Don't get old and ill in this country

[Sali]

I, too, am sorry for your loss Seminole. I'm glad your father's end was peaceful. I'm sure he appreciated having you in his corner. If any future action you take prevents another patient suffering, then it is all to the good.

[Seminole]

Thank you all for your kind words. My dad's funeral was yesterday and so I'm going to start getting back to normal from today.

 

With ironic timing the London Ambulance Service response to my complaint turned up yesterday. I only read it briefly but it was a typical piece of self justifying rubbish and mealy mouthed apology. I'll post up more in due course.

[Seminole]

I now have three complaints against the NHS. I imagine that some may think that I'm a serial or vexatious complainer but I'm not. My father received appalling treatment at the hands of those who we trusted to look after him.

 

In summary the complaints are:

 

1) The extreme delay in getting an ambulance to him when he had a serious head injury. I have a reply from the London Ambulance Service that I will scan and post up here.

2) The failure by Kings College Hospital to put him on a geriatric care ward because he came from the wrong post code. As a result of this they didn't look after him properly and he lost his hearing aids. These were replaced and I now regard this matter as closed. However, I have a new issue with them about his diagnosis.

3) Various issues whilst he was in hospital in Bromley. I have set out the draft letter I'm proposing to send to them. I have put everything in there, including a couple of minor matters. I would appreciate any views or comments. Writing the letter was a cathartic experience and I needed to do it. However, I am happy to change the detail.

 

Draft letter

 

As you are aware my father, PJJ, was admitted to thePrincess Royal University Hospital (the Pru) on Tuesday 5 October. He spent the next three weeks at the hospitalon Medical Ward 3 for most of the admission. He was discharged to St George’s Nursing Home in Cobham on Tuesday 5November. He was taken to St Peter’sHospital in Chertsey on Sunday 10 November where he passed away on Saturday 16November. The cause of death wasbronchopneumonia with complications caused by vascular dementia.

I sent an email to the Pru on Tuesday 29 October asking anumber of questions about my father’s diagnosis, treatment and nursingplan. I had a useful meeting with Dr Xon Wednesday 30 October.

The purpose of this email is to make a formal complaintabout aspects of my father’s nursing whilst he was in the Pru. Some of these are issues that I raised in myprevious email that have become more significant now that my father has passedaway.

The issues are:

Admission to the Pru

My father was taken to the Pru by ambulance on 5 October onthe advice of a GP who visited him at home. The GP believed that my father needed an urgent blood test. When we arrived at the hospital a blood testwas taken by the triage team. We werethen taken to a cubicle. The hospitaldoctor gave my father an intravenous antibiotic as she believed that my fathermight have had a recurrence of a previous kidney infection.

At this time my father started to become agitated, confusedand ultimately quite distressed. Whenthe antibiotic treatment was complete,the doctor said that my father should go home. I attempted to help him to get dressed but he would not cooperate. When I told him that he was going home hesaid repeatedly that he was already at home. A nurse attempted to help him to get dressed but he would still notcooperate.

I asked whether my father was in a suitable condition to gohome. I was told that the hospital hadno beds. As my father would not get intoa wheelchair, we attempted to guide him to the hospital exit on foot. He was clearly very confused as he didn’tunderstand why his ‘home’ had changed. He also because quite abusive and security was called to help us. Ultimately the doctor decided that it wouldbe “unsafe” for him to go home and he was admitted to the hospital.

I have to say that it was extremely upsetting to see myfather behave in this way and I was astonished your staff felt it appropriateto essentially try and push him out the door.

Antibiotic treatment

My father was given an antibiotic as noted above. My father subsequently developed acute kidneyfailure. I was told on at least threeoccasions that the initial antibiotic caused the kidney failure.

Please confirm the types and dosages of antibiotics thatwere given to my father during his admission. Please explain the clinical reason he was given antibiotics and explainany link between them and the acute kidney failure. If the antibiotics were not responsible forthe kidney failure, please explain how it developed.

Dementia diagnosis

Dr X told me that my father had vascular dementia on 30October. By 10 November, his dementiahad deteriorated to the point that he had extreme difficulty swallowing. I understand that this is one of the laterstages of the disease.

