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By listening to our patients' stories, we can understand more about what really matters and, where needed, improve the quality of our services.
This is why we have introduced patient and carer stories to all our Trust Board meetings, and at a variety of Trust meetings and training. These stories seek to:
(not her real name) is a 67 year old, retired teacher who lives in Sherborne.
In 2017, Amelia experienced two sudden bereavements (her mother and her five
year old dog, which leapt over a ledge on to a road) and, additionally, a 27
year relationship breakdown. These events took place over a three month period,
leaving her feeling alone, empty and bereft.
evening in October 2017, Amelia drove to The New Forest, with her new puppy.
She drank half a bottle of gin and waded into the river, with the intention of
drowning herself that night. Thoughts of her daughter and family prevented her
from further self-harm that evening and somehow 48 hours later, she managed to
drive to Worthing to stay with her family.
stayed with her daughter and family for the next three weeks. She suffered from
severe panic attacks and dissociation; she couldn’t talk, eat or sleep. Her
daughter started to become severely concerned by Amelia’s behaviour and mental
state, and contacted the West Sussex Mental Health Team and local GP Practice.
Within days, Amelia saw a Psychologist from the local Community Mental Health
Team; she also saw the GP Practice’s Counsellor many times over the 3 weeks.
her meetings with the Counsellor and the Psychologist, they made contact with
the Sherborne Older Persons Community Mental Health Team (OP-CMHT), as Amelia
wanted to move back home. At first, she was reluctant to meet with the team, as
she didn’t want to expose herself, following her teaching roles in local
schools. However, following conversations with her daughter, Amelia agreed to
meet with the team, and her daughter made the initial appointments with Dr Sue
McCowan, Associate Specialist, and Katie Higgs, Community Mental Health Nurse.
McCowan visited Amelia at her home regularly, and would discuss various things
with her and review her medication when Amelia felt it was needed.
the first few months with the service, whilst Amelia still had suicidal
thoughts, she was seen twice a week by Katie. When Katie couldn’t attend, she
would be notified and someone else would visit. Amelia felt that Katie
understood her creative nature; she got her to do things and would make
something of their conversations, mirroring Amelia’s comments back to her.
Amelia describes the visits as ‘helping
me to understand that tiny improvements were very good, Katie became a sort of
touchstone to help me ground myself through the darkest of days.’
felt that both Dr McCowan and Katie were absolutely incredible, supportive and
diligent about her needs. They knew the ideal time to say things to Amelia and
trial certain techniques and methods with her. Specifically, they found the
optimum time for Amelia to begin psychological intervention with Psychologist,
Dr Theo Roberts. Amelia commented how this was seamless and perfectly timed
early 2018, Amelia started her appointments with Dr Roberts. She originally
found it hard to meet with him at Stewart Lodge, but, in time, realised that
the space was less important and the time she spent with him was more valuable.
For her, this was an indirect form of healing. Amelia found Dr Roberts’
sessions practical and compassion-focussed. Dr Roberts was able to accommodate
Amelia’s antipathy for diagrams and used a slightly different approach.
had in excess of eight sessions with Dr Roberts; some had long periods of time
between appointments, owing to room demands, whilst others were regular weekly
sessions. However, she found the larger gaps gave her time to reflect on what
they had discussed and allowed for her to go camping and “live”. Amelia
describes her sessions with Dr Roberts as him “lighting the wick, and she would
let it burn.”
had her last session with Dr Roberts on 12th November 2018 and had
her last appointment with Dr McCowan on 7th November 2018. She now
believes that she is in a more positive place and has a far better and clearer
sense of understanding herself, and a more contented outlook on her life than
before her mental health deterioration.
reflecting on her initial journey with Sherborne OP-CMHT, Amelia described it
as ‘being in a frightening and
intimidating jungle, where everything was going to hurt me.’ She described
the sensation that each person she worked with was carrying her above their
heads, supporting her and thinking for her; whilst not disabling her in the
journey, but more enabling her to take responsibility for her recovery. Amelia
also felt that the team had such a cohesive way of working with her, where each
member of staff involved fed into her care and ensured it was joined up –
everyone knew what was happening and when.
Amelia cannot fault the care, compassion and treatment she received from everyone at Sherborne.
The OPCMHT was delighted to receive such positive feedback regarding the journey this lady experienced with our service.
The response will be shared with the wider team, across both sites and also with teams within the North Dorset Locality through the Team Leaders Meeting, in order to highlight good practice.
It is recognised that it is fundamentally important to ensure there is a good liaison and continuing discussion between all teams within the wider Older Peoples Service, in order to promote the person using the service feeling empowered, supported and enabled in their recovery, as occurred in this case.
Mr Davies was delighted to be able to tell me about his story with
regards to his experience as a carer to his late wife, who passed away on 31st
December 2016 in the Jean King Suite, The Willows at Yeatman Hospital.
Davies’ wife was a retired midwife who was diagnosed with advanced breast
cancer. After receiving treatment for six months at the MacMillan Unit at
Yeovil Hospital, Mrs Davies was given the ‘all clear’. Mr Davies’ describes his
experiences of the MacMillan Unit as exemplary.
Davies subsequently suffered from a convulsion, which lead to a scan and she
was found to have secondary cancer in her liver and brain. Mrs Davies
immediately went to Bristol Hospital to receive a course of treatment, but she
was unable to go back to continue with the treatment as she became too ill.
Mrs Davies became very poorly whilst she was at home, her and Mr Davies made a
joint decision that she could no longer continue to stay at home as she unable
to move. Mr Davies stated that their General Practitioner made sure that Mrs
Davies was admitted to Yeatman Hospital, as it is their nearest local hospital.
