Long wait in emergency department with no information and without appropriate nursing care

What happened

Mr L arrived at the Trust with swelling and pain in his right ankle. Trust records show that he was booked in and triaged late morning.

He saw a junior doctor two hours later and blood tests were ordered. Mr L told us that he was seen around 8pm by a member of the orthopaedic team, who then went away to check his blood tests. Mr L then waited two more hours to be reviewed by another orthopaedic doctor. During that time he was not given any information about what was happening. He was offered one cup of tea and no food.

At around 10pm, when he started to feel faint, Mr L asked for something to eat and was offered food which he felt was not suitable for him for religious reasons. The specialist who eventually reviewed him confirmed a diagnosis of cellulitis and decided that he was to be discharged with oral antibiotics and painkillers. He was then discharged at around 11pm without any take-home medication, after the hospital pharmacy had closed. There was therefore a further significant delay before a family member could return to the hospital to get Mr L's medication. He was not given any help with calling a taxi.

What we found

The medical treatment Mr L received was reasonable, but it was unacceptable that he waited for such a long time before a decision-making member of the orthopaedic team saw him. He received no information about his treatment, diagnosis or management plan during his wait. The level of general nursing care he received was inadequate, because he should have been checked regularly, including being offered food, drink and painkillers.

We concluded that the long delay could have been avoided if a consultant had reviewed Mr L in the emergency department. We also found that the Trust's response to the complaint was inadequate. We upheld the complaint.

Putting it right

The Trust has apologised to Mr L.