A distressing report into the lack of care and compassion experienced by a dying patient at the Royal United Hospital in Bath has been published.
Cliff Eddolls died at home following a short illness | Photo: Family handout
Shortly before his death, retired firefighter Cliff Eddolls from Whitchurch told his wife Anita that he felt staff were “experimenting” on him and that he was in the “house of horrors”.
The hospital has said it is “deeply sorry” for the care, support and communication that the 63-year-old and his family received and is acting on the feedback.
Anita has also received a letter of apology from the RUH’s chief executive Cara Charles-Barks after writing to her directly.
Cliff had been admitted to the Medical Assessment Unit on Monday 31st October 2022 after being referred by his GP. He felt unwell, had bilirubin in his urine and the doctor suspected hepatitis or an infectious disease as he and Anita had returned from a holiday in Egypt.
An initial scan the following day showed cancer in Cliff’s lungs had metastasised into his liver. Two days after being admitted he was moved to Haygarth Ward – and what happened to him in there until he was discharged three weeks before dying at his home is outlined in the report.
It has been released by the independent body Healthwatch Bath & North East Somerset and makes five recommendations. It was co-written by Mr Eddolls’ widow, family members and Healthwatch’s development officer, based on letters and conversations.
It says: “The family’s concern in sharing their very personal story is to highlight the very real and long-lasting impact on the patient and their family when difficult and negative experiences of care and treatment are compounded by communications lacking in compassion.
“Their hope is that their story will help to ensure that others do not have to go through similar experiences.”
The report highlights the delays and mistakes in Cliff’s treatment, as well as the family’s feelings about the “lack of kindness and compassion shown by some of the key people responsible for his care” which impacted greatly on the much-loved father, grandfather and great-grandfather.
Cliff was a well-respected firefighter with Avon Fire & Rescue | Photo: Family handout
Summarising what happened, Anita says in the report: “Cliff was in hospital for 23 days. He received no treatment for 15 days and suffered multiple delays in treatments and scans because of mistakes made. Not one mistake, not two but mistake after mistake after mistake! There were non-existent referrals made and promises made to us that were not kept.
“Cliff was starved and left severely dehydrated which was made worse by your hospital and again another mistake. He deteriorated day by day because of this, in your care.
“The people who are meant to help him, not make him worse. Cliff did not see an oncologist until two days before he left hospital and only seen the consultant when we put in a complaint to the chief executive.”
Anita says her husband only then saw the consultant when he wanted Cliff to sign the DNR (Do Not Resuscitate) after Cliff had already told the medical nurse practitioner (MNP) that he didn’t want to as “he wanted to live”.
She continues: “After Cliff was pushed into signing the DNR, he said, ‘That’s it, I am a gonner’. He did not speak much after then, he shut down and gave up.
“He knew he had no chance of survival at your hospital. It haunts me every day and it is the cruellest thing I have ever experienced but Cliff was the person going through it. He was traumatised, frightened, very low/depressed and he had no hope.
“He told me he felt like he was being experimented on and said he was in the house of horrors.” Anita says that whilst initially being welcomed on to the ward, they found that as time went on, the MNP became “unapproachable and unkind towards us as his family and showed a lack of compassion
towards Cliff”.
“This included telling him he had bile duct cancer without any family member present despite saying she would not do so.
“If you spoke to her, she would put a flat hand towards your face which we found rude and extremely worrying for us as we had to liaise with her to find out what was happening.”
Anita says that whilst there were nurses, doctors and other staff who treated Cliff with the kindness and compassion he should have been able to expect, their overall experience was that the hospital did not take proper care for him, or care about him and his emotional wellbeing. No counselling or other support was provided.
The report includes a section from a cognitive behavioural therapist who has been helping Anita this year. She says: “Writing and publishing their story has been an important part of her journey, allowing her to express her thoughts and feelings and voice her experience in the hope it may help others in the future.”