Davies recalls various feelings of uncertainty at this point. He recalls the
doctor on the ward sharing with him that doctors ‘don’t get training on how to
give bad news’. He also recalls being told, by an outside agency, that the ward
wasn’t suitable for end of life care. There were discussions around care
packages from Marie Curie, but the correct package was not available. A nursing
home was suggested and Mr Davies visited some nursing homes, but he and Mrs
Davies really did not feel comfortable or happy with the idea of a nursing
home. With all of these feelings of uncertainty, Mr Davies was very well supported
by the nursing staff on Rowan ward and was encouraged to speak to the Matron
about his concerns. Mr Davies wrote to Anne Hiscock, Matron at Yeatman Hospital,
and she immediately visited him on the ward. Anne immediately made it possible
for Mrs Davies to stay on the ward, as per her wish. Mr Davies was reassured by
Anne and the staff and he describes Anne and the team as kind, caring,
compassionate and they could not do enough for him and his family. Mr Davies
has a disabled son and another son, along with two grandchildren. He recalls
the nursing staff always asking after them all. He recalls always being
directly asked himself if he was alright and if he had eaten etc.
Davies was at The Willows for three months. She enjoyed being in the bed next
to the nurses station, as being a retired nurse and midwife herself she could
engage in what was happening around and have friendly conversations with the
nurses. Towards the end of this time, she decided that she would like to be
moved to the Jean King Suite (purpose built end of life suite) within the ward.
Mr Davies describes the suite as a lovely personal suite with an en-suite and
kitchen. Sadly, Mrs Davies passed away on 31st December 2016.
after Anne approached Mr Davies to ask him if he would be interested in joining
a Bereavement Café/ Group that she had set up. Mr Davies’ first thought around
this was did he really want to talk about his late wife and what had happened.
However, he decided to go along and found that the group was nothing like he
had envisaged. It was a group of people getting together for coffee, cake and a
chat but they all had a common factor and were able support each other and be
there for each other, week upon week. Mr Davies feels that the Bereavement Café
has had a huge positive impact on his life and he doesn’t know what he would do
without it. The group meet weekly and are joined by a voluntary nurse and
voluntary Health Care Assistant. They talk about all kinds of things and are
even planning a day trip out together later this summer. Mr Davies wanted to
highlight the time, dedication and compassion that the voluntary nurse and
Health Care Assistant give to the Bereavement Café.
It is always so rewarding to receive such positive feedback from patients and their loved ones.
We all take huge pride in all aspects of our clinical care here at the Yeatman, but end o life care is a very special and intimate element of nursing, which we view as such a privilege to deliver.
We continuously strive to improve our knowledge and skills, and regularly reflect on how we can make what we do even better; as there is always room for improvement, no matter how good we think we are...
X is a 23 year old young
man who three years ago was studying mental health nursing at Bangor
University. He was diagnosed six months
after beginning University with bipolar disorder. For two years he was unstable with frequent
medication changes and eventually had to move back home to Sturminster to live
with his Mother. He was taking mood
stabilisers and an antipsychotic when he returned. In line with guidelines for bipolar disorder
the CMHT team stopped prescribing his antipsychotic as they felt he no longer
needed it, and the mood stabliliser on its own would be enough to keep him
On Thursday 25 January,
after withdrawal of the antipsychotic X began to feel unwell quite quickly. The
patient’s Mother quickly contacted the CMHT team on Friday 26 January. However he rapidly became more unwell over
On Monday 29 January the
CMHT arranged for an assessment and a psychiatrist assessed that X was
psychotic. The psychiatrist said she
would speak to the bed manager and send the Crisis Team. X agreed to go to St. Ann’s as a voluntary
inpatient. The Crisis Team attended at
5pm on Monday 29 January and said that if he had not agreed to go in on a
voluntary basis they would have sectioned him as he was very unwell by this
stage. However X began to feel that the
team were very unhelpful as they told him “if you don’t take your medication
you will be taken away and injected”.
Later that evening they
were advised by the Crisis Team that there were no beds available at St. Ann’s
Hospital and that someone would come out again tomorrow. Due to X’s psychosis he began to think that
he would be kidnapped and injected. His
Mother and his girlfriend were trying to keep him calm. X’s Mother pointed out that her son is a
tall, well-built, fit young man who could easily have physically moved her and
his girlfriend out of the way if he wanted to get out of the house.
The following day, Tuesday
30 January, the Crisis Team arrived in the afternoon. By now X was under the impression he was on a
secret mission and had to get to Wolverhampton.
“Nick from the Crisis Team who attended was great with X, he really
managed to calm him down” said X’s Mother.
Nick said that X needed to be in hospital and he would ring later. At 6pm they were advised that there were no
beds. However, in a bid to find a way to
get X admitted, the team suggested that they section him, and the assessment
wouldn't take place until the following day, despite the fact that X was still
willing to be voluntarily admitted to St. Ann’s.
X’s Mother and girlfriend had an even more
difficult night as he wanted to leave the house as he believed there were
people in the woods and he began barricading the house. X’s Mother did not sleep at all that
In sheer frustration X’s Mother
drove to Wimborne CMHT and door-stepped the psychiatrist. She was extremely shocked that X was not an
inpatient. In relief that she had found
someone who realised the seriousness of the situation X’s Mother burst into
tears and then explained that X was going to be sectioned as a means to get a
bed. The psychiatrist from Wimborne CMHT
wrote a letter strongly disagreeing with the section. X and his Mother were very happy with the
treatment and support received from Wimborne CMHT. The team performed as was
expected and they have no concerns about their actions.
X’s Mother then rang the
Crisis Team to ensure that it was on record that she did not agree with the
section. She was told the section was
going to happen anyway and the team would be round at some point. Another phone call was received later on that
day explaining that the psychiatrist from the Crisis Team was going to carry
out an assessment. After assessment, the
psychiatrist agreed that a section was not necessary but X did need a bed at
That evening a bed was found on AAU – Seaview
in St. Ann’s. The following day X’s Mother received a phone call from a bed
manager who explained that they had not been made aware of the case and
apologised for what had happened. X’s Mother explained that this phone call
from the bed manager is the only reason she had not made a formal
In total X waited 4 days
for a bed whilst suffering a psychotic episode.
In addition, X’s Mother is concerned
what could have happened if X had been alone and not had her there to
fight his corner. He was willing to go
to hospital but would have been sectioned against his wishes.
