Lack of Care From the NHS

[SkintBag]

Hello there, please forgive me if this turns out to be a long thread but the issue is very complex.
I dont really know where to start so Im gonna jump straight in. In Nov 2004 I gave birth to my son and after 6 months or so in March 2005 I started to bleed very heavily and did'nt stop until Dec, during this time I had regular doctors appointments to try and find out why but they did'nt seem to intrested and gave me some tablets to "control" the blood loss. Obviously I was bleeding non stop so became very ill whilst this was going on dropping down to below a size 8 (bearing in mind that I am a 6ft tall lass who is usually a size 12) and had to sleep all the time due to having zero energy for anything. After another visit to the doctors in November 2005 she realised that even on the highest dose of the medication given (9 tablets a day) they were having no effect what so ever and decided to prescribe the Pill??? (maybe she thought it was irregular periods) to try and control the bleeding. However before I could start taking them I fell pregnant again (must have been one of the days I stopped bleeding for 5 mins) and the bleeding appeared to stop. The doctor said that it seemed to clear up on its own so not to worry and that none of the medication I had been taking would affect the baby.

Then in January 2006 I started to bleed again, fearing the worst I headed to hospital and had an early scan to check, everything OK. The bleeding continued and I started to have regular appointments with the doctor again and also the hospital to try and locate the problem( i had to fight for these appointments as it was not worrying the doctors/hospital. After several tests they told me that they could find nothing wrong with me or the baby and that I should'nt worry about it to much (easy for them to say, I was bleeding so heavily that even maternity pads were useless) so on it went.

Then in April I started to get excruciating stomach pains and contractions and passing clots, I telephoned the hospital and they told me that I should go home and rest up as there was nothing they could do, they did'nt even tell me to come in for a check up (this all happened on a friday night and I called them on saturday morning, as I did'nt have a phone and where I lived at the time no-one opens their door after dark) anyway I had an appointment on the Monday so I just grinned and beared it.

Then, at the Monday appointment at the maternity clinic they checked baby and said everything was fine, I went to the consultation only to be told that the consultant who's care I was under was discharging me from her care as "it was no longer required". I went home and cried.

The following saturday I started having pains and contractions again and after fighting it for about 4 hours I finally gave in and let my husband get me a taxi to the hospital while he stayed at home to look after our son. After arriving at the hospital and having all the staff watch me try and make my way to the maternity department (I was in excruciating pain and could not stand up properly, I even had to take the stairs as no-one would let me into the lift) I gave birth to my daughter at 21 weeks obviously by this stage there was nothing that could be done. Strangely after all this happened the bleeding completely stopped and has not re-occured.

Sorry for the ramble but I want people to know what happened prior to the event before asking any questions.
What I would like to know is
1. How would I go about getting copies of my maternity notes for this pregnancy?
2. Would I be able to take any action against the hospital for failing in their duty of care, since afterwards a midwife said it was obvious that there had been warning sign's but no-one picked up on them.
3. I don't want any compensation, just an apology would be nice and for them to change they way they provide care (or lack of) is this possible or do I have to claim compensation?

We did go to a solicitor when it happened and he took the case only to drop it as soon as the hospital sent him a generic explanation about miscarriages and did'nt explain their actions leading up to the event.

Any advice will be greatly appreciated. And on a happier note I got pregnant again a few months later and now have a beautiful baby girl (3 months)
Thanks again, for any help.

[nearlyoldwoman]

hi skintbag, gosh dont know what to say after reading your story, i'm truly moved and very sad to hear what you've been through, i'm utterly appalled. i'm afraid i can;t help you with any of your questions, but i'm sure someone will be along soon to help you with your queries and their advice and knowledge is fantastic. hope you get your answers soon.

[ScarletPimpernel]

1. How would I go about getting copies of my maternity notes for this pregnancy?
2. Would I be able to take any action against the hospital for failing in their duty of care, since afterwards a midwife said it was obvious that there had been warning sign's but no-one picked up on them.
3. I don't want any compensation, just an apology would be nice and for them to change they way they provide care (or lack of) is this possible or do I have to claim compensation?

1. Yes. Submit a Subject Access Request to the NHS Trust concerned. Make sure you ask for all the records they hold including those relating to your maternity care.
2. Possibly, but you would need advice from a lawyer specialising in medical negligence.
3. It isn't necessary to make a claim for compensation, or take an action for negligence. You can simply make a complaint.

There are two ways to make a complaint. You can just write a formal letter of complaint to the Trust setting out the situation. Or, you can go through the hospital's Patient Advice and Liaison Service (PALS). PALS remit is to deal with 'concerns'. They have access to everyone in the hospital and will work to a laid down procedure. Don't be fobbed off lke the solicitor was; insist they provide a full and detailed response to the points you raise.

I'd suggest that everything is in writing, so there can't be any misunderstanding.

It may well be that on some of the occasions you describe there was nothing that could be done clinically, but that should not stop staff explaining why and providing reassurance.

I find it incredible that so many NHS staff working in Obs and Gynae seem not to realise that whilst miscarriage may be a routine situation for them it is a major event for the patient, who may well go through the same grief as if the baby had been born and then died. Emotional support is as much a part of care as any clinical procedure.

You can get some useful information on the standards that nurses and midwives (difference between a midwife and a rottweiler? - lipstick) should adhere to from the UK Nursing and Midwifery Council at NMC Internet (tip - look for Duty of Care and Midwives Rules)

The Miscarriage Association at The Miscarriage Association - introduction also has some info on the standard of care you should expect.

Ask if you need help drafting anything.

[louis wu]

I am sorry to say this, but if there is something in those note that they don't want you (or a solicitor) to see, then you can be sure they will have gone missing.

Its a sad state of affairs, but the NHS has become the victim of so many compensation claims that they will do anything to hide the evidence. This leaves people like you with little/no hope of getting to the truth or receiving an apology.

I would just urge you to be careful where this goes, I have known people tear their families apart trying to get to the bottom of things, and have never been satisfied with the result. I am not trying to say leave it, but don't sacrifice the needs of yourself and your family to persue this.

Whatever happens, I sincerly hope that you get some closure from this, and can move and enjo everything that your little girl brings you.

louis

[ScarletPimpernel]

Originally Posted by louis wu

I am sorry to say this, but if there is something in those note that they don't want you (or a solicitor) to see, then you can be sure they will have gone missing.

This does seem to happen with depressing regularity. I am aware of one place where the chief executive (a nurse) insists that all SARs are dealt with personally by her, on the grounds that 'they aren't a matter for administrators'.

The NHS has many contradictions, and the way they handle complaints is one of them. There is always some new policy or system for improving care, backed up by seminars and some impressively pompous articles in the journals. The difficulty is that they don't follow it through - senior staff attend meetings and pat each other on the back for achieving targets and producing glossy reports - but the reality is that on the ground little changes.

But, if a complaint is raised as a concern, and that the intention is to seek to offer constructive criticism and provide an opportunity to identify lessons rather than to seek compensation, it may be easier to follow through.

In defence of NHS staff, for every genuine patient who simply wants to know why things didn't go as they had expected, or why something went wrong, there are ten who are seeking compensation because the lavatory paper was the wrong colour, or the food did not contain the level of additives to which they are accustomed, or the fact that they were enormously obese and smoke should not have prevented the doctors curing them at once.

Persevere; it will be worth it.

[SkintBag]

Thanks alot for all advice, i am going to request my notes but i dont really know what to put in the letter, any suggestions will be gratefully recieved. I will perservere thank you coz i know that it will be worth it.

[ScarletPimpernel]

Suggested letter:

Data Compliance Officer
Insert NHS Trust/Hospital name here



Date


Dear Sirs

Data Protection Act 1998 - Subject Access Request

Please provide me with a copy of all data relating to my treatment at (NHS Trust/Hospital). Note that I do not require x-ray films.

Please ensure that this request is fulfilled within the statutory time limit.

Should you need to verify my identity, or if it is your intention to charge a fee for the provision of my records, please contact me without delay.

Yours faithfully

Notes:

1. The fee for a medical records S.A.R - (Subject Access Request) is £10 where the records are held electronically and £50 where the records are manual, or a mixture.

2. Many NHS Trusts use their own forms for SARs, and they may ask you to complete one of these.

3. Dept of Health/NHS policy is to deal with SARs within 21 days, though the Data Protection Act allows up to 40 days.

4. The time limit clock starts after they have verified your identity and any fees have been paid.

5. The fees aren't mandatory, but are the maximum that can be charged by law.

6. If you need your GP records, you will have to submit another S.A.R - (Subject Access Request) to the GP.

7. You are not required to give a reason why you want your records.

8. The letter refers to x-ray fims not being required. This is becaase they are unlikely to be helpful in your case, and because most Trusts won't release them; if they do, they have to be returned anyway.

