Hospital death rates: Report findings
5:59pm Wednesday 6th March 2013 in News
A REPORT investigating “significant discrepancies” in data at the Royal Bolton Hospital has revealed more than half of cases tested “did not meet national standards”.
Today, Bolton Clinical Commissioning Group was presented with Dr Foster’s final report into whether staff at the Bolton NHS Foundation Trust have been “coding” patients’ illnesses and causes of death incorrectly as septicaemia.
Dr Wirin Bhatiani, chair of Bolton Clinical Commissioning Group, said: “The final report confirms that clinical coding of sepsis is of concern.
“This report looked at the quality of the coding process — we now need medical input to understand how and why this happened, and to understand if the coding was clinically appropriate. We have no evidence clinical care of patients has been compromised. We have jointly agreed with Bolton NHS Foundation Trust the scope of an independent, clinically-led review and the terms of reference with its chair David Wakefield.”
Dr Foster found the standard of coding before clinical validation takes place was robust.
However, Dr Foster found that, of the 150 patient cases coded as septicaemia reviewed by Dr Foster, 76 were found not to meet national coding standards.
Of these, 69 were as a consequence of the retrospective clinical validation process.
As a result of the report’s findings and recommendations, Bolton CCG is now supporting a further clinical review to understand the implications from a clinical perspective.
The independent clinical review team will be chaired by Kathy Doran, chief executive Cheshire, Wirral and Warrington PCT cluster, and be clinically led by Dr Peter Williams, medical director at Royal Liverpool and Broadgreen University Hospitals Trust.
Comments(47)
SmoggyDiasboro
says...
8:42pm Wed 6 Mar 13
'Dr Foster found the standard of coding before clinical validation takes place was robust.
However, Dr Foster found that, of the 150 patient cases coded as septicaemia reviewed by Dr Foster, 76 were found not to meet national coding standards.
Of these, 69 were as a consequence of the retrospective clinical validation process'
In other words the 'retrospective clinical validation process' changed the cause of death after review. Seems strightforward then - I wonder whether the original recording included such elements as MRSA, C Dif? Someone, i.e the person who CHANGED (I hate to say "fiddled") the original records deserves immediate punishment. If this is a systemic attempt at corporate falsification, then many should be subject to disciplinary action. I'm not going to say that they should have to pay back to the public the additional cash that RBH received (and again I'll politely put this) "incorrectly" as that would be vindictive. But someone is accountable and has to resign / move on
macauley
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9:43pm Wed 6 Mar 13
Rememberscarborough
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10:30pm Wed 6 Mar 13
Given the large number of cases involved and what looks like a failure of care those in charge must press for a public inquiry to discover whether medical failings are causing un-necessary deaths.
oldjourno
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11:03pm Wed 6 Mar 13
maryhorts
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2:51am Thu 7 Mar 13
charlie1973 wrote:We as front staff do our best we can .Half the time the shelves are empty and we bust a gut trying to reach all the standards that have been crazily set ...Most countries have basic nursing care delivered by friends and relatives .I am not saying this is right and it is not something I would ever have welcomed ,but It seems it may be one answer .Rather than come on and stamp about why not pitch in and help .At least advise us on likes/dislikes etc ,bringing nightclothes,towels and toiletries would help ...Don't complain if dentures go missing ...last time I looked it wasn't my job to supply a pot .I spend more time on a late shift answering bizarre comments than I do turning patients to prevent sores etc ...also why can't families communicate with each other .Rather than take ten time consumming calls giving the same info ....just have one port of call .
I havent a clue what country these people are living in when they say paitents care has not been compromised.RBH has a bad reputation for compromising on paitent care.I am experiencing this first hand.I was diagnosed with a disease that is killing me.I was diagnosed in may 2012 but nobody told me all i was told by rbh i was fine.In feb 2013 i read my notes only to find im going to die.The whole system is a joke.People left in their beds not eating or drinking medications not given results lost.And you have the cheek to say paitent care is not compromised.But the best one is we cannot afford to treat you welcome to RBH.How many doctors and management get their treatment at rbh or do they use bupa.
