"Diagnosis over the phone?"

About: Epsom and St Helier University Hospitals NHS Trust

I brought my elderly mother into a&e last Tuesday after she had fallen off her bed and damaged her shoulder.

She has osteoporosis, so it was inevitable that something was broken. We arrived just after 5pm and she was admitted to a ward at 5am.

By 7.30pm it was confirmed that she had broken her clavicle and although we were dealt with by an extremely competant nurse she was not seen by a dr? Apparently the orthopaedic team are at St Helier and via a phone call they decided that she should be put in a sling, given codeine and sent home. Had the dr seen her in person they would have seen that her bone was moving and that she was unable to dress herself, let alone be able to take her numerous tablets and nebulise (she has COPD and suffered a heart attack last year) once back home. The nurses then had to call St Helier again to make them aware of the change in situation.

Nevertheless They decided she could still go home.

The nurses warned us that if the bone moved and broke the skin that we she go to a&e at St Helier Asap. I expressed my concern that if she went home she could easily fall out of bed again. At which they went and spoke to someone else and came back and told us that she was going to be assessed by a 'medic'. It was now 8pm. At 8.30 I asked if a nurse could redo her sling that was loose and move her up on the bed as she had slipped down. I was told the medic would be another hour or so.

She wasn't seen by a dr until 11.40. Who did a quick assessment and then arranged for her to be admitted. She also arranged for blood tests and an ecg. The nurse then adjusted her sling. I left at 1pm and when I came to see her the following morning the Britten ward nurse said that she didn't come to them til 5am.

Now while I appreciate my mother was never in immediate danger the whole process could have been much quicker and far less stressful and frustrating for both your staff and patients.

it would have been much easier if there was an orthopeidic dr on site saving the nurses valuable time as they had to make several phone calls and appeared to have great difficulty getting through to people. I don't know if it was particularly busy that night but surely if there is such a backlog another dr could be called in to assist. All your staff were courteous and efficient but clearly frustrated at the system and the pressure to appease stressed patients and relatives.

To top it all the vending machine was almost empty and items not priced or coded resulting in me paying £2 for a packet of crisps. Plus a £12 car park charge.

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Response from Epsom and St Helier University Hospitals NHS Trust

Thank you for your feedback. We're sorry to hear about your mother's experience and would welcome the opportunity to discuss this further with you. Please contact our Patient Advice and Liaison Service (PALS) on 020 8296 2508 or email pals@esth.nhs.uk.