"The Chest Clinic (Outpatients) and Asthma"

About: East Surrey Hospital

(as a carer),

My husband has been seeing the Chest Specialist as an Outpatient for several years. He has severe uncontrollable asthma. Despite being told he could be prescribed Xoliar, (which is covered by NICE guidelines), instead of referring him to a hospital that could help, East Surrey waited a further six months before stating there were 'funding issues' and referred him elsewhere.

East Surrey stated he would be seen within a month at another Hospital, but did not mark the referral as urgent. Hence, he has a three month wait to be seen elsewhere. In the meantime, oral steroids (which are supposed to be taken for 5 days or so) have caused untold problems. He has been diagnosed as having an Addisons Crisis, fainted and cracked his head open and ended up in A&E. He is just on his way to A&E again with a potentially fatal adrenal crisis. I am hoping that the Consultant at East Surrey is on duty tomorrow, but my husband tells me he works one day a week. So I am less than impressed with the East Surrey operative who is choosing to ignore NICE guidelines about the prescribing of life changing medication. They seem to think a visit to A&E once a month is equally cost effective and constitutes 'treatment'

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Response from Fionnula Robinson, Director of Communications, Surrey and Sussex Healthcare NHS Trust

Dear Quin,

Thank you for taking the time to post your comments. Whilst the respiratory/chest department at East Surrey Hospital offers a wide range of services we are not a specialist centre and therefore do not assess for Xolair and can only refer patients to a specialist centre. Our consultants do spend one day a week at the Brompton Hospital which is a specialist centre but we have no control over the waiting lists for this hospital. I’m sorry to hear of your experience and if you would like to talk to someone in more detail about it please contact our Patient Advice and Liaison Service (PALS) which is available to listen to concerns, suggestions or queries and can help sort out problems quickly on your behalf. You can contact PALS by telephone on 01737 231958, email: pals@sash.nhs.uk, or by writing to: PALS, East Surrey Hospital, Canada Avenue, Redhill, Surrey RH1 5RH.

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Update posted by Quin (a carer)

Thank you for the information about PALS - I obtained this information from the SASH website this morning. I am of the humble opinion that I would rather Clinical staff provide patient centred care for patients, rather than have to bat off queries from PALS. I am very surprised that the responder to my story from East Surrey chose to explicitly name another Hospital involved in my husband's situation. Unless 100% of the patients from the department treating my husband are referred on to this Institution, then this could well be a breach of patient confidentiality, or Data Protection. Here's hoping it does not affect the care or perception of my Husband, or any other patient referred to the other Hospital. At the very least, this is points scoring against another NHS institution which should have common aims to East Surrey/SASH. Specifically, my Husband was told his referral to another Institution would be marked 'Urgent'. It was not. Thus, the expectation/information he was given turned out to be way off the mark. It is also a point for debate why he has to attend East Surrey as an Outpatient for 2 years before someone deciding they could not help for whatever reason, and being referred elsewhere. This speed of response/decision making could be improved. Clearly, Hospital A has no control over the waiting lists of Hospital B. I would be foolish to think otherwise. the exception to this would be if Hospital A sat on referrals for whatever reason, or made them in batches to Hospital B, rather than on the basis of clinical need. I have seen this happen with a small number of health professionals in a previous employ, albeit in a non NHS setting. Finally, if East Surrey Staff work part time for whatever reason, then their email inboxes/telephone voicemail boxes/intrays should be routinely monitored by colleagues, and actioned as required. Sadly, my Husband's health is such that his flare ups rarely coincide with office hours Monday to Friday. I do not expect a response from East Surrey, except to tell me what action is being taken about my suggestions, and also to respond by return about whether a breach of patient confidentiality / The Data Protection Act has occurred?

Response from Fionnula Robinson, Director of Communications, Surrey and Sussex Healthcare NHS Trust

Dear Quin

I'm so sorry if you found my response less than helpful. I was trying to address the concerns you raised about the prescribing of Xolair and the availability of our consultants. All comments on Patient Opinion are anonymous so I have no details of your husband or his care so no breach of patient confidentiality or the Data Protection Act has occurred.

The reason I suggested you contacted our Patient Advice and Liaison Service is so that you could dicuss your husband's care in complete confidence.

Kind regards,


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