I appreciate that the diagnosis of vascular dementia isdifficult. However, I find it hard tounderstand how someone could be diagnosed with mild cognitive impairment in Mayand then progress to the most advanced stages of vascular dementia in earlyNovember with a formal diagnosis only at the end of October. I think this is particularly strange giventhat my father spent a week in Kings College Hospital in September. At that time he was also very confused.

Please could you explain the steps taken by Kings CollegeHospital to determine whether my father had vascular dementia as opposed todelirium arising from a kidney infection. I appreciate that this is not a matter for the Pru as such and you maywant to deal with it separately.

Nursing on MedicalWard 3

There were times when I observed apparently low staffinglevels whilst my father was on this ward. On one Sunday I was left with my father and two other patients sufferingfrom dementia opposite the nursing station with no other staff in sight forabout 30 minutes. Essentially I was leftto look after them and call out if there were any problems. Whilst I would rather not have done this, Idid not mind doing so but it did not seem like good practice.

Obtaining Information

As someone who works I was generally only able to visit myfather in the evening and at weekends. The evening visiting hours for Medical Ward 3 coincide with a shiftchange. This means that the staff goingoff shift are involved with handover meetings and unavailable to speak to. The new staff coming on shift have verylittle information about the patients. I,and I imagine other visitors, found this frustrating and unnecessary.

Discharge Timing

Following my meeting with Dr X, I identified a suitable nursinghome for my father near to my home in Surrey. Staff from the nursing home visited the Pru on Monday 4 November toundertake an assessment.

I was surprised to receive a call from the hospital on 4November saying that the assessment had been completed and that my father wouldbe transferred to the home that afternoon. This was because the nursing home “wanted him to come” that day.

In practice this was wholly inappropriate because his roomat the home had not been prepared and I had not had the opportunity to movesome furniture and personal items there. I spoke to the nursing home and they denied telling the hospital thatthey wanted the transfer to take place that day.

It appeared to me that the hospital was unduly keen todischarge my father. Whilst this was aninconvenience and fairly minor issue, I do not think it was professional.

Bruising

On his admission the nursing home, the staff noticed anddocumented severe bruising to my father’s back. I have photographs that demonstrate this. My father’s discharge lettermakes no reference to this bruising. Under the heading “Wound Care” the letter says Nil but this is crossedout and replaced by “haematoma on left leg”.

I was told by the hospital that my father had had two orthree falls whilst he had been in the hospital. I noticed some bruising to his skull. Noone told me about the bruising to his back.

The discharge notes refer to falls under “Reasons forAdmission” but do not do so under “Mobility”.

The nursing home was so concerned by this bruising that theymentioned it to me. They were alsoconcerned that the hospital had not told them formally or informally of theextent of his falls. He had another twoor three falls in the nursing home before they realised how big the problemwas.

I am astonished and frankly disgusted that the dischargedocumentation was so inadequate. Itseems to have been put together in haste and without proper thought. I believe that the hospital behavednegligently in not mentioning the bruising to me and not making the scope ofproblem clear to the nursing home.

On admission to St Peter’s, the nursing staff drew myattention to the bruising and made a safeguarding referral. I have also asked the safeguarding team toinvestigate this matter.

Pneumonia Diagnosis

During his final week in the Pru, I noticed that my fatherhad a build-up of fluid in this throat. At times he had difficulty speaking and it sometimes sounded as if hewas gargling when he was speaking. Othervisitors noticed that he had a cough and everyone noticed that he waspersistently drooling.

I asked about all of these matters and was told over thephone that there wasn’t a problem. Inretrospect I believe that these were, at least in part, the early symptoms ofthe pneumonia that killed my father shortly after he was discharged from yourhospital.

I require a detailed explanation setting out what steps you tookwhen I reported the symptoms to the hospital and why I was told that there wasnothing wrong. I believe that thehospital was negligent in dealing with this matter and that earlier treatmentof the problem would have prolonged my father’s life. Please note that I will not accept anassertion by you that you were not told about these matters.

Insummary I am extremely unhappy with my father’s treatment whilst in the nursingof your hospital. I am copying thiscomplaint to my father’s MP, Bob Neil and to my own MP, Dominic Raab. I am also preparing a dossier setting outdetails of my father’s negligent treatment by the NHS from the beginning ofSeptember to his discharge from the Pru. This will be sent to my solicitor and to national and local newspapers.

