Trusting NHS 111 with my care plan?

[LovelyBath77]

So the GP had kingly put info about my health condition on the 111 service so if it flares up (needs A and E) I can ring them. I rang it to check and sure enough, they tell me if it happens I need to ring and say I 'have a plan of action'

It is supposed to get me into hospital (not the nearest one but the next closest, where my surgical team are). I mean, is DH is here I guess he;d take me but it may need an ambulance otherwise.

Do you think you'd trust this service for this kind of thing?

To be clear, it;s too an urgent a thing to be assessed by the GP for, before admission, and i know it;s best not to just turn up at A and E without info. Have also got the care plan printed off for me to take.

I used to work for 111; if you call and say you have a care plan, we would ask what you'd be told to do, then assist you in doing it. I.e sending details to ambulance service for a dispatch etc

Thanks, the 111 man said he'd read me out what it said, and it was that i had a history of the condition, and needed to go to the certain hospital in an emergency. However, the GP had also added I have a history of MH including anxiety, as well. I worry this may cause problems in their assessment, 9in case they think I'm 'just anxious'.

Thats a great idea, I'm glad you also have paper copies,

I always kept plenty of paper copies to give to community nurses, a and e, employers and the like, I liked being able to rely on it and they can't say they can't find it or have deleted it.

Yes, have had problems int he past with A and E, so glad the GP has done this.

If they're professional they won't use it against you, don't worry,
I once called an ambulance because I was extremely suicidal, (I have schizophrenia, depression and anxiety) and I was so anxious that I'd go through with it, (but to their knowledge I'd never attempted before so I wasn't on the system or anything) explained this over the phone and the ambulance came in minutes and the paramedics were so respectful and nice they really put me at ease, got a mh assessment and did everything they were supposed to.

I have worked there too. If there is a care plan it will be followed to the letter..... but do mention you have it incase the call handler doesn't notice it illuminate (you have to click it to open the message it doesn't do it automatically when you give your details)

In my experience 111 tend to over react rather than under react as the people you initally speak to are not medical professionals and even if they were no one can fully assess you over the phone.

Thanks, this is reassuring. It would be a situation requiring and urgent CT scan and surgery, so it is important. Many thanks.

I've found them to be really good with 'complex' patients, you can almost hear the poor nurses going grey whilst they ask the questions that are meant to determine how serious your condition is, but you suffer with that kind of stuff anyway.

I've got to say I've never had a problem with 111, they've always referred me to a Dr, even a county duty one who was here at 5am, as I said I can't really tell you whether I need to go to hospital, as my condition is always bad.

A few times just from speaking the the nurses they've sent an ambulance and I've needed a week in hospital. It's kind of funny in a not so funny way, but at the moment I've got bad oedema, this shit always happens on a bank holiday.

So I would feel pretty confident, plus you're known at your receiving hospital. I know for some ambulances are a waste, but I'm guessing if you're like me, getting a car or taxi really isn't wise if you're that ill you need urgent care. Generally unless the situation is bad it'll be dealt with at home, there's a cut off point where the hubby and children know I need to go in. Even then I'll be in ultra stiff British top lip mode, delaying it just to make sure.

I've always ended up on surgical too, it would be a blessing if the paramedics took me to the next hospital that isn't the closest. I know the disparity of care to be quite big, where the closest won't operate unless it's an emergency, the other next closest hospital would take more proactive action.

Best of luck, I hope you don't have to use it that much. I know of a few people who have care plans in place. I think the biggest thing is checking for ambiguity that Drs can't read in say 3 or 4 different ways.

Also if you're ill enough you're calling 111 you will be anxious as it's a bit like being in no mans land. I have found that 111 & A&E know you need to be there, so aren't as fussy as if you're say a frequent flyer with something easily managed at home.

I read sometimes of people going to A&E for the slightest thing, usually in the hopes of pain relief, but personally I'd stay at home and use hot water bottles, resting etc. I have had pain relief in A&E, but with what I'm on at home, it's not going to be a couple of paracetamol. I always wait till I'm asked if I want anything, I always accept the IV paracetamol plus whatever else they'll deliver IV, as years ago I was told if you take morphine style analgesia then paracetamol helps.

The only thing I'll badger them for is IV anti emetics, or say fluids if I'm dry & cant do a sample and/or my BP is low. The last admission, well most admissions at my local, I'm there with dehydration as one of many issues, they make up fluid charts as they go along, which for saying I have ascites seems a bit daft. I'll go all day on ward giving no sample, then produce less than 100ml, it's deemed I'm not trying enough. Like if I could void my bladder I'd happily sit in discomfort.

Are you ok this weekend?

I'm Ok thanks. Your replies have been really helpful, yes have gone to some bother to get this sorted out as last time, was on the way to a wedding miles away and had to get ambulance into the local hospital who thankfully were fab and had emergency surgery on the Saturday morning (small bowel obstructions need surgery same day if bowel is ischaemic). Was in about a week that time. had to take a metre of it out.

Since then, have met surgeons nearby who keep me under regular review but is in the stage now where will only operate in such a severe situation, as surgery can make it worse (more adhesions). It is all documented about this care plan in my hospital file and they have a copy, GP has a copy, 111 has details and husband and i have a copy.

For anyone else with such a situation, I think it might help as it can be a bit risky going straight into A and E, in the past at my local hospital the triage have been not so good, querying why I'm there and not checking things out properly, as I seem young / general readings OK to start with. But it is a serious problem. So think it is worth getting something like this done.

It could even be useful if you were away visiting relatives and needed to go in there, I guess.

"I've always ended up on surgical too, it would be a blessing if the paramedics took me to the next hospital that isn't the closest. I know the disparity of care to be quite big, where the closest won't operate unless it's an emergency, the other next closest hospital would take more proactive action."

Yes- that's kind of how it is with me also. So first i went through Choose and book to get referred to surgeons at the other hospital, now 111 have the info I need to go there in an emergency. Do you think they'd actually do that though- I guess so- send an ambulance to a different hospital than the closest A and E.

If you're worried about your MH issues being on your care plan, ask your GP remove it. It shouldn't have been put on there without your explicit consent.

Should I worry though?

You could take yourself to A&E without 111's permission anyway.

I could, but don;t drive and don;t think it would be possible with a bowel obstruction as you vomit profusely and are in severe pain. In the past the ambulance has given pain meds through the veins which helped immensely, you also go straight into assessment. If DH was away which he often is with work, it might be very difficult. The consultant said about maybe getting a taxi, but that would cost a fortune, and don't think they;d appreciate the bilious vomiting...

Trust me, the moment the call handler sees you have a care plan it makes their job 100% easier, smoother and simpler. They will definitely stick to it so please don't worry.

Care plans are an absolute God send for the out of hours staff.

What would 111 do though if you were in that much pain? They'd send an ambulance. You can ring them instead of 111.

Should I worry though?

Depends. If you are happy to challenge those who you think may be using your MH issues to make a decision when they shouldn't be, fine. But if your MH issues don't have any connection with the issue you may need to contact 111 with, is there any need to have your MH issues included in your care plan?