Medical Report on Mrs V Waylor

Dr DG Smithard 17.11.11
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Medical Report
(edited version for blog)

With Respect to the Care Needs of

Mrs Vera Waylor


Prepared for Hassocks Solicitors

By

Dr David G Smithard
BSc MBBS MD FRCP RICR


Dated 17
th
November 2011






Contents
1. Title Page Page 1
2. Author Page 2
3. Commission Page 2
4. Introduction Page 3
5. Visit to Mrs Waylor Page 3
6. Summary Page 5
7. Medical Opinion Page 5
8. Conclusion Page 5
9. Statement oI Compliance Page 5
10. Statement oI Truth Page 6
Medical Report on Mrs V Waylor
Dr DG Smithard 17.11.11
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1. My name is David Graeme Smithard. I am employed as the Interim Medical
Director by Kent Community Health. I also undertake medical clinics in New
Romney and Spire St Saviour`s Hospital, Hythe. I have been the Clinical Director oI
the Kent and Medway Comprehensive Local Research Network since 2007.

1.1. I hold Hon Senior Lecturer posts both at Guy`s King`s and St Thomas Medical
School and Canterbury Christ Church University. I lecture at University College,
London and Roehampton University.

1.2 I qualiIied Irom the (Royal) London Hospital Medical College in 1986 with an
intercalated BSc in Biochemistry and the medical qualiIication MBBS.

1.3 I am on the GMC Specialist register Ior Geriatric and General Medicine. GMC
number 3120529.

1.4 I obtained my MRCP (UK) in 1989 and was awarded my FRCP in 1997 and my
MD in the same year.

1.5 I have worked as physician in Elderly Medicine and Stroke Medicine since 1994,
initially at Queen Mary`s Hospital, Sidcup; then South Kent Hospitals, and
subsequently East Kent Hospitals Irom 1997 until 2009.

1.6 I am a Iounder member oI the British Association oI Stroke Physicians. I have
served on the scientiIic committee and the executive committee and Ior the years
2005-2009 I served as deputy and then Hon Secretary. I am also a Iounder member
and President oI the UK swallowing Research Group and a member oI the British
Geriatric Society.


2.0 Commission
I have been asked to review Mrs Waylor to assess her dependency level and care
needs, providing second medical opinion. As a consequence I have been requested to
address the Iollowing issues;


2.1 Can Vera`s needs be met by a residential care home? If not then could a care
home commission other care in - this was held to be possible and perhaps
desirable in a case called Coldsmith
2.2 Is it in her best interests to return to Bowles Lodge? You should not have in
mind that Bowles Lodge may close as this is for the Court to decide if agreement
cannot be reached between the parties
2.3 If so what steps, if any, over and above what they would normally provide
will the care home have to put in place


Medical Report on Mrs V Waylor
Dr DG Smithard 17.11.11
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3.0 Introduction
3.1 To be able to provide a satisIactory answer I visited Mrs Waylor in room 20 oI
Ward 22 on the evening oI the 11
th
Day oI November 2011. I reviewed her medical
notes and I also spoke to various members oI the nursing staII. I have also discussed
her case with Dr Reynolds and Dr Fox as they both contacted me.
3.2 I have read the documentation provided (letter to Dr P Reynolds,updated INP,
Report by Dr GC Fox, Statement oI deIence KCC) to me to enable me to Iorm a
complete picture but I have not made reIerence to them in this report as the purpose oI
the report is to provide an independent medical assessment.
6.0 Opinion
6.1 Mrs Waylor clearly does not want to be in hospital. She requires non
specialist care. She is not in need of a regular medical review in the home as her
clinical condition is not unstable. Although she has several co morbidities none
require sufficient level of care that would qualify for health funding.
6.2 Mrs Waylor`s need for care should be based upon her physical needs as any
memory loss is not playing a significant factor to suggest that she requires EMI
care, however it would be a factor in determining the need for nursing as
apposed to residential care.
6.3 Can Mrs Waylor return to her Bowles Lodge? This is a difficult question to
provide a categorical answer just based on a medical opinion. From a purely
medical view point, it would be possible for Mrs Waylor to be cared for in a
residential setting. Mrs Waylor would need some extra care support, which
given the present level of occupancy at Bowles Lodge could be met by her
present carers. She already has access, at Bowles Lodge, to the equipment
(furniture etc) that she requires.
6.4 The best option would be for Mrs Waylor to be discharged to a Care setting,
ideally back to her present accommodation. If this is not an option, the a Care
Home that is dual registered would be the next best option, allowing her to have
her level of care increased as her needs change as they probably will with time.
6.5 Finding a replacement home is likely to take an undefined period of time, so
consequently it would not be unreasonable to suggest that she is discharged to
Bowles Lodge with a view, if required, to moving to a new home rather than
staying in hospital.
7.0 Conclusion
7.1 In conclusion, it is my opinion that, at this time, Mrs Waylor`s care needs
could be met at Bowles Lodge or a similar care setting.
8.0 Statement of Compliance
Medical Report on Mrs V Waylor
Dr DG Smithard 17.11.11
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8.1 I understand my duty as an expert witness is to the court. I have complied with
that duty and will continue to comply with that duty. This report includes all matter
relevant to the issues on which my expert evidence is given. I have given details in
this report oI any matters which might aIIect the validity oI this report. I have
addressed this report to the court.

9.0 Statement of truth
9.1 I understand that my duty is to the court and this is to conIirm that I have
complied with that duty. I am aware oI the requirements oI Part 35 and Practice
Direction 35, and the practice direction on pre-action conduct. I conIirm that I have
made clear which Iacts and matters reIerred to in this report are within my own
knowledge and which are not. Those that are within my own knowledge I conIirm to
be true. The opinions I have expressed represent my true and complete proIessional
opinions on the matters to which they reIer.