X and his Mother would like the following points to be noted and/or actioned by the Board:
The Community Mental Health
Services Manager, Crisis Team and Bed Manager have reviewed the story of this
gentleman and his mother, and are really grateful they spent the time providing
their feedback. All services involved absolutely agree that to wait four days
for an inpatient bed whilst experiencing a psychotic episode is a highly
distressing situation to be in for the person and their family.
The Community Mental Health
Services Manager and Inpatient Services Manager contacted Mr X and arranged to
meet with him and his mother to discuss what happened.
From this feedback the team are able to improve the
experience of people needing to access crisis care and to help avoid the
situation that Mr X and his mother found themselves in earlier this year.
The actions that were taken from the feedback and meeting are
We have undertaken a reflective feedback session during a Crisis Team meeting about your experience, which we do for all feedback received. Some particular staff were referenced in the concerns and we have therefore also addressed in one to one supervision the feedback about tone and style, both positive and negative, and the impact this had on the experience.
DS is an 38
year old man, who lives in Bournemouth. In
2015 DS had an operation on his Achilles tendon. Unfortunately this was not successful and he
was left in a cast and then a boot. He
had a second operation, where bone was removed from his hip and used to help
the bone to form in his foot. His foot
was also pinned. The wounds healed but
unfortunately there were further complications which meant a third operation. Prior
to his operations DS played football and was not overweight.
operations DS weighed 122kgs, over 19 stones.
Unfortunately due to his long period of illness his position at work
became under threat as he was not able to carry out his role. Luckily he was offered voluntary redundancy
from his well-paid job in retail. DS
visited the doctor for thrush and had a diabetes test. His BMI was 34.96 and he had a very high
HBA1c level. The doctor prescribed three
separate medications and statins. He was
also referred to the Diabetes Education Programme.
He was also
seeing the physiotherapists at Royal Bournemouth Hospital for his foot and
began to visit their gym regularly. He
said their help and support was magnificent.
He explained that going to the gym for physio really was a springboard
for him. He explained that he had never
been in a gym before. He explained that
the physiotherapists at Royal Bournemouth now refer to him as their pinup!
the Diabetes Education Programme and undertook the 3 sessions. He found the information useful despite
having a fairly good knowledge of the disease because his mother is diabetic. He says that he realised he was going to have
to make a significant change in his lifestyle.
He knew his mother and her friends did not seem to try and manage the
disease as well as he thought they could.
He decided he would be different and decided to really engage with the
advice he was receiving.
One of his
motivations to change was to be there for his children’s children. So he began an exercise and healthy eating
programme. With his food, he used the
information he had learnt from his courses at the Diabetes Education Programme and
made better choices. He then reduced the
amount of food he was eating by only using tea plates. In regards to his exercise he initially
tried to find something he really enjoyed and began with table tennis, playing
in Boscombe Gardens. He then had to walk
back up the hill to get home. He
explained that without his experience under the care of the physiotherapists at
Royal Bournemouth, he really would never have considered going to Littledown to
use the gym. He feels that safe
introduction to a gym environment took away the anxiety and fear of walking in
to a public gym.
He has now
lost 44 kgs (nearly 7 stone) and is now pre-diabetic. He takes no medication for his diabetes which
is now completely controlled through his lifestyle. He looks back at his diet when he was going
through the issues with his foot and admits his diet was bad, he ate comfort
food and ice cream and was constantly thirsty.
He now enjoys healthy food but still enjoys a Chinese meal once a
week. To control his alcohol calories, when
meeting up with his male friends he now arrives a couple of hours after
everyone else and leaves a little early.
This way he does not get caught in the cycle of buying rounds and feeling
he cannot leave.
DS says he
feels younger. He incorporates walking
into his day whenever possible and goes to the gym almost daily. He now
helps other friends who are diagnosed with diabetes and a friend recently has
lost 6 stone.
He was very
happy with the information on the courses from the Diabetes Education Programme
but is concerned that some attendees really did not grasp how serious diabetes
could be. He felt some were of the
opinion that the tablets would do it all and they did not need to change. He wonders if a little more information with
a shock factor i.e. how many diabetics lose a limb or their eyesight, could
help people who do not have a strong will.
He now does voluntary work for Victim Support and is currently looking
for a new role, perhaps within the NHS.
are delighted that DS was able to use the information provided on the Diabetes
Education Programme to make lifestyle changes that resulted in him controlling
his diabetes with lifestyle alone. The Diabetes Education Programme aims to
empower and motivate people newly diagnosed with type 2 diabetes
approach a diagnosis of diabetes in different ways. Whilst people like DS use the diagnosis as a
motivator for change, for others it takes a while for the seriousness of the
condition to register. The programme is structured to include information about
diabetes complications, what they are and actions to reduce the likelihood of
I am Mrs X, a new mother of a 5 month old baby. I’m a Speech and Language Therapist, specialising in feeding, and this role encompasses regularly working with Health Visitors (HV). I’ve experienced the Health Visiting service in a new light, after the birth of my child.
When the HV completed her initial home visit, she was more sympathetic and supportive; they were present for a longer period of time and saw how upset and distressed my child was, following his feeds. The HV was the first person to say I wasn’t losing the plot and advised me to take him to the GP. I went to the GP, and the outcome was that he had a cow’s milk intolerance. From this, it was recommended to place him onto a special formula and I immediately noticed a vast improvement after feeding, and in general.
Prior to this, we had previously attended Poole General Hospital (PGH), due to his poor weight gain, and a heart murmur was identified. A scan was arranged and this will be reviewed at 1 years of age. At this time, there was a very strong focus upon his weight. However, following this I still remained concerned regarding his feeding and presentation.
In addition, she took time with my husband ensuring that he was involved and understood what was happening. I really appreciated her approach, as it kept him part of the journey with our son. I also found it very helpful that the Health Visiting service provide set times and are always on time, which other services don’t always offer. As my baby was born in November, knowing when services are coming made it easier for us to go out and do things before it got dark and cold.
She had completed additional visits whilst his weight was being monitored and we were trialling the new formula. When she did this, she provided us with a phone number to contact her, and we now use drop-in clinics monthly to have him weighed and to seek further advice; I make sure that I attend these, as they are very useful. Others may be unable to attend these if they do not access to a transport.
