You see the Ombudsman will only investigate fully if they consider that the response from the hospital has been unreasonable. This is not a criteria which appears on their website, but it will be part of their communication to you once you have escalated a complaint. Consequently your relative may be butchered and mistreated and all the Trusts have to do is to sound 'reasonable' in response to your formal complaint. They are good and practiced at this. The Ombudsman decision is final. You have no appeal unless you go to judicial review. A member of the public cannot even report poor care to the CQC. Complaints to the hospital will merely result in a 'thank you for your feedback' and 'we have learned lessons.' It's complete flimflam. We have seen only too clearly recently that the GMC also only exists to protect its own. Our healthcare system and the processes in place to protect us are a disaster zone.

I wish you luck. Every case will be different. I too had proof that my relative was overdosed on a drug and mis-diagnosed causing death. The doctor only found out the cause of death because I insisted on a post-mortem. The Ombudsman did not investigate. Apart from the hospital, whose major aim is to avoid responsibility and blame, there is absolutely nowhere else to turn to but private ligitigation.

Obviously I do not know of your dad's financial status. However, my relative owned their own property and had limited savings. I had to fight really hard to get them 24/7 care paid for by social services. I contacted the DoH for advice. Initially they would only offer 2-4 hours a day. As I said I wrote to my MP and many others. I got the feeling that Trusts and social services do not like people making a fuss and having the spotlight turned on their incompetence. I applied and got attendance allowance at the top rate for my relative as well as the 24 hour care. I also applied and received a blue badge and found out about the free wheelchair service too which needs GP referral. My advice would be to challenge any decision you are not happy with and do your own research. Don't expect good or accurate advice from social services or the discharge team at the hospital. At a pre-discharge meeting with social services/doctors/nursing staff/physios I was told categorically that I would not be able to get my relative 24 hour care due to costs and 'the system' (their words). I remain bitter that in the midst of the stress of dealing with a loved ones illness they made life so much harder. I dread to think what happens to those with no advocate.

If you follow the formal complaints system you will be waiting months for a response. If you escalate your complaint to the Ombudsman, you will wait a further six months plus just to see if your complaint will be fully investigated. Your stories regarding poor care for the elderly resonate with me. A relative of mine was also epileptic and had accompanying bowel issues. The hospital and social services were preparing to discharge her home with a few hours of care a day. I refused to allow her discharge, wrote to my MP, the DoH, Social Services Director. Everyone I could think of. I got 24-hour care at home. I wasn't impressed by this service, which appears to be staffed by people without any training who arrive straight off the plane from Eastern Europe. Language and cultural differences were also an issue. How they manage to CRB these people, I have no idea. I caught one of the staff stealing. However, worse than this, my relative fell and cut her head whilst under their care. I also found out about direct payments, which allows your relative to employ somebody to care for them. This could be a relative. Although my local authority declared themselves (in a letter to my MP) to be the flagship for this service, their staff were ill-informed. I am left with absolutely no faith in the people who are supposed to be managing the NHS and Social Services. The system is a complete failure.

Night Owl I think many people who make a stand against what they see as unfair or unjust or plain wrong, get slowly worn down by officialdom and eventually give up. This would be exactly what they want. I can only imagine how frustrating this must be for you. I hope you don't give in. Good luck.

NurseAnne I have consistently commented in my posts that I recognise understaffing to be a major, (but not the only cause), of declining standards of care in our NHS and I rest the blame on this stupid Government and those that manage our hospitals. I'm sorry to hear that your husband has a chronic illness and that your son has special needs. I'm sure you have enormous empathy with your patients. I'm not questioning how tough your job is or how hard you work. I am intrigued to know how you think your blog will help? As a member of the public I found it alienated me from the nurses' plight. I desperately want things to change for you and the patients - one of which I may be one day. I note you mention that in the States there is a legal requirement for a trained nurse to patient ratio. This is something I previously considered when my relatives were in hospital. It would be a way of making the management accountable. Perhaps the NHS should be dismantled? It was a great idea of Mr Bevan's, but the world has changed. The NHS seems to be so heavily abused and no organisation that the government has a finger in seems to be well-run.

