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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

NHS issues - urgent advice appreciated please.

104 replies

OldQueen1969 · 21/01/2020 20:38

Hi there all,

Would appreciate some advice for a friend of mine who is currently in hospital and seems to be at some risk from some sort of system cock up.

I'll start by saying this is not about bashing the frontline staff who are obviously doing their best under pressure and with poor resources.

So my friend L who I saw yesterday evening had the beginnings of a tooth abcess and planned on sorting it with the dentist today - he's had them before and knows the drill so to speak, and would have done the usual routine except by this morning his face had swelled dangerously and his eye was closing, so he rang 111 and they advised A&E.

He and my other friend M for support went to one A&E (we have two on opposite sides of our town) at around 1.00pm. After three hours there it was concluded that no-one there was insured to go near teeth so they had to drive across to the other where they have been since. The swelling has got worse and L is actually crying with pain (chap in his early 30s and not a wuss by any means).

It was decided he should be admitted as he now has a fever and high temperature, but they didn't have any male beds available for a while so they had to wait in A&E. No meds could be administered until he was admitted.

He has now been given a bed, but apparently he can't be given any meds because his admission is nit showing on the system yet and until this happens they can't prescribe etc because they need to know where to "bill the meds to". It's nothing to do with cross referencing for allergies or anything. I have asked all the logical things and M is messaging me as time goes on. They are both really worried as he is now "ill" with this infected abcess and treatment is being withheld, and his pain is unbearable.

A nurse tried to get a canula in in preparation, but that went wrong as the vein was missed and has caused further distress. I guess that happens but it's not helped the situation.

My main question is whether this system failure is a common thing? And what should they do now? L has been seen by doctors etc but all say no system confirmation, no meds. Surely that can't be right as he is getting visibly worse - I've seen pictures and he looks terrible.

Any advice / opinions gratefully received.

OP posts:
exWifebeginsAgainat46 · 21/01/2020 21:05

i had a fall in september and attended a&e on the advice of 111. i was given codeine on arrival, and two hours later 10ml of oramorph. both given in the waiting room. i’d been triaged but was waiting for x-rays etc.

cannotmakemymindup · 21/01/2020 21:06

I wonder if its because they're seeing it as a dentist issue, which we all pay for, not a hospital issue? Especially as they had to swap hospitals to have correct insurance available. Some hospitals do dentist work that normal dentists cannot like removals so I'm wondering whether it's a separate unit in that hospital? Plus trying to find a dentist who can also advise the best treatment path. Still to wait is unbearable. I had my face swell up once, I looked like I had a golf bowl at the side of my face. The pain is literally the worst, you can't eat (I pureed food as I could barely open my mouth). Nowadays I know I probably should have been in hospital myself. Took two sets of very strong antibiotics to clear.

Original poster
OldQueen1969 · 21/01/2020 21:06

@independentfriend

Thank you -all good suggestions. Will pass them along.

To be clear it's not just the pain meds, no anti-biotics have been prescribed either. I can understand concerns about drug seeking, but his face looks like a football now and his eye is pretty much closed. he has shivers and everything.

OP posts:
TitianaTitsling · 21/01/2020 21:06

Never ever heard this, either as PT or as staff- recently was in with similar and as pp above had to wait to be seen by max-fac for what actually needed done, but the pain meds were brought out quite quickly!

cannotmakemymindup · 21/01/2020 21:06

*ball not bowl.

ShakeTheDisease · 21/01/2020 21:07

The billing thing doesn't make any sense. But focus on his treatment for now. Ask to speak to the person in charge of the ward. Tell them you are there as his next of kin and want to know what their diagnosis is and what treatment they are planning. Ask them to explain any terms you don't understand. Get a pen and paper from somewhere and write it all down and ask for the names of the staff you speak to. This is helpful not only for supporting the patient but for making complaints later if needed. Be polite but persistent in asking for pain relief and other medication. Advocate for your friend.

Cohle · 21/01/2020 21:09

It sounds like a series of cock-ups or misunderstandings rather than a systemic "NHS issue". I wonder if the dentistry issue is confusing things because that might account for the discussion of billing.

MsMarvel · 21/01/2020 21:11

I wonder if the dental vs medical thing is whats causing the delay...

Maybe they are debating whether he has delayed dental treatment to save money and getting it via the hospital?

Whentheleavesfalldown · 21/01/2020 21:12

This makes no sense! I'm a nurse in a south east hosp. He needs antibiotics asap, he or someone needs to talk to the nurse in charge to see what's going on!

HappyHammy · 21/01/2020 21:12

If you are in touch with your friend who must be feeling pretty rotten, ask him if he is happy for you to speak to the nurse in charge or bleep the site manager to explain that you are very worried about him and ask why hasn't he been given any treatment yet or pain relief. I wouldn't pretend to be nok unless you are, there system may not update till midnight which is not acceptable. He must have a hospital number if he has seen a doctor, been put on a theatre list so someone needs to get him seen properly.

