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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Should I Complain? NHS 111

137 replies

Lilwelshyrs · 25/02/2015 23:19

I had a bit of a nasty fall off my horse yesterday. I hit my head, and skidded on my back. I honestly don't know exactly how I fell as no one saw it, but crucially, I was wearing a helmet, I didn't black out and there was no blood. I had to get up and get my horse - we were in a big field on our own.
I took the evening off of work and my DH was with me for the whole day.
This evening I went back to work and a few of my colleagues said I should probably go to A&E as I was complaining of a sore back and whip lash. As the end of work was only a few hours away and I managed to successfully commute into London, I figured I'd try NHS symptom checker. I would answer a few questions and then it would say the service was "currently unavailable".
So I thought, why not try 111?

I work in London but live in Sussex...
So I'm asked all the usual - home address, doc etc. Then the guy asked if I was safely at home to which I explained I was at work. He then asked me the usual questions - chest pain? No.
Hard of hearing? (Pardon?) No.
Loss of sight? No.
Then "have you had any neck pain?"... "Yes, and it's gotten worse since the fall".
He puts me on hold.
He asks me if my workplace is hard to access? I said no.
He puts me on hold.
He then comes back and tells me an "urgent ambulance" has been booked and is on its way...!

Eh?! What?! Why was I not asked? Am I about to be bundled into an ambulance like I'm some emergency case and then left in a London A&E which will have patients in far greater need of assistance than what I need?!
He never asked me about concussion or if I had blacked out upon impact of the fall, hadn't asked if I had felt nausous today and crucially hadn't asked if I was able to get myself to A&E (yet I had miraclously made it from Sussex to London without the need of assistance?!).
I thought 111 was to weedle out the non-emergency from the emergency? I felt he didn't ask me the right questions and I nearly wasted valuable ambulance services!

AIBU? Should I complain? Has anyone had this happen to them?!

FYI I am on the way to my local hospital which should be much quieter and will be assessed quickly with my DH in tow.

OP posts:
fanjoforthemammaries7850 · 26/02/2015 06:07

He totally did the right thing.

Fortunately you were OK but he couldn't tell that and if you had had a broken neck you could have been at risk of paralysis at any time.

Booboostoo · 26/02/2015 06:12

I have a friend who walked around for a week with a broken neck from a horse fall - the tiniest movement in the wrong direction would have paralysed her for life.

I don't think you have anything to complain about and please replace your hat ASAP, damage to the hat is not always obvious.

Becles · 26/02/2015 06:27

Epic, self indulgent thread which screams that UABU.

BTW, for all those unhappy about the call handlers this is actually a deliberate, risk assessed model. Various countries, including ours, have tested having paramedics or clinicians as 1st stage.call handlers on a 111 / NHS Direct style service. In Every trial it was found that the clinicians actually slowed the system down and did not get all the appropriate info to safety net (they start diagnosing rather than getting name etc, checking out if the person is in a safe place, has someone there etc and more importantly significantly reduced the ability of the service to cope with demand).

olympicsrock · 26/02/2015 06:41

You are being totally unreasonable. The show must go on my foot! You could have had a broken neck. The correct course of action was for YOU to have called an ambulance and to have gone to the nearest hospital immediately irrespective of the convenience. You are looking through the wrong end of the telescope.

NARsWife · 26/02/2015 06:56

Are most of you deliberately missing the point?

Yes, as had already been said many times, he was right to suggest urgent medical attention and to offer to call an ambulance for a potentially life changing /threatening injury.

He should have told the op he was doing this rather than treating her like a child and doing it without asking.

I'd feed this back to them. Politely and not as a complaint and stating you understand why he did it but that it's not appropriate to treat an adult calling for advice like a child and not give them the choice of refusing.

NARsWife · 26/02/2015 07:00

And he doesn't need to be medically trained to say 'one of your answers has tried the need to call an emergency ambulance for a possible life changing /threatening injury. Are you happy for me to do that?'. Or to put her on to one of the nurses /paramedics to explain in more detail.

But I agree with the op (although I think putting in a complaint is too heavy handed an approach) that it isn't appropriate to call an ambulance for a normal adult with capacity without asking them first.

NARsWife · 26/02/2015 07:01

Tried = triggered thanks autocorrect...

NARsWife · 26/02/2015 07:05

But to the op - the reason he didn't get to the questions you thought were more relevant is because an answer you'd already given had triggered the need for emergency medical attention. So there was no point in asking anymore. That is how the system works, it's not there to diagnose the problem just to identify potentially serious conditions. So I don't think the questions were wrong to do that. It would have been different in hospital as I'm sure you found out.

Cornettoninja · 26/02/2015 07:12

Thing is NARS he (and I presume a clinician advising) don't know the op from Adam. They have no judgement to go on as to her capacity or judgement just a short conversation.

Whether that was impaired by injury or not they have no idea and their choices are either act on the information they have - which isn't much and limited by the mode of communication - or be led by the patient and risk not only their job but their own conscience if they get it wrong.

111 is great for accessing out of hours or urgent GP care, it can't and will never be able to diagnose the extent of injury or physical harm by phone. That needs a pair of eyes, hands and clinical knowledge. Even they need equipment and tests in ambiguous cases.

