To think nhs direct hasn't really been thought through.

[JeezyOrangePips]

I was speaking to a friend, who had been away on a camping trip. She ended up in a lot of dental pain.

Her phone was out of battery (nowhere to charge it when you are camping), so she travelled 30 miles to thd nearest hospital (on a Sunday).

They told her she had to go and phone nhs direct.

She went and found a phone box in and called them. They told her they had to speak to an assessor who wasn't available, so they would phone her back within two hours.

Two hours, hanging around a phone box, in a town she doesnt know, while in pain?

Is it just me or should there be some facility to bend the rules in some cases?

Hes fine now, says its still a bit sore when he sneezes but a vast vast improvement :)

I do see what you're saying, and it's good that you're conscientious about using an ambulance appropriately. But you need to consider a few things.

People having a heart attack are high risk of VF (cardiac arrest I think holby City calls it ), this is not something you can deal with effectively yourself. However ambulance staff can.

The other thing is it depends what services your local area provides. I know (having previously worked in cardio) that if I was to rock up to my local a&e having a full blown heart attack, I'd be in the wrong place to get it fixed. We have specialist facilities in the hospital five miles down the road. The ambulance staff know this and can assess us at home to decide the severity of heart attack (if any) and take us to the right place. Our city is not unusual in this approach.

I'm not saying everyone should be ringing ambulances, far from it. But what I am saying is sometimes theirs more reasons than you're aware of for the NHSD nurses decision.

Sorry for any typos, wriggly baby!

She wasn't abroad, she was holidaying within the uk. I was revering to honeytea feeling that NHS direct should know where to he when abroad.

I am risking a flaming, but I am an NHSD health adviser, so can say with confidence that there is a clear policy for this. The service has to be available to all users. This include nurse/dental nurse advice. If the caller does not have a return telephone number, or is in a phone box, and is assessed as needing a nurse assessment, the must be put through immediately to the next available nurse. The Health adviser did wrong in this instance.

It is supposed to be a equitable, non-judgemental service, so though we may roll our eyes at the patients who don't know their own telephone number, or might need an immediate nurse transfer above those who have more urgent symptoms, because they happen to be in a phone box, we must not deny them the access to treatment that we can provide.

I just wanted some advice about what would be the sensible thing to do. I'm not really used to medical things as I have been lucky enough to be really well most of my life. I just wanted to know if it was silly to go to A+E and say "my leg hurts a big and I'm pregnant" in the end I called my midwife who called me back 2 days later and said I should have gone to A+E I would have appreciated them saying to me something like "we can't advise you on the system in the country where you are but if you were in the UK we would advise you go to A+E.

Another NHS direct situation I had was when I was at uni, I lived with my (now ex) DP and he burnt his hand on hot water. We had no idea what to do as we were only 18 and not very worldly I called NHS direct for a bit of first aid advice as it was 1 in the morning and I didn't want to phone and wake one of our mothers, they told me to go directly to A+E, we didn't and ex was fine.

But you'd be lucky to get emergency dental treatment on Sunday unless you tried very early on in the day.

It is a risk averse system Honeytea, so they do tend to er on the side of cution because they are not doing a face to face assessment.

caution even ffs.

It was awful when I called them about my leg I was crying so much I couldn't speak poor NHS direct opperator.

honeytea when you and called NHS direct and got no joy and your mw was calling you but you had waited a day for a call back. Why at no point did you speak to some local (staff at hotel restaurant) etc or seek out arrival professionl?
Rather than moaning abot the NHS direct?
The other situation was handled correctly. They can not see the burn or assess risk of further damage over the phone. The assumption would be that if an adult has burnt their hand and seeking medical attention it must be fairly bad. While he was ok, there was also a chance it was worse than you thought and he wouldn't be ok.

I am not trying to be mean honeytea, but you seem really annoyed that you have got the service you should.
you don't really have a reason to moan on either occasion and the first could have been resolved quickly by you seeking medical attention I. The country you were in.

But I don't get what it's for...
I believe it's just a holding pen to stop everyone rushing off to A&E at once.

Because I have never yet met anyone who has received useful information form them, what is it that they are supposed to do?

Because as a non-face-to-face service all they can do is tell you to go to A&E.

eg. "My arm is falling off"..answer "go to A&E"
"My arm has been nibbled by a small rodent in a country without rabies"... "clean it up, don't take a painkiller because I can't tell you to that, and if your arm is falling off in the morning go to A&E"

They can tell you to do more than go to a&e?

