We started this blog with the letter I wrote to Calderdale Royal at the beginning of June. Nearly three months later, I still have not received a proper response. Their latest letter to me says that are still waiting for Elaine’s permission to release the results of their investigation – having sent me a letter on 12 June confirming they had received Elaine’s consent! Elaine has asked me to post my latest letter which I am sending today. Chris
Saturday, August 26, 2006
Re: Elaine Connell
Royal Calderdale Hospital
Bowel op: 24th January 2005
Reversal: 7th February
Liver operation at St Jamesâ€™: 31st May 2005
Chemotherapy: March 2005, July 2005 to January 2006
Dear Mrs Whittingham,
On 4 June, I wrote to the hospital with some concerns in respect of my partner, Elaine Connell. You initially replied on 8 June saying you would contact me â€œwithin 4 weeks with either our response or a progress report.â€ Over two and half months later, I have not received this.
On 12th June the hospital wrote confirming receipt of Ms Connellâ€™s consent to release medical information. Yet on 9th August, the hospital write to me saying you have not received Ms Connellâ€™s consent. I have both letters in front of me as I type this.
It is exactly this kind of administrative incompetence that aroused concerns expressed in my first letter, and which seriously undermines our faith in the hospital management.
We have certain questions which we would like answering.
1. Ileostomy – Why did this go wrong?
After her operation Elaineâ€™s ileostomy bag presented many problems in that it kept coming away from her body. She also developed very badly excoriated skin in the region which was very painful.
2. Why was Elaine not listened to, or taken seriously
Elaine is an intelligent and articulate woman. We cannot understand why the nursing sister refused to respond to Elaineâ€™s concerns.
Elaine is not squeamish and has in the past done some nursing training. She has had no difficulty in helping others change their bags. When Elaine complained about the problems, she was not taken seriously by the Ward sister who gave the impression that the problems were all of Elaine’s making. As did the consultant: “You cannot stay in hospital forever. I have 86 year old ladies who do this.”
Yet, highly trained stoma nurses were unable to affix it so that it remained attached for more than a couple of hours or so.
Since then Elaine has seen other peopleâ€™s stomas and photos of them on the internet and realises that hers was not properly formed. She has never been offered an explanation for what happened.
If the outcome of the scans and colonoscopy mean that Elaine has to have a permanent stoma, she is terrified that all this could happen again.
3. Why was Elaine forced to share a room with senile, incontinent patients so soon after her operation?
Elaine was returned to the ward from the ICU very early after the operation. We asked for an individual room but were told that this wasnâ€™t possible, even though there were empty rooms constantly available during Elaineâ€™s whole month in the hospital.
At times she became desperate for sleep. It also seems to both of us that priority for single rooms could be given to those learning how to use and manage an ileostomy bag; especially if that person is, like Elaine, having very serious problems with the bag management.
Senile, incontinent patients were on the same ward. These ladies were often awake right through the night disturbing other patients. The kidney infection Elaine caught was probably caused by this.
4. Would Elaine have contracted a potentially fatal kidney infection if she had been given a single room, or a room with other post-operative patients?
5. Why were visitor regulations not enforced around a patient who had so recently been through surgery of six or more hours?
Visitor regulations were not enforced so that a large family with loads of young children was right next to Elaine’s bed, giving Elaine great distress.
6. Why did the Sister of Ward B resist Elaine basic need for a little privacy?
When Elaine had visitors and wanted some privacy, objections were made by the Ward Sister of Ward 4b and one of the staff nurses when she pulled curtains round her bed. This was a complete contrast to St. Jamesâ€™s Hospital where the staff appeared surprised when Elaine asked if drawing the curtains around her bed was acceptable to them.
7. Although the consultant instructed staff to arrange a MRI asap, this didnâ€™t happen. Why?
Elaine was told that something was seen on the liver by Mr. Subramanian that was probably benign but should be checked. On her discharge in February 2005 she heard Mr Subramanian tell one of the staff nurses to arrange an MRI as soon as possible but this only happened a few weeks into her first course of chemotherapy which began in mid March. The MRI was eventually done at Elaineâ€™s insistence and did not occur automatically, as Mr Subramanian had instructed. In the event, Elaine had to have half her liver removed at St. James Hospital. Had Elaine not insisted, it may have become too late for surgery. Who know whether this delay may have had an influence on her current condition.
8. Why did Elaineâ€™s repeated asking for an explanation of Acidic burning defecation never receive a response?
Elaine has complained about this ever since she left hospital in February 2005. No-one has been able to give her an explanation, or even acknowledge that they understood what she has been talking about. At times she has felt like she has been disbelieved & had considered seeking a private consultation about it.
9. Why did the second colonoscopy not take place for nearly eighteen months?
Elaine was told to expect six monthly scans and an annual colonoscopy. She has had one scan at St James in November 2005 but the colonoscopy never happened. Her first colonoscopy was in January 2005 and only followed up on 6 June when we started asking questions in late May this year.
10. Why wasnâ€™t Elaine seen by the consultant for so long before the eventual May appointment?
She was not given any information about how many times she could expect to be seen in Mr Subramanianâ€™s clinic. We now understand that the protocol for her type of illness is three monthly consultations which she has not had.
11. Why was Elaine not notified about the May appointment? Is it really enough to rely on the post with such serious matters?
After not hearing for some time, I urged her to contact the hospital. She contacted the stoma care nurses in April and spoke to one of them named Lisa. She informed Lisa of our concerns that she hadnâ€™t received an appointment for the colonoscopy and asked her if she could investigate. She said sheâ€™d get back to Elaine, but didnâ€™t. In May, I persuaded Elaine to phone again. She was told that she had missed an appointment for that very day: 17th May. We had not been notified of it.
12. Why was Elaine told firmly on by both doctors and nurses on 28th June that she should attend a scan timetabled for the next day at St James when it had already been cancelled. I needlessly took a half day off work to drive Elaine all the way to St. James.
I write as an enthusiastic supporter of the National Health Service and feeling that if Elaine didnâ€™t have the best experience at Calderdale Royal by our raising these serious questions we can perhaps play our part making things better for the future.