I really feel the expectation here was unrealistic. It's a telephone, no one can diagnose a neck injury with any spectrum of certainty over the phone and with the benefit of hindsight I hope the op sees that.

It is UR to expect a stranger to have personal knowledge of your 'usual' and capabilities off the back of one short conversation. It's also UR to expect them to know that you personally wouldn't hold them responsible if it goes wrong.

SoupDragon · 26/02/2015 07:13

I felt comfortable in my assessment

So why bother wasting their time phoning 111? You were only prepared to listen to any advice that you thought appropriate so you might as well have made it up yourself.

fanjoforthemammaries7850 · 26/02/2015 07:16

If he had tried to explain OP would probably have argued back putting self at more risk.

SoupDragon · 26/02/2015 07:17

Are most of you deliberately missing the point?

Maybe people simply have a different opinion to you...?

There are many people who would refuse the ambulance and say they aren't happy for one to be called. There are many people who "don't like to be trouble". Not all of those will have made the right judgement about their health.

SoupDragon · 26/02/2015 07:21

I had a bit of a nasty fall off my horse yesterday. I hit my head, and skidded on my back. I honestly don't know exactly how I fell as no one saw it, but crucially, I was wearing a helmet, I didn't black out and there was no blood.

As I understand it, Michael Schumacher was wearing a helmet when he had his skiing accident. He was up and talking etc after the accident.

IMO there are some things you don't take risks with.
Might have broken a leg? Fine, take your time of you feel OK.
Potential head, neck or back injury? Don't be stupid!

Madamecastafiore · 26/02/2015 07:25

Liam Neeson's lovely wife was also walking around after the accident that ended her life if I remember rightly Soupy.

Delayed confusion is v v serious.

lougle · 26/02/2015 07:28

Anecdotally, people say that NHS 111 sends everyone to A&E/calls ambulances. But the actual statistics released by NHS England say only 8% of calls result in emergency protocol.

You had a fall from a height. You had worsening neck pain. Every second that your neck was allowed free range of movement was a risk that you could be paralysed. That's why, if you'd called for help at the time of the accident, you would have been strapped to a spinal board and had your head wedged between two blocks to keep it still.

There is nothing to complain about here and if you wanted to make your own way to hospital, that's what you should have done. Once you consult NHS 111 they have a duty of care.

lougle · 26/02/2015 07:30

Oh and no blood after a head injury is worse than blood - it means any bleeding is trapped in a fixed space and will squeeze the brain because there is nowhere to go.

TickleMyTitsTillFriday · 26/02/2015 07:33

I think he was right op and would have wanted to call an ambulance so your neck could have been immobilised rather than you getting yourself there.

I hope that you have had your xray (although x-rated did make me chuckle!) and that all is ok

ShadowSpiral · 26/02/2015 08:02

I think the call handler acted correctly.

With a fall like that, you could have broken your neck. And it is possible for someone to walk around with a broken neck and not realise it, but in that scenario, moving their head too far in the wrong direction can cause paralysis.

The call handler had no way of knowing whether you had a broken neck or just a bit of whiplash, and without an x-ray, neither did you.

Fortunately in this case, you were fine, but sending an ambulance for you would have been appropriate under the circumstances and not a waste, because until you'd been seen at the hospital, it couldn't be known whether you had a broken neck or not.

NeedABumChange · 26/02/2015 08:18

Could you actually imagine if everyone with neck pain got an ambulance. How bloody ridiculous.

fanjoforthemammaries7850 · 26/02/2015 08:20

Could you imagine if everyone who fell off a horse and hit their head got an ambulance?

Not ridiculous at all

Vycount · 26/02/2015 08:29

I'm a rider. He was right. He didn't need to ask you about concussion because a potential broken neck was enough to need you in A+E,

SoupDragon · 26/02/2015 09:18

Could you actually imagine if everyone with neck pain got an ambulance. How bloody ridiculous.

It's not "everybody with neck pain" is it? It is worsening neck pain following a bad fall from a horse which involved a head and back injury.

frostyfingers · 26/02/2015 09:19

I had a heavy fall from a horse but stupidly didn't go straight to A&E. The next day though I felt crap so rang my GP and asked if I should go to them or to the local small hospital. The receptionist said hospital so off I went - they were great and said I was badly concussed and had whiplash and needed 3/4 days bed rest, prescribed painkillers and then rang my GP to advise they'd seen me. GP asked me to come via him so I did where he did all the same checks and then told me off for going to A&E when I should have come to him.....

You can't win sometimes! Actually I was so woozy from having banged my head that I didn't register that I'd hurt my back for another 3 days - soft tissue tears in my lower back which would have benefited from immediate treatment - possibly you could argue that I should have been more thoroughly checked but I felt that responsibility was 50/50 there as I was adamant I was fine! I'll know better if there's a next time.

IAmAllImportant · 26/02/2015 09:35

Just when you think the OPs on MN could not get any more ridiculous....................

ClumsyNinja · 26/02/2015 09:47

I agree with the OP.

Regardless of medical need, the OP should have been told that he intended calling an ambulance to take her to A&E, BEFORE he actually booked it. Thus giving her the option of refusing and saving him having to cancel the call.

She obviously didn't want to travel by ambulance to a London based A&E at night. That's her choice.

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