To put in a complaint against NHS

[Vanillaisboring666]

My beautiful 14 year old dd attended hospital Tuesday last week to have her ACE stoma reversed . It was a simple 20 min procedure that was class's as day case surgery. We arrived at 8am and she went down to theatre at 12pm , arrived back onward at 1pm . At 230 pm she was discharged . She was un comfortable but managed to walk to car . Upon getting in car began to cry saying she was in a bit of pain . I got her home and into bed and gave paracetomol as per hospital instruction. At 4pm she was in agony and sweating. Took her to A&E as day case unit advised on phone they would be closing at 8pm . Anyways 2 hrs in a&e she was sweating , breathing fast and writhing in agony. After 2 hrs a paed doc came and gave oromorph and placed her on paediatric ward. She stayed overnight and was given regular oromorph but she was still In agony . The sister the next morning said it was post op pain and told me to take her home amd have a duvet day and give paracetomol. By this point she could not walk and looked gravely I'll with sweat running down her face. I took her home and once again tucked her up in bed. At 4pm wednesday (day after her stoma reversal ) she was in absolute agony so I called gp and he prescribed oromorp and we gave it her overnight. Thursday mornine she was unable to lift her head and gp advised over the phone i ring an ambulance . Ambulance arrived (after 1.5hrs) and she was once again took to a&e . A gastronsurgeon came immediately and she was then rushed to theatre . I was signing consent forms running along corridor. It was terrifying. Anyways she ended up having a full blown laparotomy after the attempt at doing surgery laparoscopically failed. She has 4 laparoscopically incisions and a huge vertical cut down her tummy from laparotomy and also a cut on right side of tummy from her ace reversal surgery and initial ace surgery. She has been through hell. She was on itu for two days and is now on ward but is still critically ill as having temps and heart rate fast. The surgeon who did the ace reversal was never informed dd was readmitted by the ward and has profusely apologised as he said this should never have happened. He is going to be looking into why he was not told dd was back in hospital with pain 4 hrs after his surgery and why the bloody hell she was discharged in such a terrible state the next day when she was very obviously seriously ill. She is so so so poorly now and is still critically ill amd at risk of sepsis . She will be getting ct scan tomorrow as nothing is bringing down her temps . I am furious she was made to suffer such pain for 48 hrs and has ended up needing full blown laparotomy. If her surgeon had of been informed on the Tuesday he said he could have managed to do surgery laparoscopically. Instead he said her abdomen was so full of puss and poo he had to open her tummy from top to bottom. I am heart broken and not coping well with seeing how much pain she is in. I am strong in front of dd but have to go to toilet amd cry every now and then. We have a huge long road ahead to get her better but I am now starting to realise just how appallingly she has been treat by the ward who initially discharged her. No doctor even examined her before discharge and the sister said it was post op pain amd to have a duvet day and paracetomol ? I can tell the hospital is shitting themselves as they rolling over me and dh now . Even my dds consultant has admitted this should not have happened amd has apologised . He came to see dd twice a day Saturday Sunday despite it being his day off. I pray to god she recovers as docs say she is still critical and may need more surgery amd to go back to picu if her temps don't drop. Sorry it's so long and I hope it makes sense. I'm in bits and can't believe our wonderful nhs could have gotten something so wrong. A routine simple procedure has ended up with 8 hrs of surgery ,paed intensive care for two days,severely in pain child that is bed bound ,catheterised and has no clue just how serious this situation is. Her whole abdomen was filled with puss and poo and her bowel had ruptured . According to ward sister though it was post op pain and all she needed was paracetomol and a duvet day. My dd is so lovely and never complains so I knew something bad was wrong but the sister said she knew best and discharged her ??? AIBU in going to pals ????

I don't think you have to decide yet but it would be prudent to get what happened down in note form with times and dates while it is still fresh in your mind.

I worked in complaints and would hope that the hospital takes complaints and incidents as an opportunity for improvement. I've personally made complaints about my own children's care that resulted in changes that would have helped future patients. It's not always an adversarial motive behind complaining.

I hope your daughter makes a good recovery and gets everything she needs for the road ahead.

I feel so angry at the nurse after hearing this story. I'm sure there were factors (overcrowding, overworked, etc) that led to the oversight, but the image of someone insisting the poor girl head home with Paracetemol while in that kind of distress is appalling.

I have no medical advice but just wanted to add I'm sorry your daughter and yourselves are going through this, it must be an absolute nightmare. Thoughts with you all x.

As others have said the Consultant will likely have raised this as a serious incident which would trigger an internal investigation. You should be able to get results from this but it will take a long time.

It would absolutely be justified for you to raise your own complaint with PALs. They are generally very good and thorough and will feedback to you.

Your poor daughter!

