"Wait and Repeat... repeat and repeat again..."

About: Royal Berkshire Hospital

My daughter, 25, suffered a stroke on 27/3 and was treated at Charing Cross (brilliant care!) and is now staying with me in Reading to recuperate. She got a sudden headache and nausea yesterday; I rang Charing Cross and they asked me get her to hospital immediately by ambulance. I rang 999. A Paramedic arrived within 15mins and checked her vitals...but the ambulance came nearly 1hr after my call: disgusting. This for a patient who is considered to be high risk - she could have been having a bleed in the brain or even another clot... The paramedic was just as incensed as I was and requested that I complain. Apparently, such are the effects of cuts that they don't have enough ambulances....In the ambulance they checked her vitals. When we arrived at A&E they didn't have a bed; the ambulance crew located one and cleaned it and for my daughter - why? Wouldn't it be better for them to be collecting patients and for nurses/auxillaries to be doing this...?? Then began the wait....followed by the hand over to a nurse who took her vitals....then this nurse handed over to another nurse...more waiting.... then this second nurse took her vitals, some blood and inserted a catheter and promised to speak to a doctor. Each time a new professional made contact with us, we were asked the same questions. More waiting...I chased for a doctor to see my daughter who was a high risk patient and was told they would be with us shortly. More waiting... then a cubicle was found...and we waited some more. At the cubicle she was hooked up to a monitor and her vitals taken again..no doctor had seen her yet, nearly 3hrs after I had made the 999 call. Finally a doctor came over and asked the same questions again, so for possibly the 5th time we were reiterating the same information! Why didn't they simply confirm the information they had..!! Didn't anyone write anything down? I had even given the paramedic my daughter's discharge notes which are very detailed. Everyone had seen these but we were still asked. This was tedious and unnecessary. However, the doctor was efficient, ordered a CT scan which was carried out within 15mins and the results too were obtained quickly, which the RBH team discussed with those at Charing Cross: thankfully there was no bleed or clot. I accept that my daughter did not have any overt signs of a stroke but she was still a high risk patient - 25yr olds do not usually get strokes - and for her to have to wait nearly 3hrs to see a doctor is appalling. I could have driven her to Charing Cross in this time. What the RBH has to improve includes: number of available ambulances; method of prioritising; amount of repetition of the same information and long waiting times for high risk patients. I pray my daughter doesn't have to attend the RBH again.

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Response from Royal Berkshire Hospital

Thank you for raising your concerns and please be reassured that we take them seriously in order to help us improve the care we provide. We strive to provide excellent patient care and satisfaction at all times so it is disappointing to hear that you and your daughter had a less than satisfactory experience. We are unable to comment on the ambulance service as it is run by South Central Ambulance Service so you may wish to raise your concerns directly with them. We apologise that there was not a bed immediately available for your daughter when she arrived. The department was very busy and there were capacity issues. We try to ensure there are empty trolleys ready for patients as they arrive but depending on how many patients we have in the department, this is not always possible. We also cannot predict the number of ambulances arriving in one go which can also affect the availability of stretchers. With regard to the ambulance crew locating and cleaning a trolley, there is a process in place that the ambulance crew cannot leave until the patient is on a stretcher and has been handed over to the staff in the Emergency Department. At times when the department is particularly busy, and the nurses and health care assistants are attending to the needs of other patients, the ambulance crew will help out in order to improve patient experience. We aim to see each patient as quickly as we can within the department and we are sorry that your daughter had to wait to be seen by a doctor. After the initial assessment on arrival, your daughter’s vital signs were continuously monitored during her wait. The staff would have been doing all they could to see your daughter quickly; however, there are times when we need to prioritise the care we provide as some patients arrive needing urgent life-saving treatment. If there had been any deterioration in your daughter’s condition while she waited, it would have been picked up immediately by the nurses who would have escalated this to the doctors. With regard to the repetition of information, in order to ensure patient safety we do expect all staff to confirm information such as demographics and allergies with patients upon each intervention. We see a large number of patients in the department each day and so it is imperative that we have processes in place to ensure that mistakes through misidentification do not happen. We are pleased that you found the attending doctor efficient and hope your daughter is now recovering well at home.

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