National Concern for Healthcare Infections

Going into hospital

How to help yourself:

These days going into hospital can be scary enough with all the stories of infections but you can try to help safeguard yourself by following the small tips we have put together.

vBefore entering hospital buy antibacterial soaps & washes from any reputable high street pharmacy.

vUse them before, during and after your stay in hospital .

vBuy any antibacterial wipes such as Parazone or Dettol and take those in with you.

vUse them to wipe down any surfaces ~ bedside cabinet ~ telephone and specially in the bathroom area such as the toilet seat.

vTake in with your slippers and ensure you wear them at all times do not walk around in bare feet.

vIf on admittance the area around the bedside is dusty or dirty then insist it is cleaned immediately.

vInsist at all times the healthcare workers and visitors always wash their hands and use the alcohol gel before and after attending you.

vDo not be afraid to insist on these things it is your right to safe guard yourself.

vDo not out up with soreness & discomfort, tell someone immediately and keep on telling them.

vRemember you are the expert in your own body or that of your loved one.

Above all if you feel that the healthcare workers are not taking any notice or are making you feel like you should not be complaining then ask to speak with the ward sister in charge or the manager. At the end of the day they want their hospitals running properly.

Contraction

What to do next:

Firstly if you are told (which sadly is not often the case) that you or your loved one has contracted the infection in the hospital environment, this is what you are entitled to do:

► Find as much information that you can from the health care workers assigned to looking after the      patient.

► Contact the infection control team within the hospital.

► Make an appointment with the Consultant in charge of the patient, do this by ringing the secretary and      booking an appointment this way the time will be allotted and not just taken from the time in ward      rounds.

► Be insistent on being told the whole story do not let the fob you off.

► Make sure you write down all the questions you will need to ask and ask them over and over again the      question is answered.

► Ensure that all Infection Control Procedures are adhered to by both staff and visitors alike ie: washing      hands before and after visiting, sanitising surfaces.

► Ensure anyone with broken skin, skin abrasions or open wounds has them firmly covered up and does      not touch the patient concerned.

If you find out about HCAI after the patient is discharged from hospital still infected
then there are also several things you can do:

► Again ensure all Infection Control Procedures are being practised by healthcare workers, family members and visitors alike.

► Contact the NHS direct line to get the number of the infection control team working in your area and get advice from them.

► Again contact the Consultant under which care the patient was discharged from and make an appointment to see them.

► Contact the patients GP and make sure they know what is happening and if they know about the HCAI.

► Ensure that the patient is given a healthy balanced nutritional diet this will give their immune system the strength to fight off the infection.

Help the aged and age concern can also help if the patient lives alone.

A Patients rights

What to do next:

From the start of your complaint you have 6 months to lodge a complaint against the trust involved. You also only have 3 years in which to lodge litigation

► Start by writing a letter of complaint to the Chief Exec of the hospital and also copying the same letter to the Chief Exec of the Trust. (this is the same route as PALS but might have the effect of getting them moving quicker)

► You have 6 months, although some trusts may waiver this rule on the grounds you were too bereft by the loss to do anything

► Write to the Medical Records Office requesting notes:- ask for nursing notes/doctors notes ~ daily communication sheets ~ lab reports/results and any other ancillary notes NB you may be charged for this although it has been said if you have already started a complaint they may be free of charge ~ but if you request before starting the complaint you are more likely to get the full notes

► When the notes arrive they will be in no sequence of order ~ try not to read them but out them in some kind of order ie nursing notes ~ doctors notes ~ lab reports/results and so on. Then put them in date order it will then be far easy to track back

► Meantime having sent your letters of complaint, they have 20 working days to reply back to you. Please be aware they will try to drag their heels and it could be anything up to 6 months before they finally complete their investigations. At which point they should ask you to meet with them

► Involve your MP this might have the effect of getting them to move quicker

► If after meeting with them and you don’t feel the investigation was resolved to your satisfaction then they have to mandatorily advise you to move to the next level which is the Health Care Commission (HCC) ~ this is mandatory duty for them and they breach NHS complaints system protocol if they fail to do this.

► If at this level if you are still not satisfied with the findings of the HCC then you will be asked to go to the Health Service Ombudsman

► During any time of your complaint you can ask your case to be forwarded to the NHS LA with a view to compensation. This is the legal department and are the only ones who can award compensation.