Another nurse here who thinks you should complain, I am really sorry that this happened.

Definitely put in a complaint this is malpractice. So sorry your daughter and you have had to suffer needlessly. Terrible. I hope she gets better soon xXx

Also a nurse here who thinks you should complain. Hope your daughter recovers well.

Your poor daughter... hope she turns a corner really soon.

I would hold off making a complaint for now- both because you're clearly feeling very emotional, and won't get your point across as clearly as you might like, but more importantly because at the moment it seems that your surgeon is working with you, is addressing the cause of everything and has apologised. I think if you have someone powerful advocating for your daughter, that's more effective than anything PALS will do. Often you achieve more by working with the team to get answers than placing yourself against them. Questions I would be asking (but not right now, focus on you getting rest and your daughter getting better) would be what team was your daughter admitted under and why wasn't she admitted under the Paediatric surgeons? In my experience it's often difficult to get get surgeons to accept a child under their care, and if that has happened then what are they going to do to address that culture and make sure no one else falls through the gaps. Who was the most senior doctor wo reviewed her on readmission? It's very very unusual in the UK for a sister to have discharge powers in paediatrics, so who actually made the decision? Did your daughters observations at the time suggest that she was getting sick? Often kids don't show signs until much later, but it should definitely be looked at to see if something was missed. And finally, what have they learned, what further steps are they taking to stop it happening again?

I think you are within your rights to complain, but it sounds like she is now getting excellent care and this is all being looked at- if that is the case, a formal complaint is not going to add anything, and you may find people become more defensive when dealing with you- its human nature that if you know a complaint is in and the notes will be scrutinised that most people will try to avoid unnecessary interactions and minimise conversations with you to keep out of it- not the consultants, but many of the day to day staff who most of your time will be spent around. Once you're through the worst of it, if your questions haven't been answered, then your complaint will also have more weight because you've tried to work with them along the way.

Okay, you should definitely complain. This is terrible and needs a full review.

However, I wouldn't blame the Ward Sister. She will not have the authority to discharge your daughter home, that will have been decided by the doctors and she will have just been the person who relayed the information. I'm guessing your DD was reviewed on a ward round and then the nurse will have been left to handle the discharge.

The issue here (from what you have said) is that her surgical review was either inadequate or never actually happened.

I'm so sorry you're going through this.

Complain - the treatment by the ward sister was disgraceful
Thinking of you and your daughter

Another nurse saying complain. How dreadful. Certainly go to PALS, but is it also worth you keeping a 'diary' both of the sequence of events so far whilst fresh in your memory, and her day to day care going forward?

The ward sister rang the sho/registrar whilst I stood at nurses station and asked if she could be discharged. He said yes over the phone without seeing her . I heard the whole phone call as was stood beside the sister. Her temps had been consistently high overnight and oromorph was given every 2-4hrs overnight and in morninG of discharge. The ward sister did say to my dh earlier in the morning (8am ish) that they were full to bursting on ward and she discharged her after phonecard to paed doc at 2pm

Yanbu to complain. This needs dressing because your DD has been through something horrific and unavoidable and they need to put measures in place to ensure it doesn't happen again.

However I'd hold off on complaint until you are strong enough. Right now you're understandably scared and angry. Your complaint needs to be measured and factual.

If there's PALs onsite I'd visit and tell them you need support but won't be logging complaint yet.

Sending you prayers and strength

Don't be put off complaining, it needs to be recorded and no one would avoid talking to you because of it. That would be incredibly unprofessional.

I am a big advocate of using PALS, certainly in my trust, they are non adversarial and can be a really positive influence on a potentially difficult situation.

Sorry that should read the ward sister asked doctor over phone if she could discharge dd . I never asked for her to be discharged

Sorry - horrific and avoidable

Thank you for your advice and support. I guess I just needed to vent and let out some of my feelings. It's been the worst few days of my life . I'm beyond exhausted and have the worst headache ever . I just can't get rid of it ? We are literally living hour by hour as one minute she is fine amd the next all her machines are beeping and buzzing and docs n nurses are called etc etc it's truly terrifying and I just don't know if she will make a full recovery and how it's going to affect her longterm ? Consultant said this next 3 months is going to be critical and she is at serious risk of bowel rupturing again . If she makes it to 3 months then we next hope she makes it to a year and so on and so on. He said she has a lifetime risk now of it happening again but with each year that passes the risk lessens but it will ALWAYS be there . This all could have been avoided if she had of got surgery the night she was re admitted after the initial day case surgery. She has been through and continues to go through hell. She doesn't deserve this . She is the sweetest girl

Sorry your daughter has bee through this - it sounds like an awful time for your whole family.

Have they mentioned duty of candour?

This involves a conversation where they explain that something went wrong tell you that they will be Doing an investigation and that you will be invited in once it is complete to discuss the report?

