"Feeling involved as Mum's carer is greatly valued by me"

About: The Royal Liverpool University Hospital / General medicine

(as a staff member posting for a patient/service user),

After having a routine mammogram, my Mum received an appointment at the Linda McCartney Centre for further tests.

As Mum is disabled, it was agreed that I could attend with Mum. When we arrived, we booked in at reception. As Mum is a wheelchair user, we went to the 'dropped' counter part of reception as Mum wouldn't have been able to see over the higher end of the counter. The receptionist then shouted to her from the higher end of the counter, asking her name, DOB and what she was here for. Mum had to say quite loudly that she was here for more tests after having a mammogram, plus her details. This could be heard by everyone in the waiting area. It wouldn't have taken much for the receptionist to move so that they could actually speak to Mum. There isn't any point in having a wheelchair accessible part of the reception, if the receptionist won't go to it to speak to patients.

Once we booked in, we asked for the accessible toilet, to be told they didn't know if there was one on this floor (3rd floor), and we'd have to go back down to the ground floor to use the bathroom. When we returned, the receptionist then said 'oh sorry, there is one up here!'. Not ideal, receptionists should really know where the loos are!

We waited for around 5 minutes before being called through to the clinical areas, which was great. We were greeted by a person, who initially, spoke to Mum like she may have had a hearing impairment (she doesn't), speaking quite loudly and slowly. They then asked Mum if she is able to use her own electric powered wheelchair properly. It all seemed a bit odd and condescending, although I do think this person was just trying to be friendly.

We went through to the mammogram room, and they explained the process again and gave Mum a gown to change into. They didn't leave the room for this which I felt they should have. Mum then had to ask them to tell her why she had been recalled following her mammogram, as this hadn't been mentioned so far. Mum said that considering how worrying it is to be recalled, this should be one of the first things that should happen. Mum also had to ask their name, as they hadn't introduced themselves.

From this point on however; they were helpful and friendly. They got the images from Mum's original mammogram up, and when we asked to see them, they were a little surprised. We began helping Mum to position herself properly on the machine which was tricky due to Mum's movement limitations. I moved out of the way to give them some more room with Mum. They then tried to manoeuvre Mum's wheelchair closer to the machine by pushing the back of it - it is a large indoor and outdoor powered wheelchair, so obviously, can't be moved like this. Once Mum was on the machine, they then tried to move Mum closer by pushing on her back. I feel if they had have given Mum a little more time, Mum could have moved herself closer and I could have supported Mum to do this. Of course, we understand that they needed to manoeuvre Mum to get the optimum position, but some more communication would have been good here, so Mum was aware of how they were going to move her body before doing it, as any movement is very painful for Mum.

Once the mammogram was completed, we were directed to a large waiting room, and told someone was going to look at the images and then decide the next steps. I was surprised to see lots of posters and leaflets in this waiting room about 'dealing with cancer' and groups for cancer patients. Considering the patients here are waiting to find out if they have breast cancer, this was a little unsettling.

We waited for around 15 minutes, and then someone different came and asked us to follow them. We didn't know where we were going or who this person was. We were then taken to a small waiting area outside of the mammogram room we'd just come from, and told the mammogram needed to be done again as they 'weren't happy with it', which was worrying. This waiting room was just a small cluster of chairs, and had no space to park a wheelchair, meaning Mum ended up parking in the corridor. We felt this area wasn't well thought through, and having to sit in a wheelchair in a hospital gown with nothing on underneath, in a corridor, did not have much dignity for Mum, and also meant Mum felt she was in the way and was being stared at, as she was partly blocking the corridor.

We were then called back in by the person who had done the original mammogram, which Mum was pleased about as they already understood Mum's circumstances, and they had built rapport. They explained why the test was being repeated, and communicated this clearly, which alleviated some worry.

After this, we went back to the larger waiting area for around 5 minutes and were then called in by 2 very smiley people, who introduced themselves immediately. They seemed very warm and friendly. They explained the next test and why it was being carried out. They asked Mum if she could get out of her chair and lie on a bed, which Mum had to say no to. This wasn't a problem, and they moved the room around  quickly to accommodate us. They also introduced themselves to me as her carer, which I greatly appreciated, as this is obviously a difficult time for everyone involved. The test was carried out and they encouraged me to watch the ultrasound monitor if i'd like, which i appreciated, as feeling involved as Mum's caregiver, is greatly valued by me.

They had a good sense of humour and made us feel at ease. They regularly chatted and checked how Mum was doing. They confirmed the findings of the ultrasound, which were a relief to hear, with no presence of anything sinister. They then gave us a discharge leaflet and directed us to another room next door, which they said we could use to get changed in, due to the changing rooms being too small for the wheelchair, and told us to lock the door and leave the gown on the chair, and they would sort it for us. This added level of consideration and dignity was great, however; it is worth noting that this room was clearly the 'biopsy room' with medical equipment including biopsy needles and the PC in this room was left on, and I could see a list of patient details. While we so appreciated them accommodating us so well, obviously this was a bit of a concern, and the screen should have been switched off before we were allowed in there.

Overall, an anxious time for us, made better by some very caring staff. However, I hope this story is used to make the few improvements needed in the unit, as well as commend the clinical staff mentioned, for the difference they made.

Thanks to all for the care shown!

Posted by Healthwatch Liverpool, on behalf of patient and her daughter/carer.

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