I reply to Zippygbr's comments from the 22 December. so the 10 + years of direct , personalised , abuse and agressive behaviour i have witnessed or experienced was all fantasy? the public do blame Nursing Staff - FACT! I don't think you could have read my comment fully. I said I had never witnessed abuse or attacks on my two years of visiting. I didn't say it did not happen. I have a close relative who is a nurse, who has worked on various wards in various parts of the country, and she has never been attacked or abused. I'm sure A&E on a Friday and Saturday night can be hell. it does not need a nurse to refill a water jug when the jug is there and there is a clearly signed chilled water fountain and clearly marked ' this tap is drinking water' above the cold tap on many of the sinks ... an empty jug at the beginning of afternoon visiting is a good sign ! - it shows that he patient has drunk at least a litre so far today ... is it beyond the abilities of a mere mortal to spread out a blanket which is folded at the foot of the bed ? Yes, it does if the person laying in the bed is not able to assist themselves. An empty jug is not a sign that a patient has drunk a litre! There were many occasions when I visited and there was either no jug or no glass...and the fluid chart was blank too. I became so fearful and anxious about the neglect of my relative that for two weeks I sat for six hour stints without moving from the bedside. Not one time outside of meal times (and even then it was not consistent) did any member of staff assist any patient (in need of help) with fluids. One time I arrived to find my relative shaking with cold beside an open window . I often fetched extra blankets when I saw my relative was cold because there were too few nursing staff to notice individual's needs. the difference is that t other professionals are not expected by the public and the press to stand there and be a punchbag How self-obsessed are you? How about fireman, ambulance crew, police, teachers? Feeling so embittered must surely have an impact on your patients. Night Owl is trying to take positive action to change things for the better. I don't think Nurse Anne's blog will have the same effect?

I'm more inclined to agree with Frankieg. At the moment there appears to be no accountability. We have Chief Execs walking away from Trusts where many people have suffered and died with 6 months pay and substantial pensions. We have many doctors who are grossly incompetent, yet are still allowed to practice. Where is the protection for the patient when things go wrong or care is sub-standard? We cannot rely on the CQC or the GMC, or even the Ombudsman. We certainly cannot rely on the hospital managers whose sole aim appears to be to hide failure and evade blame. Unless this changes, sadly, the only course of action for the aggrieved is to litigate. I imagine in the States if a medic is sued often and loses often, he can no longer get insurance and no longer practice.

I have never been abusive to any member of the medical profession whilst visiting my relatives, although I have been shouted at by a nurse when I asked for a bedpan for a relative. I have also never witnessed, in over two years of daily visits, seen any other relative shouting abuse or going beserk. I'm sure it happens, but I wonder how long the fuse has been burning. People generally do not formally complain because they feel they or their relative may suffer as a result (and it can), they don't want to make a fuss or they simply do not think that it will make the slightest bit of difference. It is a sorry state of affairs.

There will be many non-nurses following this post with interest and fully supporting the actions of Night Owl. NurseAnne is wrong. The public are not fools. Lots of us who see our relatives suffer and die at the hands of the NHS do not blame the nursing staff directly and we do complain to management and see it as their responsibility to ensure that staffing levels are sufficient. The management's response seems always to be that they have 'changed procedures' or some such nonsense....and then the same failures recur, because ultimately the root causes (understaffing being one) are not addressed. I have read parts of the blog and I found it quite offensive; slamming the Daily Mail, (believe me it is not the only newspaper reporting negatively on the NHS), bitching about 'over concerned' visitors and whinging about the pay of other professionals. Do you really expect family to stand by and say nothing when they can see their loved ones in pain? I hope you are never on the other side of the fence. In a service industry, it will be always those in the front-line that come under attack. This is not exclusive to the NHS. Night Owl has encouraged visitors where appropriate to complain to PALS. The current complaints system favours management cover-up and evasion. It is not in the management's interests (personally) to expose the truth. Look how many months Mid-Staff and Essex were a problem before becoming public. The CEO of Staffs walked away with six months pay I understand. Believe me, many of us are wondering why he was not prosecuted. I completely understand the frustration that Night Owl must feel and what a tough decision she has made in taking this stand. It is not only the nurses who feel that they are banging their heads against a brick wall trying to change things for the better - the 'concerned' public feel this too. Perhaps, together, we will succeed.

