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NHS complaint: Yes or no?

(45 Posts)
boat Sat 11-May-19 15:59:39

I spent last Tuesday,or at least a huge chunk of it, at a hospital seven miles from where I live. I was there for 13 hours.

I won't go into details of why because I don't want to give any clues that might identify the hospital or department. Frankly I was only too glad to be there having waited a month for a GP appointment just to be referred.

My problem is not with my treatment. The staff, without exception, were professional, competent and lovely. It's the way the department operated.

A large number of patients had been called in for 7:30 am so we were all nil by mouth from midnight because every one was expected to have at least a minor operation.

It was chaotic! There weren't enough seats for the patients (let alone the relatives/ friends who had come with them because if you have a general anaesthetic you can't go home alone afterwards).

I heard people saying to each other, "This is organised chaos, isn't it?"

At 11:30 I was given half a plastic cup of water and told to sip it slowly. As it turned out I had plenty of time..

By mid afternoon there were only three of us left in the waiting room.

One guy had been rung up the day before and told he was first on the list. He was the main carer for his partner and had had to pay for two days care by a professional. The problem was there was no bed available for him. Eventually at about 4 pm they found one.

The other guy's problem really upset me. He had insulin dependent diabetes. He hadn't had an injection since the evening before and no food since midnight. Eventually they tested his blood sugar level and injected him. They sent him home and promised to treat him the next morning.

I went down to surgery at 4:30.

My problem is, can I complain on other peoples' behalf.

It seems to me that it would make more sense if there were two times for admission: Crack of dawn and late morning with different times for nil by mouth. What do GNers think?

notanan2 Sat 01-Jun-19 13:01:43


notanan2 Sat 01-Jun-19 13:01:31

They do do appointments. Just not for surgery lists as there is no way to stick to time slots as there are so many variables as to how long each will take. And how it needs to be ordered and prioritised changes even while the list is started.

Some people come out of surgery then need to go back in. Appointment slots would never work in the nhs as the only way to do it would be to give long slots to allow for all possibilities, and that would leave loads of wasted time when theyre quick. Wait lists would have to trebld

Eloethan Sat 01-Jun-19 12:32:05

The NHS doesn't operate a "normal appointment system" because there are many selfish and inconsiderate people - or, to give some the benefit of the doubt - people with issues that affect their ability to function normally.

Many hospitals and GP surgeries publish the numbers of missed appointments that they experience- and they can be surprisingly high. By booking in several people for the same or nearly the same time slot there is more chance that resources will not be wasted.

You can't really compare a hairdressers' appointment to a hospital appointment.

notanan2 Sat 01-Jun-19 11:16:40

Yes but even assuming you could get bumped up to first on the list. Which happens: people no show, havent stopped meds they were supposed to stop etc, most people should still be allowed to have water up until about 4 hrs before start of list. Not nil by mouth 12 hrs before start of morning list.

Some people will sleep past that window but many arent able to sleep well before ops and could have a drink in the early hours.

Not for all ops mind. Not the ones that need an empty gut, just the ones that need an empty stomach, which is most.

Lazigirl Sat 01-Jun-19 09:35:41

The nil by mouth policy allows hospitals to switch and arrange lists on the morning of operation, otherwise some would have to be cancelled I think.

notanan2 Fri 31-May-19 21:49:51

Not the research is already available that 12 hrs is only necessary for certain proceedures and not needed for most, even more than that, outcomes can be better when people are not routinely completely nil by mouth since the day before (with exemptions for certain abdomen / digestivs surgeries. but in practice there are still people who say 12hrs for no reason other than habit or erring too much on the side of caution

NotAGran55 Fri 31-May-19 21:22:09

5 years ago I had an operation to repair my abdomen following a previous appendectomy ( I had a mesh repair to a rupture )
Whilst waiting I was asked if I would take part in research into ‘nil by mouth’ prior to surgery as there was a school of thought that the time of abstinence was too long .
I had to answer a questionnaire before and after the operation.
I wonder how long the research project is running for ?

notanan2 Fri 31-May-19 18:40:04

There are some proceedures where the gut has to be completely empty and for those a long total nil by mouth period is needed.

For other ops though people only need empty stomachs so they dont vomit so there is really no need for them to be nil by mouth for 12 hours! 6/8 hrs for food and 4 hrs for water is plenty. Ask at pre admission for it to be clarified for your specific proceedure.

It does need an overhaul. No one should be putting ALL pre op people nil by mouth for 12 hours that should only be for specific cases

trisher Fri 31-May-19 16:02:59

My son benefitted from the no drinks beforehand policy when he went for an operation on his ankle. The woman due in before him drank water, so he was bumped up the list!

Lazigirl Fri 31-May-19 14:21:53

My OH had a similar experience when admitted for hip replacement. Everyone called early in the morning, but wasn't chaotic. All bloods etc and admission procedures carried out whilst people were in the waiting room. Advised it was difficult to give patients timed admissions as lists may be changed because of emergencies and so on. He was allowed a drink when he wasn't called by lunch time. This way it is flexible for the hospital and meant that wards were not used until post op giving time to discharge inpatients. This seemed the most efficient way in my experience.

notanan2 Fri 31-May-19 13:01:21

CTs can be appointment based. Its totally different and not comparable at all to surgeries

boat Fri 31-May-19 06:38:21

Hi Folks.