[FantasticDazz]

Nice advice, scarlet you seem to know your stuff

[SkintBag]

Thankyou Scarletpimpernel, Your advice is very useful and i am very grateful for your advice i know some people will think that i am just someone who cant move on and so am looking for someone to blame but that is not the case and i appreciate you taking it seriously.
It states in the template letter
Should you need to verify my identity, or if it is your intention to charge a fee for the provision of my records, please contact me without delay.
Does this mean i can send the letter and then the charge is sent later. If so this would help as i dont have the money yet but that i can still get the ball moving.

[SkintBag]

just a quick note to louis wu vbmenu_register("postmenu _1011644", true); thanks for the warining but my family are completely behind me as its not just me who has lost a daughter, my husband lost his daughter. Its not for closure as to why im doing this i have already accepted that i have lost a daughter but that is not what its about its about the lack of care i recieved for example at worst case At 21 weeks if i was threatning a miscarriage yet i was told to stay at home and rest up which would be ok had i not been so far gone. But coz i was it wasnt pretty. When i did lose her i had a clot of over 700ml so had i stayed at home there could of been serious complications and put me in danger yet this was not taken into account.
So i know there was lack of care

[ScarletPimpernel]

Originally Posted by SkintBag

Thankyou Scarletpimpernel, Your advice is very useful and i am very grateful for your advice i know some people will think that i am just someone who cant move on and so am looking for someone to blame but that is not the case and i appreciate you taking it seriously.
It states in the template letter
Should you need to verify my identity, or if it is your intention to charge a fee for the provision of my records, please contact me without delay.
Does this mean i can send the letter and then the charge is sent later. If so this would help as i dont have the money yet but that i can still get the ball moving.

There's no reason why you shouldn't send the letter now. The charges aren't mandatory - they can provide the info free if they wish (MOD policy is not to charge, for example), but I fear that most NHS Trusts will charge the max - as a deterrent if for no other reason. The hospital may have a concession policy, but these are locally determined. CAB may also be able to advise you on this.

Remember that the 40 days doesn't start until you have paid, however.

You should not feel bad in any way about raising your concerns; As professional practitioners, doctors, midwives and nurses are all accountable for their work, and should act accordingly. The hospital should view your raising of concerns as a positive attempt to help them to identify lessons for the future, and to gain an insight into the patient's experience, which, now that everyone is supposed to be more involved in their own care, is important. There is a huge difference between curing and caring - there has to be a balance of both.

You will need to give some thought as to how you will submit your complaint; ideally it should offer a brief overview, a diarised version of factual events, an account of what the effect has been on you, and a summary in which you also outline how you would like to see it resolved. Please remember that you don't have to do all this by yourself. I can help you with it if you wish.

[SkintBag]

This is for scarletpimpernel, thank you for all this help once again. For your to be able to help me, and because you really seem to know your stuff, would it help if i scanned the previous complaint procedure? the reason i ask is really because i would like someone elses opinion about the occurance of the event. And i would really like to see what you make of it. Im gonna send the letter off requesting my notes anyway but feel an outside onlooker would help me to know that what i am doing id right.

[ScarletPimpernel]

I'm happy to look at it. However, for reasons of medical confidentiality and to prevent possible compromise of any future plans, for you to send it to me by email in the first instance. I will pm you an email address when I get home later.

I'm aware that the moderators rightly feel that all CAG advice should be in the open, and it is my intention to continue to do this. Unlike bank and DCA letters, the details of a medical complaint is likely to be difficult to anonymise, so I propose to look at the docs offline, but will post a summary and all replies to SkintBag in open forum. If any mods object to this plan, please let me know.

[FantasticDazz]

Bump

[SkintBag]

Soz hubby was logged in but showed it was me?? lol.
Thanks Scarlet I'll wait for your PM. Same goes for me if the Mods have any issues with this please let me know and we will work around it

[nearlyoldwoman]

way to go skintbag if i was in your position i would do exactly the same as you (it would tear me apart if i didn;t!) good luck and i hope you get answers...an well done to scarletpimpernel for your amazing knowledge!