Even though I have extensive knowledge of child development and the service in general, I would have liked to have a longer period of support from the HV to just to check everything is okay; maybe even a telephone call, just asking the question ‘how’s everything going?’ because I would always have had something to ask!
Overall, the service we have received, from all the services, has been fabulous and all staff are very supportive and caring; every person we’ve seen has been great and knowledgeable – from PGH, to the GP who we have always been able to see on the same day.
The main point about my experience with the HV is that she listened to my concerns and did not dismiss these, which in turn had a huge impact on my son's wellbeing. I felt more listened to with her, than I did with other services.
The Health Visiting Service was delighted to receive this positive response regarding the support a family received from one of our teams in Poole.
This response has been shared at a recent Poole HV Locality Meeting to support good practice and learning and will also be shared at the forthcoming Pan Dorset HV Leads Meeting for wider dissemination.
The comments regarding access to Well Baby Clinics have been noted and will be fed into our current review on this aspect of service provision by the Health Visitor Advisory Forum. It is acknowledged that the mother would have valued active input or telephone support from the service for a longer period, whilst it is noted that she had contact details for her Health Visitor. Therefore, it is important that practitioners continue to work to empower families to take a proactive approach - encouraging parents to contact the service to discuss any concerns or queries they may have, rather than feeling they have to wait for the service to contact them. Our aim is to provide a personalised service that can respond to identified needs and supplementary advice or additional visits can always be arranged as required.
for someone with dementia entails a lot of ‘firsts’ – the first time you
realise they are never going to get better. The first time he went out and
forgot where he was. The first time he no longer knew how to make a cup of tea,
and the worst ‘first’ of all – the first time he didn’t know who I was.
was well with dad living in his annex, pottering around with support from me
and my husband – we both work full time, and took it in turns to help dad get
up each day. Suddenly he took a down turn and we realised we needed more help.
This was especially difficult for dad, being from a Dorset gypsy background
there is a cultural fear of ‘authority’. I gently persuaded him it was for the
best and so a social worker arrived…sadly he didn’t gel with us and offered
very little support. I felt the assessment was a form filling exercise - I
hadn’t slept properly for 18 months due to dad calling out every night, so
being offered a trip to the cinema was not what I needed. We were offered a week respite, but with no
notice and the home being well below standard I wasn’t letting dad go
there. I felt awkward, we don’t like to
‘make a fuss’, but I asked for a different social worker, who was much better
organised care workers to help dad get up and eat etc. It was difficult as they
never arrived at the same time and with staff were continually changing there
was no consistency.
this situation began to have an impact on my working life. It was agreed I could compress my hours to
four days, which helped me balance work and dad.
2016 dad fell over, he could barely stand unaided - he was taken to A&E but
sent home as no broken ones. He fell
again the next day, I tried to lift him and in the confusion he punched me …
hard. He was taken back to A&E while
an emergency care home was sought. Against the wishes of his GP and Social
Worker he was sent home again, this time he couldn’t stand at all so we stayed
up all night with him to keep him safe.
I felt we had been treated very poorly, with no understanding or
compassion shown to me or my dad.
care home in Hampshire was found (nothing in Dorset available) - I asked for a nursing home but my views were
not listened to. After two weeks dad was asked to leave as he ‘needed nursing
home care’. I was offered a place the other side of Weymouth but turned it
down, as dad needed to see us and would decline if not.
specialist dementia nursing home in Bournemouth was found. Dad was sadly
mistreated there and I lodged my concerns to social care and the CQC, who
inspected and found them ‘Inadequate’ in all areas. It was very distressing as
staff at the home didn’t speak or listen to me or dad and spoke to him in a
gruff way. He stopped eating and drinking as they were not making any effort to
support him. Dad lost 3 stones in 9 weeks and was covered in bruises.
lovely district nurse assessed dad for Continuing Healthcare – she even came to
my home to explain why and how it worked, she listened to me and I felt at last
someone was showing us care and compassion.
managed to get dad moved to a new and vastly better nursing home, where he
started to eat and drink again. Sadly after only a short while he died. They
were wonderfully supportive of us all and dad had a ‘good death’.
summary, I feel that my story demonstrates:
This story covers a wide range of
issues and is focused on the patient and carer’s journey rather than a specific
service. In this case, it is felt that feedback from the Dorset HealthCare service included
in the story would not add any value.
Mr X is a 50 year old man who got out
of bed on the morning of his birthday in November and promptly fell down. He was suffering with dizziness and he
couldn’t stand as he felt the room was spinning. He was diagnosed with benign positional
Mr X was
treated by his GP using the Epley manoeuvre which is the sequential movement of
the head in positions designed to get any floating debris to the bottom of the
ear canal. It was explained to him by
the registrar that this treatment worked in 80% of cases.
this did not resolve his condition and he was referred to hospital where the
manoeuvre was carried out by a further two medical staff. Mr X noted that each time the manoeuvre was
undertaken it was performed differently, and again did not resolve his benign
was finally referred to Audiology when the manoeuvres previously undertaken
failed to cure his benign positional vertigo.
said "I was seen by the Audiology Service on the 14 June. After waiting a few minutes I was called in
by the audiologist, who asked me to lie down while she watched my eyes.” The
audiologist explained to Mr X that by watching his eyes as he goes to lie down
she would be able to tell which ear is causing the problem. As it turned out it was Mr X’s right ear.
audiologist told me that as people get older calcium deposits form in the
liquid in the ear and they confuse the brain as they continue moving in the
fluid in your ear when you are standing still. She wanted to perform the Epley
Manoeuvre, the aim being to get the calcium deposits at the bottom of the ear
canal where they will settle. I told her
that it hadn’t worked before and it made my dizziness worse so I didn’t want it
done again. She carefully explained and
demonstrated what she would do so that I knew what to expect”. Mr X explained that the audiologist seemed to
understand how he felt which was reassuring.
agreed to have the manoeuvre performed.