[Seminole]

Apologies, spacing and fonts went a bit awry in the last post. It looks OK in Word so I'm not sure what happened.

[mr_mastiff]

Seminole, I have had a quick read there are aspects that I would like to comment on. Unfortunately I am at the hospital myself this afternoon and must leave shortly. Could you please give me 24 hours or so to get back to you?

[Seminole]

Thanks Mr_Mastiff. Yes, more than happy to wait for your feedback.

[Sali]

My goodness, your father was certainly not safe to go home and the doctor, regardless of his statement that there were no beds, was negligent to allow it. Odd that they did magic a bed when they had no alternative. I also know that you would have been justified (I believe) legally (and morally) to refuse your father's discharge.

 

You need your father's notes from this hospital stay. Make the request soon, hospitals have a tendency to lose data that may incriminate them. The information that your father's kidney failure was caused by the anti-biotic, as you were informed on three separate occasions, should (well, you hope don't you) be written in these.

 

The brain is one area where we still have so much to understand. An MRI could have helped in the diagnosis, but truly only a post-mortem can confirm it. I am not convinced on the current memory tests used for diagnosing dementia and I think there tends to be a confirmation bias towards it when any memory impairment is noticed. Once diagnosed, I do believe you are pretty much abandoned by the health service as a lost cause and seen as only fit to be fast-tracked to the grave.

 

I think it extremely frightening that the medics presumed vascular dementia whilst your dad had a kidney infection. Any blood test results will be useful.

 

Yes, where do the nurses go? I know when I was frequently visiting my relative in hospital there were often no nurses to be found on any of the wards. There's low staff, but no staff?! A FOI should be able to find out the nurse/patient ratio (don't let them include HCAs in their calculatuion) at the time of your dad's stay.

 

I also found the shift changing frustrating and I think used by some of the nurses to avoid questions from anxious relatives and any extra workload that may bring. You'd have thought that a one or two hour minimum handover was a possibility, but I guess the eye is always on cost.

 

I cannot help but be cynical about the super fast finding of a care home place. Again you would have been within your rights to refuse his discharge here because he was residing elsewhere on admission.

 

It's frightening (but not surprising) that the 'professionals' who looked after your father were incapable of completing an accurate discharge plan and the consequences, as you have found, were grave. It's sloppy, uncaring, unprofessional and dangerous.

 

I'd also request the notes from the care home. What observations were made on your father's health and general well-being? Was a doctor called at any time? What procedures were in place if a member of staff was concerned about the health of a resident? Was there a resident nurse? How frequently did a doctor visit the home?

 

I have travelled the stony path of hospital complaints and the Ombudsman and I have no faith in either. The hospital obfuscates and dissembles and the Ombudsman always seems to side with the hospital whatever the evidence. If your anger is burning bright and long enough - and I hope it is because it should help patients yet to be - you may eventually get some answers.

 

Good luck.

[Seminole]

Thanks. Comments in red below.

 

My goodness, your father was certainly not safe to go home and the doctor, regardless of his statement that there were no beds, was negligent to allow it. Odd that they did magic a bed when they had no alternative. I also know that you would have been justified (I believe) legally (and morally) to refuse your father's discharge.

 

I didn't know I could do that. If I had, I would have done so.

 

You need your father's notes from this hospital stay. Make the request soon, hospitals have a tendency to lose data that may incriminate them. The information that your father's kidney failure was caused by the anti-biotic, as you were informed on three separate occasions, should (well, you hope don't you) be written in these.

 

I'm speaking to a solicitor today to see whether there is a case and, if so, whether they will take over registering the formal complaint etc. If they're not interested, I'll ask for the notes myself.

 

The brain is one area where we still have so much to understand. An MRI could have helped in the diagnosis, but truly only a post-mortem can confirm it. I am not convinced on the current memory tests used for diagnosing dementia and I think there tends to be a confirmation bias towards it when any memory impairment is noticed. Once diagnosed, I do believe you are pretty much abandoned by the health service as a lost cause and seen as only fit to be fast-tracked to the grave.

 

I think it extremely frightening that the medics presumed vascular dementia whilst your dad had a kidney infection. Any blood test results will be useful.

 

Actually it was the other way around. I am concerned that they assumed his confusion at Kings was just due to the kidney infection.

