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?

Absolutely, I trained for the job and failed the exam. After being upset I was relieved. I have no medical background, and I had no confidence in the system. This is partly because like you say the service doesn’t quite know what it’s for.

ballsdeep we reckon it was maybe conjunctivitis my DS had a few years ago. We never went to A&E (as GP was open) but it did result in pretty strong antibiotics, an urgent referral to an eye Dr and a 4 week open discharge for the eye clinic.

I am not saying that is normal for conjunctivitis - but it could possibly have been periorbital cellulitis.

I never trust 111 know the signs yourself and seek urgent care. Sepsis isn’t easy to recognise in its early stages but you can see the signs and symptoms if you are looking for them.

So few people know how many breaths per min are normal for different aged children. How to check capillary refill rates, the signs of a non blanching rash (in its actual true form). What it looks like when a child is struggling to breath, sucking in at certain areas.

Knowledge is power, we’ve beaten sepsis, bowel obstructions, all sorts in our home. All of which would have been easily missed and were even missed several times in A&E. I think as a parent sometimes you know but having the information to fight your own concern is key.

111 is essentially a symptom of an ailing health service. It exists solely to gatekeep access to NHS care which is too stretched to accommodate everyone who feels that they need medical attention.

The UK is the only place, to my knowledge, where in order to access an out of hours appointment with a doctor for you or your child, you first have to go through a national call centre, answer a series of flowchart questions asked by someone with no medical training, wait, often for hours, for a callback from a nurse, who will then go through the same questions and make a decision, without even seeing you, about whether you should be "allowed" to access medical care.

111 doesn't exist for the benefit of patients. It exists entirely to ration appointments for out of hours services and to prevent people from going to hospitals because the NHS is such a mess that it can't cope with the strain it's under.

@Shedidnt or you could have called a taxi to take you to A&E?

Of course 111 isn’t worth 5 children’s lives that’s a ludicrous statement. However you understand that the medical profession makes mistakes too, and more than 5 children have died by misdiagnosis in hospital under the care of professionals .

I’ve used 111 a couple of times when my kids have had minor injuries and in one case where my son was having a bit of difficulty breathing. They got a doctor to call me back. However if your gut gut is telling you to go to A&E, GO!!!!!!

I think we have a special out of hours number in our area if you need a weekend doctors appointment anyway. I wouldn’t ring 111 for something I considered could be serious and wait for someone with no medical training following a script to decide what to do, that’s madness. So I just wouldn’t bother calling them personally. They might be useful for minor ailments if for some reason you can’t ring a gp directly but I just think it’s madness ringing them and farting about with 50 questions, if someone is seriously unwell/had a serious accident and needs immediate attention you ring 999, if someone is seriously unwell but you can get them to hospital quickly you take them directly to a+e.

problem is if you do go to A and E without a doc ringing ahead they can be a bit dismissive. It can be a bit risky. I had them say to me what can we do for you at this time in the morning? (when I had the intussuception). they thought I was dramatic, the other patients were all drunk as it was a weekend night.

Some of the examples being used to demonise 111 here are ridiculous, if you call them when it's not appropriate- when you actually need 999 say- of course they aren't suitable. It's a service for non-emergencies and out of hours advice, in some areas also to get OOH appointments. If you think you or someone else needs a&e go to a&e or ring 999.

There are sadly many cases where doctors have missed or given an incorrect diagnosis that results in death. If there is no 111 and everyone is adding extra demands to GPs and hospitals the doctors and nurses are put under extra pressure and mistakes more likely, wait times increase and services suffer. then we'll have all the same people calling for 111 to be scrapped shouting about the incompetent medical staff.

While we were in the waiting room at A & E, someone came out and said everyone waiting to see the urgent GP could go now - half the room walked out! There would be more resources to treat people in A & E, if there weren’t so many people there, who were not accident or emergency!

?
In my area the out of hours/urgent GP service is located in A&E (which you can only access through 111). The amount of people in the A&E waiting room is not indicative of the amount of people actually using A&E.

I’m quite concerned people waiting to be seen by a doctor were dismissed like that as it sounds like they weren’t seen at all??!?

I would never bother to contact them, have used them before and was woefully misdiagnosed, so would google and then make decision based on that and own judgement.
Personally I would scrap it and replace with online questionnaire, which is effectively what it is, but with human voice at the end. Invest the money saved in mental health services and better provision for the elderly, surely that would reduce some unnecessary a&e visits.

I used 111 on New Years Day after numerous rubbish GP visits for my dad. They were brilliant. Got paramedic emergency response out to us immediately. Literally was just putting phone down as there was a knock on the door. Our GP and the Gp practice were the weak link in our chain.
There aren’t enough good GPs working anymore and services are tight. Last year while in A&E with my son someone came in because they’d had 3 separate bouts of hiccups during the day. You could hear the drs impatience in their voices but obviously they couldn’t turn this person away and needed to check him over.
Very thankful for our NHS at the moment.

wait for someone with no medical training following a script to decide what to do, that’s madness.

That's what we're expected to do however.

I would never bother to contact them

As I have asked earlier in thread - what would you do if you needed an emergency GP appt and that was the only way to get one in your area?