“When I got up to my surprise I didn’t feel dizzy, I had to eat humble
pie because I told her it wouldn’t work.
The audiologist asked me to wait in the waiting room for 30 minutes and
she would call me back in and repeat the manoeuvre again if necessary. The dizziness had gone!”
audiologist advised me that she would call me at home a week later to make sure
that the dizziness had not returned.
called me a week later and then again a further week later. She told me “that if I had the symptoms again
to call the Audiology Department and she will see me”.
Mr x was suffering with dizziness
and he experienced episodes on a daily basis.
He was diagnosed with benign
paroxysmal positional vertigo (BPPV), which is a common balance disorder due to
calcium carbonate crystals (‘otoconia’) falling out of the correct part of the
inner ear (‘utricle’) into the wrong part (‘semi-circular canal).
He was treated by his GP using
the Epley manoeuvre which consists of the sequential movement of the head in
positions designed to move any floating otoconia back into the utricle.
As people get older, otoconia can
sometimes fall into the liquid within the inner ear and they confuse the brain
as they continue moving in the fluid in your ear when you are still. The
Audiologist who treated him explained to him that this treatment worked in 80%
of cases. It was unfortunate that it did not work on previous occasions.
The Audiologist performed the
Epley Manoeuvre, the aim being to move the otoconia out of the wrong part of
the inner ear, back to where they belong.
The Audiologist treating this patient was able to gain his trust to
perform this manoeuvre which resulted in a positive result for the
Miss X is a 21 year old young woman who lives in Poole.
X explained that she began to suffer with issues with her eating in November
2015. She had been attending her GP from
December 2015 as she knew she had a problem with her eating but was only referred
to the Eating Disorder Service in June 2016 after making an attempt on her own
life. Due to her illness Miss X had to
leave her job at a gym as this was adding to her body image issues. Following a year of treatment she was
discharged from the service on 7 July 2017.
X stated “My problems with eating started in November 2015 when I decided to
enter a body building competition, which meant that I started to eat less and
exercise more. I didn’t get placed in the
competition and I felt that I had done all that work for nothing”.
explained “After the competition I felt that I was now free to eat anything I
wanted, that there were no boundaries. I
would starve all day. Then late at night
I would drive to the supermarket to get some food; eat it in the car and then
go in and get some more food. I would do
this up to five times and would feel so full I couldn’t move. I wouldn’t do it for a few days and then I
would repeat the process again.
knew I needed help so I went to the GP in mid-December he didn’t take it
seriously and I was told to try and eat regular meals. If I had been referred at this point things
would not have got so bad. I had put on
weight and would hide it by wearing a large coat and wrap it around myself; I
wouldn’t make eye contact with anyone and I felt so guilty.
this time (February 2016) I started to look at website chat rooms like
Instagram and chat to girls with the same problem. I learnt a lot of bad things from these sites
which led to bulimia and I started experimenting with laxatives.
started to feel disappointed with myself, I began to feel depressed, and I
didn’t want to live. I took an overdose
in March 2016. I went to see another GP
in May and I was finally referred to the Eating Disorder Service, without that
GP and the support I received from the Eating Disorder Service I don’t think I
would be here now.
I had my assessment they asked me what goals I would like to achieve. I told them I wanted to wear leggings or jeans
and tops with no sleeves. At this point
I was referred to the dietitian. The
dietitian undertook some tests to see what proportion of my body was muscle and
fat. It was decided that I needed to eat
2000 calories a day and a diet plan was put together for me. By following this I lost 10 kilos. I no
longer feel guilty about what I eat as I eat healthily so I don’t watch what I
service did a lot of work around body image with Miss X. Her support worker asked her to draw the body
shape that she thought she was and then she had her lay down on the paper on
the floor and drew around her real body shape.
These drawings were compared. Miss
X explained that she also learnt that lighting has an effect on what you see in
the mirror and mirrors can distort your image”.
Miss X has discovered
that she enjoys painting and Calligraphy and she has her own Facebook page. It
is called @creatinglillie and it's on Instagram. She shows the reality that
social media doesn't always show, and talks about some of the challenges she faced
and how she overcame them mainly surrounding food and body image. She wants to try and give women a better
example on social media that isn't perfectionism but more about loving you for
you no matter what size you are.
“I have now got a job as
a shift manager at Starbucks and I am going on a self-love retreat to Bali for two
weeks. I am also studying counselling as
I would like to help other people”.
Miss X stated “The service really helped me but because my GP did not seem to understand my illness it took a long time to be referred to the Eating Disorder Service. I would have liked to be able to talk to someone who understood my illness while I was waiting to be seen”.
Figure 1: A picture created by Miss S.
The Eating Disorder Service is delighted with this feedback.
Areas of activity relevant to the issue of delayed referral raised in this
patient’s story are:
Mr C is the husband of Mrs C a 76
year old woman from London. Mrs C was an
inpatient in Ashmore and Shaston Ward, Westminster Memorial Hospital, between 29 March 2017 and 25 May 2017.
Mr. C explained how they both came
to be in Dorset. Mrs C had been
diagnosed with Parkinson’s disease and because her health was going to decline
further Mr. C sold their flat in London and purchased a smaller place. This new ground floor flat was to be altered
to ensure that their new home was suitable for Mrs C. This would involve significant building
Whilst the building work was being
undertaken they moved down to Dorset for the beautiful countryside and to
escape the disruption. Mr. and Mrs. C
had loved France during their marriage and he planned a “last adventure” with
his wife so that she could enjoy a last holiday whilst her health allowed. Unfortunately Mrs. C became very unwell and
she was taken by ambulance to Yeovil hospital.
After assessment and treatment she was eventually moved to Westminster
hospital for rehabilitation.
“This place is a blessing” said Mr.
C. “The occupational therapists got my
wife moving and all the staff are extremely patient and helpful. Everyone was
so encouraging to us both.” Mr. C was
given a Carer’s Passport and said the ability to come and go whenever he wanted
meant he was really involved in his wife’s care.
