"Problems at Edinburgh Royal Infirmary, Accident and Emergency"

About: Royal Infirmary of Edinburgh at Little France / Accident & Emergency

(as a relative),

I attended Accident and Emergency last night with an elderly relative. She is a diabetic and had been unable to measure her blood sugar levels, which she is required to do in order to take her insulin.

I have a number of observations to make about the service we received. I should make it clear that the care she received from the nurses was very good, and that they were kind and courteous throughout, despite clearly being under enormous pressure.

The service is clearly operating well beyond its capacity. The waiting area is entirely inadequate, with insufficient seating. We waited an hour and a half to be triaged, but were fortunate as my aunt had a seat throughout this period. Some patients were not so fortunate. Additionally, it was impossible for my aunt who is hard of hearing, to hear the names being called by the nurses for triage from her position at the far end of the waiting area. It was clear from the number of times that individuals had to be called for repeatedly, that it is quite possible for patients to miss their 'turn'. This is also obviously delaying staff, who have to repeatedly ask for the same patients.

I also noted that the information board providing the names of the lead staff for the unit was empty, making it impossible for patients or relatives to ask to speak to anyone senior should they have concerns. This may be a deliberate policy, but in that case I would suggest the board should be removed, since it gives an entirely false expectation.

Having been triaged, we were told that although the nurses had no concerns, they could not discharge my aunt. This could only be done by a doctor, but there were no doctors on the unit after 22:00 hrs. As a result my aunt was moved to the Out of Hours Service to be discharged by a GP. I am astonished that the major Accident and Emergency Unit for Edinburgh and the Lothians has no doctors available after 22:00 hrs, despite being extremely busy. Effectively this would mean that no patient arriving after 20:30 (our arrival time) could be seen by a doctor, without additional and significant delay. I do not consider this acceptable, and I cannot believe that units of a similar importance elsewhere in the country are run on this basis.

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Response from Dougie Brownlie, Patient Advice and Support Service (PASS) Marketing Officer, Citizens Advice Scotland

picture of Dougie Brownlie

Hi steviant,

I have seen your post and noticed that there hadn’t been a response as yet by the NHS. It was good to hear that the service provided by the nurses was first class but I am sorry to read of you and your aunt's experience and that you were upset by various other aspects of your visit to Edinburgh Royal Infirmary

therefore, I thought I would let you know about the Patient Advice and Support Service (PASS) which is an independent service which provides free, accessible and confidential information, advice and support to patients, their carers and families about NHS healthcare in Scotland.

You can access this service from any citizens advice bureau in Scotland by going to a bureau in person, or by telephone. The number is in the phone book. You can find more information about the service at www.patientadvicescotland.org.uk

We have specialist advisers in every health board area in Scotland and who will give advice on health related issues. If required, a specialist adviser can meet you and work with you to draft a written letter to the relevant NHS area which will then raise this issue with the NHS. The adviser can also explain the NHS complaints procedure and support you if you are asked to attend a meeting with the NHS.

We work closely with all the health boards across Scotland and one of the key objectives is to drive improvements from previous experiences. From what you have said in your initial posting, I think improvements could be made so if you wish to take this further, I would encourage you to visit your local citizens advice bureau regarding this.

Hope this helps

Dougie Brownlie

PASS Marketing Officer

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Response from Customer Relations and Feedback Team, NHS Lothian

Dear Steviant

I would firstly like to apologise for the delay in responding. Thank you for your feedback and pleased to receive the good feedback regarding the nurses. I will ensure that this feedback is passed on to the team.

I was sorry to read the remainder of your feedback. If you would like to send us your details to the Customer Relations and Feedback Team we can full investigate your concerns. The customer Relations and Feedback Team can be contacted on 0131 536 3370, email craft@nhslothian.scot.nhs.uk or by writing to the Customer Relations and Feedback Team at Waverley Gate, 2-4 Waterloo Place, Edinburgh, EH1 3EG.

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