to think there is no point in NHS Direct...

[tholeon]

Just phoned because my 13 month old DS has a high fever 8 days after his MMR. Hoping for some advice as to whether we need to take him to A & E or just wait it out. Tried looking info up on the web first but it directed me to phone for any advice relating to under 5s...

Got an obviously completely unqualified person on the line who first asked me a long list of questions along the lines of is he in imminent danger right now (no - would be calling 999.) Then a brief question about whether he has any chronic illnesses (yes - a rare one - she didn't want to know which.) Then some really ridiculus stuff like 'is he in pain anywhere?' 'does he have a headache' - he's 13 months...he can't tell me..

Interestingly she didn't want to know how high the temperature actually is..

Eventually she told me that a nurse would phone me back in about 3 hours. I suppose that is the point of it and eventually I will speak to somebody a bit qualified. But really is there anything that can be added to

Is there any point to this service at all? Oh I know that the point is that the nurse will eventually phone but will they really be able to add anything to my own judgement? I guess I wish that if they are too busy to get a qualified person to speak to me straight away they would put some more stuff on the web.. I really just want to know what level of fever is concerning in a one year old...

Sorry probably just wanted a rant!

Agree with you about being asked questions that are clearly irrelevant - I rang up when my DS was 15 weeks because I thought he may have swallowed something and was asked whether he was 'talking normally'!

Really don't see the point of NHS Direct. The default position is almost always "Go to A&E". Doctors with huge amounts of training find it difficult enough to judge how sick a patient is over the phone, never mind nurses who are really not trained in this!

(As it is, how high your temperature is isn't that important, beyond that it is high. If you are worried about your little one, A&E would be happy to see you tonight or see your GP in the morning.)

I think that NHS direct is a bit pointless. If you are worried about your child then you go to A and E. I would rather have a walk in clinic where you physically meet the nurse.

NHS Direct was originally set up in the hopes that it would stop people who don't need to go to A&E rocking up at the hospital. Hasn't actually worked. A&E attendances were still going up last time I checked. Phone triage is ruddy tricky and for obvious reasons the call handlers and nurses have to/should be cautious and point people towards A&E/GP out of hours if there's any doubt.

Have to admit though, one time I used them it was v. good. They were able to call the poisons unit and get reassurance that ds would be OK and didn't need to go to A&E and have his poor little stomach washed out. Which would have been extremely miserable for him.

Oh, and slhilly's dead right about the two types of triage. Although I think there is still debate about whether it's better to have a GP at the front end or a consultant.

Funny thing about triage is that it has been turned around completely from the original military meaning. Triage on the battlefield involves sorting the injured into those who will die quickly anyway, so no point wasting any effort on them, those who can be saved so you should put your efforts there, and those who can wait.

NHS triage = putting most/speediest effort into those patients in the most need. Not leaving those with the most severe and life-threatening injuries to die!

As a frequent user of NHS Direct I have nothing but praise for them. They kept me calm after arranging for the ambulance when DD's lethargy became full on floppyness as I was on the phone.
DS's temperature frequently spikes and when it does he complains of a sore neck (he is two). Each time it happens I phone NHS Direct, each time they take it very seriously, and each time we are able to have a conversation about what course of action to take next. They have never been wrong.

They ask the questions because these are the questions they need to ask to rule out despatching an ambulance. You can tell if a 13month old has a blinding headache because they would not open their eyes in bright light for example.

Once again it amazes me that we have a free-at-delivery medical service that provides reassurance and advice for thousands of parents each week, and yet still it is lambasted as useless. It is supplemented by walk-in centres, out of hours GPs and A&E departments with the lowest waiting times in my memory, and still people imagine that they are being somehow short-changed.

