Can anyone in Sussex give me advice on navigating the NHS?

[SquirrelsAreGo]

I'm visiting from overseas, I've lived abroad for 20 years.

Currently visiting elderly friends. One had very painful sciatica when I first saw them last week, really debilitating. She had some physio or similar, and it made it worse.

After travelling for a week I'm back with them tomorrow. One of them called in a really panic today, I think worried about the other, but also about "hosting" me, which is important to them, they always want me to sit and not do anything, which is hard.

The sciatica is so bad she's finding it hard to think, talk, sleep, and they said it's impossible to get an emergency appt with a gp these days. The worried caller is very frail and can't drive her friends anywhere "but there's no point going to the hospital anyway".

I'm sure this is all absolutely right, but when I arrive back early evening tomorrow, should I frogmarch her to Eastbourne hospital (I think the closest?), or is this something that is better seen in one of the injury/ less urgent care clinics? She's mid-80s, still working, but exhausted, and has other conditions.

Thanks for any and all advice, I've no idea what they would do if I wasn't here, but I am and want to find the most useful plan for them.

She needs to ring 111 which is the non emergency line and see what they advise - in my experience older people are reluctant to “make a fuss” but it sounds like does need some medical attention!

It sounds a bit less like reluctance to fuss, and more that everything is catastrophic and nothing will help.

Can have read about 111 calls now, but don't understand when they say they can make appts on your behalf. Is this 111 sending doctors to them, or make an appt with their local GP? How does that work?

111 is telephone advice. They will point her in the right direction eg advise out of hours GP, a&e or own GP. They can prescribe some painkillers etc over the phone.
There's no point taking her to a&e unless you've already been assessed as needing to be there as the waits are long & the waiting area is cramped & uncomfortable and almost certainly make back pain worse.
There's not much they can do for a chronic condition in a&e anyway - they just rule out anything life threatening & advise you to contact your own GP.

Her own GP is prob best option - there will probably be an online form to complete & an initial phone triage with a doctor. They will arrange an appointment if they need to. It can take a few weeks for a non-urgent appointment.

If she's already been seen by a GP & physio there's probably not much else that can be offered other than pain relief. Has the physio given her exercises to do at home - it's important to follow these even if she doesn't feel it's helping.

Sciatica is so painful, she needs to put a hot water bottle on the spot and keep changing it when it cools down, it should give some relief. I agree with 111 call, failing that if you ring the Dr’s at 8am you should be able to get an urgent appointment. Anti-spasmodic medication, pain killers and maybe infra red treatment by a physio is the best way forward. Can she do a private physio as NHS will take too long.

111 can do things like book in slots at minor injuries, A&E or GP sometimes, and they know the local system.

I don’t in the least want to bang the drum for the NHS here because I know too many people are getting shit responses these days, but if you stick with it you might find the response is pretty good. If you remain focused and stay on the line, you should find help to get the right route in.

Sciatica is nerve pain.

the treatments such as they are are physio and drugs. The physio is about gentle movement and there are some specific exercises that ideally she would be doing daily.

the exercises will hurt, but they improve the situation long term. She needs to balance the short term pain and the long term gain.

the drugs are usually not painkillers but are drugs like amytriptyline or duloxetine which turn down nerve pain. Not all drugs work on all people so sometimes people have to try multiple drugs before they can be sure which one is best for them.

if she is on drugs and has seen a physio then the best you will get either from GP or A and E is either painkillers (possibly codeine or similar) or a change or nerve pain drug.

i have nerve pain (not sciatica) and there is literally nothing else they can do.

Thank you so much for all the follow up. I'm aware of degrees of pain and back issues, and I'm concerned because the pain was suddenly a lot worse after what I thought was physio. Turns out she went to a chiro. Hence my wanting to get her seen.

I'll get her to ask whether she'll be ok with amitript, as clearly the pain relief isn't doing the job, but mostly I want them to check there isn't a new injury.

Thanks again.