RECORD-keeping at a Ramsey nursing home should be improved after a critically-ill patient’s wishes on hospital treatment caused confusion in the hours leading up to her death.

An inquest heard that dementia-sufferer Janet Strong, 78, died at the Red House Nursing Home in Bury Road on July 5, after developing a severe infection of the bile duct.

Her GP, Dr Nikul Patel, told the coroner that he recalled a conversation with her in which she stated that she did not wish to go into hospital.

However, staff at the home produced a letter signed by Mrs Strong stating she did want treatment. The confusion meant there was a two-long delay taking her to Hinchingbrooke Hospital and she died before she was admitted.

Dr Patel, a GP at the Ramsey Health Centre, said a few months prior to her death she had refused to go to hospital for treatment of a recurring infection.

He said: "We had a conversation when she specified that she did not want to go to hospital for investigations and that she did not want to go into hospital for any reason if it could be helped.

"That was in the back of my mind and I wasn't sure which way to go. The nurses couldn't find the care records at the time and I asked for the next of kin to be called so we could discuss it but the staff couldn't get in touch with them.

"It was very difficult and in hindsight I should have stood by my original decision. It caused me to doubt myself when I saw that signed note. At the time I felt that I couldn't ignore that."

Jean Gallagher, Mrs Strong's next of kin, said she had been with Mrs Strong when she signed the letter approving treatment, but that her wishes had changed and the letter should have been updated.

"I know that she didn't want to go into hospital - even when she had her pacemaker fitted. I know she didn't want to go in unless it was really, really urgent."

A police investigation concluded that there were no grounds to bring criminal proceedings against the nursing home. Medical staff said record-keeping was a problem at nursing homes across the region.

South and West Cambridgeshire coroner Dr Sam Bass recorded a verdict that Mrs Strong had died of natural causes. He said she would have been unlikely to have survived even if she had been admitted to hospital straight away.

However, he described communication at Red House as "muddled" and said he would write to the Care Quality Commission and Red House.

Dr Bass praised Dr Patel for his actions. He said: "It was a very difficult call to make. He [Dr Patel] had the knowledge of his patient in his head and that is far more important than something written on a piece of paper. He acted in her very best interests; he just had a moment of doubt."