The 'Investigating Officer's Report' - 19 pages long, with Appendices totalling another 80 pages - 99 PAGES IN TOTAL! (of A4) - Overkill? Overkill? Overkill?
HIGHLIGHTS, COMMENTS, and the FULL REPORT just a click away!
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For a list of those failings that have been admitted by Mr Senior in his Report see THE TRUST FINALLY REVEALS OTTO BOCK's BREATHTAKING INCOMPETENCE!
Appendices and Dr Walsh's Report to follow! Now that will cause embarrassment!
The highlights are;
Despite its length the Report stifles the truth and contains umpteen gross misrepresentations. I believe that Mr Senior's Report was as good as finished in early January 2011, but I was repeatedly denied access to any information as was my 'Designated Complaints Manager' - why? No wonder my Designated Complaints Manager rarely had anything to report. This was despite the fact that the ultimate Head of Complaints Mrs Alison Last promised to instigate Daily Reports in her email dated 22nd December 2010 (Previously Mrs Last's promised me Weekly Reports but they never got going - the whole thing was a farce, with Mr Senior denying both of us any information. Yes, I wrote to various people at the Trust on numerous occasions - who wouldn't. Yes, I don't beat about the bush, probably because I don't suffer fools lightly. At least I get things done AND treat others fairly! The Trust's Complaints Administration was a total shambles.
Mrs Taylor et al MUST BY NOW be aware that the Reports is crammed full of gross misrepresentations - if they weren't before. Surely it is time to open a dialogue and put the record straight?
The Report and other damning information has only been made available to me by virtue of the Data Protection Act. Had I been made aware of the contents back in January I could easily have drawn the Trust's attention to serious mistakes and gross misrepresentations, and all this unpleasantness could have been avoided - but they wouldn't tell me a thing - is it any wonder I continued to press the Trust for information?
A deliberate and totally unprovoked attack on my integrity.
To add insult to injury Mrs Taylor's Final Response ended with an entirely untrue and wicked attack on my integrity. An attack that my Consultant Dr Martina Walsh was happy to perpetuate in correspondence addressed to the Head of my GP's Practice (I would hope that, given their eleven years experience of my timekeeping and attendance they would regard Mrs Taylor's account as fanciful - but that's not the point. Dr Martina Walsh also spread the news to my local Acute Hospital, and my Neurologist, who was taken in by it and has treated me accordingly. And that was just for starters, when you consider just how many other hands Mrs Taylor's Final Response and Dr Martina Walsh's Report would pass through, both Medical and Secretarial. No-one has rescinded their comments which amount to defamation of character - at least I admit it if I make a mistake, especially one as serious as this. (Full details will be uploaded shortly.
I have been amazed to discover that, having denied me the services of an Orthotist (there were quite a few in the Dept. at the Centre), with effect from the end of September 2010, on 6th January the Trust took the decision to discharge me, in the most spiteful manner imaginable, even though they had not received Otto Bock's final Report nor gathered other critical evidence! Whilst at the outset the Trust admit that they sat on their collective hands for six whole weeks (no explanation provided), the Trust were happy to barge ahead after having a Meeting, specifically arranged to enable me to dispute their findings, in my absence. It was a Kangaroo Court pure and simple.
Extracts from the Report in BLACK, comments in RED and GREEN.
e. Focus on ongoing care. Mr Dawson's primary desire, expressed in his letter, was for appropriate ongoing care and treatment. The investigation therefore dedicated a considerable amount of time to this element of his request as detailed later in this report.
Subsequent to this, much of the time in November and December was spent establishing and agreeing the interim prescription that would be provided as agreed at a meeting held with the Complaints department on 17th November.
How could anyone take this long to agree to put one extra layer of foam on top of my usual prescription (to fit deeper shoes), that had NEVER before changed! And when did I receive the orthoses? Due to an almighty cock-up by the Trust AND Otto Bock, which the Trust completely denied, it took until 2nd February for me to receive replacement orthoses, by which time irreparable damage had been done to my feet and mobility - fact. The November - December - January 'total cock-up' was finally admitted in mid - January (in writing), after the Trust had as good as called me a liar. Of course I was angry - who wouldn't have been - I was in terrible pain, including throughout a short cruise during which time I was completely confined to an electric scooter because I had nothing fit to wear in my shoes.
5. Complaint investigation
The investigation has taken longer than could be expected. There are a number of reasons for this:
a. It is accepted that the initial complaint was received in the service in early September but not delegated until mid-October. This appears to have been a failure in the system for managing complaints. Addressing this weakness is part of the recommendations.
I was told by the Complaints Manager who acknowledged my Complaint, that the delay was not for want of her trying to progress it - I assume from that that her efforts were thwarted. It landed on Mr Senior's desk six weeks later. I have not been told how or why this delay occurred.
