I'm an NHS 111 health advisor. AMA

[BeautyGoesToBenidorm]

I'm sure this has been done before, but we're under immense pressure at the moment and there's a lot of criticism aimed at us. Come at me!

What qualifications do you need to be a health advisor?

If I phone you, which parts of my health records can you see or access?

Or do you rely entirely on what I tell you?

Why do you tell people to do CPR when we've already told you there's a respect form in place?

What proportion of people have social needs or mental health needs ie. Not physical health issues?

Do you get frustrated that you have to ask people (sometimes) stupid questions?

I had to phone 111 as my DS had an allergic reaction (hives appeared all over his face and body after eating something).

I was asked if I was absolutely sure that the rash couldn’t be cradle cap..

Do you get to exercise any personal discretion or do you have to go purely by what the computer says?

I'm a 111 health advisor so I can answer some of these questions. Hope the op doesn't mind.

@Goatymum It's usually a couple months of training. You have to learn the theory so for example symptoms of sepsis/ heart attack. You have a written exam and a computer exam. Then once you pass these you have an oral exam. You then shadow for 2 weeks and gradually start taking calls. My training was nearly 7 years ago and it is much more thorough now.

@AutumnCrow we don't have access to anyone's medical records despite many people thinking we do. For some people there may be special notes such as they have a child protection order, DNR, repeat caller etc.

@tescocreditcard you have to have the dnr with you.

@Toefingers majority of callers will have physical health issues. I'll probably get one mental health call a shift. Sometimes none at all.

@DuploTrain yes it's very frustrating! However we can bypass questions if the answer is obvious or already been given. I tend to skip the cradle cap question if they say they've got a rash all over.

@riotlady we are not medically trained so we cannot make any decisions. However, if I don't agree with the outcome of the assessment I can query it.

How often do you send me people to A&E?

Is there just a note that states send all kids under 5 to a&e/out of hours because I don't think I've ever called and not been sent 'just to be sure'

Do you ever NOT tell people to go to A&E?

As a health advisor, I don't send people to a&e all the time. What happens now, is if the outcome is a&e we have to send it for validation. Because a&e is so busy, it may not be appropriate for them. So usually a clinician will call the patient and will decide whether a&e is necessary. However if we are extremely busy, validation may be closed so we just have to offer the outcome as there's not enough clinicians to call these patients back. It's very hard to assess anyone over the phone let alone a baby or a young child. So it's not unusual if a baby is told to go to a&e.

Why did you start the thread @BeautyGoesToBenidorm if you're not going to answer any questions?
Has there been an all staff email telling you not to?
I do imagine 111 would not approve of this thread!

@PronounsBaby probably because the op started the thread 3 days ago and only today people have started asking questions.

@Ohdearohdearohdea do you like your job? Thinking of applying for this as they are advertising in my area. I haven't worked for about 14 years as took redundancy to raise the kids.

Why, when people tell you they're calling you because their GP is full to safe capacity today, do you then tell them to call the GP to be seen today?

The much maligned GP Receptionists at our practice have a 6 month training. It's pretty shocking people calling themselves "Health Advisors" have such a brief training. Computer based questioning or not.

They do have the respect forms with them. I'm a carer and they are in my clients houses.

Are you in the uk? It's just that you said DNR and it hasn't been called that for quite a few years now.

@loobylou44 I don't particularly enjoy the job but I only work part time so probably that's why I can tolerate it. A lot of people do the job as it's quite flexible. Most call centres are open 24/7 so you can choose when you'd like to work. I'd say go for it, you can only try.

@HollyFern1110 The gp surgery is open from 8am to 6:30pm. If you're calling during that time, we are 'in hours'. Unless the outcome is a&e, ambulance, pharmacy etc we will mostly refer patients to their gp surgeries. There isn't any where else we can refer them too. If someone has told me their gp has no appts today, we are told not to get them to contact their gp again as they can't magic up an appt. It may be different in other call centres. During the day (in hours) some areas may have a clinical assessment service we can refer them to. But a lot of the times were telling them to contact their gp. I used to be able to contact peoples gp surgeries to ask if they can get an appt for the patient this afternoon. Sometimes they're able to but we are not allowed to call them anymore. I suspect it's due to call times. In reality, no body should be calling 111 during the day as the gp surgery should be dealing with them. We do reserve some gp appts. However, usually when I start my shift in the afternoon they've all gone. I once called my gp surgery and they had no appts. But I knew 111 would have for my gp surgery. I called them straight away and 111 was able to book a telephone apt with my gp surgery.

The training is actually quite intense I would not say brief. As it said earlier, it's much more thorough now. Not to be rude but why is the training 6 months for a gp receptionist? When you become a health advisor and start taking calls, you still have to do another module later on to get paid more. I'm not sure if this has changed. Every so often we have training days and they explain what's been updated.

@tescocreditcard yes I'm in England. It was DNR when I first started 111. If they have a dnr/respect form I don't ask them to do CPR. I'm not sure why you were asked. There should be a question in the pathways that asks if you've got a form.

@tescocreditcard DNR or DNACPR is alive and well in many areas of the UK.

And a lot of Respect forms don't do much else than a DNR form did anyway, I see so so many bad ones. Changing the paperwork didn't change the world.

@tescocreditcard also you shouldn't be calling 111 if the patient is unconscious. Even if they are elderly and or have a dnr in place. We would still have to send an ambulance and that will be coming from 999 anyway.

Any more questions?

Apologies for not returning to the thread, last time I checked there were no responses and I have an unwell 1yo!

I'll reply to everyone as much as I can.

Oh I assumed you’d name changed… but I’ve just re-read and realised that another 111 advisor has answered them all on your behalf. You must be good team players 😂

Thank you for filling in for me, of course I don't mind!

The training isn't that much more thorough than it was, tbh.

I personally take a lot more MH-related callers per shift, they're on the increase in my area and it's bloody hard. We have a script we HAVE to stick to, I recently failed an audit for trying to comfort a very, very distressed caller as I deviated from the script!

We try to be, and I really appreciate her answering on my behalf 😅 We're mostly employed by contractors so I doubt I know @Ohdearohdearohdea as we're scattered around everywhere!

Absolutely. I've had callers where their tiny babies have tracheal tug, you can hear the poor little thing struggling for breath in the background, yet they call us instead of 999.