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The Royal Wolverhampton Hospitals NHS Trust

February 3, 2013

This is a personal account of my recent experience of New Cross Hospital, Wolverhampton. The experiences have derived from visiting patients in hospital and after discharge.

My sister has just returned to hospital having spent two weeks at home following a spell in hospital. The discharge itself was interesting. She is told by one of the nurses at visiting time that she is to go home. No, that was not the arrangement. the consultant said that I was to await certain tests and anyway I am not well enough to go home. ‘Well you’ve got to go,’ No, says the husband she is not going until we have seen a doctor. The doctor who appears is a junior doctor who doesn’t know anything about her case and there is no choice but to go. Even the consultant acknowledges in a letter sent after this charge which begins. ‘I hope you are feeling better than when you left hospital.’ Am I missing something here. I thought that hospitals were there to send you home if not recovered then in a state which was bound for improvement, not in a state in which you acknowledge that you are sending home very ill patients with little support?

In both my sister’s case and a friend’s case, they were sent home in spite of the fact that they were unable to eat. In both cases they were sent home with high energy drinks and an appointment to see a dietician the following week. Good as dieticians are, they can only work with the information to hand. In neither case had the doctors worked out why the patients couldn’t eat, therefore the dieticians were working in the dark. It is so obviously  a waste of money that one wonders why it is done. I can only assume it is because it gives the appearance of doing something and at the same time making a stay in hospital as short as it can be.

It would appear that the days of being in hospital as long as one needs, have gone. The chief criterion of hospital performance is not the quality of care but how quickly one can get patients in and out of hospital. What I am going to tell you now may seem like something from a farce, I can hardly believe it myself but this is the truth.

My sister returned to hospital in an ambulance as a result of a call to NHS DIrect. She was weak, dehydrated, in agonising pain, and the medication provided, far from helping the condition, had made matters worse. When she recovered she spoke to one of the nurses and said that the consultant should never have agreed to her discharge. The nurse said that he may not have agreed to it, it might have been the yellow clock team, which did that.

So who are the yellow clock gestapos and what do they do? My sister has actually heard a nurse say the yellow clock was ticking for two beds in the ward. She has seen someone in a sister’s uniform going through all the patients’ notes in the middle of the night and she has seen an actual image of a yellow clock on the wall behind a bed. All of this information begs certain questions. What is the yellow clock scheme and how many are there employed in  its operation? They may well get people out of hospital quickly, ‘before the yellow clock starts ticking,’ but what state are the people in who are discharged? Last time my sister was in, two people were discharged, one made it as far as the discharge lounge, was so ill she had to go back to the ward and the other had to be readmitted a day or two later.

Perhaps all that was good from the point of view of bed blocking and targets. Even someone readmitted after a brief stay in the Discharge Lounge may become a new bed statistic I don’t know. But that is all you are at this hospital, a statistic, a number, an inconvenience. especially if, God forbid, you are ill. When I went to visit my friend Frank, always the most positive of people, he was saddened by the way he was treated. Not angry, not bitter, but just saddened that what may well be the end of his life has been marked by  being treated not as a person but  as a number. Sent home to a cold house with his wife doing her best but what can one do as an amateur if the patient can’t eat? I felt desperately sorry at the loneliness of both of them.

So what would it take to change this attitude?

Firstly the medical hierarchy has got to be re-established as it used to be and as it should be. The idea of everyone being part of a team, from the highest to the lowest doesn’t work. I am not a great lover of hierarchical organisations but this is one case where the hierarchy is important. From the patient care point of view, the most important people are the consultants and  the consultants’ orders should be obeyed. The most important people are not the nurses, cleaners or yellow bed inspectors.

After an operation, nil by mouth was the order, yet the person who came round with the food tried to get my sister to eat. ‘I can’t have any food’ she said feebly, barely conscious.  The answer came back, ‘You can in my book.’ I don’t know where you were in the staff hierarchy, food lady, but I have to tell you that your book doesn’t count for anything. Who do you think you are to challenge the orders of a consultant? Nurses similarly should do what is asked of them. A consultant had asked the nursing staff several times to remove the staples after an operation. In the end he resorted to joking to get it done. ‘I am going to charge you rent on those staples,’ he said. Other consultants simply do the job themselves – replacing drip bags for one. It was not unusual for drip bags to remain empty for a day, may be longer I don’t know. I do know that the sound of bleeping, indicating that the bags were empty,  was happening all over the ward and could be heard at visiting time. In the past this blatant disregard of consultants’ wishes, would have been unthinkable. It is certainly detrimental to patient care.

Secondly,be professional in what you are doing. A ward is a patient’s home for the time they are they. Make it a place which looks as though it is fit for the purpose for which it is intended. Make sure it is clean at least. There clearly aren’t any lavatory gestapo at New Cross.  If you are a nurse, if you are a cleaner, if you are a consultant, you all have a vital role in patient care. Do your job. If you are a nurse then nurse, a cleaner, then clean. There is something about an atmosphere which everyone working there plays a part in creating. When my husband was dying in a hospital in Stoke, where there were a lot of very ill patients, the staff clearly recognised the state that many of the visitors would be in. I was impressed that everyone, from the newspaper seller in the shop, the canteen staff, right up to the consultants all managed to set a tone of professionalism which allowed for the grieving and the anxiety of loved ones. There was kindliness without intimacy and somehow an empathy. You recognise that atmosphere when it is there and you recognise it when it is not.

Thirdly, patients are people and not just numbers. Treat everyone as you would wish to be treated yourself. If the patients weren’t there, you, the staff, wouldn’t be in a job, so respect them. Don’t talk over them as though they weren’t there, don’t talk in a foreign language in front of them, try a smile and please keep your social chit chat to your off work time. Be courteous and be focused on the important person – the patient. Visitors would welcome a smile too!  I once went for a foot operation to a hospital in Hereford. The receptionist was so warm and friendly I have never experienced anything like it before or since. It didn’t take him any longer to get the basic details, probably less time, but it just gave you confidence you were in good hands and I was. In contrast at an outpatients visit to a local hospital I heard a nurse chiding an elderly man because he hadn’t heard his name called out. ‘I’ve called your name before Mr Smith.’ Another man who could hardly walk was told to hurry up. It sent shivers down my spine and I hope I never have to go back to that hospital.  I hate cruelty. Patients are vulnerable. Sometimes I feel my dogs get kinder treatment at the vets than people get.

Yesterday, the staff were clearly talking with visitors about discharging an elderly patient. The discussion was in front of the lady who was quietly crying.  I am not surprised. She was being discussed as though she was a commodity. It is surely cruel to discharge patients who are not in a fit state . What sort of society have we become if we think that is right?

So that is my experience of the NHS written mainly from experiences in the last two weeks at New Cross Hospital Wolverhampton.

I thought you might like an update on the two patients. My sister is now at home and as well as can be expected but will need another operation. That is the relative success story.  Frank has been back to hospital as an out patient where ‘they’ were very concerned that he wasn’t eating. (As I recall he wasn’t eating when he was discharged from hospital so were they hoping for divine intervention or what?) So concerned were the doctors that Frank was offered an appointment at a local hospital which specialises in rehabilitation. Later the same day there is a phone call to say that Frank is outside the area and the appointment has been cancelled. It’s a desperate situation. The wife who has severe mental health problems looked yesterday (Saturday) as though she ought to be in hospital never mind her husband. I just hope that both of them make it to Monday when they can speak to their GPs.

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2 Comments
  1. Very well described. Also very sad.

  2. zabir khan permalink

    they stole my new born boy nearly 21 yrs i cant even get close

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