"Inability of many staff to give medication advice"

About: NHS Direct NHS Trust Torbay Hospital / Accident and emergency Torbay Hospital / Ophthalmology

(as the patient),

At the end of March 2012, I noticed slight flashing at the left edge of the left eye when the eye is moving left and right. A very large floater of about 25% vision also passes left across the left eye when looking to the right. Conversely it passes right across the left eye when looking to the left and similarly when looking up and down. There is no pain or irritation.

The next day the flashing remained till around 9am but the large “floater” remained. Medical Adviser did not have an answer but on NHS Choices on the internet “Retinal Detachment” appeared to show similar symptoms. The advice was to contact the doctor immediately.

Contacted NHS Direct immediately at 3:10 pm and a Mr Webster advised going to Torbay Hospital A&E immediately. Arrived there at 3:40 pm, was moved to a room at 5:05 pm and seen by a nurse who carried out an eye test which appeared reasonable. From there to a side room where a junior doctor made an eye examination. The only problem he found was a cataract, but he was concerned about the flashes. He booked me in to see an eye specialist the following day at 2:40 pm and gave 4 forms to take along.

The next day, 2:30 pm, saw Dr Roberts, an Ophthalmologist at Torbay Hospital Eye Clinic. An examination of the eyes was made after which he put 2 lots of drops in both eyes to dilate the pupils. At 3:50 he made a further examination and said the gel at the back of the left eye had become detached but there were no signs of a tear. He said to come back in 3 weeks for a further examination.

As the A&E doctor had mentioned a cataract in that eye, I asked what steps could be taken about this, (none at this time). I also asked about the nasal spray I had used for congestion, which has cataracts as a possible side effect. He said to take this up with my own doctor. Booked to see my GP next day.

Saw my GP at 9:10 am and gave him a letter which stated the above and asked about 2 drugs I was currently taking and whether they would make this problem worse. When asked about whether the corticosteroid nasal spray (Beclometasone) would make things worse with the eye problem he was non-commital, merely saying the dose I was taking was very low and would make no recommendation whether to continue taking it or not. When asked about taking Levitra (I had a prostatectomy in 2007) he again gave the same answer and would give no advice. He was so concerned that I might take him to the solicitors if he gave wrong information that he gave next to no information at all. His advice, if you can call it that, was for me to decide myself whether to continue taking the 2 drugs.

As I have no medical experience I remained without the basic advice whether it is wise to stop these drugs or not. The two drugs are Levitra 20mg, one tablet a week and Beclometasone Diproprionate nasal spray, taken about every other day.

Having a poor response from my GP, I attempted to contact NHS via their email, however this failed 3 times so I contacted them by phone at 10:45am and was advised I would receive a call back within the hour. Sarah, an NHS Direct nurse, telephoned at 11:20 am who again could give no advice on drugs and as the GP had not given advice she said to contact the local pharmacist.

I Rang Buckland Pharmacy at 11:35 am but they could only comment that the nasal spray could increase the pressure but was unsure whether in my case whether this would be a good or bad thing. The Levitra could also cause increased pressure in the eye but is less likely to cause problems. He advised contacting an ophthalmologist.

Following this I rang Torbay Eye Emergency Outpatient Department at 12:15pm as given on the Flashes and Floaters hand out from Torbay Hospital. I left details but no-one returned the call. After 5:00 pm I rang the out of hours number also given on the fact sheet. Again no-one called back. At 8:00 pm I made a further call leaving my details and again no-one called back.

I ask, what is the point of handing out telephone numbers if nobody returns the call? This whole day has shown only a great let down by many in the health service.

Do you have a similar story to tell? Tell your story & make a difference ››


Response from Caron Brittain, National Clinical Governance Manager, NHS Direct

Dear Sir/Madam

It sounds like you have had a very difficult time and had a less than satisfactory outcome to your request for information. I am sorry that you have not received the answer that you needed.

We would like to take the opportunity to investigate this further and to respond to the concerns that you have highlighted that relate to your contact with NHS Direct. In order to do this we would very much appreciate it if you could provide us with some further details so we can contact you directly. The details we need are your name/address/date of birth and the telephone number that our Nurse Advisor called you on. If you would kindly provide this information using the Contact Us facility on our website at www.nhsdirect.nhs.uk, we will look into your particular case and get back to you directly.

I look forward to hearing from you.

Yours sincerely

  • {{helpful}} of {{total()}} people think this response is helpful

Response from Torbay and South Devon NHS Foundation Trust

Dear Patient,

We are very sorry to hear about your experience and that the standard of your care fell below that which we strive to provide. We would like the opportunity to discuss your experience with you and try our best to resolve it.

If you are happy for this to happen, please contact our Patient Advice & Liaison Service (PALS) so they can look into your situation in more detail. PALS can look into the hospital issues you raised, as well as liaising with PALS at NHS Devon regarding the GP, Pharmacy and Out of Hours service.

A PALS Officer is available in person, Monday to Friday, between 9.00am and 4.00pm. You can contact them by calling 01803 655838 or on our 24 hour freephone number 0800 02 82 037. They can also be contacted by Text Phone on 01803 654742, by FAX on 01803 617162, or by email (your email will go direct to our PALS Service).

We look forward to hearing from you so that we can address the issues you have raised.

Yours faithfully

Update posted by Elvis (the patient)

As promised I wish to finish this Patient Opinion with a short resume of what happened after I posted it.

The eye clinic did ring the following day and promised to get an answer for me, but that was the last I heard from them. Undaunted, I next tried Dr’s on Call who have always been excellent in the past. They did not fail me this time. Dr Julie Clarke rang back and after taking full details advised me not to take the drugs till I saw the Ophthalmologist in a couple of weeks. I was greatly impressed at her attitude and professionalism. I had a telephone call at from a private phone in response to my out of hours call to the Eye Ward. It appears her number is being given out by the Eye Ward. I promised to inform the authorities so she no longer receives wrong numbers. Both NHS Direct and PALS left comments for me to contact them.

Carol Pearson, NHS Manager rang to discuss the PALS issue. I gave an outline of the Hospital issues which are the only things she can deal with. I mentioned the wrong number and forwarded a copy of the sheet with it on. She is dealing with this.

Being disgusted with my own doctors response to my question, I followed PALS advice and soon changed to a new doctor in a different practice. I have high hopes here.

Pauline Lambell from NHS Direct rang on 16 April 2012 to look into the details of the Patient Opinion. She said her role was only with NHS Direct, so I said I was quite happy with NHS Direct's response. They also have always given good responses in the past. I later took a letter to my previous Surgery addressed to the lead doctor expressing that I regretted moving to another practice and detailed my reasons for this. I feel it is essential she is aware of the reasons. Her reply was very short and non-committal.

I went to Torbay Eye Clinic on 19 April and saw Dr Armdghani. He carried out a visual examination after which I asked certain questions. Besides answering all the questions promptly, he said it was alright to keep taking the prescribed medicines and that usually this type of condition goes away in time and the eye becomes normal again. He discharged me and said if things did change, to book another appointment. He too is an excellent doctor.

Of course, the doctor who failed me will not be brought to book. Unless he admitted what he said it would be my word against his, and as such not worth making a complaint which would get nowhere. I am happy to be at a new practice now where I am sure I will get a good medical service.

Response from Caron Brittain, National Clinical Governance Manager, NHS Direct

Dear Sir

I am very pleased that we were able to respond to your concerns with NHS Direct to your satisfaction and thank you for taking the time to post your update. Yours sincerely

  • {{helpful}} of {{total()}} people think this response is helpful