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AIBU?

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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:
faw2009 · 21/01/2020 21:34

Wouldn't be a dental / non-dental issue. My OH had exactly the same thing a month after root canal. Cheek ballooned up, incredible pain. Paramedics worried it could be sepsis - got treated with intravenous meds - painkiller & antibiotics - very quickly at the hospital.

Miljea · 21/01/2020 21:36

OldQueen, are you actually there or relaying to us the friend's version of events?

Not criticising that, just getting clarification.

People are saying 'demand this, talk to them' but if you're not there, that doesn't help.

70isaLimitNotaTarget · 21/01/2020 21:36

I would imagine there are waiting for some in Oral/Maxiillary .

There was a post years ago (by a Dentist) about antibiotics prescribed by GPs for dental and the consequences of non specific antibiotics .

He will likely need IV and they have to be the correct ones .
You'd have thought painkillers would be given though

Original poster
OldQueen1969 · 21/01/2020 21:36

To clarify it's nothing to do with his status he is a UK citizen.

Whatever this EPR system is it was definitely mentioned about billing though - I suppose these things have to be allocated to a trust accounts department or something - possibly it's been very badly communicated?

OP posts:
MummyFriend · 21/01/2020 21:36

This happened to me a couple of weeks ago, though A&E did administer treatment while I was waiting for a bed...
Once I'd been wheeled up to the ward the porter took me straight to the reception desk on the ward so they could scan me in etc., except there had been a cock up and my information hadn't been sent over by A&E staff. I was in urgent need of meds and a bloody nebuliser (serious asthma attack, couldn't breathe!) but they said they couldn't give me anything whatsoever until my details came through on the computer. It was an absolute nightmare!

It sounds like your friend is going through the exact same thing. Get the friend who is with him to run down to A&E and grab someone to tell them to send his details over immediately to whichever department be is currently in. Until someone in A&E does this the ward can't do anything.

With regard to the 'billing' comment the person who said it didn't literally mean they want to charge him for the drugs. It was just a turn of phrase. They can't just hand out drugs without having an officially record of who they're being given to, it needs to be entered onto a person's record. For all they know they could prescribe antibiotics that your friend is severely allergic to and could inadvertently cause his death. The procedures they have in place are to stop things like that happening.

Anyway, go get your friend to run around and liaise between departments to get this sorted asap. Good luck!

CoffeeRunner · 21/01/2020 21:37

At sepsis level - no dental/non dental doesn't come in to it.

At anything less @faw2009 it most certainly could.

CoffeeRunner · 21/01/2020 21:38

EP is electronic prescribing.

Medication has to be logged in the system to be given.

But as I said previously, emergency stat doses can also be given if appropriate.

ShakeTheDisease · 21/01/2020 21:40

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'.

@Miljea I haven't demanded, I've asked politely. But I can tell you I don't give a shit if it 'does not endear'. I care about my friends and family getting properly treated and I don't respond to guilt trips about what is 'endearing'.

Original poster
OldQueen1969 · 21/01/2020 21:40

And no I'm not with them - just on the end of messenger because they are very dear friends and I want to make sure they are ok - M is very good at dealing with this sort of thing, but doesn't want to antagonise anyone by being too demanding though she is very worried. I also wouldn't want to get in the way - whatever the problems are I wouldn't want to make it worse by wading in and taking up time that should be spent on him being treated......

Am pretty gobsmacked - it should have been a bit more straightforward than this.

OP posts:
Miljea · 21/01/2020 21:48

Can I ask everyone on here to email their (Tory) MP, to remind them of the lavish funding promises that have been made to the NHS?

I am not joking.

Tho I object to 'cock up'. Q: except there had been a cock up and my information hadn't been sent over by A&E staff - Was it a 'cock up' or was it a) an IT systems go-slow (like Windows 3.1 Grin ); it can take minutes you don't have to log out of one system and into another- I'm NHS coalface, but not Emergency; or was it b) staff who hadn't managed a wee in 4 hours, let alone a break, with no time to do the logging?

I am on a one woman mission to assist people in understanding that they need to convert the tabloid 'massively overstretched NHS/struggling staff' issue (tho will happily then do 'NHS let-down sad-face' 2 pages later...) to 'Hey, Dear MP...'.

CoffeeRunner · 21/01/2020 21:50

And your final post explains all of the issues.

You are sat at home, deciding for yourself what the failings of the NHS are.

