"Visit to ENT: clinical risk, poor patient involvement"

About: Torbay Hospital / Ear, Nose and Throat

(as the patient),

I was referred by my GP following unsuccessful treatments with antibiotics for a persistent nasal and sinus infection with inflammation, pain, disturbed sleep and nosebleeds.

After contacting DRSS I was called by the clinic within two days and offered a cancellation appointment within four days which I accepted. Well done!

I saw a consultant and the consultation took less than 10 minutes; again well done on speed, especially as I waited for less than 10 minutes to see the consultant too.

However, the consultant seemed to be totally focussed on treating the symptoms and to have no interest in determining the cause of the problem. I just about heard a muttered reference to Rhinitis (well that's a diagnosis and not a cause and it could be just about anything causing it).

I left the hospital with 240 units of Avamys nasal spray, a tube of 2% Bactroban ointment to use on the spots that keep recurring inside my nose and a proprietary leaflet describing a product designed to "rinse out my sinuses' and an indication that I was to come back in 6 months.

The leaflet for the sinus wash described three products all made by the same company, and I left not knowing which one I was supposed to use and an instruction to go online to find out how to use it (whichever one it was) and a pantomimed example of using it. I was given no information on where I might get the system recommended (whichever it was) or indeed any indication of what it would cost me. It turns out they come in at about £30!

That was the first shocker. More worryingly when I read the leaflet that came with the bactroban cream it stated that "This product should not be used in the eyes or nose'.

Good job I checked! I went to a pharmacy and spoke to the pharmacist as I am aware that consultants can sometimes choose to use products that are 'unlicensed' for a particular use where this has been found to be effective. But, in the words of the pharmacist "Someone has made a mistake".

I have no idea what the clinical consequences would be of putting a skin preparation of bactroban on the more sensitive tissue of the nasal cavity; but given the instructions and the pharmacist's advice to "...get the bactroban designed for nasal use..." from the hospital I am not keen to find out. Why is an ENT department doling out the incorrect medicine?

I have to say that none of this inspires confidence for a return appointment in six months time.

Finally, a word about staff attitude. The consultant I saw made me feel as if I was wasting their time (not my view as I have suffered with this for over 18 months and my GP's efforts have not been able to alleviate the symptoms). Their attitude was cavalier and the only impression I got was that they couldn't wait to get me out of the consulting room. I went to the ENT department expecting specialist expertise and got the type of response I'd expect from the generalists that are GPs (no offence GPs you are generalists). The consultant's attitude also precluded my asking questions and therefore being an informed patient. Not good Torbay.

So in summary, good on speed, absolutely crap on expertise, effectiveness and patient involvement. Get your act together ENT department. Give me effectiveness over speed any time and I'll forgive staff attitude (a bit).

Oh and courier me over my nasal bactroban. I suspect the cost of doing so will be significantly less than the cost of lost time at work, mileage and parking... I am not paying for your mistake.

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Response from PALS Dept, Torbay and South Devon NHS Foundation Trust

Dear Patient,

We are very sorry to hear about your experience and that the standard of your care fell below that which we strive to provide. We would like the opportunity to discuss your experience with you and try our best to resolve it.

If you are happy to talk to us about this, please contact our Patient Advice & Liaison Service (PALS) so they can look into your situation in more detail.

A PALS Officer is available in person, Monday to Friday, between 10.00am and 2.00pm. You can contact them by calling 01803 655838 or on our 24 hour freephone number 0800 02 82 037. If you get through to the voicemail service please leave your contact details and you will receive a call back within two working days. PALS can also be contacted by Text Phone on 01803 654742, by FAX on 01803 617162, or via email to sdhc@nhs.net (your email will go direct to our PALS Service).

We look forward to hearing from you so that we can address the issues you have raised.

Kind regards South Devon Healthcare NHS Foundation Trust.

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