Intended for healthcare professionals

Practice A Patient’s Journey

Left atrial myxoma

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4430

Re: Left atrial myxoma

Many thanks for another thought provoking article in the Patient's Journey series. Having just read in the preceding issue the summary of proposed changes to future hospital care from the Royal College of physicians I was struck how this indeed addresses some of Susie Layton's concerns.
I presume her feeling that she had been discharged too soon relates to her post operative stay but clearly she remained unwell at home whilst awaiting her urgent echo cardiogram after her first admission and enabling crucial investigations to be done promptly at the initial inpatient assessment would be invaluable for clinicians and patients.

I am aware as a GP that I used to visit more post operative patients after discharge but of course as Des Spence and many others point out we are all being assigned more and more activities of limited value to complete now leaving less time for more traditional tasks.
Also as patients are discharged earlier and sicker nowadays, often (unlike in this case) with incomplete investigations and no planned follow up in secondary care I find that even when I have visited or the patient has come in to the surgery there is definitely a need for more seamless secondary care as seems to happen after admission with IHD as indicated by Dr Ripley.

Thank goodness the District Nursing Service is available to ensure there is some contact but paradoxically their numbers and time are under great pressure from the increasing amount of more specialist community services.

Competing interests: No competing interests

22 September 2013
Robert Bunney
Brannam Medical Centre
Kiln Lane, Barnstaple, Devon, EX32 8GP