Thanks for all your advice and comments. I have gone down the PALs route.

I now have to have a CT scan at another hospital seven miles in the opposite direction to the previous one. They are saying no food, just fluids, for four hours before my appointment time at 3 pm.

It's all very educational.

notanan2 Thu 30-May-19 20:15:06

However nil by mouth policies do need to be reviewed. There is often no need to be completely nil by mouth from the previous midnight. And water is usually fine up until 4 hrs before. People should be advised if they can have a light early 6am breakfast instead of everyone having nothing since the day before

notanan2 Thu 30-May-19 20:12:28

You cant run an appointment system for surgeries. There really is no way of knowing for sure how long it'll take till they go in. It would be too wasteful to leave an operating theatre and full staff doing nothing because apt 1 was a quickie and the next "slot" person hadnt arrived yet!

GrandmaJan Thu 30-May-19 16:27:14

boat I worked as a nurse for over 42 years and although I can empathise with you I do understand just how these things happen. You wouldn’t have been made aware if there was a good reason for the delay due to patient confidentiality but one of the doctors could have been asked to deal with an emergency or perhaps a day patient may have taken longer to deal with due to complications. I frequently investigated complaints from patients and very often something like this can easily be explained.

Franbern Thu 30-May-19 16:19:46

As others have said, not a formal complaint, but a letter. However, as has also been pointed out there can be good reasons for needing everyone there to start with.
When I needed minor day surgery on my stoma, it was me that pointed out to the Consultant previously that as there were no nerves there I could have it done without anaesthetic.
Caused my own chaos with that, when it was finished, nurses kept trying to prevent me leaving without someone accompanying me, and I kept pointing out that I did not need anyone as I had received no anaesthetic.
When I went first thing in the morning, and realised I was not going to be done until afternoon, I asked if I could go back home to wait. As the Sister in charge knew me (I worked at that hospital), I was eventually given permission, being told to return by Midday. When I did return I queried why they had been so reluctant to let me leave for a couple of hours and was told it was because, when they had done this with other patients, they often did not return.
Yes, they do expect, and have to take into account, a lot of 'no shows'.
Nothing to be feared about with day surgery, Take a good book, and a bottle of water. Unless you have some sort of condition like diabetes it really does none of us any harm to go a few hours without eating.

MawBroonsback Thu 30-May-19 11:22:40

Others may have said this already, but if not, contact the PALS department at the hospital.

Fennel Thu 30-May-19 11:20:47

I've decided to take s bottle of water with me. My letter does say I can have fluids before the procedure.

boat Thu 30-May-19 04:45:12

Hi Fennel

I hope it goes better for you and it probably will. Most of the hospital experience is good and at least is interesting in some ways.

Missfoodlove Wed 29-May-19 13:16:33

I took my 88-year-old mother for day surgery at a local hospital.
She had been nil by mouth from midnight by lunchtime she was sitting not having been seen and was parched. I asked the nurses if she could have a cup of tea she said yes and would organise one when the volunteers came in to make it. They all had cups of tea as they shuffled around in scrubs moving pieces of paper around.
So they had 14 people all of whom were told to attend the hospital at 8:30 am even though they would not be seen for hours.
Why can the NHS not operate a normal appointment system?
My hairdresser does it and I’ve never had to wait

Fennel Wed 29-May-19 11:40:23

I'm due to go for day surgery on June 18th - dreading it even more now hmm.

trisher Wed 29-May-19 11:09:47

Please do complain. I did it for my mother when she was in a day ward a few years ago. I complained straight to the hospital (there will be a complaints procedure you can get) I emphasised what had been good about her visit, said what wasn't and made suggestions about how things could improve. They sent me a lovely reply saying the unit was new and they were trying to improve it. My complaint included the lack of proper seating , mum had significant back damage and found sitting for long periods difficult. I think hospital administrators are not the monsters they are sometmes made out to be, they just don't use the service themselves and if you don't tell them they don't know.

Whingingmom Wed 29-May-19 10:18:19

Incidentally, it is only necessary to be nil by mouth for 4 hours pre general anaesthetic. The stomach is empty of contents after 2-3 hours, so 4 hours is ample to negate the risk of accidental inhalation of stomach contents.

harrigran Mon 13-May-19 08:45:14

Our hospital is quite specific, relatives should not sit and wait for day cases, they should leave and return later in the day. If everybody took someone with them it would be chaos.
Last time I had surgery I arrived at 7.30 but did not go to theatre until 4pm. I arrived in a ward at 10pm.

DillytheGardener Mon 13-May-19 08:20:59

I have had this same experience through several minor surgeries I have had with the NHS. It makes recovery so much harder when you feel weak and depleted before even having the surgery from being terribly thirsty and hungry. The last surgery I had I nearly walked out I was so fed up and thirsty.
Do complain, it’s a miserable experience.