Also get your local newspaper involved your local MP will be more interested

in sorting your case out then.

September 2005

A full and comprehensive guide to the complaints procedure can be found as a pdf file here .

We now have on board a member of N C H I who can help translate your loved ones notes. If you are experiencing difficulties in deciphering the medical jargon please send an email outlining the query and they will get back to you as soon as possible. Please email info@medicalnotes.com

Attending an inquest

When someone dies it can be very distressing to hear that a post-mortem has to be carried out. The Coroner’s Clerk will normally contact the family within 24 hours of a death to inform them of this. In some cases, such as if someone dies within three months of an operation, it may also be necessary to hold an inquest. This news can be quite a shock when you already have enough to cope with, especially as in some cases this can delay the funeral. The next thing you have to be prepared for is A LONG WAIT. You will receive an interim death certificate listing the causes of death. Then eventually you will be contacted by the Coroner’s Clerk informing you of the date the inquest is to be held. A wait of at least eight months is not unusual. In the same letter they also suggest that if you require any further information you should contact them.

Make full use of this opportunity. You will be allowed to ask questions in court but ask anything you are not clear about such as courtroom procedure, whether witnesses will be called etc. You will normally be informed in advance if you will be called to give evidence yourself. You may be asked to put your concerns in writing for the coroner to consider before the hearing.

Next sit down and discuss with your family all the questions to which you want answers. Type them out so that everyone attending the inquest has a copy. This is important because it can be very distressing hearing a blow-by-blow account of your late relative’s debilitating and deteriorating condition. You become very emotional and if you haven’t written down some questions beforehand your mind could go blank just at the crucial moment.

When you are ushered into the courtroom you are shown where to sit and then everyone present is asked to introduce themselves. Relatives of the deceased usually sit directly in front of the coroner who sits higher up on a platform like a judge, although this may vary of course depending on the size of courtroom used.

First witnesses are questioned then the pathologist will be asked to read out his report. The coroner may also be required to read out a long detailed report from the hospital which can be pretty harrowing to listen to. Make sure you have some tissues with you.

Relatives are usually given several opportunities to ask questions both of the coroner and the pathologist. Do not be afraid to ask them questions, they are professionally impartial but actually quite caring and empathic people. Many of them are very concerned about the number of cases they are having to hear nowadays where the deceased has suffered a healthcare associated infection.

It is important if you can to take someone along to the inquest who can just sit and make notes, as you may need these later for litigation, or if you wish to write a letter of complaint to the hospital. If someone sits there with a shorthand notebook and a pencil writing copious notes and looking very efficient they have to take you seriously and be careful what they say. Write down all the medical terms used too, and ask the coroner to spell them if necessary, so that you can look them all up in a medical dictionary or on the internet afterwards.

At the end of the inquest the coroner will announce the verdict decided upon. They may suggest at this stage whether it would be advisable for the relatives to consider legal action or to whether they intend to write a letter of complaint to the relevant health authority.

As you leave the courtroom the coroner’s clerk may hand you or tell you the instructions for obtaining a copy of the final death certificate, and tell you the earliest date to ring up about this. The formalities usually take several working days. You can purchase as many copies as you want.

Reporters from the local paper may be in court and may approach you for a brief word after the hearing. You do not of course need to say anything to them, but they will report an inquest in any case so it might be helpful to have a brief written statement ready stating what you are prepared to see written about your late parent in the local press. They may also ask for a photograph.

Before you decide not to speak to the press just remember that any publicity to highlight the number of people who have a healthcare associated infection in this country will help to fuel the arguments of the NCHI team when they campaign on our behalf.

You may feel a great sense of relief once the inquest is over. Nothing you can do will bring your loved one back, but at least you should feel that you have tried your best to make sure their case was heard.

You may decide not to take any legal action as bereavement and all the attendant responsibilities can be physically and emotionally draining enough. You can, however, if appropriate write to the local health authority to express your concerns, and to seek reassurance that the hospital concerned has tightened up its infection control procedures in the meantime. The FAQs listed in NCHI fact sheet entitled Investigative Meetings using the NHS Complaints Procedure might be helpful if you decide to do this.