obtaining medical records for a parent

[sick.as.a.chip]

Busy trying to put my letter together for the trust CEO. My main problem is how do I start it? I dont feel "can you help" is adequte??? Any suggestions welcome??

[mr_mastiff]

Busy trying to put my letter together for the trust CEO. My main problem is how do I start it? I dont feel "can you help" is adequte??? Any suggestions welcome??

 

How about Dear Sir/Madam I would like to bring to your attention my concerns about the delays in my late Mothers appointments. There are a number of issues which I feel need to be addressed in relation to the appointment system and the failure of communication between the departments within the hospital and to my G.P.

 

Below are the events that happened to my mother prior to her death.

[sick.as.a.chip]

Thank you. I've been stewing over what to say. I've got everything I need its just I've found getting started so very hard. Mr mastiff you are a star!

Does my prior post help with the congenital thing?

[mr_mastiff]

Thank you. I've been stewing over what to say. I've got everything I need its just I've found getting started so very hard. Mr mastiff you are a star!

Does my prior post help with the congenital thing?

 

 

Glad I could help.If you look at point 5 it suggests that your mother had hypertension for some period of time. This I believe would rule out the condition being congenital. To be 100% sure I would have a talk with your G.P.

Edited October 8, 2013 by mr_mastiff

[sick.as.a.chip]

I thought as much but should this not have been picked up too? I'm not sure how

Easy to diagnose it would be?

[mr_mastiff]

Sick as a chip, I am not a cardiac specialist but I did care for large number of patients with heart failure brought on by another condition.

 

Diagnosis of early left sided heart failure by simple observation is very difficult because the body as many complex coping methods by which the the heart rate and blood pressure are kept within normal ranges. It it only when these mechanisms fail that problems become more obvious and by that time some damage will have already been done.

 

Reading your mothers report I would be 95% certain that these were all long standing conditions. For example the scarring on both kidneys would indicate that the hypertension was over a long period of time. The only part that I could question would be the pulmonary oedema which would have been picked up on pre operative examination and X-ray, Because it was not picked up then it would suggest that the oedema (fluid on lungs) was something that your mother developed after leaving hospital. This could be due to a simple chest infection.

 

Was your mother on any blood pressure medication before she went into hospital or did she take "water Tablets"(Diuretics) for swollen legs.

 

Without knowing her medical history prior to going into hospital I am sorry but I would only be guessing with any other comments. I hope I have helped you in some way.

Edited October 8, 2013 by mr_mastiff

[fletch70]

Hi again

 

I have sort of been following this thread and I did post a couple of times on page 1 or 2 . With the greatest respect it seems that people are making statements and assumptions without any medical evidence other than the cause of death.

 

All I can say is that both my father and wife died of similar cardiac events, Dad had high blood pressure which we knew about but was being treated, my wife had had two valve replacements and was on lots of medication. Having said that my GP suggested that he was not surprised that she died in her chair(tv on, legs crossed, looked like she was asleep) but without any real warning. Similarly Dad had a coupe of episodes of pains in his legs a few days prior to death and felt ill for a few minutes prior but again it is just one of those things.

I do believe that neither could have been prevented and worrying about it would drive me mad.

 

I do hope that things are becoming a little easier for you, nothing will make the pain go away but you do learn to live with it (most of the time)

[sick.as.a.chip]

Sick as a chip, I am not a cardiac specialist but I did care for large number of patients with heart failure brought on by another condition.

 

Diagnosis of early left sided heart failure by simple observation is very difficult because the body as many complex coping methods by which the the heart rate and blood pressure are kept within normal ranges. It it only when these mechanisms fail that problems become more obvious and by that time some damage will have already been done.

 

Reading your mothers report I would be 95% certain that these were all long standing conditions. For example the scarring on both kidneys would indicate that the hypertension was over a long period of time. The only part that I could question would be the pulmonary oedema which would have been picked up on pre operative examination and X-ray, Because it was not picked up then it would suggest that the oedema (fluid on lungs) was something that your mother developed after leaving hospital. This could be due to a simple chest infection.

 

Was your mother on any blood pressure medication before she went into hospital or did she take "water Tablets"(Diuretics) for swollen legs.

 

Without knowing her medical history prior to going into hospital I am sorry but I would only be guessing with any other comments. I hope I have helped you in some way.

 

Mr mastiff and everyone else who has made a comment please never underestimate how much you have all helped. Having somewhere to rant and talk has been such a huge help to me. I'm not sure if I've mentioned before but my dad died when I was 12. I had no grandparents left by the time I was 25. Lost one at 7 one at 10 one at 17 and one at 25. There is just me and my older siblings left now. Life at home is very busy with my children and working to make ends meet like any normal family does. It does not leave a lot of time to try to come to terms with the loss of my amazing, loving, caring and fantastic mum. So just being on here and getting even some of the simple things explained to me when all I have had at each and every turn is unhelpful and sometimes even dare I say obstructive people has been a god send for me. I'm fully aware what the nhs is probably going to say but need to see this through. Without your support and guidance I may have well gone mad by now. It's so lovely to know In this awfull world where terrible things happen that people are willing to offer support effectively to strangers! So thank you all. Nothing is going to bring her back I sort of know that but if something's gone wrong people need to know or other people will be left like this and that's a burden too much to bear xx

[sick.as.a.chip]

Hi again

 

I have sort of been following this thread and I did post a couple of times on page 1 or 2 . With the greatest respect it seems that people are making statements and assumptions without any medical evidence other than the cause of death.

 

All I can say is that both my father and wife died of similar cardiac events, Dad had high blood pressure which we knew about but was being treated, my wife had had two valve replacements and was on lots of medication. Having said that my GP suggested that he was not surprised that she died in her chair(tv on, legs crossed, looked like she was asleep) but without any real warning. Similarly Dad had a coupe of episodes of pains in his legs a few days prior to death and felt ill for a few minutes prior but again it is just one of those things.

I do believe that neither could have been prevented and worrying about it would drive me mad.

 

I do hope that things are becoming a little easier for you, nothing will make the pain go away but you do learn to live with it (most of the time)

 

Thank you. My mum had no diagnosed heart problems prior to the events detailed here. I can't even imagine your loss and my heart goes out to you. My mum up to her bladder tumor was in fine health and right up to the day she died never complained about a thing. My next step is to write to the trust and make them aware of the failings in her case so that hopefully lessons can be learnt. Coming to terms with this will hopefully help me and more importantly I will have something to tell my children. My baby is too little and probably won't even remember her fantastic grandma however if I can build memories for her and instill in her the things my mum taught me (one of which is not giving up) I will have done her proud. I'll keep you posted when I get my letter done and what reply they come back with. Thank you foracoming back to check on us x

[mr_mastiff]

Hi again

 

I have sort of been following this thread and I did post a couple of times on page 1 or 2 . With the greatest respect it seems that people are making statements and assumptions without any medical evidence other than the cause of death.

 

All I can say is that both my father and wife died of similar cardiac events, Dad had high blood pressure which we knew about but was being treated, my wife had had two valve replacements and was on lots of medication. Having said that my GP suggested that he was not surprised that she died in her chair(tv on, legs crossed, looked like she was asleep) but without any real warning. Similarly Dad had a coupe of episodes of pains in his legs a few days prior to death and felt ill for a few minutes prior but again it is just one of those things.

I do believe that neither could have been prevented and worrying about it would drive me mad.

 

I do hope that things are becoming a little easier for you, nothing will make the pain go away but you do learn to live with it (most of the time)

 

Hi fletch I totally agree with your comments and I have always been careful if you read my posts, I have suggested that talking with her GP would be the best option and would give her the best information.

[Sali]

Fletch70

 

I am sorry to hear about your losses and am glad that things are becoming a little easier for you.

