24 February 2016
Hospital’s Weekend Scan Policy “Highly Unsatisfactory”
A recent tragic case of mine clearly demonstrates how some hospital weekend policies can lead to potentially devastating consequences.
I’m currently representing the family of a 69-year-old woman who died after she was not admitted to hospital and a potentially life-saving scan was not carried out urgently.
She was referred to Tunbridge Wells hospital in Kent late on a Friday afternoon for emergency treatment in April last year after her GP suspected she had a dangerous bowel obstruction.
But after she was diagnosed with a urinary tract infection and constipation, doctors failed to conduct a CT scan which would have identified how seriously ill she was because it was not “hospital policy” to offer the scan at the weekend unless it was an emergency.
Her inquest was told that she was instead discharged with a prescription on Friday night and asked to return for the scan on Monday. Tragically, she collapsed at home on the Saturday and was rushed to Maidstone Hospital where she died at around midday.
In a damning ruling, the coroner at her inquest said that delays in diagnosing her condition were “critical” and that doctors should have realised the gravity of her situation when she arrived at A&E and arranged for a CT scan “as a matter of urgency.”
He said: “Arrangements should have been put in hand for the CT scan to have been carried out on the 17th/18th April 2015 due to the emergency situation that had occurred.
“It is highly unsatisfactory that facilities for the CT scan to be carried out at the weekend at Tunbridge Wells hospital (Pembury) are not routinely available without having to go through a number of steps for this to be arranged. In this case, the delay until the Monday was critical as the outcome has sadly demonstrated.”
Her death was recorded as due to natural causes “as a consequence of the failure by the Tunbridge Wells hospital (Pembury) to correctly diagnose and treat” her when she arrived at A&E.
The coroner has demanded urgent action to prevent future deaths and spare more families of having to sit through inquests listening to how their loved one was so badly let down in their hour of need.
This case poignantly illustrates how a specific policy can lead to tragic consequences. This tragedy must be a catalyst for improvements so that processes are put in place - both at the trust, and across the NHS - to prevent a similar incident happening to another family.
An analysis of 14 million patients admitted to hospitals in England in 2013-14, published last year in the Journal of the Royal Society of Medicine, suggested that those admitted to hospital over the weekend were at a greater risk of dying within 30 days than those admitted during the week.
The study, which was authored by researchers from University College London, revealed that around 11,000 more patients died within 30 days of being admitted to hospital between Friday and Monday than those who arrived on a Tuesday, Wednesday or Thursday. One of the reasons cited for the high number of deaths was the fact that fewer hospital consultants were available on Saturday and Sunday. Some argue that not only is the NHS mortality rate higher at the weekend but efficiency is impaired due to the absence of consultants to make critical decisions.
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