Mr. C said that every element of the
care his wife received was explained to him and he felt fully aware of what was
happening and why. He sat in on meetings
to discuss her care and it was tough to hear the honest truth from consultants
who explained her prognosis. He said “it hurt but it had to be done” and he was
grateful that he was fully involved. Her
medication was reduced from ten tablets a day to 5 to help her mobility issues. He was concerned about her Parkinson’s being
managed with reduced medication but felt supported by the team and happily her
mobility increased and she did not appear to have suffered as she remained
bright and cognitive.
Mr. C explained that the
preparations for discharge started fairly early with discussions with him and
the rest of the family. We went through
a “pros and cons” written exercise with the family and the biggest benefit for
moving back to London was his wife’s closest friends could see her more often
and her family could be involved. He
said he was personally conflicted as he would have preferred to stay in Dorset
as the county had really grown on him.
However he recognised he had to put his own wishes lower down on his
priorities and he realised that he would need additional help to care for his
wife. So the decision was made that on
discharge they would be returning to London.
Unfortunately there were issues with
the housing situation in London as the building work had not been passed by the
local council which meant a delay in discharge.
The discharge coordinator explained that they would not be “thrown out”
as his wife was physically well enough for discharge. He said that he felt incredibly guilty that
they were using a bed but the team reassured him that this was not his concern
and that he and his wife would go to London as soon as everything was
The ward manager advised that Mr. C
was so supportive of his wife and he would dance backwards whilst supporting
her to get her moving. The ward staff
found this charming and the other patients laughed and enjoyed watching them
Mr. C said he was now looking
forward to returning to London as he loves the museums and live music. He said that one suggestion he would make,
would be to suggest that the Trust looks into the Parkinson’s Classes that the
English National Ballet run. His wife had
always loved the ballet and they attended for five years prior to their move to
Dorset. The classes include dancing to
the music from the ballet that the company are performing for that season. He
also said the social interaction was a key benefit from the classes,
particularly for those patients who live alone.
In addition he said that patients
suffering with Parkinson’s need stimulus and the staff work really hard to
provide that. He felt that a Sunday
Lunch where the patients sat around a table, as they would do at home, would be
a great idea and something to look forward to.
Mr. C said the flexibility of the
Carers Passport was really great. He
knew when the OT would be seeing his wife so he could be there for the “dance
class”. Mr. C said “I can’t say thank
you enough. The care my wife has
received has been second to none. The
lovely staff care so much and their interest and involvement in my welfare has
been very touching.”
It was lovely that
this positive patient experience was captured so well by the Patient Experience
Team, who met with Mr C.
The problems with
housing issues that were highlighted were dealt with in a timely manner through
the coordination of our Discharge Facilitator and the team as a whole. We
always strive to ensure the involvement of all those concerned; with the
patient remaining always as our main focus.
‘dancing’ between Mr & Mrs C was both enjoyable to watch and certainly
beneficial to Mrs C ‘s mobility. It has long been recognised that
patients with Parkinson’s Disease can benefit from music therapy, and I plan to
discuss this further with our Parkinson’s Disease Nurse Specialist.
Mrs R is a 71 year old woman who lives in Blandford
Mrs R was found on the floor of her flat by a senior care assistant on 18 April 2017 and taken to
accident and emergency at Dorchester County Hospital. She was found to be suffering from a
urinary tract infection and to have a very low insulin level. Treatment commenced and she was
admitted to Tarrant Ward 24 hours later to continue her recovery.
Mrs R explained “I don’t
remember being in Dorchester Hospital, my first memory is arriving at Tarrant Ward”.
Mrs R explained “I had been taking my insulin but I didn’t seem to have any appetite, which I feel
was how I started to become ill. I must have been hallucinating as well as I thought I was going
to an orthopaedic appointment, in a taxi and then later thought I was on trial for my life!”
Eventually, I became aware of where I was and the staff really helped me. “The food was
wonderful and the nurses were so special they must have had intensive training. The nurses kept
on top of my drugs, I used to take my insulin 4 times a day and they altered it to two times a day,
I wasn’t sure, but it did the trick, I am fine now on less insulin”.
Mrs R said “I enjoyed being on the ward and the therapy that I received. The nursing staff were
always available if I needed them but they allowed me to be as independent as I wanted to be. I
took part in quizzes on the ward which I really enjoyed.” Mrs. R said she had her haircut whilst an
inpatient which made her feel good. She really appreciated having help to have a shower and
wash her hair as it gets dirty quickly when you are unwell.
On one occasion the ward organised a visit from ‘Lofty’ a therapy horse. She said “I had been
around horses when I was a child and it brought back lovely memories. I thought it was funny
that the horse had shoes on and was amazed it did not slip!”
“While I was in hospital I set up a memory box with the Occupational Therapist which was
lovely. I enjoyed being taken out on to the patio, it felt like a secret place to enjoy the fresh air, it
made my day as I was in hospital for a month”. Mrs. R recalled. Mrs R said “The patient next to
me kept trying to get out of bed, so I kept ringing the bell so staff could stop her from getting out
of the bed. I felt guilty as the staff were so busy but realised I was helping the staff and helping
the patient from falling again. I enjoyed helping the patients around me”.
Mrs R explained that she watched over another patient next to her who had dementia. Because
of her dementia she used to swear and I would suggest she used a politician’s name when she
wanted to swear “I knew it was the dementia and not her, she was a lovely lady and I did her
exercises with her to help”. The staff referred to us as ‘The Naughty Girls Club’, we had a good
Mrs R summarised her experience “Woe betide anyone that closes Blandford Hospital as it was
wonderful. It’s the very best I’ve been in, and I have been in a few. The nurses put up with me
and I know I can be difficult at times, particularly when I was so unwell”.
Mrs R was taken to her home for a pre-discharge visit by a member of the Integrated
Rehabilitation Team (ICRT) to assess whether her home had equipment in place to ensure her
return home would be to a safe environment. Mrs R was discharged from Tarrant Ward on the
16 May 2017.
This story will be shared with the team, it is always lovely to hear how the great care we deliver has made a difference to our patients and supported their recovery. The visit from Lofty the therapy horse was greatly appreciated by both patients and staff and we look forward to his next visit in December.