 

Yes, where do the nurses go? I know when I was frequently visiting my relative in hospital there were often no nurses to be found on any of the wards. There's low staff, but no staff?! A FOI should be able to find out the nurse/patient ratio (don't let them include HCAs in their calculatuion) at the time of your dad's stay.

 

I also found the shift changing frustrating and I think used by some of the nurses to avoid questions from anxious relatives and any extra workload that may bring. You'd have thought that a one or two hour minimum handover was a possibility, but I guess the eye is always on cost.

 

In the wider scheme of things this seems like a minor issue but I certainly found it extremely frustrating. Getting information generally was far more difficult than it needed to be. At best the timings were set without thinking about their effect. At worst it's a deliberate ploy to avoid patients families who shouldn't be asking challenging questions and just be grateful for the "free" service.

 

I cannot help but be cynical about the super fast finding of a care home place. Again you would have been within your rights to refuse his discharge here because he was residing elsewhere on admission.

 

Sorry, I wasn't clear. I found the care home place. I took two days off work and visited a number of homes. The problem was the attitude of the nurse in wanting to ship my dad out of the hospital and being prepared to lie about it.

 

It's frightening (but not surprising) that the 'professionals' who looked after your father were incapable of completing an accurate discharge plan and the consequences, as you have found, were grave. It's sloppy, uncaring, unprofessional and dangerous.

 

Yep and I intend to hold them to account. If they had done their jobs properly, my dad might still be alive. I will be going after the organisation and, if appropriate, the individuals.

 

I'd also request the notes from the care home. What observations were made on your father's health and general well-being? Was a doctor called at any time? What procedures were in place if a member of staff was concerned about the health of a resident? Was there a resident nurse? How frequently did a doctor visit the home?

 

Actually the care home were pretty good in all of this. They were in constant communication with me and called the doctor the day after my dad was admitted. I think they are quite nervous about what happened but they were put in a difficult position by the NHS. I found it interesting and worrying that the keenness social services showed in investigating the care home dropped more than a couple of notches when I said that the majority of the problem had occurred in an NHS hospital.

 

I have travelled the stony path of hospital complaints and the Ombudsman and I have no faith in either. The hospital obfuscates and dissembles and the Ombudsman always seems to side with the hospital whatever the evidence. If your anger is burning bright and long enough - and I hope it is because it should help patients yet to be - you may eventually get some answers.

 

I will be going to court if need be, not to get compensation (any money awarded will go to charity) but because I want to hold the organisation and individuals to account. I will pursue the complaints and ombudsman process as well but I don't have much faith in it. I will involve MPs and I will go to local and national newspapers. At the end of the day, nothing will my dad back, but as anyone who knows me and knows my history on this site will tell you, I am pretty determined.

 

Good luck.

 

Thanks

[mr_mastiff]

Seminole, My first point would concern the antibiotic treatment. Unless it was known that your father was allergic to the antibiotic the Doctor would have been correct to give him I.V treatment. The point that concerns me was that it was a one off dose and then home. Normally to treat a kidney infection there would be a number of I.V treatments followed by a course of oral antibiotics.

 

I would question what dosage he was given (for a man of his age and condition consideration would need to be given to possible side effects I.E kidney damage etc) and what follow up did the doctor arrange.

 

Did he prescribe oral antibiotics, What tests were made? he should have had a number of tests sent away on both his urine and blood. When a person as a infection bloods are sent for culture and sensitivity to determine what type of bacteria are present and what antibiotics they are sensitive to. Which leads to the question was he given the correct antibiotic in relation to his blood cultures?

 

He was diagnosed with acute renal failure, Who made that diagnosis? Did the ward seek advice from a Consultant Nephrologist. The reason I ask is that a degree of renal impairment would be considered normal in man of your fathers age. For example about 15 years ago I was given a course of treatment, about three weeks later I became unwell. I saw my Gp who took a blood test and I was found to be in renal failure. My GP stated that my kidney function was that of a 75 year old. I am just wondering if the basis for the diagnosis was made on a slight impairment in his blood results rather than acute renal failure. You need to ask for the results of his hospital blood test.

If the results were high then this would rule out renal impairment due to his age however, if they were high then this could be the cause of his confusion.

