Age at interview: 61
Brief Outline: Hugh had knee problems since he was a boy. He had partial knee replacement surgery to his right knee and later to the left knee in 2014. Hugh’s operation was postponed 3 times and he contacted PALS for support.
Background: Hugh is a fork lift driver and has 3 adult children. Ethnic background / nationality: Jamaican

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Hugh had knee problems since he was a boy. A few years ago while playing cricket, his right knee gave way. He had keyhole surgery (arthroscopy) and, later, partial knee replacement surgery to his right knee. After some time, his left knee started to feel painful and gradually got worse. His GP referred him to the Nuffield Orthopaedic Centre, an NHS hospital, where the doctor advised him to take painkillers and use a pain relief gel to see if these would work first. 

Hugh followed the doctor’s advice and starting taking lots of painkillers until he says he got ‘fed up’. He went back to the GP who referred him to the hospital again, and this time he was offered a steroid injection. The consultant asked him to wait six months to see if it worked. The injection didn’t work, though, and Hugh carried on putting up with the pain. He went back to the hospital again and this time was given an x-ray. Hugh was later booked in for a pre-operative assessment. By then, it was almost a year since his first visit to the hospital and two years since his knee pain started. He was put forward as emergency surgery.

On 6th May 2014 Hugh had his pre-operative assessment. Doctors hadn’t received a letter from another hospital about tests he’d had earlier for chest pain. Hugh asked medical staff to write to his GP about this. His operation was scheduled to take place on 29th May but was cancelled at the last minute because doctors hadn’t received the report. At that point Hugh was in his hospital gown and ready for surgery. He had to put his clothes back on again and go home. Later he went to see his GP who, after checking her records, said she had not received any requests from the hospital. 

Hugh was sent a second surgery date of 10th July but, on that day, was told that his operation had been cancelled and he wasn’t given a reason. He was then scheduled to have surgery on 31st July but it was cancelled a third time and there was no explanation why. Having had his operation postponed three times and given just one good explanation, Hugh felt very frustrated and wrote to PALS (Patient Advice Liaison Service), explaining the situation. PALS contacted the hospital and the 31st July appointment was brought forward to 24th July.

A friend recommended that Hugh should contact PALS about his hospital cancellations. Hugh hadn’t heard of PALS so he asked Human Resources at work to find out more about it. He then wrote a complaint letter and asked for their support. In the letter he explained that all the cancellations were having an impact on his work and job security. He works as a fork lift driver so his company needed to hire and train someone to replace him while he would be off work because of surgery. The company had to plan twice for a replacement to cover him for the ten weeks. He said that his hospital cancellations were becoming ‘a joke’ at work, and feels that more communication is needed between GPs and hospitals. 

Hugh didn’t get a chance to see the Technology Enhanced Patient Information (TEPI) videos for long. While watching them he was called away to see one of the health professionals. When he wanted to go back to see them, there were too many people waiting to see the site. Seeing the TEPI videos in hospital was Hugh’s only chance to see them as he does not have a computer or internet access at home. He also did not get the opportunity to have things explained to him by the surgeon as he was called away during the appointment. 

Hugh is waiting for his follow-up appointment and expects to be referred for physiotherapy, as he was when he had his right knee done. He lives with his son who works during the day, so has to look after himself. Hugh does most things at home, including cleaning and cooking, and when he feels pain he sits and rests. Hugh does his knee exercises regularly because he wants to get better and be able to walk normally again.

While Hugh was watching the TEPI videos, he was called

While Hugh was watching the TEPI videos, he was called

At which point did they explain to you about the TEPI website that you can go and look at the information that is there?

Oh, that, when they brought me to show me on the TV well. And they show me on the TV what you could see on the TV and what you can do and what you can’t do. Well, while I was doing that, I had to come out the office to go and see someone else. So we had to stop that and I go and see someone else. And I think when I come back it was so much people want to go in at the same time. 

So you, how much did you see?

Not a lot, not a lot.

I just have a printout here. And you can tell me how much you saw of it. This is the partial knee replacement. So the first part is sort of kind of what’s going to happen during the pre-admission clinic and day of surgery and recovery. Did you, do you remember how much you saw? And there’s that and... Did you get any information about your knee problem?

For the first, when I first went in they were telling me about the knee. That’s, I saw this part here, where they show how the knee kind of, how they’re going to operate and things like that. Yes, I see this part here. But I didn’t see the whole lot of it, the whole CD what they were showing. I had to come out the office to go and see some, the doctor.

And then there was no time --

No time, no time, yes.

-- to go and see it? And can you see it at home? Do you have a computer at home?

No, I haven’t got a computer.

So your chance of seeing the website was in the hospital?

Yes, yes.

Hugh’s surgery was postponed three times. He couldn’t understand why and contacted a patient advice service for help.

Hugh’s surgery was postponed three times. He couldn’t understand why and contacted a patient advice service for help.

I called my GP and I said, “They cancelled it for the 10th.” And then they put me in for the 31st of July. And then it was cancelled as well.

Any reason?

Well, I haven’t seen any reason in a letter. These are the letters and they didn’t say any, give any reason. So I called my, I went to see my, I called the GP and I said, you know, “It’s been cancelled again. And that’s the third time.” And I don’t get any good reason why. I mean the first time, when they said they couldn’t get the letter from the, they didn’t have the letter from the [hospital name], then I could see with that. But the next two times after that, I can’t see why they cancelled it. And I was supposed to be emergency.

Did your GP call them afterwards?

Yes, my GP, well, she didn’t call them in front of me, but she said she will call them and she will talk to them. And she talked to the consultant at the Nuffield, secretary, speak to them and things like that. And every time when she called and they make an appointment, then they cancel it. 

So next time that I went back and I said, “I’m getting fed up of this thing. I’ve got to make a complaint, I shall complain.” And I said, “I’ve been cancelled three times.” The first one was because I didn’t get any letter from the [hospital name]. And I saw them cancelling as a lack of communication between my GP, the [hospital name] and the Nuffield. So I get, I get a bit cheesed off with it all. I wrote to PAL and 

You wrote to PAL, PAL? Patient Assistance? [Patient Advice and Liaison]

Yes, yes. Patient Advice Liaison, yes. And I wrote to them and I explained to them about being cancelled so many times and with one reason that they gave me. And they contacted the Nuffield, this is the letter I’ve got from them, and they contacted the Nuffield and the Nuffield put it from the 31st of July and brought it forward to the 24th of July because PAL got in touch with them.
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