Yes, good luck Night Owl. I am not in your field but whatever job I did, if I was left with nobody to accompany me as my witness and for support, I would cancel the meeting and no amount of sweet talk would change my mind. Let us know how things go.

I have a question. Is there an accurate record kept of who is on duty for each shift, including a breakdown of personnel - viz. trained nurses, bank nurses, HCAs etc? How long is this information kept and is it available via Freedom of Information? Do hospitals have policies which state the preferred ratio of trained nurses to patients on particular wards? I'm assuming there is no legal obligation to ensure that a minimum number of trained nurses need to be present on a shift? Many thanks.

Night Owl, I am appalled that you find yourself in such a situation. After Margaret Haywood's treatment by the NMC, it's a wonder that any nurse raises her head above the parapet. This must be a tough one for you. I admire you for making a stand but you must be torn between doing what is right and compromising patient care further. I'm not criticising you for this; you seem to have tried endlessly to highlight and deal with the issues. Part of me wonders why your colleagues are not standing with you in solidarity. It would certainly focus management attention and make the public (rightly so) aware of the issue. It will be interesting to see what the whistle-blowing policy is post-Margaret Hawyood. Me. Well, it's easy for me to say, but I would think about how I would feel if it was my loved one in the bed. After following the official line, I would resort to sub-version if necessary, alerting MP/press. The public would applaud you for it. However, you risk your career. Please let us know how things progress. I wish you well. It's probably of little consolation, but I'm on your side.

The GP may well ask you who you would like to provide the second opinion. Do some research beforehand so that you are prepared. It'll speed things along.

ziggybr Well the original post has gone missing, but it did state that the drugs were being dosed incorrectly and I responded accordingly. Any patient/relative/carer who has any doubts about the actions of any medic should be positively encouraged to question and should expect a prompt explanation. If I was still unsure, I would escalate it. Yes, the medic may be right...but equally they may be wrong. Would you want to live with the regret of not doing what you thought was right at the time, even if that meant the hospital staff thought you were being confrontational? It is the Trusts who fail to be honest and transparent when dealing with complainants that turns them into 'crusaders and meddlers' (as you so sweetly put it). In truth they are just ordinary citizens seeking justice. The best thing is not to let it get that far and to stand up for yourself or your relative before things go badly wrong. This is not just my opinion - have you read the Patients Assocation's reports, the newspapers, seen the TV documentaries? Libellous comments? Please! There were no names mentioned. The NHS would be never out of court if it spent all its time defending the negative comments thrown at it...most of which they'd have a hard time proving false.

I'm sure you must feel extremely powerless. Don't let them blind you with science. Doubt them and question everything. Good luck. I really hope everything goes well.

My advice is to keep a very accurate diary of events, including names and times and exactly what happened. You may need this in the future. I would almost be tempted to get a copy of the hospital notes for the period through Subject Data Access. The nurse who is wrongly dosing the drugs needs to be reported immediately. She is a danger to your son and to other patients. Put this in writing and deliver it by hand to the modern matron. If I saw this nurse dishing out drugs again without supervision, I would probably just contact the NMC for advice. It may be an idea to contact the DoH Patient Choice Patient choice : Department of Health - Health care to ask their advice prior to the meeting. In the meeting with the hospital managers, try to ensure that you are accompanied and that you take notes. Perhaps you could even ask if to record it. There really should be no objection to this. Involve your MP. He/she may agree to accompany you to the meeting. Mine did. Don't be intimidated by these people and never believe them when they tell you they have your son's and your best interests at heart. If you do not understand something, don't be afraid to ask them to explain.