 

My next and biggest concern was the nursing care for a man who was in renal failure. You stated I believe that your father did not have a cup or access to water when you visited him. Acute Renal Failure is a very serious condition which must be monitored very closely and a strict fluid balance must be maintained. Some patients in ARF stop urinating and if you give them water it can lead to fluid overload were fluid can get on the lungs etc and cause the patient many problems, other patients start to produce gallons of urine which makes them very quickly dehydrated which makes the renal failure worse.

 

Your father should have had all urine output recorded and any fluid intake recorded so that his fluid balance could be maintained. On a renal ward these observations would be done one to two hourly. If these observations were not done then it would be a failure of care especially if he had no access to water to maintain his fluid balance.

 

Renal nursing is a specialist area and I am concerned that the Nurses on the ward were not aware of the care required in a patient with acute renal failure and I would be questioning if the nursing carried out the most basic care for a patient in acute renal failure.

 

I have read Sali,s points with interest and I believe that I can add more to some of the excellent point she as raised unfortunately due to my O.A I need a break. I can only type in short bursts. I will get back to you later. MM

[mr_mastiff]

Seminole, My next point would be about the Doctor trying to discharge your father.

 

Having No beds is not a basis to refuse admission Hospitals have procedures/protocols for this.

 

What was the position of the doctor I.E House officer? Senior house Officer? registrar?normally a decision to discharge would only be made at a senior registrar level. Did this happen?

 

For clarity your father became confused after being given the antibiotic. I have doubts that this was the cause. I can only go on your description of events but this sudden onset of confusion is likely to have been caused by a T.I.A (see post 44) rather than infection or ARF. Which is a point you bring up in your complaint. Did he have an any investigations on his first admission (MRI etc). If not the the hospital was was giving care based on a presumption that his confusion was caused by infection not fact.

[Seminole]

Comments in red:

 

Seminole, My first point would concern the antibiotic treatment. Unless it was known that your father was allergic to the antibiotic the Doctor would have been correct to give him I.V treatment. The point that concerns me was that it was a one off dose and then home. Normally to treat a kidney infection there would be a number of I.V treatments followed by a course of oral antibiotics.

 

There was no suggestion of oral antibiotics- just IV and then home.

 

I would question what dosage he was given (for a man of his age and condition consideration would need to be given to possible side effects I.E kidney damage etc) and what follow up did the doctor arrange.

 

In all honesty I can't remember what was said about follow up. We were left in the cubicle for long periods of time and my father became upset. I wasn't completely focussed on what the doctor said.

 

Did he prescribe oral antibiotics, What tests were made? he should have had a number of tests sent away on both his urine and blood. When a person as a infection bloods are sent for culture and sensitivity to determine what type of bacteria are present and what antibiotics they are sensitive to. Which leads to the question was he given the correct antibiotic in relation to his blood cultures?

 

They did blood tests but they were unable to get a urine sample.

 

 

He was diagnosed with acute renal failure, Who made that diagnosis? Did the ward seek advice from a Consultant Nephrologist. The reason I ask is that a degree of renal impairment would be considered normal in man of your fathers age. For example about 15 years ago I was given a course of treatment, about three weeks later I became unwell. I saw my Gp who took a blood test and I was found to be in renal failure. My GP stated that my kidney function was that of a 75 year old. I am just wondering if the basis for the diagnosis was made on a slight impairment in his blood results rather than acute renal failure. You need to ask for the results of his hospital blood test.

 

I can't remember the name of the units of measurement used but I remember that the number was 266 and that dialysis is normally required if people have regular measurements at around the 300 mark. The measurement varied quite a lost. It started at about 140 when he was admitted and it escalated before falling back. I don't know what the final measurements were before discharge. I don't know who made the diagnosis but his consultant was aware of it and I know they took a kidney ultrasound.

 

 

If the results were high then this would rule out renal impairment due to his age however, if they were high then this could be the cause of his confusion.

 

My next and biggest concern was the nursing care for a man who was in renal failure. You stated I believe that your father did not have a cup or access to water when you visited him. Acute Renal Failure is a very serious condition which must be monitored very closely and a strict fluid balance must be maintained. Some patients in ARF stop urinating and if you give them water it can lead to fluid overload were fluid can get on the lungs etc and cause the patient many problems, other patients start to produce gallons of urine which makes them very quickly dehydrated which makes the renal failure worse.