 

I don't want to criticise you, I can see you have (and are still having) a very hard time, but you must see that we are all different and many of us cannot - and should not feel we have to - just accept that unexpected or untimely death is, in your words, 'just one of those things.'

 

I'm not sure what statements and assumptions you refer to. If I look back through the posts everyone has tried to be supportive. The OP knows the cause of death; she has the death certificate and the PM report. What she is striving to understand is if anything could have been done to prevent her mum's death.

 

Isn't it a normal human reaction when something like this happens? It's like your brain is filled with the flying blocks of a rubik's cube. Only pulling them all together in colour order can bring some calm back to your chaotic world. Many people who lose someone they love suddenly, (not just in medical accidents), need to know the where, the how and the why. Only then can they begin to grieve and hopefully start to heal.

 

The other point is what you find out in the course of your questioning and if there is anything the medics could learn or improve to lessen the chances of another person suffering the same fate. Sadly we have a health service that is rather too keen NOT to admit to their mistakes and shortcomings or learn by them: It has to be forced upon them. For example, in this case, the system of cardiology informing urology, who contacts the GP only for them to contact the cardiology again on behalf of the patient is, in my view, absolute stupidity and open to error and delay.

 

Personally, I would, every time, do as the OP is, because not doing so would leave me with a grief that never grows old.

[mr_mastiff]

Fletch70

 

I'm not sure what statements and assumptions you refer to. If I look back through the posts everyone has tried to be supportive. The OP knows the cause of death; she has the death certificate and the PM report. What she is striving to understand is if anything could have been done to prevent her mum's death.

 

Hi sali, I think Fletch70 was referring to the congenital comments which worried me to some extent. I would agree with you that there are still a number of issues that sick as a chip needs answers for but will the nhs learn from this I very much doubt it. When I trained to be a nurse a nurse call Graham pink made public appalling conditions on care of the elderly wards. That was 1990. The powers that be made grand statements that this will never happen again. Sadly it still keeps happening .

[fletch70]

Hi both

I am a huge believer in understanding what happens and why, of course that is up to the individual. As an example , some cancer patients just do what they are told, others ask ever question and in some cases actually know more about their condition and treatment than the junior doctors that work on the ward. ( I have experience of this with my stepson who died in 1999 of Hodgkins after 10 years of treatment...he knew when his body was doing well, when it wasn't etc)

I think the OP is quite right to want to know the whys and wherefores and some of the what ifs. If I am honest I would like to talk to my dad's Doctor about why some of his things weren't picked up,would it have made a difference or did they know it was going to happen...but Mum is content with the explanation and it would only hurt her if I interfered. As for my wife, I am as content as I can be , I am as certain as I can be that she didn't suffer and for that I am grateful. ( I should confess at this point that my wife and I were separated and had been for several years due to shall we just say my orientation, but I still loved her and treated her badly (although others say I did all I could). Sorry if all that sounds a bit confessional or after sympathy...not intended to.

 

Yes my comments were really aimed at people offering medical opinion such as the congenital comments without the full background .

[Sali]

Mr Mastiff, I think whoever raised the congenital factor originally was just expressing an opinion, not a definitive diagnosis on the OP.

 

I am not surprised that many elderly patients in hospital have been subjected to apalling care for so long. I know when I spoke to my MP some years back, I was told that her predecessor had threatened to expose our local hospital, (the one I was complaining about), on this very subject if they didn't improve and that was back in the 90s. I cannot help but think if he had of and those responsible had been publicly punished, (and I mean more than sacking), things would have improved. There's nothing like knowing your own head may be on the block to focus the mind. Too few people from mid-staffs et al have been brought to account. What message does that send out to others?

 

Fletch, you seem to have been through the mill. It is a very selfless thing to think of another's feelings - as you have with your mum - and not question the doctor about your dad's death.

 

You're right, we are all different and we have to deal with what life throws at us as best we can.

[mr_mastiff]

Hi Sali yes it was an opinion and I know that everybody on this forum wants to help. My only concern was that the OP who was already in distress should have a another worry placed on her without a lot more facts to back it up.