• The disorientation felt by a patient in a semi-conscious state with an infection.
• The importance of therapy in a patients recovery.
• The interpersonal relationships on the ward can help patients feel relaxed and happy.
• A positive response to her admission and her appreciation of the ward staff in her recovery.
That occupational therapy plays an important role in the patients’ recovery. Personal care and
normal activities such as hairdressing and being taken outside improved her wellbeing.
The reason for the hospital stay was her physical health but her wellbeing was equally
Monica (not her real name) is a 29 year old woman who was diagnosed with psychosis and bipolar disorder in January 2016. Monica said there is a family history of mental illness, her mother suffers with alcohol misuse, her father with depression, her maternal grandfather with depression and alcohol misuse and her maternal aunt with bipolar disorder, but this was the first time that Monica herself had experienced this.
Before her illness Monica was a successful accounts manager who travelled the country and lived in a shared house. She now feels she has nothing following her illness and the ten months since her diagnosis and the time she spent in hospital.
Monica was taking antidepressant medication prescribed by her GP. But she knew that she was not feeling well. Having previously taken illegal drugs she explained she felt ‘high’. She contacted her GP who suggested that she increase her dosage of her antidepressants, however Monica stopped taking them instead. It is not known how long after stopping her medication, but this led to her feeling even more unwell and feeling very ‘high, so she called an ambulance, as she knew that she needed help.
Monica was admitted to Seaview Ward St Ann’s Hospital, following admission from Poole Hospital in January 2016, and was then transferred to Chine Ward two days later.
Monica felt that Chine ward did not manage her illness well as she felt that she was not getting better.
Monica felt that she was being given the wrong medication to help her and that they could not get her medication right. She did not sleep for many nights as she did not feel safe, this was mainly due to the way her illness made her feel, and also other patients, who she found to be noisy, aggressive and intimidating. The lack of sleep led Monica to become aggressive and violent to both staff and patients. She needed to be restrained and have rapid tranquilization on many occasions and Monica said that as a previous rape victim earlier in her life, being held down made her feel even worse. This was known to staff at the time of her admission.
Monica continued to be violent, and at the time of her hospital admission there was no provision for female intensive therapy beds at St Ann’s Hospital, so Monica was transferred to a hospital in London for further treatment. Monica stated that the move to London made her feel worse and that her medication continued to not work effectively, she thought that she was in a hotel but was being restrained by someone. She tried to escape frequently. She felt like she was in prison and was only allowed half an hour’s break each day, Monica also felt the hospital was dirty.
After a month in London Monica was discharged back to her parents’ home in New Milton. Unfortunately, Monica quickly became unwell again and was readmitted to St Ann’s Hospital in May 2016. Monica continued to be violent and had to be restrained on numerous occasions. Her care team at St Ann’s suggested that she have Electroconvulsive Therapy to try and help improve her behaviour/violent outbursts and to manage her illness. However, her parents felt that this was an archaic treatment and refused for her to have this. Monica was therefore transferred to a different London hospital in July 2016 for further treatment, as there was still no provision of female PICU beds in Dorset at that time.
Monica felt she was bullied and racially abused by other patients during her stay in the London Hospital, as she was one of the few white patients there. They took some time to get her medication under control, and during this time Monica suffered many side effects from the medication she was taking, and she also felt that this hospital was dirty as well. She felt isolated, as her friends could not visit and her family were not nearby for support.
After a month in London Monica was transferred back to St Ann’s Hospital, again initially to Seaview Ward, but she was then transferred to Chine Ward, to stabilise her medication and to support her discharge into the community Monica was discharged in October 2016 to the Early Intervention Service (EIS) .
Monica feels that this admission was much better than her previous one, as the staff in the main were caring. Monica felt she was able to be involved in her treatment and care, was given more leave and had the support of her family and friends nearby.
Monica explained that staff on Chine ward, helped her to find a place to live and she was discharged to the YMCA in Bournemouth following completion of her inpatient stay.
Monica is now under the care of the Early Intervention Team (EIS) and says that their support is ‘phenomenal’ and that she cannot fault the care and support that she has been given by the team. Monica has a really good rapport with her support worker and is also under the care of a psychologist, which is enabling her to talk about her care at St Ann’s and her previous sexual assault.
Monica is currently working part time but is aiming to return to work full time in the near future with the support from the Early Intervention Service.
Monica will benefit from being able to tell her story and will feel listened to. If she feels that telling her story might help to change/inform future treatment for others then this would be a positive achievement for her.
From an objective standpoint Monica was very unwell for a sustained period of time and achieving the effective combination of medication was very difficult. However reading her personal account of her experiences and the consequences of these experiences highlights how we should all work together to improve care where possible and to also build on the positives.
Working with Monica since she was discharged from hospital she has consistently moved forward in her recovery through her own determination to rebuild her life. The team are really happy that she has managed to achieve so much in a relatively short space of time and look forward to continuing to work with her.
As we did not have a female PICU Monica stayed on the ward longer than we have liked as we were aware of the consequences for sending her to an out of area PICU, which meant an unfamiliar environment, away from her friends and family, staff that did not know her and she did not know them, and we had little control over their choices of treatment.
Whilst Monica was out of area we stayed in contact with the PICU, with Monica, and Monica’s family. The hospital in London appeared to have a lot of ‘blanket’ rules and patients were not allowed mobile phones so this limited Monica’s contact with her family and friends. All visits had to take place off the ward as visitors were not allowed on the ward, meaning they needed to have staff escort, which affected the length of the visit.
For the new PICU at St Ann’s Hospital we have made a lot of effort to treat patients in the least restrictive manner and have tried to avoid blanket rules - phones are not routinely removed - and if they need to be, the rational for this is clearly documented and if necessary a care plan put in place. Family can also visit on the ward, unless there are significant concerns.
We agree with Monica with regards the out of area placements, and on her first admission there we made the decision to get her back to St Ann’s as soon as possible as the environment was in our view, not conducive to her recovery.
