"My father was admitted after a ..."

About: City Hospital campus

(as a relative),

What I liked

My father was admitted after a stroke and spent approximatley five weeks there until a further stroke and his death last September. I wanted to write and express my thanks publically for the care he had during his last weeks. [I did write at the time too].

In general this was good and the care at the end when he was so ill and we were implementing his living will that he be allowed to die was wonderful. The staff were exceptionally sensitive and there was absolute respect for his wishes that he be given no active treatment - just kept comfortable. He was given a single room and the staff were attentive and caring to the end. Thank you.

What could be improved

After his orginal stroke, I feel it took rather too long for staff in A & E to recognise what the problem was.

During his stay on the ward there were times when busy staff could have been more careful about making sure he drank and that he could reach the things he needed from his chair. However, they were hard pressed and the general care was good.

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Response from City Hospital campus

Thank you for taking the time to post your feedback to us. The stroke service continues to develop at NUH and it is good to hear your positive comments particularly in relation to the support given to your father in implementing his living will and the sensitivity shown by staff in respecting his wishes and being attentive and caring to the end.

It is disappointing to hear that you had a long wait in the Emergency Department and felt that it took too long for staff to recognise the problem with your father. We would like to reassure you that we have made improvements, as we have a pathway now to enable paramedic staff to triage patients at home, look for signs of either face and arm weakness or speech problems – known as the FAST test - which then enables the ambulance crews to take patients with suspected stroke straight to the acute stroke unit at Nottingham City Hospital bypassing the Emergency Department. GPs can also arrange for patients with suspected stroke to be admitted directly to the acute stroke unit on the City Hospital campus.

If symptoms are unclear patients will still be seen in the Emergency Department, but medical staff are aware of the pathway and on examination of the patient if they find the problem to be a new stroke, they will send the patient immediately to the acute stroke unit. This should reduce any delay in patients accessing specialist stroke care.

You raised concerns about staff needing to ensure patients can reach drinks and meals. Nursing staff are aware of the importance of screening patients for swallowing difficulties and providing nutrition. The staff working within stroke services have regular training sessions to maintain skills. That said, we will ensure that the Head of Stroke services for Nottingham University Hospitals emphasises to all staff the need for drinks and meals are within easy reach.

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