Regarding Bupa treatment ....With the slightest hint of 'tits up'...the private patient is 999'd to RBH ...
boltonchap
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6:55am Thu 7 Mar 13
genesis22
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9:03am Thu 7 Mar 13
Taxpayers and patients are being shafted by our political elite, Bolton NHS Trust along with others is litterally collapsing under the demands it faces, reducing financial resources and incompetent mall administration both at clinical and organisation levels. Any claim made that clinical treatment is not compromised must be false, as therein lies both the underlying reason and motive behind the fabrication of official causes of death. No NHS Trust will openly admit clinical negligence hence, management are now cooking the terms of the investigations in order to conceal the truth.
genesis22
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9:08am Thu 7 Mar 13
Dobbler
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11:41am Thu 7 Mar 13
You knew the required role of nursing staff before you decided to become one..so get real or get out. Your attitude is typical of the general one at BRH at I hope that your family are just as disgusted with you as i am. I also hope that if you eventually end up in there- you get a dose of your own lousy medicine.
Check out the definition of the verb 'to nurse' becasue you seem unable to know what it is already. You sound like the typical lazy, couldnt-care-less staff that populates that vile place disguised as a hospital.
charlie1973
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11:43am Thu 7 Mar 13
maryhorts
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4:24pm Thu 7 Mar 13
boltonchap wrote:I have just received a long service award .....Most people would have fled and run with the idiotic changes that have occured.I really like my job but what i don't like is the emphasis to continually improve when we are already failing at a lower level .Endless audits and mindnumbing paper exercises mean that patient care is sidelined for target collection .There is only so much you can do in an allocated time and sadly we are being pushed in the wrong direction..I and my colleagues do care it just seems that management don't care about what we feel to be right .Everyone should step back and listen to what staff,patients and relatives want .It will be hugely different from what the Govt and management want .The question is what is the priority at the end of the day !!
Maryhorts, shame on you -," it's not my job "', classic public sector mentality. Your job is to care, simples! You have in a nutshell summarised what's wrong with the NHS, the wrong attitude: might I suggest a change of job where empathy isn't necessary - prison guard seems apprpriate here.
boltonchap
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10:44pm Thu 7 Mar 13
boltonchap
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10:45pm Thu 7 Mar 13
Janch1
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1:50pm Fri 8 Mar 13
maryhorts wrote:Well Said. I work on a hospital ward and I spend half my shift taking phone calls from several relatives, friends, neighbours asking ridiculous questions about the same patient. They ought to know we can't discuss patients over the phone but still they insist and then report you for being rude when you refuse to give the answers! Why can't they communicate with each other? We do the best we can with the few resources we have but the public don't make it any easier for NHS staff. They are so quick to complain and moan rather than see how busy we are and what we are doing for their relative/friend. Last week a relative was waiting to speak to a doctor who had been called to a cardiac arrest minutes before she arrived. What a fuss she made, swearing and shouting, even though we explained the seriousness of his absence and why she had to wait a few minutes. Selfishness is an unpleasant trait but sadly prevalent in todays society.
charlie1973 wrote:We as front staff do our best we can .Half the time the shelves are empty and we bust a gut trying to reach all the standards that have been crazily set ...Most countries have basic nursing care delivered by friends and relatives .I am not saying this is right and it is not something I would ever have welcomed ,but It seems it may be one answer .Rather than come on and stamp about why not pitch in and help .At least advise us on likes/dislikes etc ,bringing nightclothes,towels and toiletries would help ...Don't complain if dentures go missing ...last time I looked it wasn't my job to supply a pot .I spend more time on a late shift answering bizarre comments than I do turning patients to prevent sores etc ...also why can't families communicate with each other .Rather than take ten time consumming calls giving the same info ....just have one port of call .
I havent a clue what country these people are living in when they say paitents care has not been compromised.RBH has a bad reputation for compromising on paitent care.I am experiencing this first hand.I was diagnosed with a disease that is killing me.I was diagnosed in may 2012 but nobody told me all i was told by rbh i was fine.In feb 2013 i read my notes only to find im going to die.The whole system is a joke.People left in their beds not eating or drinking medications not given results lost.And you have the cheek to say paitent care is not compromised.But the best one is we cannot afford to treat you welcome to RBH.How many doctors and management get their treatment at rbh or do they use bupa.
Regarding Bupa treatment ....With the slightest hint of 'tits up'...the private patient is 999'd to RBH ...
Dobbler
says...