Mrsmorton · 21/01/2020 21:13

Huge sympathies to your friend OP, sounds awful and I have no advice above what's been said.

Here's hoping that folk gobbing off on the other two threads about dentists/mouth care have a read of this. Almost 100% preventable. ¯\(ツ)/¯

Babyroobs · 21/01/2020 21:13

If he's stuck in A& E for hours and needs intravenous antibiotics or something he would be given them there. I have never heard of people not being given medications until admitted, that's ridiculous, people are given all sorts of meds in A&E surely ??

Original poster
OldQueen1969 · 21/01/2020 21:15

Whether it should or should not have been treated before as a dentist thing is surely irrelevant when he's developed such a rapid infection though? This has blind sided him with the speed of onset, it's not like he calculated a way to avoid going to the dentist.....

M is with him and advocating for him - I'm still a bit shocked it's going to be surgery!

OP posts:
MsMarvel · 21/01/2020 21:17

Im not saying thats what hes done, completely understand how quickly these things can come on and all of a sudden be unmanageable. But thats what the hospital may be (wrongly) thinking. It might be worth him getting clarification that the treatment is going to be covered under his nhs entitlement.

HappyHammy · 21/01/2020 21:18

M needs to speak with the nurse really. If he is shivering then he will be feeling rotten, poor guy. Surgery may be to drain the abcess and flush it all out,

WheresMyChocolate · 21/01/2020 21:20

Poor guy, he must be in agony.

HappyHammy · 21/01/2020 21:21

If he ever does get painkillers written up and doesnt have a cannula he can insist they are given another way, dont let that delay things any longer. If M is still there he can push the nurses and doctors about the sepsis path way and are they using it.

Original poster
OldQueen1969 · 21/01/2020 21:21

Thanks all for your input and kind words x Will update if anything else happens x just waiting now. M's phone is dying so I will have to wait for more news x

OP posts:
CoffeeRunner · 21/01/2020 21:24

Also a nurse.

Some hospitals with an A&E do not do dental. The one I work at included.

However, they can and will give medication to help with the presenting condition (fever, swelling, infection etc.).

This can be given stat generally.

Miljea · 21/01/2020 21:27

As ever, there will be a pile of 'blanks' in here; stuff that hasn't been communicated in a way a lay-person can understand( not patronising; fact); stuff that is happening which is not observed to be happening by distressed patient or bystanders.

I genuinely hope this friend is sorted asap. It genuinely sounds horrible.

As for 'billing'- that either is completely the wrong end of a stick or some non UK entitlement issue. Some Trusts are clamping down on 'non-entitlement'.

But I bet all is not how it seems.

As small thing: demanding 'names' from staff does not endear. Especially as on here, it comes with that advice for 'when you make a complaint'.

wibdib · 21/01/2020 21:27

Is there something odd going on like they think he might not be from the Uk ? Or they don’t have his go or dentist listed?

Also it might be worth asking the medics what would be the worst case scenario of giving him the meds now if he doesn’t have an abscess and/or billing info. And then what is the worst case scenario of him not having meds asap - could it turn to sepsis for example? And get them to document that you’re worried about sepsis/other serious complications but have been told [whatever they say]. If there is the slightest risk of sepsis find out what their protocol is for dealing with - in lots of places now they’re realising it’s better if there’s an inkling it could be an issue to get treatment started and then worry about billing etc as it can make a difference to outcome.

And getting them to consider worst outcomes and put their name to it tends to focus the mind!

Other things that might help - is the PALS unit there always open? They can help sometimes. At least get details to be ready to talk to them in the morning if necessary.

I’ve also heard of patients (or their family or friend) tinging 111 for advice from a doctor and getting them to chase from the outside so to speak.

Good luck - I’ve had abscesses in the past and they’ve been agony - I’ve also had a couple when the dentist had said there’s cellulitis around the tooth/jaw and to take the antibiotics and painkillers but to get to hospital straight away if the pain goes up a gear or it spreads or gets worse in any way - scary for him to be in that position and for them to effectively not treat him SadAngry

Hope they start to do something soon and he’s out of pain very soon.

TatianaLarina · 21/01/2020 21:28

What surgery is he having do you know?

lljkk · 21/01/2020 21:31

I'm wondering if the hospital is worried about other drugs he may have used or other info they are missing that they need to safely prescribe.

TatianaLarina · 21/01/2020 21:32

As for 'billing'- that either is completely the wrong end of a stick or some non UK entitlement issue. Some Trusts are clamping down on 'non-entitlement'.

The only billing issue I can think of is if he is non EU.

Namechanger001 · 21/01/2020 21:32

Iif it’s a computer issue ask them if they will find a paper chart and do it as if it were down time. That is when we can’t access computer system so we go old school and use paper charts. He should not be waiting as he could end up needing an op for airway occlusion at this rate or sepsis!