Our local hospital is among those being investigated in the wake of the Stafford Hospital report. Colchester Hospital University NHS Foundation Trust is one of the five found to have a persistently high death rate over the past two years. That's rather depressing, particularly as it sits halfway along one of the most dangerous roads in Britain, but doesn't come as a particular surprise, and I suspect the problems go back far longer than two years.
About ten years ago someone I know was on holiday over a bank holiday weekend when they began to experience severe pain in one of those parts of the body that it is not considered nice to discuss in public. They are entitled to their privacy, and I won't say who they were or how I knew them, but this is a story of someone known to me personally, not just a tale about a friend of a friend. They returned from holiday, and saw their GP first thing on Tuesday morning, GPs not operating on Bank Holiday Mondays. The GP diagnosed an anal abscess and said that it was too serious to be treated in a GP's surgery, and they were to go straight to A&E. The GP would telephone ahead so that they would be seen immediately.
The seeing immediately bit worked very well, and the GP's diagnosis was confirmed. The patient needed surgery. It was after the admission to Colchester General Hospital that things began to unravel. The patient was by then in what they described as the most intense pain they had ever experienced, and the doctor who saw them prescribed a strong painkiller, but instead of being given pain relief they were sent to sit in a side room. And left there for an hour, during which time no hospital staff paid them any attention at all. After an hour the patient's companion went to look for a doctor or nurse, to find out whether the patient could have something now for the pain. It turned out that they had not been given relief, because the injection had to be given when they were lying down, and the wards had not called to say a bed was available.
Eventually a bed was found. By then the patient had begun to run a temperature and was showing symptoms of incipient blood poisoning. The surgeons would not operate while the patient had such a temperature, and the medical staff tried to control the developing septicemia with drugs. The patient had been put on nil by mouth as soon as they were admitted, but was not attached to a saline drip despite the fact that they were running a fever.
The temperature abated, but surgery was delayed again as the air ambulance brought in more urgent surgical cases (from a crash on the A12, as it happens). It was only when the nurses changed shift at nine in the evening that it occurred to one of the nurses on the new shift that the only fluid the patient had received since going to bed the previous evening was a glass of orange juice before going to the GP's surgery that morning.
Finally the abscess was operated on by whatever general surgeon was on duty at eleven or twelve at night. The initial surgery failed to heal, and required a second operation, this time with a consultant specialist in bowel surgery. The second operation was a success, however, the patient learned that if the abscess had progressed another centimetre before treatment, it would have attacked the patient's anal sphincter, and they would quite probably been left permanently incontinent.
It might be that things have improved in the past decade, and that this story has no bearing on Colchester General's excess death rate in the past two years, but I wouldn't count on it. In the meantime, as Jane Eyre put it, I must keep in good health. And not die.
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