YES dental issues are for dentists. Many hospitals cannot deal with dental. Unless they, you know, have an actual dental department (dentistry is a different degree course to medicine).

However, in terms of emergency treatment we will give antibiotics and/or pain relief to ANY patient requiring it for whatever reason.

As someone who works on the frontline of medical care, I politely need to tell you that you know absolutely fuck all about the situation sitting at home on your phone.

Toddlerteaplease · 21/01/2020 21:50

Nurse here too, of course they can give medication without being admitted.

Toddlerteaplease · 21/01/2020 21:53

I think they mean, which specialty budget the medication will come out of. But it isn't a reason to delay treatment and I would think that all drugs given in A&E would come out if that budget. It's a bit odd that there is no max fax

mummymayhem18 · 21/01/2020 21:54

Hope they get sorted very quickly. It doesn't make any sense as surely he could be at risk of Sepsis which they would need to treat promptly.

lljkk · 21/01/2020 21:55

There are whole teams of people sorting out which budget pays for a patient long after all their care was given, long after patient recovered & discharged. That is normal practice.

Miljea · 21/01/2020 21:55

Shake everyone cares about their friends and family. You're not unique. But a sure way to get 'politely' blanked by hospital staff, in a verbal setting, is to insist on a name. 'How do you spell that?' and a notebook out.

Think of the context. They're trying to explain, you're seen to be gathering evidence.

That behaviour does not promote 'proper treatment' for your loved one over and above anyone else's. That's not necessarily how it works.

Toddlerteaplease · 21/01/2020 21:55

The pain team will not see a patient with a dental access. We would give simple analgesia and possibly some Oramorph. We have kids in with dental accesses all the time. It's not a big deal.

Looobyloo · 21/01/2020 21:57

When I went to a & e in agony they gave me morphine straight away. Once I was moved to the ward and the pain started again the nurse said she couldn't give me anymore pain medication until she had permission off a doctor
I could hear her ringing round frantically. I just laid there swearing like a trooper until I was given more pain meds.

All sounds very odd.

katielilly · 21/01/2020 21:59

It's not simply a dental abscess from the OP's description. It's facial cellulitis.
"Surgery" will be GA extraction and incision & drainage. IV antibiotics.
This should be a wake up call to him to look after his teeth going forward, as a previous poster states, the vast majority of dental disease is entirely preventable.

Original poster
OldQueen1969 · 21/01/2020 22:00

@CoffeeRunner

I expressly said that this not about bashing the NHS or staff when I posted, but to get advice as the updates I have been given were very worrying. It has been confirmed by HNS workers and patients that the EPR system can cause delays for whatever treatment. You're right I am not there, but I haven't had to use the NHS like this in so long I am not sure how it works.

OP posts:
Miljea · 21/01/2020 22:01

And might I doubt a dedicated, specialist 'pain team' will be funded to be on duty at 20:30?

Please be aware, that does not mean 'no pain relief', it means no individualised, specialised pain relief on a per-patient basis, available into the night?

MummyFriend · 21/01/2020 22:02

Miljea, this isn't an issue regarding funding. If it was it would be relatively easy to solve. There are massive issues regarding software used within the NHS. A friend of mine's company was paid an enormous amount to try to fix some of the issues... the problem being that the civil servants responsible for hiring this team of programmers just had no idea what to look for and pickled a really crappy firm full of idiots. Think about your typical recruiter trying to hire an incredibly highly intelligent and skilled individual for a niche project in a field that recruiter has no experience of... Anyone who regularly deals with recruiters will know that even when they're doing their best the recruiter will still unknowingly put forward plenty of unsuitable candidates for the position. It's really not unlike that tbh. The problem is that really, really good coders who actually have the talent to be able to fix any software issues within the NHS are in INCREDIBLY short supply and tend to be snapped up to do more interesting work elsewhere...

Original poster
OldQueen1969 · 21/01/2020 22:02

Just been updated that antibiotics have just been started. Very relieved all round.

OP posts:
Miljea · 21/01/2020 22:03

OldQueen You may not know, but you're making loads of assumptions!

LotteLupin · 21/01/2020 22:03

He needs sorting out quickly or could die.

I don't understand why they're making such a fuss about the paperwork - they never do here where I am (also South of England) - they just get on with helping people! Is he not an EU national??

Jump UP AND DOWN. NOW.