 

Access to water was sporadic but better than when he was in Kings. My concern is that no one seemed to be helping him to drink. He was too confused most of the time to pour his own water and probably to drink it. He did drink quite a lot of tea. They were measuring fluid output as he had a catheter.

 

Your father should have had all urine output recorded and any fluid intake recorded so that his fluid balance could be maintained. On a renal ward these observations would be done one to two hourly. If these observations were not done then it would be a failure of care especially if he had no access to water to maintain his fluid balance.

 

I don't know how frequently these were measured but I guess the hospital would have a record of this.

 

Renal nursing is a specialist area and I am concerned that the Nurses on the ward were not aware of the care required in a patient with acute renal failure and I would be questioning if the nursing carried out the most basic care for a patient in acute renal failure.

 

I have read Sali,s points with interest and I believe that I can add more to some of the excellent point she as raised unfortunately due to my O.A I need a break. I can only type in short bursts. I will get back to you later. MM[/

 

Thank you for all your help with this.

 

QUOTE]

[Seminole]

Comments in red below:

 

Seminole, My next point would be about the Doctor trying to discharge your father.

 

Having No beds is not a basis to refuse admission Hospitals have procedures/protocols for this.

 

What was the position of the doctor I.E House officer? Senior house Officer? registrar?normally a decision to discharge would only be made at a senior registrar level. Did this happen?

 

I don't know. I only spoke to the junior doctor who was treating him. She was extremely busy. To be fair she said that he could stay but it would have to be in a cubicle in A&E.

For clarity your father became confused after being given the antibiotic. I have doubts that this was the cause. I can only go on your description of events but this sudden onset of confusion is likely to have been caused by a T.I.A (see post 44) rather than infection or ARF. Which is a point you bring up in your complaint. Did he have an any investigations on his first admission (MRI etc). If not the the hospital was was giving care based on a presumption that his confusion was caused by infection not fact.

 

They did a CT scan at Kings but they told me that they didn't find anything unusual. The Pru told me that they did a CT scan as well but again didn't identify anything unusual. In retrospect I find this hard to believe.

 

 

[mr_mastiff]

Seminole, Glad to help. Send in your letter of complaint. This will be a long process of information gathering. The devil is in the detail I.E nursing notes etc when you get access to these you will probably get answers to many of your concerns.

 

If you think I can help get back to me.

 

Good luck.

 

P.S if is blood figures were near the dialysis point he should have been seen by a nephrologist.

[Seminole]

Thanks. I'm going to redraft parts to reflect your comments. I'll also explicitly ask for all of his medical records whilst he was in the Pru. If the solicitor doesn't want to take over the enquiry, I'll send it to them and pursue it through the complaints process.

[mr_mastiff]

O.K, If you need a hand with jargon in the notes let me know. If its personal PM me.

[Seminole]

Turning back to an earlier matter. Here is the response from the London Ambulance Service over the 1hr 41 mins it took them to get an ambulance to a 92 year old man with a head injury.

 

Please ignore the references to an earlier call. None was made because I didn't know how to call 999 from Egypt but the carer who did make the first call didn't know I hadn't been able to call.

 

The LAS target response time for a C2 call is 30 minutes. Interestingly when you look at the target criteria, age isn't mentioned.

 

I think the statistics they have provided are pretty meaningless. Surely it would have been more useful to provide data for calls in the local area eg South East London. I can't imagine that they send ambulances from North West London to Bromley. Also they haven't provided a category breakdown of the 574 calls within the two hour period that they mention, nor a average response time for each category. I am going to ask for this information under an FOI.

 

Two further relatively minor points:

 

1) The FOI enquiry was dealt with badly. I received an email from their FOI team asking if I would accept a policy document explaining their call handling and prioritisation procedure in lieu of the statistics I originally requested. I said yes but what they have provided is nothing more than background. Interestingly, from the email correspondence, I know that it took them longer to refer the matter to their FOI office than the statutory number of days for them to reply in full!

2) They state that the call recordings can be provided under the Data Protection Act but want to charge £50. I am less concerned with getting these now but does anyone know whether this is the correct fee. I believe that they are allowed to charge this for written medical records but recordings are quite different.

 

Thanks

[nolegion]

Under the DPA health bodies can charge reasonable fees to produce copy health records (not exceeding the actual cost of complying with a subject access request inclusive of all postage etc and v.a.t.) up to a maximum of £50.

