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?

111 is a great service, however its reliant on your answers to their questions.

We have used the service twice for our children, both times I've been very happy with their support.

First time they identified an urgency we weren't expecting and an ambulance arrived while we were still on the call. Our child was kept in hospital for a week.

The second time they provided comfort to stay as we were, advised that a doctor would call later in the day and for us to monitor in the meantime. The doctor called and advised us further without drama and our child recovered.

111 are only as good as your own observations and responses to their questions.

It shouldn't exist in the first place.
You should have out-of-hours GPs and A&E or you GP.
This 111 nonsense does not exist in any other country that I'm aware of - happy to be corrected.

It absolutely shouldn't exist but what else can be done when we have a massive shortage of GPs, A&Es are bursting at the seams at we discourage foreign doctors from coming over to fill the gap because of shit conditions and a culture of xenophobia.

It fills a need but a properly funded healthcare service wouldn't have this need.

I have a child who has an intestinal blockage (intussusception) that 2 of those 3 cases died from. We saw 6 doctors who said it was norovirus/ gastro/ gastritis over a 72 hour period. I knew, after the first 24 hours, that it wasn't. There was no diarrhea - no poo at all - and vomit turned from undigested food to brown liquid. There was no high temperature. Luckily the liquid challenge was failed after the doctor at a and e was due to send us home again, so we were kept in and a drip was used. The next morning I had to insist the surgical reg do an examination. I can well understand how children lose their lives from that.

If you don't get a call back within a certain time you ring them back. It's always been great for me.

I've found 111 to be an excellent service. I've called it 3 times:

1. On holiday (in Scotland) and had coughed non stop for 6 hours and was struggling to breathe and feeling dizzy. The operator had a nurse call me back, arranged for me to go to the local hospital and talked me through some breathing exercises. Got to hospital where the staff were waiting for me and I was seen immediately. My first asthma attack.

1. Dsis had complex medical issues and was unwell whilst staying with me. It was difficult for me to know if she was just having a bad day or whether it was something more serious. 111 sent out an emergency doctor who suspected sepsis and called an ambulance. He was right.

1. DSis again and her nursing home hadn't given me the full complement of drugs. The nursing home (and her GP) was 200 miles away, local chemist couldn't help so I called 111 and they arranged an appointment for a local GP to write an emergency prescription that day.

Maybe I've been lucky but I have found it to be a really valuable service.

It's not just 111 hough bowel blockages can be difficult to diagnose. I've had the hospital think it was gastroenteritis also and it was a bowel obstruction and sepsis. At least I was there I suppose. But it is not simple. Even on examination

I think the problem is where people are reassured and then don't seek further help. there seems to be a gap there between 111 and unavailable GPs.

Luckily the liquid challenge was failed after the doctor at a and e was due to send us home again, so we were kept in and a drip was used. The next morning I had to insist the surgical reg do an examination. I can well understand how children lose their lives from that.

Interesting - so what did the surgeon find? How was it diagnosed?

Faina I also had a rare intussusception as an adult and nearly died of it. They (hospital) sent me home with 2 week wait flexi sig appt, I wa like that for two seeks and had sepsis, surgery and resection saved my life but only just. Can see exactly what you mean as babies / DC smaller and more vulnerable than adults. They even missed stuff like green vomiting / rectal bleeding.

Then for other obstructions from adhesions thought it was gastroenteritis. And it was consultant surgeons examining me. They got there in the end after CT scans etc, but it took time.

So yes not just a 111 issue.

I think it varies across the country. They are never going to get it right 100% of the time. An accident and emergency department isn’t going to get it right 100% of the time either. Neither is a GP. It’s human fallibility.

I think of greater concern is the increasing policy of ambulance staff not transferring but treating on site. Many technicians have limited knowledge and ambulance trusts don’t follow up on outcomes for patients who weren’t transferred. There is no real way of knowing how many elderly patients with treatable conditions don’t get the right treatment. Ambulance staff are not the same as doctors.

Intussusception is a kind of bowel blockage mainly found in children when the small bowel (narrower) telescopes into the larger bowl.

Symptoms include severe abdominal pain, 'redcurrent jelly' bleeding from the rectum and green vomiting (bile). It can be difficult to diagnose as bowel sounds are present /active.

in adults rarely a tumour or something can get caught and cause the same thing (which happened to me, a benign tumour) but this is incredibly rare

What it is or isn't is irrelevant. 5 children have died.