A disclosure conversation will be followed up in writing within 10days.

If they are following this process it is already being taken seriously and complaining at this point is probably a waste of you effort (writing decent letters of complaint takes time). I would be inclined to wait and see what the investigation turns up and what they do in response.

I know my trust and department take things like this really seriously and lots of soul searching and thinking goes on to try to prevent the situation recurring.

I'm so sorry for what your DD has been through.

When you're able to please put in a complaint. The NHS do wonderful work a lot of the time but that doesn't mean they can't learn from mistakes and this needs to be addressed so it never happens again.

Oh, and a complaint won't affect your treatment at all (in fact sometimes it can really help) but doing it is time consuming.

Yes, you are allowed to be fucking angry. I'm angry on your behalf. I love the NHS, I think it is one of the great Humanitarian institutions of the world which proves we are civilised.

Go to PALS. The nurse who dischard your dd got it wrong, and getting it wrong when you 're playing with people's health is very serious and should be reated as such.

I'm really sorry you're in this situation. I don't think you'll need PALS specifically, because they often get involved when you can't get a response that is satisfactory at ward/ local level. That doesn't mean a complaint shouldn't be made, but it sounds like an effective complaints process is already underway, and I would give the Consultant time to treat your DD and get back to you with the result of that.

When a Datix is raised, it is circulated to a variety of senior managers, according to its nature. One person will then be assigned the 'data handler'. That person will conduct the investigation into the subject of the Datix, but it takes time. In your DD's case, they may decide they need to look at:

• The case notes
• The Operation notes
• The Recovery notes
• Any notes made regarding her stay on the ward on the day of discharge

They may then want to talk to, or get a statement from, the nurses and doctors involved in her care on that day, and anyone involved in the decision to discharge, etc.

Then they would look at the subsequent admission, the time elapsed, the symptoms noted,
and the treatment that was needed when she was admitted.

That takes a huge amount of time to look at, as it's so complicated. They will have to try to work out if your DD was showing enough signs of infection or serious illness that she should have been kept in or reviewed by a doctor prior to discharge, or if it was reasonable to decide that her symptoms were due to discomfort, as they seemed to think at the time, sadly.

I work for the NHS and realise why these things can happen, but it is in no way acceptable. You should definitely contact PALS as this is a "never event" ie should never have been able to have happened- there should be steps in place to make it impossible when a patient is obviously so seriously ill to be discharged.
By going through the official channels, it has to be fully investigated and dealt with properly and they have to inform you of the outcome. I would hope this would happen anyway, but having more official complaints helps to highlight the lack of resources available which are not an excuse, but definitely a factor in how situations like this.

Doing so may help you process what's happened as well? Having the chain of events explained to you could possibly/probably make you more angry initially, but by creating a problem for the NHS by complaining, in the long-term it should hopefully facilitate a solution- be it staffing levels, flow chart protocols or whatever. I would hope having done something proactive might help you feel a bit more in control of a situation you unfortunately have to observe and suffer as you can't physically make your DD better yourself.
This is my opinion of the situation but can only imagine what you're going through. I hope this hasn't been an unhelpful comment. Above everything, I wish your DD a speedy and full recovery; and hope the months ahead become less stressful for you. Take care x

Please do complain. You can put in all of the good parts as well but the major failures need to be highlighted to prevent this happening to someone else. Complaining is not the same as suing. I wish you all the best and hope she is better very fast.

Until very recently I used to work in a field relating to NHS complaints so my advice would be:

Yes, make a complaint. What you've described is very bad, in terms of severity and potential consequences. However you don't have to do it now, or even in the next month. When you're ready is fine. However if you think you'd like some support go to PALS now for that.

The only thing I would do is make a note of any of the names of relevant staff you can remember now, together with exactly what they said, and what time, as that's the sort of thing that can fade quickly from your memory particularly if you're under such stress. If you're not sure about names make as detailed as physical description as you can. For people like the consultant it will of course be easy for the complaints dept to identify them, but if it's just 'a nurse said this' it can be surprisingly easy for them to wriggle out of being definitively identified.

When you do get to making the complaints you can either go via PALS or directly to the hospital/trust. They usually prefer you to put your complaint in writing but they should allow you to do it via a phone call if easier for you. You don't need a solicitor or advocate but can use one if you wish.

Most complaints take aaaaaages to be processed. The timeframe target under relevant guidance is 30 days to receive a final response - most, particularly if they are very complicated, take a lot longer - like up to two years longer. Yes, that's a disgrace.

Depending on where you live, once you receive a final response, if you're unhappy with it you can either choose to take legal action, or take it to the Parliamentary Health Services Ombudsman, or devolved equivalent.

hope dd gets better soon