Tuesday, April 14, 2009

Pity The Poor Dieticians Again!

I really do feel sorry for them!

During one of my telephone conversations with Geraint about the NG tubes he suddenly decided to quiz me about what Hari eats. Now admittedly I wasn't exactly forthcoming in my response but that is because I had already given them this information - the repeated inquisitions were getting boring!

I am sure that the dieticians would love to give us accurate advice and recommendations with regard to Hari's diet but they are not in a position to do so. As I've said before, they cannot advise responsibly whilst there is no diagnosis for the undiagnosed. They would be required to follow policies which would result in their advice being harmful to Hari. The policies, which take no account of individual need, decree that pre-prepared nutritional feeds must be used. They will not and cannot deviate from these policies without a diagnosis for the undiagnosed - so until the doctors decide to diagnose the dieticians are being prevented from advising accurately and appropriately and will be forced to recommend the pre-prepared nutritional feeds.

Well Hari's doing very well without them thank you!

So this week we received a letter in the post from the dietician's department.

The letter requests my 'permission' for the dieticians to review Hari's nutritional status and feeding equipment needs. Her equipment needs have very recently been ascertained and organised. I have already explained her nutritional status, emphasising that the changes we have made have resulted in her health improving and in Hari being pain free for the first time in five years.

They have even, very kindly, included a tear off slip at the bottom of the letter for me to sign and date. On this slip I should apparently indicate whether or not I agree to such a review.

We wonder exactly who has decided to send this letter - and why.

Hari has decided that she will respond to this letter herself.............just as soon as she manages to stop laughing!

1 comment:

BloomingPouf said...

This is evidently just administrative politics and backside covering with tear off slips for indemnity reasons!

Harri is well within her rights to respond. The Response should point out that this document and any response does form part of her medical records. As such, it is to be fully applied to her medical records. It is a Consent Form and any and all Consent Forms are themselves Medical Records and have to be treated as such and kept!

How any response is written there after, and what it contains is, of course up to Harri. The Obligation to correctly store, manage and use Medical Records falls fully upon the Record Holder - who is of course acting on behalf of the Sec State.

Should there be any negligence and or mismanagement of Medical Records, This is very serious and it is the Chief Executive of a Trust who holds the liability for any such events.

Any negligence and or mismanagement of medical records is best addressed under the NHS Complaints procedures. However, as a Chief Executive of a Trust is responsible for the Trusts Complaints Procedures there is a conflict of interest. The Trust therefore can not investigate their own mismanagement.

Under such circumstances the Sec State should be asked to investigate under the NHS Complaints procedures, and that will entail the setting up of a Fully Independent Review Panel!

Normally the Sec State is obliged to Instruct the Chair and Board of the Trust to fully investigate and report! Most Trust wisely request that others then carry out a full investigation so that any and all Conflicts of Interest are removed - for the sake of fairness and Natural Justice.

Hope Harri sends the right response!

November 21, 2008 1:01 PM
(reposted by moderator April 09 after technical changes)