Dr Walsh was asked to prepare a clinical report of her review of the patient (appendix 9). In this she states that at the second appointment, Mr Dawson's feet "looked exactly the same, and there was no change to the physical examination". This is corroborated by the other team members present at this meeting (see appendix 6), who noted that Mr Dawson's feet were in structurally good condition.
Re appointment 19th November 2010. Well, well, well, now you know! The NHS can save itself a huge amount of money by abandoning X-Rays, Scans, and MRI's! All they need to do is get Dr Walsh and her team to 'have a butchers'. It has long been established, beyond a shadow of doubt, that my main problem concerns the first phalangeal joint of my left foot - fortunately, this is not showing through the skin! Was this a realistic diagnosis i.e. there is nothing to see!
Dr Walsh did advise me, but did not recommend, two different surgical procedures that were possible - both were complicated operations that Dr Walsh said needed someone with very specific skills. What was more, Dr Walsh said that the outcome was by no means certain, and might leave me considerably worse off. Surely, Dr Walsh would not have been commenting on such a drastic course of action if she thought that there was not much wrong with my left foot!
It is also worth mentioning that Dr Walsh repeatedly maintained that she 'knew nothing about orthotics', of that both my wife and I are certain! In the circumstances I found her statement somewhat confusing, considering her specialty.
Mr Senior was determined that I would not have any access to his Report or knowledge of it's contents prior to the Meeting that I was unfit to attend due to continuing ill health. This was due to a particularly severe virus that I was treated for at the end of January, on top of months of sleep deprivation caused by unnecessarily lost mobility. This directly aggravated longstanding low back pain (pain patches no longer gave me relief), together with neuropathic pain (20 year history of progressive pain), and very regular night-time 'cramps' in both calves. Prescription medicine for this caused very severe nausea leading to internal damage from violent retching - it's all in my medical records and Mrs Taylor could have verified this had she chosen to - but she didn't want to verify my account of events! She was intent on getting me to attend the Meeting however poorly I was, but I stood my ground and thank goodness I did!
Despite these overwhelming reasons for my repeatedly giving my apologies that I was unable to attend (to my Designated Complaints Manager and to her Line Manager Mrs Alison Last, Head of Patient Experience, when she telephoned to confirm the position the following day, and then in writing to Mrs Tracy Taylor, and again from someone who answered her telephone and sent her an email (I have a copy), so Mrs Tracy Taylor was well aware that I was not going to attend, yet she went ahead in my absence. Also, Mrs Taylor could have accessed my Medical Records if she had wanted to verify the facts. Instead she deliberately continued to harass me to attend. When I didn't Mrs Taylor and her followers, including my Consultant Dr Walsh-Khattack deliberately spread the lie that I had simply not turned up and left them all waiting for an hour and three quarters! To round things off, in an attempt to deliberately discredit me, Mrs Tracy Taylor spread the word that I had simply not turned up via her 10 page Final Response! In conjunction with this my Consultant, Dr Martina Walsh-Khattack took obvious delight in spreading this wicked lie further afield! (I have a copy of the Report that Dr Walsh circulated.)
I had had my 'Annual 60-Minute Review Appointment' (six months late - Dr Walsh-Khattack admitted that she 'had got a little behind' in November, and although she was fully aware that I had not been receiving the orthotic care that she had recommended (the only real action she took was to refer me to Orthotics) she simply abandoned me and simply stood by and did nothing, knowing full well that I was being deliberately denied orthotic care. She even declined to suggest any alternative arrangements between November and the following February, when she simply referred me back to my GP for the provision of shoes and orthoses. She must have been aware that, however good GP's are, they are not equipped to provide such a service. She even past on the details of the tired out and discredited orthotic prescription with the suggestion that it be used. Unbelievable!
The Report goes on to suggest my Complaint was complex. In fact my letter of complaint was only XX pages long. I accept that attached to it was a detailed account of what occurred at each of fifteen clinical appointments, which ran to XX pages and XX items of correspondence. Because of problems experienced at Worcester Royal (plenty of evidence of that), both my wife and I wrote up an account of what occurred at each appointment as soon as we got home - we then checked and amalgamated them. I was very uneasy from the outset because, having been introduced to one Orthotist, with whom I got on well, and who was designated in the WMRC records as going to treat me, on the next visit I was met by the Manager Brian Hopkins who had taken over my care - it seemed obvious that Worcester Royal had been on the telephone making out that I was difficult. Despite the fact that I am aware that they engaged in numerous telephone conversations, none were recorded in my notes - something that I believe is significant - birds of a feather stick together!
