"Appalled at the reason given for not transferring a patient from Elgin to Aberdeen"

About: Dr Gray's Hospital / Respiratory Medicine (Breathing and Lung Problems) Scottish Ambulance Service

(as a relative),

I was absolutely stunned to be told that a reason my 83 year old Father-in-Law was not being transferred from Dr Gray's Hospital in Elgin to Aberdeen Royal Infirmary was that the Ambulance Drivers wouldn't want to do that journey so close to the end of their shift as it would mean ending their shift in Aberdeen.

I find it appalling that this is considered in any way to be acceptable practice.

Following chest pains, my Father-in-Law was admitted, by ambulance, to DGH in the early hours in late January. During that same day, it was confirmed that he had suffered a heart attack. We were told that he would be transferred to ARI, when a bed was available, to have an angiogram and possibly a stent. We were told that it would likely be the weekend before this would happen.

Due to lack of beds in DGH he was not admitted to a ward there, but was given a bed in an area off A&E. Five days later, he was still in that same temporary holding area where there was a mix of patients coming and going and no windows for natural daylight for him to be able to make sense of the time of day or night or to stimulate his mind.

We were told that he might be getting moved to ARI so that the procedures could be done in a couple of days. During visiting time, there was still a suggestion that he might be getting transferred that day, and so his daughter packed his bags in readiness. My Father-in-Law, having no clarity or certainty about was happening, was then concerned about when he might be moving; that he would be getting to Aberdeen late in the evening; that he didn’t know who would be going with him; and that he did not know what would be happening when he got there. Meanwhile, his 81 year old wife, from whom he has not spent 24 hours apart for the last seven years, is at home in a very anxious state, worrying about him travelling at that time of night in wintery conditions and faced with the prospect of trying to go to sleep not knowing where he will be when she wakes up in the morning – all of which is impacting significantly on her own well-being, and those around her.

Later in the evening we were told that he would probably not be moving – and the Ambulance Drivers’ were given as a reason. I found it odd that anyone would plan to move an 83 year old gentleman at that time of night in non-emergency circumstances, but if that was what was required in order to secure a bed and be ready for the procedures, I would have accepted it as a reasonable thing to do. However to be led to believe that a bed was available in Aberdeen and then be told he probably couldn’t have it because a group of staff would be inconvenienced by having to make that journey is absolutely outrageous.

It certainly does not demonstrate holistic or person-centred care and it does not demonstrate care, respect or regard for the relatives who are worrying about their loved one. A gentleman who would do anything he possibly could to make sure others were not inconvenienced and who would always put others before him is treated as an object to be pushed through the system – and as an inconvenient object at that. It is shocking!

I received a text from him saying he was disappointed that he wasn’t going to Aberdeen.

I am quite sure that the stress of the uncertainty about the journey, the worrying about his anxious and worried wife at home and the feeling that he isn’t important enough for someone to actually do the job they are employed to do impacted upon him and contributed to him feeling unwell and having further chest pains.

He has now had an ECG and is being monitored and has been told that if he worsens he will be transferred to HDU – but at the moment he is not a priority for Aberdeen.

Not a priority! I ask you to consider how you think that phrase makes him feel?

Some words around “We’re able to appropriately manage your condition here. ” or “You’re not ill enough to need to go to Aberdeen. ” or “We can look after you fine here. ”, etc would have been more reassuring for him – and I hope would also be true. However, “You are not a priority” devalues, demoralises and depresses the person and those around him.

And we are left wondering what a priority situation would be, and sincerely hoping that he is transferred to Aberdeen where he can be given the treatment advised in good time before his physical and mental condition begin to deteriorate through being confined to bed for longer than required and denied the treatment necessary because the service that should have taken him to Aberdeen decided it would be too inconvenient for them to do so.

My Father-in-Law tells us that he is well looked after, the food is good and he gets plenty cups of tea. The call handlers on 111, the paramedics who attended him at home and the staff looking after him in Dr Grays have all done a great job and should be commended for that. However the message from the system is that he is an inconvenience and not a priority and that does not help anyone to feel positive about the situation. I ask you to consider if this situation would be acceptable if it was your family member?

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Response from Pat O'Meara, National Head of Ambulance Control Services, Ambulance Control Centres, Scottish Ambulance Service

Dear Mrs Fife,

While it was great to hear that the ambulance crew who attended to your father in law were so helpful, I was very worried to hear that he had such a poor experience getting his transfer organised. It must have been very upsetting for him and his family.

What you said just does not sound right to me. While we do have to consider the length of time our crews are working until, we stagger the shifts that ambulances are crewed for so that any impact on patients is kept to a minimum.

I would like to find out more about this so that I can get back to you and your father in law with an explanation of what happened. I also want to make sure that if there is anything to learn from this, that we do so, so that we can get it right the next time for him, or other patients.

I’m sure NHS Grampian will respond to you regarding your father in law's hospital experience. I hope he is recovering well.

Do please contact me on 0141 810 6101.


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Response from Linda Oldroyd, Nurse Consultant, Person Centred Care, NHS Grampian

Dear Mrs Fife

Firstly let me thank you for taking the time to provide us with this valuable feedback. NHS Grampian aims to be a caring, listening and improving organisation and I am responding to your concerns with that in mind. I am in total agreement with you about the use of the phrase "not a priority" and I apologise for the use of this type of language by an NHS Grampian employee.

I can well understand how both your father in law and his wife must have felt about the uncertainty of the move to Aberdeen Royal Infirmary. The situation was far from ideal and not to the standard of care that we would like to deliver. It is good to know that despite everything the staff were caring and did an excellent job. So often it is systems and not people who let us down, as seems to be the case in this instance.

Bed pressures are never far away from the NHS as I am sure you are aware, however, this is not an excuse for inconsiderate behaviours and making already stressful situations even more stressful for patients and families affected.

I will ensure that the Lead Nurse for Dr Gray's sees this feedback. I am sure she will use it to encouage staff in the Accident and Emergency Department to reflect on the situation you describe and consider what they could have done differently.

I hope your father in law is now getting the care he needs and that the family are being kept informed of any changes in the situation.

If you would like to talk about your concerns with me, please give me a call on 01224 558449 or email me at loldroyd@nhs.net

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Response from Linda Oldroyd, Nurse Consultant, Person Centred Care, NHS Grampian We have made a change

Dear Mrs Fife

The Lead Nurse from Dr Gray's Hospital, the Clinical Manager for Unscheduled and Medical Services and the Senior Charge Nurse from the area concerned have all read your feedback and it has also been shared with the staff in the department who have discussed communication and public perception.

The Clinical manager has said, "The process for patient transfer for clinical or bed pressures cannot be amended however the way staff communicate with patients can be improved." She goes on to say that, " Staff locally have been provided with the opportunity to attend customer services courses, which I have asked the Senior Charge Nurse to prioritise."

There has also been a request made for further courses to be made available to staff so that management can be assured that, over the year, the majority of staff have the opportunity to attend a course and reflect on patient interactions that could have been better.

I hope these comments provide you with assurance that your feedback has been acted upon for the purpose of improvement.

Kind regards,

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