I have always found them really helpful when I've called about ds, the longest I've waited for a call back is 15 minutes and the advice has been very good. They were useless when my nan had cellulitis though! I called on a Saturday morning because I knew she needed antibiotics and the gp surgery was closed. They agreed that it was cellulitis but said it could wait until monday. Within 3 hours her leg was so swollen I took her to a&e anyway and the infection was so bad she needed IV antibiotics. The hospital staff were shocked that she'd been told to wait so long, she was 88 and in a lot of pain ffs!

DS much better this morning hurrah. It is quite possible that I have a tendancy to a be a bit U when it comes to anything to do with his health because last time he was ill he ended up on a ventilator.

But Clemetteattlee re your comments we do all pay for the NHS via our taxes. I agree that it is a brilliant thing and am eternally grateful to them for saving my son's life when he was seriously ill. Intensive care was faultless. Watching all the expert medics surrounding each child's bed and discuss their case, no matter what background the child, was very moving - and would have been even had my child not been one of the sick ones. But that doesn't mean that everything to do with the NHS is always faultless and can't be criticised, surely? And - not being medically trained myself - I don't know how to tell if a 13 month old has a headache. Well not till you told me.. So it still wasn't a great question. And this particular operator was very 'computer says no'...

I do believe Clemetteattlee said 'free-at-delivery' not free. Which is what it is. You don't have to hand the GP a fiver to be seen.

I tried NHS Direct once and have never bothered again. For stuff that's minor, there's an out-of-hour primary service run out of the local hospital. For anything major, especially accidents, there's a paediatric A&E unit a few miles away at what is also a regional centre, and for adult A&E the local hospital is kept on their toes by being shared with the Army. When I dislocated my ankle, I was treated by the head of the UK Military's trauma surgery team, keeping his hand in on civilians while on leave from Afghanistan. Rather different to the NHS-trained staff. I'd certainly go there in preference to anywhere else.

But I suspect NHS direct is worthwhile if real doctors are further away than they are for urban folk.

It has a role in our medical system. If you burn yourself and are unclear on how best to treat it, if you have a rash and cant remember the rules on how to check it is meningitis, if you want help with how to wash out a wound...they can talk you through all that. Sometimes in a minor emergency we forget the rules, and having someone who can talk you through how best to administer basic first aid at home is far better than a trek to A&E.

I've only tried using it twice. Once for my mom, when we got the message, "If it's not about swine flu we can't help," and once for me, when I got put through to a nurse right after talking to the initial person. I didn't realise they did a call back later service, that seems crazy. But then so does having someone answer the phone and ask you twenty-thirty questions, only to pass you onto a nurse who will then ask the same twenty-thirty questions.

We've used them several times and always been really happy with the advice & support received. I think it's a fab service.

Yes it's good to know if we need to go to A&E NOW or can wait and see Dr in the morning, if what the new baby is doing is OK, I'm miscarrying and have lost LOTS of blood - do I need to go to the hospital, DH has a pain here - what to do, I've got food poisoning and am in unbelievable pain? etc.

The questions are to establish if it's potentially an emergency or not - not everyone will call 999 straight away. Yes you answer the questions a couple of times, but I can see those serve a purpose - and I've had great results and support from them & am glad of the option to use this service.

I've used it quite a few times in DD's first year, and 90% of the time they were really useful. As Findingmymojo said someone people won't call 999, i'm one of those. When DD was 21 days old, i thought we were struggling to cope with her colic, after a few hours I rang NHS Direct, as I was certain it was colic, it was 2am and I didn't know where to turn to for advice. They listened to DD as her breathing was a bit funny, but i was trying not to overreact to that, as they can't telling us babies sounds suffly on the mat word. Anyway NHS Direct listened to DD's breathing over the phone and called an ambulance. DD spent just over a week in hospital including 36 hours in the HDU with late onset group b strep, I have to say without NHS Direct I would not have sought help that quickly. I am a huge fan of theirs. Subsequently I did use them as a comfort blanket, and they were remarkably patient with me.

But occasionally they are a bit rubbish, they were unhelpful after i had a nasty fall off a horse, and was dazed, confused and unable to answer their questions properly.