The four times I've used them (or DH)...
DH pleurisy above - ambulance sent
DS1 allergic reaction to something at 6m - a&e
DS1 d&v at maybe about 4m - appointment at ooh gp
Drunk beyond falls over and cracks tooth - appointment at emergency dentist

Apart from that, I tend to consult dr google myself, which is normally just as good at telling me if its a potential emergency, or see my own gp

I have had to use them twice in the last 2 weeks () and they have been fantastic.

They got me an put of hours appointment, didn't have to wait any time at all on them phoning me back, and when we got to the out of hours both times we were seen with no delay.

Brilliant service

Maybe I should have said this before, but my comment was really about the system - but once she did get a call back (took about 45 minutes) she was sent back to the same hospital she had come from to get the treatment she needed. She saw the dentist about an hour after nhs direct phoned back.

Bobbly, thank you for confirming what should have happened. I don't see why you should get flamed.

So the policy does seem reasonable, it just didn't work in this instance. Thank you for clearing that up.

I'm a fan of nhsd, they don't always direct to a&e, I've had call backs from out of hours gp's for telephone assessments, or simple first aid advice. It's a phone service, they can only advise on what you tell them so will always treat as a worst case scenario.

What they do provide is a lot of reassurance for people who are unsure. I'm non-clinical but spend a lot of time on the phone with patients and consultants and you'd be surprised how often both groups of people don't want to 'be a bother' or don't think a particular set of symptoms need urgent attention. All the campaigns about wasting resources have made a lot of people overly cautious about using a&e or calling an ambulance. These are the same people who without nhsd would probably just leave things and see what happened and end up with a worse outcome than if they'd believed they were experiencing symptoms worthy of been checked out.

It's good to be aware of waste, but people will follow that mantra at the risk of their own health a lot of the time which ends up costing the NHS more in the long run.

Although in the op's case I think I would be advising her friend to make a complaint about their procedures - there's very little point phoning nhsd when you're standing in a&e! I can't believe that's policy tbh and think someone should be getting a talking to.

I am not complaining about the advice received because the advisors are just following an algorithm and cautiously many paths lead to A&E. I just don't think that sort of service can do anything but that. It means people who might use common sense and wait to see if it improved are sent scuttling off to A&E which is often over stretched with people who do not need to be there

NHS direct have really gone down the pan. It used to be trained nurses on the phone (but obviously I understand the shortage and they're needed elsewhere so it's now assessors.) I was very when my mum told me of her NHSD experience. She had an allergic reaction and called NHSD, who rattled of a list of questions then told her to make an appointment with her GP! When she said that would take too long, and that she just needed medical advice, the assessor (clearly based in a call centre nowhere near us) mus have done some google mapping and told her she needed to go to X clinic, which is actually further away than our local hospital. She gave up and eventually when to hospital, by which time her throat had closed up and she was on intra-muscular adrenaline!

So point of my story is that I think assessors should always refer to A&E straightaway if in any doubt of emergency. OP, in your friend's case the hospital seem to have been at fault, they shouldn't have sent her away in the first place. And if it was not appropriate for her to be there, surely they should have enough medical contacts to put her in touch with the right place. They will have seen her in pain but must have been aware that NHSD can't diagnose or prescribe, only 'advise'.

Just re-read and noticed it was a Sunday. As someone said, getting hold of an emergency dentist would have been near impossible, so yes, she should not have been sent away from A&E.

P.S. of course my view is based on personal experience, and in mum's case they just didn't exercise common sense. but i'm not saying we shouldn't have NHSD, it just needs to improve - somehow.

Error, you should have fed back what happened to NHSD. We would have logged it as a serious adverse incident and circulated it as a "lessons learnt" thing, as well as re-training the health adviser.

You are right though, NHSD has really gone down the pan and I say that as an insider who has been there for many years now. It will only get worse, creating more health inequalities and wasting much more money.

It was my Mum who made the call (as she was having her reaction) and I didn't find out what happened until later on. I suggested making a complaint but she was ill and didn't want the hassle, and still doesn't. I hope someone else does, but hope they don't have to get into a life threatening situation for it to be addressed.

but once she did get a call back (took about 45 minutes

So why was she hanging around for 2 hours as you said in OP. Did she tell the hospital she didn't have a phone?