4:33pm Fri 8 Mar 13
Come off it you whinger. If you arent happy - leave and give the job to someone else. Youc an maybe start your own business? But oh no youre probably too institutionalised to do that. heaven forbid you come from behind your veneer of mediocrity and do something bold in your pathetic life instead of sucking on the public teat on a cushy number. You are taking money under false pretences - and by definition robbing the public whilst treating them badly too. Hopefully one day you are getting the same treatment from someone equally as bad as you obvioulsy are.
Love Bolton
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8:18pm Fri 8 Mar 13
I must admit I have phoned in the past to enquire about a patient - I can now see that if you multiple this for each bed and then by the number of beds, you would probably need a full time telephonist! My apologies, you are right, good communications within families and friends would make this a lot less of a hassle, and enable you to focus on what you do so well, caring and ensuring that each patients gets the support they need.
boltonchap
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11:01pm Fri 8 Mar 13
boltonchap
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11:13pm Fri 8 Mar 13
And let's not forget the annual automatic salary increments you get in spite of all the guff we are fed about a public sector pay freeze.
You are in the real world - no job is perfect, deal with it or change jobs. So you have a bad day, tough - we all do, that's life. You clearly don't have the right mind set to work in a caring profession and a complete lack of emotional intelligence - put yourself in the minds of these relatives you refer to: they are worried, concerned and perhaps frightened. Having to deal with stony faced uncaring jobsworths like you and maryhorts, no wonder they get worked up. You need training on how to deal with such situations - oh I forgot, you're a nurse, you have been, so use it, show some empathy or go and flip burgers.
charlie1973
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12:52am Sat 9 Mar 13
Janch1
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3:41pm Sat 9 Mar 13
Dobbler wrote:I am not a whinger. Nor am I on a cushy number. You should try a 12 hour shift on a hospital ward dealing with whatever comes at you. Robbing the public and treating them badly? How do you know how we treat people on hospital wards? As for robbing the public, that is a ridiculous remark. Your comments are nasty, personal and typical of someone who knows very little about the work of NHS staff.
@Janch
Come off it you whinger. If you arent happy - leave and give the job to someone else. Youc an maybe start your own business? But oh no youre probably too institutionalised to do that. heaven forbid you come from behind your veneer of mediocrity and do something bold in your pathetic life instead of sucking on the public teat on a cushy number. You are taking money under false pretences - and by definition robbing the public whilst treating them badly too. Hopefully one day you are getting the same treatment from someone equally as bad as you obvioulsy are.
Janch1
says...
3:57pm Sat 9 Mar 13
charlie1973 wrote:There was nothing in the comments made by myself or Maryhorts that said we did not care. It is because we care, that the situations that cause difficulties in doing our jobs makes us so angry. Endless telephone calls take us away from patients bedsides, the reams of paperwork we have to complete for each patient takes more time than actually caring for them. The nasty comments from people like you and many others on this site just shows that attitudes towards nursing staff are pretty aggressive. I am proud of the work I have done over the many years and I have helped patients and their families at a time of worry and sorrow. We do care for patients and your comments about a couple of vacancies for meat inspectors was hurtful and nasty. You are obviously angry and very bitter and may benefit from some counselling.
Janc1 and maryhorts.You are part of the reason my health is finished.I will give you an example then you may understand or not On the 7th of march 2013 i went to rbh to have a test now to pass the test i had to hold my breath for 5 seconds.after 4 attempts the person doing the test said. "I WILL ALTER THE TEST SO JUST HOLD YOUR BREATH FOR 3 SECONDS I CAN PUT YOU DOWN AS A PASS AND SAY IT WAS 5.He then altered the machine and told me i was fine not to worry is it not infact illegal to alter a consultants test just to hit targets.I never told him i was infact terminally ill and the test was suppose to show how far my disease had progressed.But because he has altered the test to say i have passed when i hadnt i have to have the test again.Do you both call this care or do you call it targets.How much care do you two actually give inbetween drinking tea and coffee .My family wont ring rbh they ring me they get better answers.Im glad you both feel rejoyced in sharing how as nurses you actually do NOT care i will pass your good will on to my family.Please feel free to comment on my situation further i do intend to pass your comments on to the gmc.Maybe they could provide maryhorts with gloves for the people who have false teeth or weekends break if the pair of you could actually do the job you say your trained for.Are you sure its nursing and not meat inspectors i beleive certain meat traders have a couple of vaccancies do i care about you two as nurses not a hope in hell i care about the poor sods even after ive gone of this earth that will not get the care they deserve just as i didnt.As i have already said you are a disgarce to the good nurses of this country but you have proved a point rbh is a can of worms and two have just spilled out.
maryhorts
says...