Called at least 20 times for various things with 2x DCs over 3 years and never had a sensible or constructive result. Also called from hols in France when 16 weeks pregnant and dehydrated after suffering V&D for 5 days, and got 'won't speak to you - you're overseas. try your luck with French A&E'. Useless. YANBU.

YANBU. It should be like a triage system except it isn't. It's crap and is very "computer says no". Phoned about my daughter's finger to ask if it was broken, would they do anything anyway i.e. is it worth me waiting for 2 hours for them not to strap the finger whether it is broken or not. They insisted on keeping me on the phone for an eternity asking such insghtful questions as:

"Is she conscious" - she has only jammed her finger in the door of course she is
"Is she cold to the touch" - she has only jammed her finger in the door, of course not.
"Does she have a rash that doesn't disappear under a glass tumbler" - FFS, she hasn't got meningitis, it's her finger, I'll just take her to casualty anyway

Lola - did they keep you on the phone for 2 hours? No? Then you saved time. Quite how you expected them to tell you whether her finger was broken without looking at it I'm not sure. I bet they've had some people who have done something fairly minor as a result of something more sinister. Asking their questions takes a few minutes and allows them to rule this out.

We've used it a few times and found them helpful most of the time.

I think its useless. Whenever I've rang them I've had to wait upto an hour for someone to call me back. You may as well just go down to a drop in clinic and get seen properly.

One time I had excrutiating stomach pain. I called nhs direct who told me they'd call back. I waited in agony on the floor for 30 minutes and was later found unconcious by a neighbour with the phone beside me. Burst appendix.

NHS direct is pointless.

galena - I'd have saved the same amount of timeif they just didn't exist and I hadn't bothered.

YANBU

I AM still waiting for them to call me back about my 18 month old.

He is 9 now.

YANBU.

I won't be using them again after an incident just before Xmas '05 when ds was 16 months old.

He was suffering from what was fairly obviously an asthma attack (I'm asthmatic), wheezing & distressed. With hindsight, should've gone straight to A&E, but it was the Saturday night before Xmas & would obviously have been grim!

We did the whole triage thing, first with the call-centre staff, then a helpful nurse who said she'd ring back with details of OOH doctors so we could get him looked at.

Finally (& by this time ds was in an exhausted sleep) we got a ring-back from another nurse who:

• did the triage questions AGAIN
• called me a liar when I said we'd been through this stage
• refused to give me details of available OOH doctors, despite this having been her colleague's suggestion
• told me children of ds's age 'didn't get asthma'
• when I explained that ds was now asleep, said that he was 'obviously fine' & I 'shouldn't fuss'
• at this point I said, look, you're really not helping - I'm going to sit with him, & if he wakes up in distress again or his breathing worsened, I'm off to A&E - & she said 'Oh no, you should ring us again!'. To which I replied that I didn't have much confidence in the service tbh...

It's hard to describe now because it was so unexpected, but she was jaw-droppingly arsey & unpleasant throughout - I ended up with her on speaker phone & dh & mil 'wtf?!' -ing at what they were hearing.

At the end of the conversation I asked for details of their complaint procedure, & she said 'I don't have to answer that, or identify myself'.

Ds was, in fact, much better in the morning. I took him to the GP after Xmas, & she promptly diagnosed him as having a 'classic asthmatic wheeze'...

To be fair, I probably just got a rogue loon, but it's put me categorically off them.

gosh what an awful experience RavenAK! Poor you. Glad your DS was ok. How awful that there isn't a complaints option.

As always I guess there are good and bad experiences and the operators and nurses of course vary. I think part of what made me so cross the other day was that I couldn't do the on line symptom checker because DS is under 5 and it said it wasn't suitable, but then I was obviously put in the non-urgent category so was told I might not speak to somebody for at least 3 hours, possibly longer (though in the event I did.) So kind of felt stuck in the middle and unable to get any urgent advice.