111 failed to diagnose

[Shedidnt]

www.mirror.co.uk/news/uk-news/calls-nhs-111-helpline-probe-21216411?fbclid=IwAR3SMrfs8ptX0YbrlJozTL_PyeRzd2f6ijkqZsg_7P3EFkEi3F3Psbg2aAg

Am I correct in thinking that the warnings we are all given about not going to A&E needlessly is the cause of these deaths, and we're dealing with Joe Soaps and their questionnaires on 111 rather than trusting our own judgment?

Looobyloo the call handler can only go by what you tell them though. They can't see you and don't know your history. Call handlers are not perfect and mistakes can and will sadly be made. That is true right across the nhs sadly.
But if it was so obvious what you needed to do why were you calling 111 in the first place? Why did you not get yourself straight to hospital or call an ambulance?

And A&E staff are right to complain. There are far too many people going to A&E who don't need to be there. But it's not caused by 111 staff sending people on a whim. We can only go by what we are told by the caller. People lie, people exaggerated, people under exaggerate. We are stuck between a rock and a hard place! The level of expectation from the worried well is vast!
Where I worked ALL A&E referrals were checked by a clinician to check that it was a clinically appropriate decision. The same with low category ambulances.
But so often people would just decide they were going to go to A&E rather than wait for a phone call from a doctor or attend a MIU. The number of times people say 111 has sent them but they have actually been referred to another service is huge!
I occasionally worked on the survey team who call patients back a few weeks after their call to 111. If I had a £1 for every time I have heard that they decided to decline the recommendations given by 111 and attend A&E instead, I wouldn't need to work anymore!

@compulsiveliar2019 I don't have a history of blood clots.

I think I was in shock. I didn't quite believe what I was seeing and I guess I wanted permission to go to A & E. Sounds daft now but at the time it was just a WTH moment!

I did go to A & E though, thankfully.

@compulsiveliar2019 - do you feel that 111 prevents inappropriate A&E attendance or does it not really work?

111 is good when they find you a GP out of hours appt on a weekend. They have also helped me get a GP appt for DS when surgery was full and they said he should be seen ASAP.
There is a gap re provsion. For example, MIL was ill recently on a weekend -,but not really ill enough for a&e. However, she needed bloods which out of hours couldn’t do, so they sent to a&e.

Our doctors has this week put a statement out saying they can't cope and not to visit unless absolutely necessary. I find the whole system terrifying.

That's exactly what we do verify all etc and cat 3 ambulances

It was a lot more effective when it was NHS direct and a medical professional answered the phone. Now you get a call centre worker asking you if you are bleeding profusely or having chest pains when you told them your pain is in your leg.

The amount of people complaining about 111 on here after ringing them with an issue that PLAINLY should have been a 999 call or a visit to A&E.

USE YOUR COMMON SENSE. Christ.

The biggest issue is the lack of time/money for early treatment of issues.

Lots of things yet worse if untreated or make recovery more difficult - knees and hips especially. If someone can barely move for a while they get muscle wastage which makes recovery more difficult.

Also shoulder/back stuff. Quick referral to a physio, couple of treatments and back to normal vs 4 weeks wait for Dr, 4 more weeks for physio, sore shoulder pretty well locked up, needs more physio and possibly injections and therefore costs more to treat before you consider time off work and mental health implications of ongoing pain/inactivity.

Fortunately for minor physical stuff my family can afford to self refer to private physio for anything muscolo-skeletal.

Outside major cities there isn't an equivalent option for medical issues - no private GPs! If we did have access to one we would have paid to assess 4yo who isn't gaining weight (very active and getting taller so not urgent but 0th Centile for BMI so shouldn't totally ignore) and would probably would have paid to get 1yo seen for our own reassurance re constant colds, occasional wheezing etc.

The other hole is urgent but non-emergency stuff - fractures/bad sprains, cuts that might need probing/stitching or stuff that could wait a few hours but not until Monday morning from Friday night.

Fix the big holes in provision and access to primary care, fund mental health and elderly care properly and the A&E problem would almost certainly go away!

As I'm one of those cell centre workers as you put it alot of training goes into that role we don't simply rock up and just read off a screen. The training is tough and not alot of people actually pass the exams and audits so are let go. We also Have to continually have regular training as the system we use is the exact one used by 999. You should of been told the not all the questions will be relevant but we have to ask them and especially with leg pain the system is trying to rule out blood clot and other serious illness which unfortunately one of the symptoms is also chest pain. If we started cutting corners on the questions then a lot of serious illness would be missed and that could be life threatening.

I work for 111. We do not diagnose over the phone, as we cannot see you. People do not think about why they are ringing seriously! U need to think of what outcome you wanted. You can’t be annoyed if we said you need to see your gp and you think you need to go to a&e, then why didn’t you go. What’s the point in ringing...use your common sense.

We send ambulances all the time and trust me, we know the person doesn’t need it. But if a 19year old is telling me they’ve got a “crushing chest pain” I have to go with what they are saying as we cannot see them. Which then triggers and ambulance for heart attack. I know very well a 19year old isn’t having a heart attack but I have to go with what they’re telling me. You think people would be decent enough to refuse an ambulance but they don’t! Some do but then you get others that go oh that’ll be great, oh ok if you’re sure I’ll take it. You can’t complain we sent you an ambulance if you’ve accepted it. You can refuse.

During the day, we can only refer people to their gp as they are open. But in the evenings and weekends they have the out of hours service . Btw the ooh are separate to 111, we just send them a referral.

All in all, 111 isn’t perfect and the health advisors know that. But we are a triaging service, we do not diagnose over the phone. And you never hear of the good stories.

@Leannerab I agree with you but I think it's important to note that 111 don't use the same system as 999 across the UK, only in the areas where pathways is used for both 111 and 999.

@Henhophouse

Spot on

The 111 and 999 will soon be joining as one stop shop soon In my area that will be interesting to the cell handler including myself will be taking both sets of calls. I already work for the ambulance service who run 111 and since they have took over I've seen a huge improvement from the last two private companies to run it who was trying to run it on skeleton staff and we was getting no breaks taking back to back calls with no chance to absorb last call especially if it was a an upsetting call. People was leaving every week due to stress if I had left as well it would of been worse. So I stayed and thankfully we can finally see progress meaning we will soon be able to help our callers more efficiently.