Another big problem can be these lines and also out of hours clinic not having your basic medical history

@Shedidnt or you could have called a taxi to take you to A&E?

You're part of the problem. I was deemed fit enough to walk to the ambulance and had a sort of fit in the ambulance. A taxi would not have been able to bring me.

I much prefered 111 when it was run by nurses. It is very much just following a computer but inexperienced call-takers can miss important information. Having said that I have generally had a good service from it in recent years. However I took an overdose one evening and the call handler said a doctor would ring me back. The doctor rang in the morning and immediately sent an ambulance and once in hospital found I had toxic levels of the drug. The call handler obviously missed some of the information as they should have sent an ambulance straight away.

if you call them when it's not appropriate- when you actually need 999 say- of course they aren't suitable

But this is part of the problem imho. In the attempt to cut costs and resources needed the general public are being asked to assess symptoms and have the confidence to know what needs which pathway. There’s no ‘of course’ about it.

For every person sitting in A&E with a paper cut there’s someone seriously ill at home who won’t seek help because they don’t want to waste anyone’s time or be treated like a hypochondriac. Invariably that second person will end up in front of at least one medical professional telling them they should have sought help sooner whilst all around them are posters telling them to not waste resources and self-treat.

That’s down to a campaign asking people to be their own doctors. In principle I support that but in reality I don’t think it’s worked. The people who take that message on board are not the people who are clogging up the system. Unfortunately that group of people also tend to be the ones with no medical training and will trust that anything/anyone with NHS branding is right. It takes quite a lot for most people to seek a second opinion or override the advice of a service like 111 since they trust that the information they’re given is right.

I suspect the parents of the children linked in the OP were reassured by 111 and carried on as usual precisely because if someone from the NHS tells you not to worry then you trust that their knowledge and resources are correct because you’re not a doctor.

Gp surgeries should be open AT WEEKENDS and for longer hours each day

There’s no viable alternative as overstretches ooh centres and 111 can’t give the right level of care
It’s ridiculous in 2020 that everyone else seems to ha w to work shifts and weekends except gps

The money saved from less a and e trips for things that don’t warrant a and e would make a difference too

YABU. I wonder how many children have sadly lost their lives due to rushed/average care in A&E, yet you aren’t calling for it to be scrapped. I admit particularly defending NHS 111, by the way. I think there needs to be some improvement with this system. However, I’m just baffled especially as people have described being examined by clinicians and had bowel obstructions missed.

Last time due to knowing more, called 999 for last bowel obstruction, they were good came quickly and gave morphine, traiged straight into majors- in a very busy hospital

maybe 999 is better for severe situations, instead of 111?

It takes 10 minutes for them to get through their questions

Last time I phoned 111 for my mother - who adamantly refused to go to A&E - they asked less than 10 questions before sending round an ambulance.

The time before, they sent a GP round to visit her at my home )different health authority to my own).

On a more mundane level, they have also helped on whether certain OTC medication with prescribed medicine.

I've had mixed experience with 111, the worst was when I was concerned regards DS symptoms and tried to explain his underlying health issues to be told she "hadn't asked that and it wasn't part of her questions" so she would "disregard as unimportant". I put the phone down and rang back, got someone else who did listen and as a result asked a GP to call.
But then, I've also had a couple of bad experiences with calling 999 too, one of which meant a 25 minute delay to an ambulance arriving as the woman ignored my postcode and thus sent the ambulance to the right street name but the wrong town. She kept saying it was nearby, it was just turning to the next street, and it only became apparent she had made the error when she mentioned the roundabout at the end of my road which didn't exist.
There is room for error, in an ideal world we would have OOH GPs, better staffing, more resources, but we don't and we're not likely to in the next 5 years.
As for the Mirror being anti NHS and wanting to help Boris flog it, they actually supported Labour in both the last two general elections.

I'm fairly sure that, in our area, the only way to access the out of hours service is via 111.

I agree a lot of the examples here of how 111 failed them are situations when the poster should have gone straight to A&E. You need to use some common sense, do you think without 111 in your case you would have rung 999/gone to A&E straight away? Or do you think actually you would have waited probably as long as you did and ended up in a&e anyway?

Of course 111 is not ideal, and yes it would be better to have a system of emergency GPS and A&E. Unfortunately we do not have the capacity to do this, because the NHS is underfunded.

What you are saying is true OP, but you are demonizing the wrong people. You can't just scrap 111 without pumping masses of money into the NHS, without training more GPS which takes years.

You also can't really say 5 children have died as a result of 111 when you don't know how many people would have died without 111. Yes it is horrible that 5 children died, but there will be parents who wouldn't have taken their child to A&E who did because of 111.

111 is a useful system if you are unsure about where is appropriate, if it is obvious A&E is necessary then you not need to ring 111.

I called 111 when I had a horrific period, I couldn't do anything but sit on the loo due to the volume of blood and clots. Was soaking through a nighttime pad in 15 mins. When the doctor called me back she was very dismissive and said "well at 53 we expect changes to periods" I was 40! She had completely the wrong person's records!! She then became very flustered and said she would call me back. When she did ask she said was that I needed to go to A&E they can't do anything for me at the out of hours and hung up! I wouldn't use it again...