4:29pm Sat 9 Mar 13
boltonchap wrote:The increments stop after five years ....My salary ,just as everybody elses has not increased at all .Because ( and this may suprise you) I continue to work at ward level this will always be the case .My salary will not increase and is only marginally more than when I first qualified .Think about the cost of living 20 years ago and now .In real terms economically a career in nursing is a yearly cut in living standards ...but we do it because we actually enjoy it .The problem we face is the expectations of those around us which are unobtainable because of constraints but upon us .We didn't get a look in in the consultation but are expected to deliver the goods .If the goods can't and don't arrive who is the first person an angry or upset relative is going to confront ?
Heh listen up whinging nurses- it's your job, for which you get paid ( let's not forget the annual incr
boltonchap
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11:26pm Sat 9 Mar 13
Smile everyday88
says...
8:35am Sun 10 Mar 13
hoboh2o
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9:21am Sun 10 Mar 13
You just don't get that people are fed up to the back teeth of the system of which you are a part.
No wonder folk are ignoring the fact certain political parties are trying to privatise you.
like in all sectors of life customer service takes priority over the whinging of a few unhappy union staff.
boltonchap
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9:23am Sun 10 Mar 13
Dobbler
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10:14am Sun 10 Mar 13
Doh!
Im guessing you have been there too long to even have a clue about applying common sense and business like principles to your job. Im also guessing that you know youre on the gravy train (try being a check out operator at Morrisons instead, or working in a factory) and are just milking the system til you retire...and the next bitter and twisted member of staff steps in your shoes.....Get a grip!
boltonchap
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10:26am Sun 10 Mar 13
hazybass
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11:17am Sun 10 Mar 13
hazybass
says...
11:23am Sun 10 Mar 13
boltonchap
says...
12:34pm Sun 10 Mar 13
boltonchap
says...
10:13am Mon 11 Mar 13
Dobbler
says...
12:06pm Mon 11 Mar 13
boltonchap
says...
12:25pm Mon 11 Mar 13
Lawlesschat
says...
4:17pm Mon 11 Mar 13
What a set of ungrateful balloons you are!!! I do not work for the NHS nor am I a nurse but i am mystified by your calls for the commenting nurses to leave their jobs?
At no point did either of the nurses raise anything to merit such ridicule or the comments that followed!
I often have cause to visit the said hospital, the staff are run ragged under ridiculous working conditions with brave faced smiles.
If the nurses put forward their opinions that might assist them, essentially assisting their patients then what harm is there in that?
Get a grip, if you don't like it how about you go and get a nursing qualification and show everyone how its meant to be done?
Hand on heart, staff at the hospital, well done to you all.
The people making the personal comments to the nurses are frequent users on this site. They habitually use this site to express their ill feeling about everything and nothing, usually having an adverse 'pop' at people. A set of 'Blood suckers' on the country's welfare system would best describe them ... I'd be surprised if they themselves are unemployed.
Charlie ... It's sad that you are dieing, however every life eventually comes to an end. If you have little time left, spend it in other ways than being angry with others and spend your last days being nice so you are remembered by people as being 'nice' and not a 'sympathy seeking moaner'.
Go and do something constructive with yourselves ... Go Get a job and focus on something other than complaining all the time. Sheesh!!
Lawlesschat
says...
4:24pm Mon 11 Mar 13
"I know I might not be the only one who after an accident refuse to go there. I'd rather die than go there"
Yea right!!! Of course you would and like you have much option. Tut.
Dobbler
says...
5:04pm Mon 11 Mar 13
Me a frequent poster! Check the facts you muppet - I only joined last week!
Why should I train to be a nurse? I pay a fortune in tax and NI contributions (umlike many who plunder the nhs) so that they staff are there for me and others to use. I have never met anyone in that hospital who has shown any care - especially for old people. In fact last year, a specialist there told me I was right to grumble and that the last place anyone should be, especially the elderly, is in that hospital (infection rates). So get your facts right you total idiot before you accuse me of being a trouble maker here. I mean every word about the staff there based on my experience - so butt out!
