"Discharged home without help and support"

About: Nottinghamshire County Council Queen's Medical Centre / Gastroenterology

(as other),

Complaint re discharge of neighbour of mine who has always been independent until now, and financially poor, has lived alone in a bedsit on income support, although not every week due to DWP sanctions, recent unexpected, emergency total colectomy and, ileostomy (This is my neighbour, not a relative of mine and he has no family to help him) No transport, no working washing machine and would be unable to afford taxis to independently take care of his own shopping needs. Also has failing sight in one eyet.

Despite my informing various staff on ward E15 and also telephoning adult Social care at Nottingham City Council (Mary Potter centre) on a week after his surgery in December), to ensure to perform a safe discharge, appropriate for his needs, meaning that I felt that he would need social support until he is independent again, due to his lone circumstances as I explained to them, and also requesting a Social worker assessment, he was discharged home on the late December 2014 but the support which was promised from redcross home from hospital is not available to take place until the second week in Jan which is over a week without much needed help with his daily living.

No Social worker assessed his needs at all while he was in hospital. It also seems to me that none of my concerns were documented or passed on as I needed to keep repeating them each time I telephoned.

He had no food in his cupboards as he was admitted as an emergency whilst attending the treatment centre for a CT scan, on the day that he was due to collect his fortnightly benefit and do his shopping. The ward supplied some basic food supplies for the day of discharge and morning after, but when I asked the discharge staff nurse who would help him with shopping up until support was put in place I found her attitude quite rude and she talked over me (stating that the hospital can’t keep patients that were able to walk and care for their stoma unaided) He had only seen the Stoma nurse the day before his discharge may I add. He ran out of wipes within a day and has used a full toilet roll and a further pack of wipes which we gave to him (and it is still 6 days before support is in place )The nurse was not interested in listening to me or answering any of my concerns regarding who was going to provide assistance between discharge and the second week in January, even though I had stated in no uncertain terms that I would not be willing or available to undertake any home care tasks eg shopping, washing or keep going round to check on him etc.

She stated that she had discussed with the senior staff and that they had agreed that he should be discharged despite no available help and she told me that in her opinion he would be able to go out the next day and do his own shopping etc and did not need any help.

I told her that the roads and pavements had not been gritted and were hazardous underfoot and we were a long way from shops. On his arrival home it transpired that his prepayment gas and electricity meters had no credit and therefore my husband had to get into our car after finishing his shift at work to get meter credit for him (shops are not within walking distance and the roads and pavements were too icy to walk on even for a fit person)

We found out the next morning that the gas credit which we purchased and had dropped off to him at his door the previous evening, for heating and hot water, was used up straight away due to the meter being on emergency before and whilst he was in hospital. Therefore this man had spent the whole night of his first evening after discharge without central heating or hot water on the coldest night of the year, because you had deemed him fit to take care of his own needs. We had to go out and buy more for him the following day.

As of today, due to his Stoma being active for most of the time even during the night, he is too frightened to try and walk the long distance to the nearest shops and back, he is also very weak and really looks much less fit and unsteady than he did before he went into hospital. He says that he would not be able to go out to do his own shopping.

I therefore have now had this responsibility foisted up on me by your inept processes, eg ensuring he has provisions etc due to feeling sorry for this man.

This is unacceptable to me, especially as I had told the hospital in no uncertain terms that my position was that I would be unable to accept this kind of responsibility and that he had no-one to help him and I was assured that It would not become my problem. I have my own health and family responsibilities to deal and worry about and just cannot take this on board as well.

Please arrange some help at home for this man, as a matter of urgency to help him with his daily living and to assess his ongoing needs, and before the end of this week.

What if this person did not have a good neighbour? I feel that I have been taken advantage of by the NHS and this cannot go on and I will need to just say no this is not my responsibility, which is becoming quite a worry to me.

It does not seem to have been taken into consideration by the NHS nursing staff that this unexpected surgery has been a life changing event for this person or the fear, embarrassment and vulnerability he must be feeling at this moment in time.

This man has been ignored for most of his life, by most departments of the welfare state which I believe has in part lead to the need for this operation to be performed in the first place.

