The North East Ambulance Service has apologised to a patient who was dropped by medics when transferred home following a leg amputation.
The patient was returning home from a hospital stay when the NEAS scheduled care crew transporting him dropped him while trying to help him into his home. This resulted in his amputation wound reopening and caused significant distress - while according to the report into the case, the patient required a district nurse to visit eight times to re-dress his wound which became infected.
The two-person crew responsible for the incident are currently undergoing disciplinary procedures, while ambulance service bosses have raised concerns about the process hospitals use to book patient transport for those they are discharging. At a meeting of NEAS's board, execs said the case highlighted that often NEAS is not given enough information to assign the correct kind of crew for patients who may have complex needs.
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The complaint was presented to a meeting of the NEAS board as a "patient story" - designed to illustrate how the ambulance trust learns from mistakes. Director of patient safety Sarah Rushbrooke described the case.
"This was a complaint we received following an accident that occurred when a patient was transferred home," she said. "Sadly through not correctly carrying out manual handling they dropped the patient causing his wound to open. It was obviously a very distressing time for the patient, his friend and also for the crew.
"I would like to highlight the discussion about discharge. The patient here was adamant that he was discharged despite the fact they could not get all the measures needed in place. I wanted the board to see how we took a complaint through from it being made through the investigation and to the lessons we learned.
"This patient was deemed to have needed a lot of support but was incredibly keen to get home. He did have an OT assessment but it was a very quick discharge. The hospital booked transport and said he could travel on his own but would need a two-person crew. Looking now, it's clear he probably required more support given his complex needs."
Ms Rushbrooke told the board meeting that following the resolution of the complaints process, the unnamed patient had said he would feel confident in calling the ambulance service in future and had appreciated the service's openness while dealing with the complaint. She added that in cases like this the lack of detailed information NEAS receive posed an issue. She said: "What we get is 'this person is suitable for a two-person crew'. If we had known more about the situation we would have sent a different crew."
In the board report dealing with the issue, the results of NEAS's investigation are detailed. This found that the crew in question should have "dynamically assessed" the environment they were working in and failed to do so. They then used non-standard moving and handling techniques that have not been common place since 1981 to attempt to move the patient from his wheelchair into his property.
The investigation also found: "The discharge lounge sister did not complete the mobility, equipment, and disability fields, and the only detail added was that the patient was being discharged on the same day as the booking. The patient would be travelling in his own wheelchair and would require a two-person crew." The hospital in question was not named, though NEAS execs suggested the lack of detail was an issue throughout the system.
Chief operating officer Stephen Segasby said that this led to ambulance service staff "being asked to work beyond their scope". Non-executive director Alison Slater added: "I think it's a problem we are going to see increasing due to the pressures we are under."
John Marshall, another non-executive director, added: "It seems like there is some work we can do to help produce a guide to help those discharging. I think it will be for us to keep a really close eye on."
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