I suggested the nurses leave their jobs because they obvioulsy dont like the notion of caring for people and seem to want it to be a walk in the park for them. Id suggest they take a walk to the dole office instead.
You say the staff are 'run ragged'..yeah right. When I was there last,waiting for treatment, they were all huddled in a side room waiting for the winner of X Factor to be announced on TV like wet knickered school girls. They were noisy and racous and running round eating cakes and chocolate and drinking orange juice (probably laced with something). It was a sight to behold.
So I suggest you shove your head back up your anus and tell us when youve found your brains....
Janch1
says...
5:12pm Mon 11 Mar 13
boltonchap wrote:It has not shut us up Boltonchap. We will air our views whenever and wherever we like. You and your two friends Dobbler and Charlie need to get out more instead of sitting spewing your venom out on this site and making nasty personal comments to people you don't even know. Get a life!
That seems to have shut them up!
boltonchap
says...
5:12pm Mon 11 Mar 13
Lawlesschat wrote:" hand on heart .......well done to you all". Lawless I have to say inane, uninformed and baseless generalities such as you spout are part of the problem. Does that include those doctors and nurses who, without my own research and intervention, would have almost certainly have died a year ago. Does that include the orthopaedic surgeon who was going to perform surgery on both my wrists when the symptoms I presented indicated I needed surgery on my neck. Does that include the orthopaedic medics who, due to an incorrect diagnosis, have left me with a permanent limp and pain? Does that include the physiotherapist who actually broke my toe while trying to rectify the damage already done to me? Does that include the nurse above who said, " It's not my job...to get a pot for a patients' false teeth"? If so sir the you have very low standards and expectations and get the mediocre medical services you deserve. As for the barb about being unemployed, wrong again sunshine - I'm self employed and have the good fortune to work from home. What do you do, work for Unison?
Boltonchap, Dobbler and Charlie.
What a set of ungrateful balloons you are!!! I do not work for the NHS nor am I a nurse but i am mystified by your calls for the commenting nurses to leave their jobs?
At no point did either of the nurses raise anything to merit such ridicule or the comments that followed!
I often have cause to visit the said hospital, the staff are run ragged under ridiculous working conditions with brave faced smiles.
If the nurses put forward their opinions that might assist them, essentially assisting their patients then what harm is there in that?
Get a grip, if you don't like it how about you go and get a nursing qualification and show everyone how its meant to be done?
Hand on heart, staff at the hospital, well done to you all.
The people making the personal comments to the nurses are frequent users on this site. They habitually use this site to express their ill feeling about everything and nothing, usually having an adverse 'pop' at people. A set of 'Blood suckers' on the country's welfare system would best describe them ... I'd be surprised if they themselves are unemployed.
Charlie ... It's sad that you are dieing, however every life eventually comes to an end. If you have little time left, spend it in other ways than being angry with others and spend your last days being nice so you are remembered by people as being 'nice' and not a 'sympathy seeking moaner'.
Go and do something constructive with yourselves ... Go Get a job and focus on something other than complaining all the time. Sheesh!!
Janch1
says...
5:14pm Mon 11 Mar 13
Lawlesschat wrote:Thanks for your comments Lawlesschat. Nice to read something where I was not being ripped to shreds for making what I thought was a harmless comment!!
Boltonchap, Dobbler and Charlie.
What a set of ungrateful balloons you are!!! I do not work for the NHS nor am I a nurse but i am mystified by your calls for the commenting nurses to leave their jobs?
At no point did either of the nurses raise anything to merit such ridicule or the comments that followed!
I often have cause to visit the said hospital, the staff are run ragged under ridiculous working conditions with brave faced smiles.
If the nurses put forward their opinions that might assist them, essentially assisting their patients then what harm is there in that?
Get a grip, if you don't like it how about you go and get a nursing qualification and show everyone how its meant to be done?
Hand on heart, staff at the hospital, well done to you all.
The people making the personal comments to the nurses are frequent users on this site. They habitually use this site to express their ill feeling about everything and nothing, usually having an adverse 'pop' at people. A set of 'Blood suckers' on the country's welfare system would best describe them ... I'd be surprised if they themselves are unemployed.
