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"Excellence in acute care then lack of follow up"

About: Aberdeen Royal Infirmary / Acute Short Stay Medicine Community Services in Grampian NHS 24 / NHS 24 (111 service) Scottish Ambulance Service / Emergency Ambulance

(as a relative),

My father has  a pre-existing dementia, Parkinson's and atrial fibrillation.  Following an acute event recently when my father became extremely agitated, hallucinating, and disoriented he was subsequently admitted to Ward 101 Aberdeen Royal Infirmary where it was confirmed that the delirium had developed in response to Digoxin toxicity.  Prior to the admission we made three calls to NHS 24 who were exceptional in all aspects right through from response times, call handling and providing the most appropriate response.  On all three occasions medical staff visited my father at home to assess the situation until it was no longer possible to maintain my father at home. 

We highly commend the work, the compassion and empathy displayed by all staff we came across within NHS 24.  The Scottish Ambulance Service continued in this exemplary fashion and despite it being an extremely busy day they prioritised my father's needs and maintained regular contact with us until a vehicle could be dispatched.  Once again the care and compassion and the understanding by the paramedics was exceptional.

My father was admitted through Acute Medical Admissions (Ward 101), transferred to Elderly Assessment (Ward 102) and subsequently placed within Ward 303.  Within each of these areas the staff were incredible, they were patient, kind, compassionate, empathetic and tolerant despite my father now being extremely unwell and uncharacteristically aggressive.  They repeatedly told us that they knew this was out of character and that they could see that my father was a kind, gentle, man.  This was so reassuring and comforting for us a family as we struggled with this distressing situation.  

All staff within  the full multidisciplinary team were exceptional.  The natural, relaxed, reassuring and calm approach from nursing assistant to both the Consultant in Ward 101 and Dr Bostock were exceptional.  At all times we were listened to as a family and were fully encouraged to participate in my father's care  which was extremely important to both my father and my family.  The staff cared for our needs as much as my fathers and never at any time were we made to feel like we were a burden or that the staff were too busy, despite what I felt were ridiculously low staffing levels.

Unfortunately, despite the excellence in acute care the level of support from the Dementia Service has not compared.  The level of, or indeed lack of, response from my father's allocated dementia nurse has been extremely disappointing and despite advising the nurse of my father's admission to hospital they have still not followed this up even though he was discharged home around 2 weeks ago.

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Responses

Response from Alan Martin, Patient Experience Manager, Corporate Affairs and Engagement, Scottish Ambulance Service 6 years ago
Alan Martin
Patient Experience Manager, Corporate Affairs and Engagement,
Scottish Ambulance Service
Submitted on 15/02/2018 at 18:41
Published on Care Opinion at 23:17


picture of Alan Martin

Dear DrJ,

Thank you for taking the time to share feedback around your fathers recent admission to ARI. Your story sounds quite a distressing one for yourself, your family and of course your father. I do hope he is recovering well from the Digoxin Toxicity.

Your comments are very kind not just about our crew and the staff that kept contact with you but also about our close partners in the NHS also. I would like to thank you for those. I have had personal experience with close family suffering from Dementia and I understand how upsetting, and on occasion challenging, it can be for all involved. It is encouraging that the SAS/NHS staff involved showed all the characteristics you described.

If you would like me to pass on your kind words to the crew and their manager along with the team at control I would be more than happy to do so. You can contact me at scotamb.corporateaffairs@nhs.net. I will need your fathers name, the address that we were sent to and the date and rough time in order to track down who it was that responded.

Thank you again for your time and I wish you and your family all the best.

Kind Regards

Alan

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Response from Ruth Jones, Nurse Manager, Medicine 1 & 2, NHS Grampian 6 years ago
Ruth Jones
Nurse Manager, Medicine 1 & 2,
NHS Grampian
Submitted on 16/02/2018 at 14:00
Published on Care Opinion at 14:32


Dear Dr J

Thank you for taking the time to feedback after your father's recent admission to our hospital.

Im glad that both your father and family had such a positive experience in Wards 101, 102 and 303.

Staff are always encouraged and happy to receive feedback such as yours and I will ensure that the Senior Charge Nurse for each of these areas is made aware so they can share with their teams.

I sorry that from discharge you havent received the anticipated and required support. I discussed this with the Alzheimers Nurse Consultant for NHSG Acute hospital today, her advice would be to contact your GP re this if you havent previousley done so.

Thanks Again.

Kind Regards

Ruth Jones

Nurse Manager.

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Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 6 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24
Submitted on 19/02/2018 at 10:21
Published on Care Opinion at 10:42


picture of Shona Lawrence

Dear Dr J

Thanks for sharing your story on Care Opinion. Your father's recent acute event sounds as though it was distressing for all. I do wish him well.

It was very good of you to share your comments and to ensure that you included all areas of the NHS who were involved in your father's care. Thank you for specifically mentioning the staff members within NHS 24 who managed the calls to our service. I would be pleased to be able to identify the staff involved and share your positive feedback with them. To do this, I would require some additional detail from you, therefore should you care to contact me directly, then I would be delighted to hear from you. You can email me at patientaffairs@nhs24.scot.nhs.uk or telephone on 0141 337 4582.

As NHS 24 is sometimes only involved in a portion of a patient's journey of care, it is good for us to receive stories such as yours which reinforces for us the hugely important role we have in ensuring patient's receive the appropriate advice or referral. It is also great to see from your story how services work together to provide seamless care for patients. It is however unfortunate that you feel let down by one area. I am pleased to see that one of my colleagues within NHS Grampian has already responded to your story.

Thanks again for taking the time to get in touch. I will share your story more widely within NHS 24.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

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Update posted by DrJ (a relative)

Thank you to everyone who has responded so positively to my post on behalf of my family. I’m delighted to hear that the feedback reached those directly involved in my fathers care.

However I am rather disappointed regarding the suggestion that we should contact the GP to arrange support from the Dementia Nurse.

I had already had contact with her and advised her of my father’s admission, hence the source of our frustrations. Following discharge home again I had to actively pursue this support. Two weeks on my father has now benefited immensely from the input which only highlights the need for the earlier intervention we had requested.

While I am more than capable and know my way around the healthcare system this may not of course be the case for everyone.

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