 

I find many of your arguments very compelling when it comes to responsibility for poor care. Perhaps making the trust chairman criminally responsible for repeated and proven neglect would be a start. Following that I would put each level of manager on the block.

 

When I trained I was told that I was accountable for the care that I gave perhaps collective responsibility is the answer. The management know of the shortages of staff on many wards and areas but still allow boor care to continue.

Making them just as guilty as the staff on the ward for poor care should be the way forward, because the management at what ever level are the only people with the power to make changes.

[Sali]

Absolutely, the CEO should be ultimately responsible, but every individual worker has to take responsibility for their actions too. So a nurse, doctor or HCA making mistakes or turning a blind eye to poor care has to be accountable. The GMC and the NMC seem to me very weak-kneed bodies.

 

I was deeply angered to find out that the current CEO of my hospital is the same one who my MP told me had been in charge during a previous era of poor care. Clearly they are like Japanese knotweed; impossible to get rid of.

 

I know that there have been, and still are, issues around whistle-blowing. I recall hearing the nurse Margaret Haywood interviewed and was horrified by the way she'd been treated. However, if you make the consequences for not blowing the whistle greater than ignoring the problem, a culture change will inevitably follow.

 

I think (and I take this from my own observations and those of my relatives who have/do work in nursing) there is lack of knowledge, discipline and motivation.

 

I see the need for a legally-binding nurse to patient ratio on the wards, as I feel much of the failings that I saw were linked to low staffing levels. However, it's not just that. There was a sloppiness, a lack of basic knowledge (critical), and an inertia that was, quite frankly, scary. I would abandon the degree based-training, and I would train more nurses (and doctors) in this country.

 

Finally, as I have said before, we need to radically change the complaints system. At the moment if the nurses, sisters, modern matrons, doctors and CEO ignore your raised concerns, there is absolutely nowhere to turn. We shouldn't have to wait for the CQC to make an inspection in the hope (and they do not have a great track record) that they spot the dead bodies.

[mr_mastiff]

Sali, A legally binding nurse to patient ratio is fine in principle. I worked in a very specialised area, The ratio was 1 to 6. Unfortunately it became common for only one to be trained in that area and the other two to be bank staff and very junior nurses. Yes they could give the basic care but that was all. The rest was left to the specialist. A number of incidents happened. The attitude of the management was basically that there are three trained nurses you have got your ratio get on with it.

 

If you take A&E for example it was in the media recently that some have been running on 50 to 60% of trained staff in that area. You cannot replace a fully trained specialist with the lowest grade of staff nurse and expect quality care in that area.

 

I attended many meetings in relation to these issues and other issues and in the end money was the limiting factor.

 

Each ward as a incident/accident book. I regularly filled it in. I was basically told to stop and only report events that had happened not events that could have happened but were prevented by quick action. Nurses often know that wards are dangerous but when yours is the only income coming into the house and becoming a whistle blower means the end of your career it takes a very brave individual to speak out.

[Sali]

Why was it not possible to fulfill the 1 to 6 ratio with trained, permanent staff? Were they off sick or was it impossible to recruit? The same for A&E. People do not want to go into this area because it is highly stressful and demanding? The lack of doctors means there is an insufficient pool of qualified staff to choose from? The money is not good enough?

 

The NHS has such - and I know this from the tales I hear from those inside the monster - gross amounts of unnecessary waste. It is very much a public sector disease. I have worked, as a contractor I should add, in the public sector (not the health service) and was just shocked by the attitude of the permanent staff. I couldn't understand why they didn't think of every penny spent as if it were their own.

 

As for whistlebowing. Tough question, but how would you feel if your loved one had suffered and died because worker(s) had put their mortgage and career before their duty and conscience? As I said I heard Margaret Haywood interviewed. I was furious on her behalf and disgusted by those who made her feel like such a leper, ruining her life. She got her job back, but I would imagine the mental scars will never heal. Those that treated her so cruelly were probably not punished. That is why the stakes for not whiste-blowing have to be severe. The management will have to listen and act.