As we did not have PICU provision locally to support Monica, her family were supported financially by the Trust with reimbursing travel cost and expenses thus ensuring that they were able to visit their daughter regularly when she was in London.
Sam is a 27 year old young man who was diagnosed with Schizophrenia, diabetes and other disorders related to
excessive alcohol intake. Sam has been sectioned three times under the Mental Health Act over a five year period
between 2007 and 2012. He was first sectioned after a Ketamine overdose at the age of 16. Sam currently lives with
his father in Lyme Regis after moving from Sherborne. Sam is a very reserved young man and his father assisted him
in sharing his story.
Sam’s mother and father had been through a difficult split and his Dad felt this was the start of Sam’s problems.
Initially Sam was still living with his mother when they were in Sherborne. Sam’s Dad explained that he knew he had
to get more involved when Sam had been sectioned for the third time. He was scared that he could lose his son
forever. He hoped to move Sam away from the influences he felt were having a negative effect on his son’s life.
Eventually Sam and his Dad managed to move to Lyme Regis and they now share a flat.
Sam was originally under the Community Mental Health Team and was referred to Sarah, the Support Transition
and Recovery Service (START) Worker in July 2016 for help with his recovery. After completing the “recovery star”
where Sam’s areas of interest were identified, it became clear that Sam was very keen on improving his fitness. He
also understood that his alcohol intake was detrimental to his diabetes and mental health. Sam had a huge barrier
as he was worried about using public transport to get to Bridport to exercise.
Sam’s main identified interest was his love for animals. Sarah suggested volunteering at an animal sanctuary called
“Ferne” in Chard however the location, again, was an issue, as there was no regular public transport. However Sam
was happy to apply and deal with the travel issue should he be given an opportunity. Whilst waiting for an opening
to arise at Ferne, Sarah encouraged Sam to take up other volunteering opportunities but he remained focussed on
working with animals. There was a long period of waiting for a suitable opportunity to arise and his engagement
faltered for a while.
One day whilst Sarah was walking back to her car from meeting with Sam, she stopped to talk to a local trader who
had a dog sitting outside her shop. They chatted about the fact that the dog enjoyed sitting outside but, when she
was busy, she could not take the dog for a walk. Sarah asked whether she would consider talking to Sam about him
helping her with the dog. When Sarah had spoken to Sam he visited the shop by the end of that day. Sam now walks
the dog 4-5 times a week and has been referred by the local trader to other friends to walk their dogs.
On speaking with Sam he makes it clear that his is in a much better place now. In the last four years he has not been
sectioned. He said there are a number of issues which have been important to gain that stability in his life.
Initially his father moving in was a key change. He began to eat regularly and had someone who he could trust. Sam
said that Simon, his Care Co-ordinator visiting him at home to organise his medication has been a huge
improvement. He says the walk to the GP practice was over a mile away up a steep hill and with his fitness levels
was difficult. Sam attributes a significant impact to the change in his life to achieving his aim of working with
animals. He says that he loves to walk the dogs, which he does individually for about an hour at a time. Also having
made a commitment to walk the dogs makes him get out of the house and not sit around and drink alcohol. He has
lost weight due to the walking and his mood has improved considerably. The fact that the community are
supporting him has also increased his self-worth and is beginning to embed both
Sam and his Dad into the local
community. Sam’s Dad has also been signposted to carer’s services by Sarah who is keen to ensure he is not feeling
isolated and unsupported.
Sam and his Dad both feel the journey is not yet ended and there is still a lot of work to do. However they feel
positive about the changes they have made together. They continue to feel supported by Sarah and know if they do
need additional help she is there.
• The importance of family support;
• An holistic approach to the patient;
• Thinking outside of the norm to support patients;
• Healthcare workers knowing and working with the local community to support patients;
• Understanding barriers and working to minimise those for patients
• The positive impact of having commitments to an individual
Mrs. X and Mrs. Y both stated that they were extremely happy with the approach of the hospital in general to the patient and the family, and the care that Mr. X received was second to none. Mrs. X and Mrs. Y said “the attention we received as family of a patient at the end of his life was absolutely amazing”. They wanted to let the Trust know that overall they would not have wanted Mr. X in any other hospital. There were a few incidents which they did want to raise; however, they were very clear that these were a small percentage of the experiences on Tarrant Ward.
On admission Mr. X was being asked questions as part of the admission procedure and it became clear that Mr. X and Mrs. X (she was single at the time) were not married. Mr. X explained to the nursing staff that it was a great regret that he had not married the love of his life. He felt it was now too late to make this happen. The nursing staff were touched by Mr. X’s statement and immediately got to work to see if the hospital could support the couple to realise Mr. X’s wish. Within seven days a wedding had been arranged by the staff and no detail was overlooked, from the invitation list to the food, drink and decoration of the wedding room. “It was so amazing” said Mrs. X, “I even had music to walk into the ceremony thanks to the Matron, Darren”. The decorations were throughout the public areas of the ground floor and Mrs. X was so touched to see other staff watch her walk down the corridor on the big day. “Nothing more could have been done for us on our special day and we were both so happy.” she said.
The staff approach and attitude during Mr. X’s care was one where Mr. & Mrs. X and Mrs. Y felt they became part of the Blandford Hospital family. Staff would pop in for a chat and to see how Mr. X was doing and he enjoyed their visits. Mr. X gave some staff nicknames as he had such a personal relationship with them.
Mr. X was a man who had worked outside for most of his life and he found the first side room he was settled into a little claustrophobic. The windows were very high and there was no view apart from a small area of sky. He was moved to a nicer room eventually where the windows were large and he could look out onto the fields which he greatly appreciated.
Although the ward was being used for End of Life care some aspects of the ward Mrs. X and Mrs. Y felt were inappropriate. The fact that the ward was very warm and there was no way of turning down the temperature within Mr. X’s room meant that they opened the door to his room which mean sometimes privacy was difficult.
Overall the family felt that if
End of Life care is going to be provided on a more regular basis on Tarrant
ward they wanted to highlight:
The family are keen to ensure that although there are a number of incidents raised they also wanted to highlight the superb care Mr. X received above and beyond the call of duty.