been positive.

We are sorry that you felt that there was some uncertainty from staff about whether you should continue to inject insulin as normal. Our Nurse Consultant in Diabetes has read your concerns and provided the following comment:

“Wherever possible we do try and encourage patients to self medicate with regard to their insulin administration. However, there are times when due to illness that a patient may not be competent to do this. A patient should be observed and assessed as competent before the decision is made for them to self administer their insulin. The assessment normally occurs when a patient is admitted to a ward. Therefore, the assessment may not take place in the Emergency Department, and if the patient goes home within a short period of time of going to CDU or a ward, it may not be required. For future reference, we have recently developed a new self administration of medication policy that includes insulin administration, which will be published as soon as individual patient drug lockers are in place. This contains all the information staff need to support patients who are competent and wish to take their own medication including insulin.”

Thank you once again for providing your feedback.

If you would like to discuss your concerns further please make contact via our Patient Advice and Liaison Service (PALS) team who will also be pleased to assist.

PALS can be contacted by phone 0121 371 3280, by email PALS@uhb.nhs.uk, via the hospital website http://www.uhb.nhs.uk/pals-form.htm or in person by dropping in between 9am – 4.30pm (Mon-Fri) to the PALS office located to the left of the Information Desk in the main entrance of the new Queen Elizabeth Hospital Birmingham.

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