"Elderly patient discharged from A&E repeatedly when unwell"

About: King's College Hospital (Denmark Hill) King's College Hospital (Denmark Hill) / Accident and emergency London Ambulance Service NHS Trust

(as a friend),

I have an elderly neighbour who lives alone, so some of us in the street have keys in case of emergencies. On a Friday evening in March, she had a fall and pressed her alarm, whereupon social services phoned us for help.

We managed to pick her up, and as she assured us she was all right, we left.

Later on she pressed her alarm, as she had fallen again. Social services called us. This time she decided she would like us to call for an ambulance. At her request, we managed to assist her in getting downstairs, where her legs buckled under her, even with her zimmer. We dialled 999 and waited 1 hour and a half before it came. Our neighbour was still on the floor all this time.

The following day, she was discharged from A&E and sent home. I helped her indoors.

Late evening the day after, she pressed her alarm as she had fallen in the kitchen. Again we were called by social services. We went in, and as we were unable to pick her up, we called an ambulance.

She was discharged from A&E a day later. A carer came to help.

That night she fell, was unable to access her alarm/phone, and lay on the floor of her bedroom until next morning, when she was found by the visiting carer. This time she had sustained some bruising and minor injuries, and an ambulance was called.

Again, after a day in hospital, she was discharged from A&E.

We expected her a.m. with an assessment team to follow in the afternoon. She arrived after 5pm, exhausted, wanting to wash and change out of nightwear. I helped her upstairs to do this which further fatigued her, and I needed the help of two more neighbours to see her downstairs. The assessment team arrived at 7pm.

They assessed her ability to walk with a zimmer, and offered to help her to bed; they couldn’t stay or do anything else. Understandably, that’s the last thing she wanted. They left.

My neighbours made her a drink, then left.

At 8pm she phoned to ask me to place her zimmer so it was accessible for the lavatory, which I did.

At 10pm she pressed her alarm as she had fallen in the kitchen. Social services called me and I asked them to call an ambulance.

It arrived promptly.

Finally a full week after her original fall, she was admitted to hospital.

I am writing this because I cannot believe A&E kept sending her home in spite of it being obvious to all involved that she couldn’t cope. Why? If it was cost cutting, it probably cost more in ambulance call out. If it was new initiatives which must be followed in every circumstance, then the NHS is doomed.

And what about care? Not much going on there at A&E as far as I can see. Imagine the distress of the patient being shuttled back and forth so many times.

If anyone can give me any reasons for this, I’d be glad to hear them.

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Response from Cathy Varley, PALS Manager, King's College Hospital NHS Foundation Trust

I am sorry to hear of your concerns for the well being of your elderly neighbour and the delay that you perceived in her being admitted to hospital.

If you wished to contact the PALS service and if your neighbour were able to give consent for us to share information with you we would be very happy to seek to provide an explanation for the attendances in the Emergency Department which ended in her discharge home.

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