"Simple improvements would go a long way"

I’ll list a few of the problems I found on my recent visit to A&E with some (hopefully) positive suggestions for improvement.

PROBLEM: Without any apparent triage I was categorised as a minor injury (apparently because my injury was to only one leg and not both). Therefore I was left on a trolley in the corridor for several hours, because trolleys weren’t able to be wheeled into minor injuries. When minor injuries closed at 10pm, I was still in the corridor and hadn’t been assessed. There was no assessment or examination of my injury other than what the ambulance crew had told them until several hours after I arrived.

SUGGESTION: More careful initial triage, better prioritisation

PROBLEM: Lack of appropriate dressings. The locum doctor thought I may have a fractured knee cap, and said I would need a “cricket splint” and to book into fracture clinic. We were in hearing distance when he went to organise said splint and could hear his exasperation when told that A&E didn’t have splints and weren’t trained in fitting them.

SUGGESTION: I would have assumed fractures and broken bones were routine in A&E, therefore a stock of splints and appropriately trained staff is essential. I understand my consultant in York may also have sent an email referring to this issue.

PROBLEM: lack of basic care in supporting leg injuries. To try and get me into minor injuries, the senior nurse suggested that I “hop off” the ambulance trolley and onto a chair. My “minor” injury was in fact a serious knee injury which has required urgent surgery and the nursing staff just stood by and watched as I trustingly followed their suggestion, resulting in flexed knee cap and excruciating pain. Same happened when I was finally discharged. Fortunately my wife has some medical training and stepped in to help so that I was able to safely get onto crutches

SUGGESTION: Reminder of basic care in supporting injured areas when asking patients to mobilise

PROBLEM: Need for patient advocate. It doesn’t bear thinking about the state I might have been in without the support of my wife. As per the “minor injury” point above, I’m sure I would have been left a lot longer and suffered a lot more. It is unreasonable to expect a patient who is in shock and pain to have to fight to be heard.

SUGGESTION: Treat patients as people and individuals

PROBLEM: Support on discharge. Three issues here. 1) Doctor expected me to be discharged with some painkillers. Instead, I was given just a prescription, which was not a great deal of use at 3am. 2) It was an icy night, and my wife was expected to manhandle me into the back of our car on her own. 3) No advice given on how to look after my leg prior to attending fracture clinic

SUGGESTION: A couple of painkillers should have been provided to tide me over, and advice provided on how to manage the injury.

Positives: Ambulance crew were brilliant, as was the lady in reception - kind and helpful