He has been ill and struggling for over a year, and also received many DWP sanctions whilst on Jobseekers allowance due to feeling too ill to look for work and has only now reached a diagnosis and treatment.

Maybe if he had been diagnosed earlier he would not have needed this drastic surgery.

Please therefore fulfil your obligations and refer to appropriate agencies forthwith.

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Response from Nottingham University Hospitals NHS Trust

First, we apologise to the patient that we have neither acknowledged nor replied to their concern sooner. We have only today received the concern from the patient via Patient Opinion, several months after it was posted.

We are looking into these concerns and will reply as swiftly as possible.

Response from James Munro, Chief executive, Care Opinion

picture of James Munro

Hello Disgruntled Relative

We're pleased to hear that your concerns are being looked into.

To avoid any misunderstandings, we'd like to assure you that when we published your story, on 5 January 2015, we emailed two responsible members of staff at Nottingham University Hospitals NHS Trust the same day, to let them know.

I hope that's helpful.

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Response from Nottingham University Hospitals NHS Trust

We are concerned to read your feedback and wish to investigate this further. However, it is important that we speak directly with your neighbour (the patient) so that we know they are content that we look into these concerns (and receive appropriate consent from them to do so). If your neighbour wishes to get in touch, he can do so by calling 0115 9249924 ext. 66885 or ext. 62443.

Rekhaben Patel

Matron DDT

Update posted by Disgruntled Relative (other)

As you state it is a few months since I voiced my concerns on Patient Opinion. After being left with no help apart from mine and a few other kind neighbours until after the new year, I myself had to contact adult social care rapid response team, to make them aware of this gentleman’s needs, who in turn assessed him promptly and have provided him with that much needed help.

This social care support was not at all initially straight forward and smooth in any event, but it was needed and is still ongoing. It was adult social care who also arranged for community Nurses to help him with his Stoma care as he needed a great deal of assistance with this.

Whether the hospital investigates or not, the fact is that this gentleman and others in similar circumstances, should be assessed by a social worker prior to discharge and arrangements for community care,social or nursing, made prior to them leaving hospital. More especially, in this case,as I, as a concerned neighbour had informed the hospital on numerous occasions in the weeks prior to his discharge, that he would most definitely require help at home after discharge.

The hospital, to my knowledge, did not make any such referral. I do not really know how this man would have ever have gained any help at all without my being proactive in gaining this for him. And this was initially a very difficult process. I could have had more sympathy with your discharge processes had you been solely reliant on how you perceived this patient would cope, eg if you had only the info given to you by this patient who’s only objective was obviously to go home, which you were obviously happy to accommodate. Never the less you should have taken my concerns seriously and made a referral to community agencys, not just send him home and forget about him.

But this was not the case, I had informed you of his social circumstances, going so far as to tell you that I was only a concerned neighbour and not in a position myself to offer him care or support. Therefore I ask you, what if he had had no concerned neighbour! It does not bear thinking about! The welfare of discharged patients should not be left purely to chance, especially when you have received information that home care and support would be a necessary requirement for a safe transfer to home.

Response from Nottingham University Hospitals NHS Trust

Thank you for getting back to us and for the further dialogue regarding the concerns you have about how the discharge of your neighbour was handled. We note your concerns. We know we have more to do to reduce discharge delays and improve communication with patients, relatives and carers when patients are transferring from our care. Much work is underway across the health and social care community to make improvements. We will still be happy to discuss these concerns with your neighbour so we might better understand where me might have done things differently. Without your neighbour’s consent and knowing the details of your neighbour’s case (name, date of stay, ward etc) it is difficult for us to comment on this specific case. If he wishes us to look into this further, please do ask that he gets in touch and we will work with our partners from social care and relevant NUH colleagues to see where we may have fallen short on this occasion.

Response from Queen's Medical Centre

This feedback was originally posted in January 2014 via the Patient Opinion website. There is presently a technical problem with the NHS Choices website. This means a back log of comments are being pulled from the Patient Opinion website later than usual. We have escalated our concerns to NHS Choices, who have assured us that their team are working to resolve the problem. We responded to this post in January 2014. This issue has since been investigated and fully resolved.

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