Saturday, April 25, 2009

Girl, 3, has NHS heart operation cancelled three times because of bed shortage

A three-year-old girl awaiting heart surgery has had her operation cancelled three times this month because of a shortage of beds. Ella Cotterell was due to have aorta-widening surgery on Monday at the Children’s Hospital, Bristol. But 48 hours beforehand, the operation was cancelled for the third time as all 15 beds in the intensive care unit were occupied, her parents said.

A hospital spokesman said that procedures would be reviewed, but the case highlights a growing problem of cancelled operations in the NHS. More than 57,000 surgeries were postponed for non-clinical reasons, including a lack of beds, last year – 10 per cent more than the previous year. Latest figures show that the problem persists. At least 43,000 operations were cancelled in the first nine months of 2008-09, with nearly 1,800 patients not being treated within 28 days of their original scheduled date.

Among the excuses for cancellation the previous year were a hospital running out of shavers to prepare patients for surgery, a surgeon going missing following a fire alarm, and a patient’s translator failing to turn up.

Ella needed open heart surgery when she was nine days old to repair her aorta, the body’s main artery, which had not formed properly in the womb. At 18 months old she suffered a stroke after falling down the stairs at her home and banging her head, temporarily paralysing the left side of her body.

Her parents, Ian Cotterell and Rachel Davis, were told last October that she would need an operation within 12 to 18 months. Doctors carried out two angioplasties, where small balloons are inserted and inflated to clear a blocked blood vessel, but neither was successful. Further surgery was initially planned for April 2 but was cancelled because of emergency cases and rearranged for four days later, the couple said. However, the operation was cancelled again for the same reason.

A third date was arranged for April 20 and last Thursday Ella went to the hospital for tests. On Saturday her parents received another call explaining her operation would have to be cancelled. Ms Davis, who works part-time as an accident and emergency nurse at the Frenchay Hospital in Bristol, said that she was devastated when she was told there were not enough beds. “My husband and I were in tears,” she said. “When our six-year-old son Liam asked what was wrong we told him Ella’s operation had been cancelled again and he said we should tell Gordon Brown.”

The family are waiting for another surgery date. In the meantime, Ella is having to take adult doses of medication to control her blood pressure. “We have asked the doctors if she really needs the surgery as she is so happy at the moment and is running around like a normal little girl, but she could drop down dead at any moment,” Ms Davis said. “Twice I have been told that she may not make it through the night and there have been times when I have gone into her room in the morning and wondered whether she’d still be breathing.

She called on the Government to put more money into the NHS before a child died on the waiting list. “I have worked in the NHS for 22 years so I know what happens in hospitals,” she said. “I cannot fault the doctors and nurses for all they have done for Ella – she would not be alive today without them. “I believe Ella is the tip of the iceberg and that there are many other families out there that have had their operations cancelled many more times but have not spoken out about it. “This is a national problem, there are not enough resources in the NHS and it is about prioritising. “It is a matter of time before a child dies on the waiting list and I don’t want it to be Ella. If that does happen the Government will have blood on their hands.”

Michele Narey, of the University Hospitals Bristol NHS Foundation Trust, said that she could not discuss individual cases. She added: “The decision to cancel any patient for any procedure is taken extremely seriously but is sometimes unavoidable because of the need to effectively manage emergency patients requiring beds on a day-to-day basis. “We know that cancelling procedures can cause additional stress for patients so we will always seek to avoid this wherever possible.”


Australia: The charming NSW government ambulance service again

Culture of sarcasm familiar to another victim

THE sarcasm and insensitivity of ambulance call operators towards dying teenager David Iredale is all too familiar for Gareth Redshaw, who was called a "blatant hoaxer" when he called for help minutes after the Waterfall train disaster. Mr Redshaw, then 19, managed to kick a hole in the glass door of the overturned train carriage and climb up an embankment to call triple-0 from his mobile phone about 7.30am on January 31, 2003.

But the operator who took his first call told a clearly distressed Mr Redshaw that his story was unbelievable and a second, more senior operator also accused him of a hoax. In alarming parallels to evidence given at the inquest into Mr Iredale's death, call operators behaved as if Mr Redshaw was a teenage prankster when he could not provide an exact location of the derailment, which occurred in thick bushland between Waterfall and Helensburgh stations.

The Ambulance Service later apologised for questioning the validity of Mr Redshaw's calls and he was told by divisional management that operators would be given more information to help them distinguish between genuine and hoax calls. But yesterday Mr Redshaw, now 25, said the organisation had clearly failed to implement measures that would ensure the situation did not arise again. "I was promised that the issue of failing to deal with people who couldn't provide a cross-street would be rectified and I am disappointed that management has again failed to act. "The whole culture of the ambulance service needs an overhaul."

Mr Redshaw later told police attending the scene the operators "didn't seem to understand that it was on a railway". "They were saying, 'What suburb, what street' and I was saying there was no suburb, it's on a train line, the train's derailed." But a recording played at the special commission of inquiry into the disaster shows the two operators were sceptical.

Leyla Spinelli admitted she did not take the call seriously as she had found the idea of a whole train overturning "incredible". She had been suspicious after a spate of similar prank calls in the days before the accident and because Mr Redshaw's mobile number did not show up on her screen. "You rang up yesterday and told me … about someone hurting themselves in Queanbeyan, didn't you?" He said: "Queanbeyan? No, I told you I'm serious. F---in' train derailed here."

When Brad Deering took over the call he said: "Gareth, you're not mucking us around, are you mate?" and "Well, if this really happened the railway will know about it."

An Ambulance Service spokesman said procedures for incidents in remote or isolated areas with no street address were changed in 2008.


No comments: