GP+hospital appalling treatment of My mother 76 with pneumonia ...sent home still ill!

[think about it]

Layla, your letter doesn't need to be a masterpiece. In fact, the more straightforward it is the better. Even copying and pasting your first post would suffice, if I get a complaint letter through the last thing I worry about is how well it's written.

 

I'll try to address a couple of your points on here from a Practice Manager's point of view in relation to your concerns over your mum's treatment in the GP surgery, Bazza has perfectly outlined the clinical aspects above. So I'll concentrate on the administrative side of things.

 

Being asked to wait in reception until a doctor is available is perfectly reasonable. If a GP was dealing with your mum and then dashed out to see another patient I'd imagine that you wouldn't be impressed. So, it's only fair that people are dealt with properly, the only exception here being if the distress alarm were to sound at which point all practice staff would descend on a room carrying defibs, oxygen cylinders and crash bags.

 

A GP surgery isn't an acute setting like accident and emergency - emergency appointments are still appointments with a GP, who as Bazza explained is limited in what he or she can do in dealing with a patient.

 

Asking for an Ambulance: the GP was I'm afraid quite justified in what they said. Ambulances are for life and death emergencies, unless of course you call them for patient transport - in which case, dependant upon how busy they are might take several hours to arrive. Surely it's better to have the patient go straight to hospital in the car they arrived in than have them sitting in the GP surgery for 6 hours on a plastic chair. So often we hear of how relatives ask for ambulance transfer, wait for hours for the patient to be picked up and then follow behind the ambulance in their car, or better still take the patient home to collect their belongings and wait for the ambulance to arrive. It's an absolute waste of resources.

[think about it]

It's completely understandable that you were so very concerned for your mother's health. I think what also needs to be understood is that someone's position on the list of who gets treated first or who gets a bed first isn't based on the level of concern demonstrated by relatives but on clinical need in relation to the other patients present at the time. If you somehow perceived that your mum was at the bottom of such a list then it's absolutely certain that those who went before did so because, however difficult it might be to accept, they needed to and deserved to based on the severity of their condition.

[think about it]

Layla,

 

First of all I hope your mum is making good progress and is recovering well.

 

I wanted to come back to look into this a little better and perhaps to re-assure you. I've copied a section from a patient leaflet on Pneumonia below to show you how, being sent home with anti-biotics is the first line of treatment in such a case. Hospitals are not ideal places to recover, sleep can be interrupted, surroundings are unfamiliar and in all honesty, they're not comfortable places to spend any real amount of time.

 

The leaflet is from www.patient.co.uk

 

Treatment at home

 

Treatment at home may be fine, if you are normally well and the pneumonia is not severe.

An antibiotic such as amoxicillin is prescribed when pneumonia is suspected. Bacterial infection is a common cause and antibiotics kill bacteria. Amoxicillin is usually effective against the most common causes. If it doesn't seem to be effective and your doctor suspects a less common bacterium, they may change it. If you are allergic to penicillin (amoxicillin is a type of penicillin) your doctor will prescribe an alternative that works just as well. Antibiotic treatment is usually effective and you can expect to recover fully. Symptoms should improve after 3 days if the treatment is working. You may feel tired for a while after the infection has cleared. If the symptoms persist longer than 3 weeks, you should ask your doctor to check you again.

Have lots to drink, to avoid becoming dehydrated.

Take regular paracetamol to ease fever and headaches.

Let a doctor know if symptoms do not improve over the following three days.

Hospital treatment

 

Hospital admission may be advised if you have severe pneumonia, or if symptoms do not quickly improve after you have started antibiotic treatment. Also, you are more likely to be treated in hospital if you are already in poor health, or if an infection with a more serious infecting germ is suspected. For example, if infection with Legionella pneumophila (the bacterium that causes Legionnaires' disease) is suspected.

• A chest X-ray may be taken to confirm the diagnosis and the extent of the infection.
  
• Blood tests and sputum tests may be taken to find which bacterium is causing the pneumonia. This helps to decide which antibiotic is best to use. Sometimes the bacterium that is causing the pneumonia is resistant to the first antibiotic. A switch to another antibiotic is sometimes needed.
  
• Sometimes oxygen and other supportive treatments are needed if you have severe pneumonia. Those who become severely unwell may need treatment in an intensive care unit.
  
• When you return home, even though the infection is treated, you may feel tired and unwell for some time.
  

Now, when reading this and indeed the whole leaflet if you choose to, please bear in mind that the severity of an infection isn't based on someone looking over someone and saying 'yes, that's pretty severe' but from the tests detailed above. I have no doubt in my mind that your mum felt absolutely dreadful and that, as I would be, you were very worried.

 

However, sometimes being sent home is the best option - the surroundings are comfortable and familiar and mum is less likely to be exposed to other illnesses whilst she is already weak. We often see how, over the festive period, even the most unwell patients prefer to be discharged to spend their time with their families.

 

As Conniff asked, one thing that's worth thinking about now is what you hope to achieve in making the complaint. I make it my business to ask patients here exactly the same question. It's because I might spend days investigating something when all the person wants is an apology, or the converse where they feel an apology is insufficient and want dates / times and reasons as to what happened and when. Someone else will undoubtedly come along and explain the to and fro of making a claim for compensation and I don't feel best qualified to comment on what 'makes a case' so, as you write you letter, think about what your preferred or intended outcome is.

 

Again, I hope your Mum is on the mend.

 

TAI.

[think about it]

At the risk of sounding like a bit of a monster; Layla, you've been drafting this letter for 984 days. You've received several different views on how to do this and all you really need do is copy/paste from this thread onto a word document. When I'm dealing with a patient's complaint I don't sit and score the grammar or syntax, I don't really care if there are spelling mistakes or the dates aren't exact because I can get those later from our records.

 

Please, decide what it is you want to do and what outcome you're seeking and then act on it. You're perfectly capable of explaining the problems on here so if you do truly want to complain then do something sooner rather than later. As it stands any chance of anyone recalling your mums trip to hospital from memory is gone, as such any anecdotal evidence is already lost. I speak with patients on a daily basis and can probably recall conversations from a couple of weeks ago, but never from 2 and a half years ago. So, the only thing that can act in your favour now are the clinical records and as you'll see when you read them, they're not narrative accounts of everything that happened, just a brief history of clinically relevant information.

 

I really hope that you get the outcome you're looking for but the longer you leave it, the less likely it is.

[think about it]

Really, this has been going on for almost 6 years now, any chance of anyone recalling anything that happened is absolutely zero. I’m sorry, the ship has sailed and any reasonable opportunity to get the type of answers you’re seeking or financial compensation is long since gone. 

[think about it]

A likely reason is a breakdown in therapeutic relationship. When a complaint occurs it’s sometimes reasonable to assume that the trust between patient and doctor is damaged to the extent where it’s no longer possible to offer effective treatment. It then makes perfect sense to have the patient deal with another clinician who can take the relationship from a clean slate. 
 

Delays in appointments happen all of the time for a myriad of reasons from doctors being stuck in traffic to previous patient requiring resuscitation and everything in between. Unfortunately you’re again in a situation where the incident happened at least six months ago and you’re attempting to rely on the recall of people who are in the midst of a global pandemic to remember a relatively uneventful day before Xmas 2019 when a GP was running late. 
 

That delay again brings the likelihood of getting a meaningful response to practically zero, requiring the practice staff to trawl through all the records of that morning to see if the cause of the delay is documented, and then say: ‘sorry, we were running late because another patient really needed us’ 

 

I’d honestly suggest your mother finding an alternative practice if she’s unsatisfied with the care she’s receiving from her current one and acting promptly if an issue arises.