"Taking an 84 year old to accident and emergency via ambulance"

Dear Caggiuk,

First of all, I hope your mother is doing much better now and is recuperating well.

I was really sorry to read this as it appears as though we fell short in a number of areas which on the surface are not difficult to resolve - the main one of these being how we as NHS staff communicate with our relatives and carers on a day to day basis.

I often hear that it is not so much the waiting that annoys people - most understand that our services can be very busy - but that they are not kept up to date on what is happening. That you asked for updates from staff who did not come back to give these to you, or that no one made sure your mother was comfortable while waiting simply adds frustration and anxiety to an already fraught situation.

While we all appreciate how busy staff are, particularly in areas such as A&E and the Immediate Assessment Unit, we cannot lose sight of the difference that such simple interactions have on how a patient and their loved ones are made to feel in such situations.

The situation that you describe at the X-ray department is also about communication, but about how our departments talk to each other, and so I will also highlight this to my colleagues to see how they are doing this and how they are trying to make this a much smoother process.

Thank you very much for getting in touch with us to tell us about your experience - it is really important to us that we know from patients and carers what really matters to them so we can work together to create the best possible services.

Best Wishes to you and your mother,

Lorna

Hello Caggiuk

I'm one of the Medicine for the Elderly consultants at QEUH.

Your story is a timely reminder of the ongoing problems we have encountered during the opening of QEUH. I'm sorry that your mother received such poor care. I have discussed your story with the relevant nurse in charge and manager in IAU.

People referred to QEUH by their GP are seen in the IAU (immediate assessment unit) which is part of the Acute Receiving Unit (ARU). This is separate from A&E. It is unfair that patients who do the right thing, and phone their GP, but are referred, are often waiting longer in IAU for treatment than those who bypass their GP and present directly to A&E. These are often the most frail and vulnerable of our patients, and delays in their care lead to deterioration, distress, and discomfort.

The scale of this unit, with over 100 beds, and up to 200 admissions per day means that many patients have encountered delays in their care and treatment. During the day there are about 6 consultants working in IAU and ARU seeing the patients. After patients are initially seen in IAU, they are referred to a ward in the QEUH building, or an ARU 'ward' next to IAU which is relevant to their condition.

We are reviewing how we can work as a group of consultants to improve patient care.

For example, we now meet at a 3.30 'huddle' to review the situation within the IAU and ARU department, and consultants prioritise their workload accordingly to reduce delays such as the one you describe.

Better care for your mother would have been a prompt Xray, review by medical staff, and explanation of the diagnosis and future care. I hope this happened later in the admission, and am sorry it did not happen on the day of admission.

If you would like to discuss this in more detail, please email me on I.reeves@nhs.net with your details, and your mother's details and DOB.

Ian