Result: NHS acts on a serious medical misdiagnosis on the Isles of Scilly

Isles of Scilly; beautiful and tranquil but medically problematic

Isles of Scilly; beautiful and tranquil but medically problematic

Readers of this blog may just remember that over three years ago I suffered a serious injury – a triple shoulder fracture – when I tripped and fell awkwardly on a rocky path on Tresco on the Isles of Scilly.

An accident 28 miles off mainland Britain is always a tricky problem – but mine was compounded by the failure of both a duty doctor and nurse at St Mary’s Hospital – the GP led hospital on the islands – to realise this had happened. It was never X rayed and both staff thought I had bruised and sprained my shoulder.

 It was only when my wife made consult my own GP in Berkhamsted – a week after the  accident- that I was sent off to Watford General Hospital who discovered I had been walking around with three broken bones – and  the main bone between my shoulder and elbow had almost come out of its socket. Due to heroic efforts by one administrator at Watford they managed to find me a bed and I had a  five-hour operation to put me back together. This I might say after physiotherapy is  now 95 per cent back to normal. I have also been full of praise about the surgeon who did it,Andrew Irwin.
I put in two complaints to the NHS authorities in Isle of Scilly – one about the service – when I discovered the hospital had an X-ray machine but only a radiographer available for two hours a week. So bad luck if you had an accident outside Tuesday afternoon.

 I also complained about the doctor’s failure to diagnose the problem – and got an apology and found the doctor had been sent for retraining to deal with accidents on the mainland.

 Until today I had not heard anything positive about the paucity of X-ray services, only a rather defensive reaction saying that it was difficult to do anything. It certainly made me worried given the Isles of Scilly is a mecca for all sorts of sports from sailing, windsurfing,diving,rock climbing as well as great walking country.

Imagine my surprise to receive a communication through NHS Choices today to say the hospital has now replaced its ageing X-ray equipment with a new digital X ray – presumably allowing computer images to be sent to other major hospitals. It added: “Extending access to a radiographer is work in progress and is being looked into by the Kernow Clinical Commissioning Group and the Islands Health and Well Being Board. With regards to staff training, MIU training up-dates are provided twice a year by the MIU Lead. She will revisit limb examinations on her next visit. “

 Well it may have taken over three years but I am glad that some action is being taken. To my mind it shows that it is worth complaining if the NHS fails to deliver – authorities do appear to take note, even if it takes time.

Misdiagnosis,bad prognosis then last minute brilliance: my treatment by the NHS

preparing to go under the knife(not my operation)

Being treated by the NHS is like riding a rollercoaster or watching England play in the World Cup ( even as a non football fanatic).

One minute you cannot believe professionals can make such errors, the next you can’t quite believe how they brilliantly they got their act together.

I had the misfortune to trip over a rock on a remote headland path on the Isles of Scilly – falling flat on my face with my arm outstretched skidding across another rock. I was unable to get up unaided.

 I should have known not to do this except on Tuesdays between 2.0 pm and 4.0pm – the only time there are X ray facilities on these  islands some 30 miles from the Cornish mainland. I was later to find that while Scilly has  brilliant first aiders and paramedics who use a jet ambulance boat, its cottage hospital at St. Mary’s is a one man and a dog operation.

And unfortunately for me this was a Thursday afternoon- so no x ray without calling in an air ambulance to Penzance. I was diagnosed as to have nothing wrong with me except  sprained and badly bruised muscles and sent home with Paracetamol and Ibuprofen.

For the rest of our holiday we spent quietly on Tresco. Only after visiting my GP in Berkhamsted nearly a week later and being sent off to casaulty at Watford General Hospital, did I find I had fractured my shoulder in three places. But never mind, the prognosis was that the bones would heal by themselves. I would be sent to the fracture clinic at Watford to arrange physio.

A week later and seen by orthopaedic doctors at the clinic, it suddenly emerged that I needed an operation to restore my shoulder and upper arm to full mobility. And worse still there was only a week left to do  it, because my bones were well on the way to trying to heal themselves  in the wrong position.

Here despite a horrendous reputation trying to run a busy overstretched hospital on a  shoestring (West Herts having closed down our nearest  a&e hospital Hemel Hempstead), fingers were (metaphorically) pulled out.

Within two hours, I had a CT scan, bloods and swabs taken in case I was carrying MRSA without knowing it. Within 24 hours the hospital found me an orthopaedic surgeon, South African Andrew Irwin, who specialises in smashed shoulders and upper arms.

They had a problem- no bed. A hospital administrator -Jane Ward- came to the rescue ( remember those people politicians despise because they don’t  do front line care) and three hours before I was due to come in-had found one.

My 44 hr stay on Flaunden  general surgery ward was a minor miracle -with almost every NHS cliche in the book. The surgeon turned out to be the typical no bedside manner type – in the one minute consultation- it was simply  “you have a smashed shoulder. We’ll fix it.” The nursing care-despite staff shortages- was superb with one staffer, Trish, doing a double night shift and staying on an extra hour to  complete unfinished tasks. And while the operation took six hours -described as ” a tricky one” by a junior surgeon the next day, I actually did feel safe before and afterwards.

Slight shock at being turfed out with one hour’s notice the next day- but I suspect that with one or two patients with undiagnosed infections surrounding me, it was for my own good. Yet they managed to get me to see a phsyiotherapist, get a final X ray ( when I discovered I have a metal plate and a long pin in my shoulder), get some drugs and talk to a pain nurse and after a strong representations from my anxious wife, arrange for patient transport home.

The experience suggests -despite Labour’s spending boom –  an NHS much on the edge trying to provide best patient outcomes. My shoulder is starting to recover. All I can say is that if David Cameron or Nick Clegg – start thinking of squeezing the NHS in any way- I shall use it to thump them when I meet in the House of Commons as part of my job.