 

The NHS is the only organisation that seems to be able to kill and maim with impunity.

Edited October 16, 2013 by Sali

[mr_mastiff]

Sali the basic problem with NHS is long term neglect , short sighted political solutions that target resources away from areas of need. Massive wastage of resources on I.T systems. Constant changes to the practice and training of doctors and nurses. Hospitals being built by the private sector and then rented to the NHS at great cost. You only have to look at the news this morning 1500 mental health beds closed, community care cut to the bone, the local Mental Unit just down the road from me, 8 deaths due to poor care in 2 years.

 

I could rant on for hours but when it comes to answers the basic problem is that nobody is responsible.

[fletch70]

Could another problem be due to lack of money because of the spiraling costs of drugs and new treatments available. Lets face it there are more and more treatments available at ever increasing costs to the NHS. People who would have died even 10 years ago can now have increased life span . It is not for me to put a price on a months life but ......

[mr_mastiff]

Could another problem be due to lack of money because of the spiraling costs of drugs and new treatments available. Lets face it there are more and more treatments available at ever increasing costs to the NHS. People who would have died even 10 years ago can now have increased life span . It is not for me to put a price on a months life but ......

 

I agree when I first started in my specialist area it was unusual to find any patient over the age of 55. When I left we were giving treatment to people in their 90,s. As treatments improve then the range of people who can have that treatment increases. But who plays god!

[Sali]

Life-expectancy has increased over centuries in this country for a myriad of reasons, a very small part played by the health service.

 

I can see that meddling politicians over the years have turned healthcare workers into headless chickens. Wouldn't it be great if they (the politicians) were made accountable for all their stupid decisions, not just in office (which never seems to happen), but after they've left too. PFI hospitals would be a good place to start.

 

It's not just money wasted on IT projects. There is undoubtedly abuse of the NHS from within and without. The NHS procurement team seems to be particularly inept. They should have such clout to drive costs down because of the volume that they buy, but seem completely incapable of getting the best deal on anything, from light bulbs to drugs.

 

Do the NHS tie themselves into contracts with pharmaceutical companies rather than buy a much cheaper generic drug? Can this be justified in order to encourage companies to research and develop new drugs? How is it that certain drugs can cost much less in mainland Europe? Are we subbing them? It's such a tangled web and I don't think anyone in authority can be bothered to unravel it. Always the path of least resistance.

 

I don't want the NHS turning into (and it must seem so to grieving relatives of mid-staffs et al) one huge Dignitas clinic.

[mr_mastiff]

Life-expectancy has increased over centuries in this country for a myriad of reasons, a very small part played by the health service.

 

I can see that meddling politicians over the years have turned healthcare workers into headless chickens. Wouldn't it be great if they (the politicians) were made accountable for all their stupid decisions, not just in office (which never seems to happen), but after they've left too. PFI hospitals would be a good place to start.

 

It's not just money wasted on IT projects. There is undoubtedly abuse of the NHS from within and without. The NHS procurement team seems to be particularly inept. They should have such clout to drive costs down because of the volume that they buy, but seem completely incapable of getting the best deal on anything, from light bulbs to drugs.

 

Do the NHS tie themselves into contracts with pharmaceutical companies rather than buy a much cheaper generic drug? Can this be justified in order to encourage companies to research and develop new drugs? How is it that certain drugs can cost much less in mainland Europe? Are we subbing them? It's such a tangled web and I don't think anyone in authority can be bothered to unravel it. Always the path of least resistance.

 

I don't want the NHS turning into (and it must seem so to grieving relatives of mid-staffs et al) one huge Dignitas clinic.

 

Hi Sali, I think in many ways we have stolen Sick as chips thread with your agreement I believe we should start our own thread in relation to poor care and areas of wastage within the NHS.

[Sali]

You're quite right.

[mr_mastiff]

O.K I will make a general thread to report views on the care or lack of care within the NHS.