So, the incident(s) were recorded accurately by a junior member of staff, but later forwarded and changed by a senior member of staff following your grievance? Can we ask what the incident was? If I reported an incident at work (I do not work in the NHS) I would do so in writing and I would expect to receive a response confirming receipt. If you know the document or email title, creation date, the creator and the type of document attachment (for example Word) and maybe a string of words in the body of the original document, you should specify this in your request. Knowing who the email and attachment were sent to, and an approximate date would also narrow down the search and make finding the email easier. I do not know what the back-up policy for holding data is within the NHS. I worked for a govt establishment where it was one year. They should be open about this policy. It will be a difficult one for the IT dept though and will be very time-consuming. However, they are obliged to make the effort. Auditing is specific to people/groups/depts and events otherwise the system would just slow to a crawl and run out of space mor frequently. I agree, the ICO are pretty rubbish for the individual's complaints.

Out of interest what is the position if the LL employed a gas fitter who was not Gas Safe Registered, although they were led to believe that were by, perhaps, providing false ID? Would the LL be liable? (This is not something I have experienced by the way, but something that I never checked when I was a LL). Should a tenant, assuming they are there when the gas man comes calling, also check the ID and the Gas Safe Register? After a recent experience with carbon monoxide in my own house, I would definitely advocate a detector as an early-warning. I'm guessing that may not be the only issue if cowboy gas fitters have been in action. I think, I, as the tenant, would want to make sure that I was confident in the tradesman too. The finger of blame might be just a useless cinder otherwise.

The NHS is pretty much recession proof. The Labour government has supposedly thrown millions (nay, billions) of pounds at it over its term of office. The improvements (some might say there have not been any) do not match the outlay. Perhaps it would be fairer to fine the patient for not giving notice of cancellation as long as the patient can do the same when the roles are reversed, as in this case.

Madness. Booking train tickets in advance is often the best option financially and regardless of 'class' who wouldn't go for the cheapest as it will be the passenger's cost. The Trust then cancels. Regardless if the notice was adequate, there are financial consequences here to the patient. I would imagine that there would be resistance from the Trust to refunding any money, but quite frankly I wouldn't accept no for an answer. You shouldn't have to hope for a sympathetic ear. If the Trust is going to take this tack, they should be informing the patient of travel cost consequences if the Trust cancels the appointment. Not doing so, in my book, makes them liable.

So, when I asked the question, I didn't expect a shrug from a trained nurse and I didn't expect to have to ask the question multiple times, then the aspirn to be stopped without any explanation from nurse or doctor. If it was the right thing to do it should have been done sooner. If it was the wrong thing to do, it shouldn't have been done just because I persistently asked the question. This and many other incidents left me without confidence in the medical staff.

But questioning does seem to be a problem for many nurses ziggygbr. I was never abusive. I was certainly frustrated by the apparent lack of knowledge, the inertia and apathy. As an example (and I have many) my relative was taking aspirin prior to admission. I knew the reasons. Whilst in hospital my relative developed a DVT for which they were prescribed warfarin. I noted that the aspirin had not been stopped. I asked one of the trained nurses why this would be. She shrugged. I asked the next day and the next. Eventually the aspirin was stopped. This was pretty much the way things were. Without offering an explanation I can only wonder at the competence (and I note all the training and qualifications you have listed) of those caring for my relative.

Just recently I contacted the CQC as I was concerned with the quality of care at my local Trust. I had raised my concerns repeatedly with the Trust, who thanked me for my feedback and then carried on providing the same poor care. The CQC would not/could not help. If the public have concerns with a hospital, they must first try to resolve the matter locally. The NHS management may well take months to respond. If you are still unhappy you must then escalate to the Ombudsman who may well take 6 plus months before they even decide whether they will investigate. All this time other patients may be suffering and dying. It's an abysmal system.