"Surgical Visit"

I would like to offer some feedback following my recent experience in the Balfour, in the hope that this might help improve future patient experiences. I do appreciate the kindness that was shown to me during my stay but I feel there are some aspects of my visit that could have been so much better.

I arrived for my appointment twice, the first operation was cancelled due to a previous nights emergency (totally understandable). Both times (and from a time I have been before) the same routine ensued: I walk in on time to find no staff to greet me, unsure of what I am to do I gingerly sit down and await instruction. I saw this with every patient arrival. Even when there was a member of staff there it was the patient who had to initiate the encounter, explain who they were and ask what they are expected to do. This process of complete disregard for the service users desire to know what is happening followed through the whole day. There seems lacking such a basic courtesy on the part of the staff I met, who know exactly what the patient is expected to do and is going to be required to do, but do not tell them. The documentation sent out before the operation does in no way explain the order of events of the day or this arrival and waiting system.

I would like to see a standard procedure where:

• Every patient is with provided a leaflet explaining the routine of the day. In this leaflet it is explained

o What time they arrive

o What will happen when they arrive, who will meet them and where they will go

o What kind of wait they can expect and whether they will be waiting in a chair or in their own personal space e. g. their bed

o The order in which professionals see them and the significance of each meeting

• On the day, each patient is told when they are expected to be taken to theatre and that it is explained that this time may vary greatly dependent on previous appointments. Being given a guide time enables a person to psychologically prepare and everyone understands if it is not able to be adhered to, especially if that is explained beforehand.

• If patients have many hours of wait- more than 2 say- they should be able to either go to a bed area to make themselves comfortable, or to leave the building. What they are able to do should be clearly explained. The patient should not have to ask any questions.

• Privacy is provided.

o A fellow patient of mine had to ask the office door to be shut as we were all able to hear the nurses discuss patient cases, and then she herself was situated only a curtain away from the waiting room upon preparation and return from surgery. It was like a communal surgical experience and I am quite sure that she was not comfortable with it. 

• Staff are prepared for when things do not go to plan- they have contingency arrangements.

o In my case I had a lot of pain and was left calling for pain-killers for hours while staff member after staff member went out of my curtained area to ‘find them’. They then decided to keep me in overnight, then the anaesthetist said I would be going home and confusing messages were given.

o When you are in a lot of pain it is easier if staff are clear, consistent and know what the rest of the team are saying.

• Staff should have a minimum standard of dress and deportment.

o I have worked at the Balfour, I know that there are professional and local standards that uniformed staff have to adhere to. I was told off if I wore a discrete necklace. The surgical staff however seem to have no standards whatsoever.Now I understand that it is difficult to get staff, and I understand that everyone has different standards of personal presentation (I am not high up on this list! ) but the NHS Orkney should have minimum standards and these should be met by all staff.

o Meeting the person who would be operating on me instilled fear into me from the start. The manner and appearance of the surgeon made me doubt their capacity. As someone with a possibly nervous disposition, doubting the capacity of the surgeon about to operate on you is not a good start and I would not be surprised if this contributed to my reaction to the surgery (which was poor and resulted in an overnight stay).

I could say more- I could go through every aspect of my stay and say more, but I think I have covered the points I felt most important and easily easily achievable suggestions for improvement. I am a passionate supporter for the NHS and I think we can have an NHS that provides world class service here in Orkney. I just had to write because that is not happening at the moment, and I know this is not an isolated case.

If you would like to discuss my visit to the Balfour with me in person I would be very happy to do so with you.