If 111 didn't exist, the parents would have brought the child to A&E. But it does exist and they trusted their advice. Consequently 5 children are dead.

PE writes in a dismissive way. Misdiagnosis? No this is loss of life we are talking about here. And an unnecessary one. The system, blasé dismissive people, cost cutting, negligence. All ends up with a life lost. And that's just not ok.

What or who is PE?

111 called me back 8 hours after I called them about my very sick toddler. We live 5 minutes from A&E but I don’t want to use them if there’s an alternative and DH was away and I had another child asleep in bed
By the time they called my neighbour had been round to stay with DD, we had been to A&E and were all back home asleep.
I’ve found them to be generally useless but here you can only get an OOH GP appointment via them. I appreciate the operatives are just doing their job to the best of their ability but I’m afraid i May have lost my temper once when I was very worried about my baby and they wanted to know both my and his ethnicity for a survey!

If 111 didn't exist, the parents would have brought the child to A&E. But it does exist and they trusted their advice

I agree. Surely the main signs- rectal bleeding along with green vomiting, are pretty specific. Hopefully they will update things now but too late in these cases.

I’d always trust my instincts over 111 I’m afraid.

Sorry. It was the poster :
FreedomFromPE

The thing is that people die from mis-diagnosis when they are seen by a GP or even in hospital, no system is completely safe. It would be incredibly expensive to have every 111 call taken by a clinician and frankly there aren't enough around for that to even be a possibility.

^This. I have used 111 a few times now and they were excellent.

This us the way our GP NHS is going , too.
They have to provide online consultations as part of their contract from Apr. This will include algorithms for pathways.
GPs do not want to do this as there will be cases that slip through the net - same with video conferencing. A clinician can SEE so much more about a person's health as they walk into a consulting room instead of hoping their colour contrast is correct and the patient's parlour is actually ok.
GPs are not fans of 111, although in our region changes are being made so a clinician is always involved in the diagnosis which will be a massive improvement.
I'm not gonna bash the 111 teams, they're doing the job in tough circumstances, totally underfunded and under resourced. Perhaps, Borus will keep his promises?

I think it’s a symptom of a wider problem in healthcare. I know medical professionals are under extraordinary amounts of pressure but there seems to be a culture of of treating people as hypochondriacs and time wasters to be gotten out of the door as quickly as possible until they’re at crisis point. So many people become reluctant to seek medical attention for fear of time wasting but the fact is most of us are not knowledgeable enough to know for certain whether symptoms require attention or not.

I’ve only had good experiences of 111 but in all honesty that’s because it’s the only way to contact out of hours GP’s/dentists in my area; if I could have gone to a walk in centre or rang them directly I would have. I knew enough to know that I/my family needed qualified assistance and a face to face assessment that could never have been done accurately over the telephone.

I am surprised these recent reports are involving such young children. I have only ever experienced the cautious approach with children since it’s so hard to catch what’s going on given their lack of ability to describe symptoms. All of those poor children should have been assessed physically by someone and I’m shocked that whatever algorithm they use doesn’t weight the scenario for age/capacity to communicate.

I’ve read one of the symptoms for sepsis is ‘a sense of impending doom’, how could a small child, dementia sufferer, mentally disabled person ever communicate that?

I do fully appreciate that they’re strictly obliged to follow a script - but it does indicate mindless box-ticking by someone qualified only by being trained to follow a script.

Mind you, we were in A & E with DD1 on Friday night, who needed a CT scan. She has a life threatening condition, complex learning disabilities and is under constant supervision (mainly in a specialist residential centre with 1:1 care, audio and visual monitoring, although home for Xmas). She has had Depo Provera injections every 10 weeks since she was 17 and has not had a period for 8 years!

They insisted on a pregnancy test - even though I told them she is under constant 1:1 supervision!

Eventually they said I could sign a form!!

I have had nothing less than fantastic service from 111. Am very grateful for the service

Sometimes the GP can be falsely reassuring also. Ds (2) had pneumonia, cold, pale and clammy, GP reassured me he was Ok 'probably just a virus'.

Luckily we had the health visitor round for the 2 year check later, saw him and called GP, sent us into A and E. His oxygen was in the low 70s (sats) and needed antibiotics.

there seems to be a culture of of treating people as hypochondriacs and time wasters to be gotten out of the door as quickly as possible until they’re at crisis point. So many people become reluctant to seek medical attention for fear of time wasting but the fact is most of us are not knowledgeable enough to know for certain whether symptoms require attention or not.

Agree 100%