The report also highlights that Haygarth Ward “smelt of faeces and vomit” when Cliff was first admitted, and that due to building works from 15th November until his discharge there was the sound of “constant banging and drilling” which added considerably to his distress and that other patients on the ward.
Cliff was finally discharged on Friday 2nd December. An ambulance was meant to take him home but after waiting all day the family decided they would take him themselves.
He died at home on Tuesday 20th December, having been cared for by his family with some support from district nurses, St Peter’s Hospice and Marie Curie.
Anita says in the report: “We were left with many questions about Cliff’s treatment and received conflicting information from different people involved about what did and didn’t happen, why and when.
“This has left us feeling, even now, that we do not have full and accurate explanations about the stages of Cliff’s treatment.
“We know that Cliff was very sick, but feel that the delays, errors and mistakes prevented him from having the opportunity to fight the disease and potentially live a little longer to spend precious time with his family and friends.”
Cliff, who had four children, five step-children, 20 grandchildren and two great-grandchildren, had been a well-respected firefighter with Avon Fire & Rescue Service and many of his former colleagues formed a guard of honour at his funeral.
He first served as a wholetime firefighter at Bedminster Fire Station, starting in April 1983 with Blue Watch, and retired from operational duties in April 2013 before rejoining as a driver maintenance technician.
The Royal United Hospital’s response
The Royal United Hospitals Bath NHS Foundation Trust says in a statement: “We recognise that Cliff was very unwell when he was in our care and that he had received a devastating diagnosis which had profound consequences for him and for his family.
“The trust undertook an investigation into his care and treatment and identified that although his medical treatment was appropriate, the care, support and communication Cliff and his family received could, and should have been much better and for this we are deeply sorry.
“We are progressing with the improvement actions identified from our review of Cliff’s care and treatment.”
Meanwhile in responses to enquiries by Healthwatch’s development officer, the hospital said that with regard to training in the completion of ReSPECT forms, (DNR) this forms part of the medical mandatory training programme, and the hospital has undertaken “intensive work” with all multidisciplinary teams over the past year to raise awareness.
Its Patient Experience training programme is developed with “deep consideration” to feedback received from patients and their families through complaints and concerns and this “very much” includes the feedback in this case.
The Family Liaison Facilitator team is now fully recruited, including a lead facilitator.
The hospital also says that the new Dyson Cancer Centre has helped bring staff together which will help promote team working and care for patients. The centre has a Macmillan wellbeing hub to enable private conversations with patients, patient counselling and support.
The hospital adds: “It is our hope that it will improve the care of our future cancer patients.”
The report’s five recommendations
The report, ‘My Voice Matters – the importance of compassionate communication in care’, makes five recommendations.
They are intended for hospitals and health providers across the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board area in general, rather than being directed at any specific hospital or ward.
They focus on patient experience, and the expectation as set out in a ‘Shared Commitment to Quality’ that patient experience is given equal weighting alongside patient safety and clinical
effectiveness.
- Patients and their families being able to and have the time to ask questions about treatments and procedures should be welcomed and accepted.
- Medical practitioners should explain conditions, treatments, procedures and decisions in a clear way and check that they have been understood.
- Medical practitioners should have compassionate conversations early on, especially where diagnoses of terminal conditions are being shared.
- Medical practitioners and other hospital support services should ensure information about the range of emotional support available is readily accessible and on offer for patients and their families, especially where patients are facing stressful conditions and terminal diagnoses regardless of ‘clinical’ need for formal mental health support.
- Practitioners should give enough time to explain about ‘DNR’ processes and what this means and allow enough time for patients and their families to understand and ask questions about DNR and to consider their response. They should not feel rushed into making quick decisions.
The report will be made available to the Royal United Hospital and other hospitals within the health region to inform their ongoing training programme.
It may also be used to inform future work planned by Healthwatch into the provision of end-of-life and palliative care.
The report is available to read on the Healthwatch website.
