111 missed a red flag - what should/can I do?

[NaToth]

I have had a year of serious health problems, culminating in Christmas Eve when I called 111 because I had severe head pain. When I say severe, I was sobbing down the phone I was in that much pain. I spoke to an out of hours Doctor, who advised me to take paracetamol and see my GP today for bloods. Thankfully I did not take his advice but went to A&E.

After a night in a and E with pain that even morphine could not control, I was told that I had acute glaucoma and required emergency surgery to save the sight in that eye. That was pretty straightforward and I was home within hours and everything seems to be going well thank God.

My concern is that I told the dispatcher and the doctor I spoke to that I had a GCA diagnosis, that I was on prednisolone, that I had a significant cataract as a result of the prednisolone and that I had severe head pain. All of these points are, I believe red flags, and I should not have been told to wait five days to see a GP. Had I taken that advice, I would've been blind in one eye by now, As well as in during days of terrible pain.

I don't want to make a complaint as such, because I know the service is overburdened and has a very difficult job to do, but clearly there is something wrong with their algorithm and I would like to bring this to their attention. Does anybody know how I go about it? I have looked on the NHS website without finding anything helpful.

Thanks

Contact PALS at the hospital?

They’ve passed things like this on for me before - like you said, not as a complaint, but as a reminder/learning.

I hope you’re feeling better

I personally would have just gone to A&E if you already knew they were red flags and your pain was so severe.

Make a complaint by all means if you feel it is necessary

Which area of the country are you in? I would say start with finding out who runs your 111 service. If it's an Ambulance Service they should have information available about this sort of thing. You are right to want to bring this to their attention though.

Assuming you are England this is from the NHS England website:

If you wish to give feedback regarding the service you received from NHS 111 or make a complaint, please contact us via email: [email protected] and tell us the location you called from when contacting NHS 111. This will allow us to identify which local service took the call and provide contact details.

So important that you phone nhs 111 and make a formal complaint.
You could require out of hours appointment in the future. They need 2 ensure yours and other patients safety.
How awfuland scary near miss.

I'm suspecting their computer system didn't have the right algorithms - it's essential you write to them so this can get corrected for the future. We had the opposite experience earlier this year and were sent to a&e in similar circumstances so it's down to the exact questions and how they follow on (and no prior diagnosis here)

Need to complain but say it is to improve service and you don't want any actions taken against the individuals.

The call handler probably should have exited the NHS pathways system and referred to a clinician as you had relevant preexisting conditions and medications and the triage is not supposed to replace medical advice in those circumstances.

It sounds like you did speak to a doctor on the phone and that they did have the opportunity to pick up that this was a risk. I would write to PALS and they could look into this and see if there's any new advice/ training needed for the Doctor or anything that could be added to the NHS pathways system to cover this.

Please say something about the lack of awareness on 111's part. Please.

111 are shite. Advised me to give my child Ibuprofen when he had Chicken Pox. I made my feelings known.

@movingonup20 I understand what you’re saying but I think a human programmed it?

You need to make a complaint. Not enough people are willing to complain about the NHS which is why mistakes keep happening.

Also agree 111 are crap. I worked for the service for a while as a nurse. I'd never use it myself.

I am so glad this worked out.

yes, raise a concern at least; you aren't angry, you aren't suing, fortunately no harm done - but feedback like this could save someone else.

there's an email address up thread, please use. Thank you!

I'm a bit confused as to why a qualified doctor would be blindly following an algorithm.

I thought calling 111 might get us into A&E quicker and possibly by appointment. In my defence I am not a frequent flyer.

I think we'll see more of this. I had to call an ambulance for DH just before Christmas. The ambulance crew were very kind and appeared to be thorough but really didn't want to take him in, they'd been told to take in only the most necessary because of the situation in hospitals atm.

They did take him but only because our GP insisted and they made it clear (to us) they thought we were all wasting resources. Dh had lifesaving treatment once he got to A&E and was in hospital for 3 days.

Complain.

I tried to complain a few years ago and it was quite hard to find the right way to do it so I gave up. In our case, I’m sure they used the wrong algorithm on my 1yo and advised self care at home. I had run to check which A&E to go to as wasn’t sure if was a different paediatric centre. Something must have flagged for a clinician to call though as a nurse called me back as I was en route to check I was going to hospital and to disregard the advice from the call handler.

Just to say that I had fantastic service from 111 last week. I woke up with acute vertigo. Waves and waves of it, each one coming to a crescendo and a horrible feeling as my blood pressure crashed. I've never felt so ill in my life.

Fortunately, my phone was by my bed and I was able to call dd. She came round, rang 111, was referred to doc. He was able to access my medical records, rang us back and arranged for a prescription to be
picked up at local chemist. There was a London Ambulance service chit on the bag. I even had a phone call next day from my GP's practice pharmacist nurse - didn't know we had one - because dd googled and had a query about the medication being suitable for colon cancer patients.

This was in London, covid numbers rocketing sky-high. Everyone was professional and, most of all, kind.

No - 111 is not shite - as pp said. Sorry you had a bad experience Op but I wouldn't want people put off using the service because of it.

Yes, you need to contact 111 and lodge a complain because a potentially serious condition was missed. I used to work for NHSdirect and complaints were taken very seriously and the people involved needed to look through and listen to their calls and see how things could be changed.

It was a complicated case, but severe pain should never be ignored.

I suspect they are trying to reduce the number of people going to A&E where necessary because of covid and risk to patients of close contact. Not excusing them but I think this pandemic is causing many issues

Your issue is not with 111 but with the out of hours doctor. They are not the same service!!!!

111 is a signposting service - they referred you to the out of hours doctor! They did they right thing. It was the OOH doctor who got it wrong not 111!!!!