 

Like you, I would question whether the telephone recordings can be classed as health records, though, and - unless anyone knows differently - if they are not 'health records, the ICO seems to think the maximum fee is £10.

 

"…an organisation receiving a subject access request may charge a fee for dealing with it. If you choose to do this, you need not comply with the request until you have received the fee. The maximum fee you can charge is £10.

 

There are different fee structures for organisations that hold health or education records (where the maximum fee is £50, depending on the circumstances). Although you need not comply with a request until you have received a fee, you cannot ignore a request simply because the individual has not sent a fee. If a fee is payable but has not been sent with the request, you should contact the individual promptly and inform them that they need to pay. Some organisations choose not to charge a fee. However, once you have started dealing with an individual’s request without asking for a fee, it would be unfair to then demand a fee as away of extending the period of time you have to respond to the request."

 

( From:-http://www.ico.org.uk/for_organisations/data_protection/the_guide/principle_6/access_to_personal_data

[Seminole]

Thanks for that. It's what I thought and I've asked them the question. I'll take it to the ICO if necessary.

 

Had a very interesting conversation with solicitors regarding the Pru complaint. They're reviewing my draft complaint letter and I should hear back in the next few days. They very clearly explained the basis on which a claim for clinical negligence could be made.

[Seminole]

I've just sent a slightly stroppy email to Surrey Social Services. When my father was admitted to the hospital where he passed away, they noted serious bruising to his back. The hospital requested a safeguarding review. I did so as well.

 

The vast majority of the bruising had taken place whist my father was in hospital for three weeks in Bromley before he transferred to the care home where he spent six nights before going to a Surrey hospital.

 

After my complaint I had a call from social services asking me all about my father's stay in the care home. They didn't seem too interested in his hospital stay. I had to almost insist that this was included in the review.

 

I have now had a call regarding his stay in the care home and been given a number to ring at the hospital where he received most of the bruising. I don't really find this acceptable. I would have expected some sort of written report of the investigation and I am unhappy about having the hospital where he was injured investigating the causes of the injuries.

[mr_mastiff]

Seminole, unfortunately social services remit will only be with the care whilst he was in the care home. Perhaps the care homes report on admission detailing his bruising on admission would be the place I would start with.

 

There seems to be a massive difference between the injuries recorded by the care home and the one reported when he was discharged from hospital. These need to be explained! If your father had fallen then normal procedure would be that the Doctor would give the patient a head to toe examination. Which leaves you with two possibilities 1. the examination did not take place or only a cursory examination was given.

 

If I can remember correctly your father had a number of falls. I fail to understand how the hospital could have missed the bruising you describe If they had carried out the examination they should have done he had a fall(s).

 

That the hospital did not know if he had had two or three falls speaks volumes! Your father was a frail, confused and elderly man what risk assessment was carried out by the hospital on admission?

 

In my experience I could except perhaps one fall but three in a short period of time needs explanation.

Edited December 17, 2013 by mr_mastiff

[Seminole]

I suspect that the hospital were just lazy or incompetent in producing the discharge notes. Whether this ends up being dealt with through the courts or the complaints process, I am going to get an explanation for this.

 

As my wife said, noone should be discharged from hospital in a significantly worse condition than when he went in.

[mr_mastiff]

Seminole, Lazy is not the word I would use, He should have left hospital with a full discharge summery to enable the care home to provide all his nursing care needs.

[Seminole]

Yes. Laziness or incompetence- it amounts to negligence in my opinion.

[mr_mastiff]

Agree totally

[Lindamannion]

After a harrowing experience with the NHS, l am afraid l noted despite some excellent nurses, a few, although highly qualified where completely lacking in common sense, compassion and had not one ounce of kindness in them, and to them it was just a job, sitting chatting at the desk and huffing and puffing if someone rang the bell, they where of the opinion they where far too good for some of the tasks asked of them. Sad to have to say this, but l sat there for three weeks with my Mum and for the last week 24 hours a day until she passed away. I could write a book, it was disgraceful watching the elderly treated like that, some had no visitors or family and my heart went out to them, l did my best and spent every hour l could with my MUM, and on the occasion l went home she fell and was put back to bed despite having major brain damage. They noticed hours later as it was a Saturday night and weekend staff. Her notes also went missing and as far as l know never found.