After five long months Mr Hopkins produced shoes that were miles to small, which I simply could not tolerate wearing, After thirteen months he produced another pair the same! From then on Mr Hopkins steadfastly refused to do anything about them - it was the same when he eventually made a second pair and got one measurement wrong. He even asked me to suggest how much extra depth to add, but I declined on the basis that he was the Orthotist! His measurements were wrong and both pairs badly fouled my toes - fact! And I have the shoes to prove it!!! All I ever wanted was shoes that fit!
Initially Mr Hopkins measured me for special neuropathic pain relieving pressure fitting 100% thick Lycra stockings - it was obvious to me that he had great difficulty adding various measurements together and the socks were a failure - they were baggy at the toes and ruckled up right under the most damaged area of the sole of my left foot, on top of which, instead of stopping short of my knees they extended partially over my knees - fact. They were a waste of time and money, and I have the stockings to prove it! Because they didn't fit he simply abandoned stockings.
- Mr Dawson requesting that footwear / orthoses provided by another organisation be replicated or adapted by WMRC. This caused difficulties and delays over Christmas 09.
This is simply untrue, all the 'difficulties' were deliberately created by Brian Hopkins the Orthotics Manager, why I don't know. In November Mr Hopkins promised to have my shoes altered - I got them back 2nd February, eleven weeks later - all that had been done to them was stretching! There was never any realistic chance that they could be stretched sufficiently.
Worcester Royal asked me if I would be prepared to travel to the WMRC and I jumped at the chance. It was agreed that their Orthotics Providers Blatchford's would provide me with orthoses for the shoes that they had issued to me as an interim measure - they were not a good fit, but I rely on them to this day!
I urgently needed replacement orthoses and the materials that the WMRC were using suited me much better that that which Blatchford used. Blatchford's contacted Mr Hopkins, the Manager of the Orthotics Dept. at WMRC (run by Otto Bock), NOT ONCE, BUT TWICE, to enquire what materials he was using and each time MR HOPKINS DECLINED TO TELL THEM! THEN BLATCHFORD'S CLINICAL DIRECTOR OFFERED TO MAKE THE ORTHOSES AT THEIR COMPANIES EXPENSE - MR HOPKINS DECLINED THEIR OFFER AND IN EFFECT TOLD THEM TO 'BUTT OUT'! BLATCHFORD THEN OFFERED TO SEND THEIR LASTS TO THE WMRC, MR HOPKINS DECLINED THAT AS WELL AND IN EFFECT TOLD THEM TO BUTT OUT AGAIN. All this whilst I was left without anything fit to wear! When my shoes were finally handed back to me on 2nd February they were still miles too small, the toe-caps were not of a construction that allowed for stretching, which was obvious to me from the outset.
DON'T BELIEVE ME? I asked Blatchford's Clinical Director to report the facts to Worcester Royal and give their permission for me to be made aware of the contents of their letter and this they kindly agreed to do, otherwise I would never have got sight of it! To view their letter CLICK HERE. (Then you will have to believe me!)
- Mr Dawson being offered alternative solutions by Worcester without WMRC's knowledge — for example, Worcester reviewed footwear in September 2009, and also offered to fund a shoemaker in Derby to produce bespoke shoes and orthoses in September 2010
Again their was no mystery. An offer was made to me by email, by a fairly well known 'cordwainer' (the correct name for a shoemaker), which was subject to a list of unacceptable conditions, including my closing down my website - as if! (It was reasonable for us to assume that this had been discussed with the WMRC in one of their unrecorded telephone calls.) Mr wife (needed to push me around in a wheelchair) and I would also have had to travel to Derby and stay in a Hotel at our expense for over a week to enable casts and fittings etc., with no certainty that it would not take a great deal longer. Furthermore, although I was aware of the cordwainer's reputation, his ability to make specialised orthoses using specific materials was in grave doubt.
I was also wary as, having expressed his personal regret at a Case Meeting, Worcester Royal's CEO John Rostill OBE made various very specific promises to me, and warmly shook my hand - promises he subsequently broke. These including sending me on a visit to Sheffield to collect orthoses from which I returned empty handed - with aggravated back-ache. Mr Rostill has since relinquished his position as CEO of Worcester Acute Hospitals NHS Trust, no doubt clutching a load of dosh, leaving his replacement to face a number of serious problems (including, but not confined to, a dire report from the Care Quality Commission that has been prominently featured in the press). I did not hear direct from Worcester Royal, and I would not have trusted John Rostill given my past experiences - but that's only my personal opinion! (It was John Rostill who commissioned, and promised to implement, the main Independent Clinical Report that Mr Senior refers to. When it came back it was highly critical of the treatment that I had received at Worcester Royal's Orthotics Dept., so Mr Rostill simply binned it - subsequently they refused to say or write a single word on the subject - unbelievable! On another occasion Mr Rostill was presented with a draft letter to send out under his signature, prepared by two very Senior Executives of the Trust, which contained (from memory) eleven or twelve admissions! He binned that to! I only found out about the letter (and a lot of other things) courtesy of the Data Protection Act! Anyone that acts like that is, in my opinion, devoid of any integrity.