Charlie ... It's sad that you are dieing, however every life eventually comes to an end. If you have little time left, spend it in other ways than being angry with others and spend your last days being nice so you are remembered by people as being 'nice' and not a 'sympathy seeking moaner'.
Go and do something constructive with yourselves ... Go Get a job and focus on something other than complaining all the time. Sheesh!!
hoboh2o
says...
5:24pm Mon 11 Mar 13
Janch1 wrote:It would help if you stopped blaming everyone else and admitted some of your co-workers standards left a lot to be desired instead of going down the 'myth route' of being underpaid Saints!
Lawlesschat wrote:Thanks for your comments Lawlesschat. Nice to read something where I was not being ripped to shreds for making what I thought was a harmless comment!!
Boltonchap, Dobbler and Charlie.
What a set of ungrateful balloons you are!!! I do not work for the NHS nor am I a nurse but i am mystified by your calls for the commenting nurses to leave their jobs?
At no point did either of the nurses raise anything to merit such ridicule or the comments that followed!
I often have cause to visit the said hospital, the staff are run ragged under ridiculous working conditions with brave faced smiles.
If the nurses put forward their opinions that might assist them, essentially assisting their patients then what harm is there in that?
Get a grip, if you don't like it how about you go and get a nursing qualification and show everyone how its meant to be done?
Hand on heart, staff at the hospital, well done to you all.
The people making the personal comments to the nurses are frequent users on this site. They habitually use this site to express their ill feeling about everything and nothing, usually having an adverse 'pop' at people. A set of 'Blood suckers' on the country's welfare system would best describe them ... I'd be surprised if they themselves are unemployed.
Charlie ... It's sad that you are dieing, however every life eventually comes to an end. If you have little time left, spend it in other ways than being angry with others and spend your last days being nice so you are remembered by people as being 'nice' and not a 'sympathy seeking moaner'.
Go and do something constructive with yourselves ... Go Get a job and focus on something other than complaining all the time. Sheesh!!
boltonchap
says...
5:33pm Mon 11 Mar 13
I also missed out a key part of my comment above - it was my wife who almost died because of misdiagnosis. Oh yes, my brother died of cancer there a few years ago. I remember all too well him begging for pain medication while the staff were playing on computers, and I mean playing. We had to clean his room ourselves it was so dirty. For a while he was in the intensive care unit - the staff here were nothing short of magnificent, well done to you all in the ICU.
Smile everyday88
says...
6:24pm Mon 11 Mar 13
boltonchap
says...
11:59am Tue 12 Mar 13
Lawlesschat
says...
2:23pm Wed 13 Mar 13
Victims,victims, victims .... Someone always owes somebody something!
Get a bloody grip the lot of you, I've never heard so much incredible tosh in my life.
Your 'crazy stories' of your own medical treatment at the RBH are so common it's a wonder why you've not hit the headlines yourself.
You've all done yourselves an injustice by the responding to my earlier posts with blatant garbage!
I strongly suggest ... Bupa may be a better consideration next time!
boltonchap
says...
3:31pm Wed 13 Mar 13
Lawlesschat wrote:Offensive little tosser aren't you when losing an argument. None of the detail I gave is crazy or garbage: I don't have that good an imagination. You clearly do and it's clearly twisted - perhaps you should seek treatment.
As I am employed full time I don't have the privilege of visiting the site several times a day or even every day for that matter!
Victims,victims, victims .... Someone always owes somebody something!
Get a bloody grip the lot of you, I've never heard so much incredible tosh in my life.
Your 'crazy stories' of your own medical treatment at the RBH are so common it's a wonder why you've not hit the headlines yourself.
You've all done yourselves an injustice by the responding to my earlier posts with blatant garbage!
I strongly suggest ... Bupa may be a better consideration next time!
What happened in your life that turned you not just into a warped individual but also an apologist for lousy medical services? There's a connection somewhere, go for a long walk, get some fresh air and do some deep personal analysis.
I'm guessing also that you work in the public sector - I'd bet the farm on it - apart from your mentality which scream " public servant " you must be submitting these posts while at work.

charlie1973 says...
7:48pm Wed 6 Mar 13