To encounter one NHS CEO in total denial is very unlucky, to encounter two in a row has proved to be very bad for my health! Will someone restore my faith in the NHS - YES PLEASE!!!
- A lack of clarity that WMRC had only been asked for a second opinion. As a consequent, the regional orthotics service has gone considerably beyond a second opinion to also provide a treatment regime.
No! No! No! To suggest that I was merely referred for a second opinion is simply untrue! The copy of the referral letter, received from the Trust (the WMRC) courtesy of the Data Protection Act, is dated 23rd January 2009. It is from Dr C Ko Ko, Consultant Physician in Rehabilitation Medicine on Worcester PCT letter-heading and is addressed to Dr Martina Walsh. It reads;
'I would be most grateful if you could arrange to see this 65 year old man with hereditary sensory and motor neuropathy Type II in your neuromuscular clinic together with the Orthotist for provision of appropriate orthosis and footwear.'
That seems clear enough to me!
A meeting was held with the clinicians involved in Mr Dawson's care on 6th January. Notes of this are included at appendix 10. This meeting clarified the outcome of the second opinion requested of WMRC, and it was agreed that WMRC would write to Mr Dawson's GP to advise of our recommendations:
- Recommended orthotic prescription, for production locally as commissioned by the GP - Recommend additional referrals to pain clinic, psychology and neurology.
1) I repeat, I was referred to the WMRC 'for the provision of shoes and orthoses' and not simply for a second opinion! See above!
2) The recommended orthotic prescription was for the same old prescription that Mr Brian Hopkins had always refused to experiment with.
3) GP's do not have facilities 'to commission orthoses locally', and if they didn't know that then they certainly should have. GP's are NOT ORTHOTISTS.
4)I have an excellent GP who had referred me to a Pain Clinic. The Consultant was VERY ANNOYED that I had appeared in his Clinic. He told me (my wife was also present), in very uncertain terms, and in a very bad tempered manner, that he knew nothing about feet. For this reason he declined to examine my feet at all. In effect he threw us out - the message was 'get over it' - however busy he was there was no excuse for 'shooting the messenger'. We were both thoroughly disgusted.
5) 'Psychology'. Dr Walsh had already offered to make arrangements for me 'to see somebody to talk about your pain' and I had declined. I needed something under my feet by way of shock absorbing orthoses, talking about it was not going to make the pain go away - as she well knew, orthoses would have made a very big difference at that stage, but I was denied any orthotic treatment, Effectively, Dr Walsh abandoned me just when I needed her help most - one word from her and I would have been provided with orthoses without delay - just one word, that was all that was needed!
6) My GP had already referred me to a Neurologist (every couple of years or so) for a review i.e. just to see if their have been any developments that might help. As I advised Dr Walsh in November, I had seen a Neurologist not long before who had tried a change of medication which regrettably had not proved to be beneficial - but I was grateful to the Neurologist for suggesting I tried the more up to date drug. Generally speaking there is nothing that can be done - the condition progresses, albeit very slowly, and apart from the pain increasing over time, my neuropathy has little effect on my lifestyle. But the absence of orthoses is critical.
This order was provided at Mr Dawson's request as a goodwill gesture to enable mobility and pain relief whilst the investigation proceeded, and was not intended to replace Mr Hopkins' prescription, which was the result of 18 months of trial and adjustment.
Goodwill my _ _ _ _! By early November all the orthoses in my possession had worn out so I requested another pair. I also raised the matter as very urgent with both Dr Walsh and her Team (I showed them my worn out orthoses), and afterwards we spent over two hours with Mr Donald Harrison a General Manager who was most sympathetic, but no-one in the Orthotics would come to his assistance. Mr Harrison said that there was nothing more that he could do that day, but he would get on to it the following day and he gave us his word that he would come back to us the following day - he didn't. Presumably, despite the fact that he was a General Manager he was warned off! By the end of November the situation was critical. I finally received a replacement pair on the 2nd February by which time I was crippled - and still am.
I repeat that Mr Hopkins did NOT experiment with my orthoses. The ONLY ADJUSTMENTS WERE IN RESPONSE TO MISTAKES e.g. removing a 'rocker' stuck to the underside of the orthoses by mistake (the orthoses looks like a blunt axe was used!) e.g. adding and removing a pressure dome that Mr Hopkins INSISTED on locating directly under the most damaged and extremely painful area of my left foot (sheer madness), despite my representations that this had been tried before and had been an abject failure. My wife and I were gobsmacked!
Appendices and Dr Walsh's Report to follow! Now that will cause embarrassment!
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