to think 111 is a total liability...

[M3lon]

They advised us we needed to take our DD (8yo) to A&E last night at 10pm because she had a small splinter of ceramic tile under her finger nail.

I'm not sure the NHS needs this kind of 'help'.

I once rang them as I had come off my bike and had a cut that looked a bit odd. They told me to go and A&E which was 30 miles away and at the time I didn't have a car so they suggested I ring an ambulance!

I’ve found them good, but for adult care recently.

1. DH effectively fast tracked through A&E triage (when I couldn’t even work out Friday the website of our local A&E even exists any more)
2. some time later, again DH - 111 lady the ONLY person in a long string of medical personnel he’d seen to advise him to take it easy on the paracetamol (he had a herniated disc, was on a lot of meds, and was in danger of overdosing on paracetamol in amongst everything else)

Like so many services it depends on who you get, and I do wonder if they’re just a bit more pragmatic with adults than children.

@RunningAwaywiththeCircus
If you thought it was sepsis why didn’t you take him to hospital at the time. We have to go with one main symptom to triage but then other questions about other symptoms would appear. There’s no option to click more than one symptom on the body map but that doesn’t mean we don’t take into account other symptoms.

@tinysnickersaremyfavourite
Perhaps that particular ooh service isn’t available so the case can not be referred to them. Might be too busy or doesn’t cover that area

@GeraltOfRivia.

If the child cannot keep their eyes open for more than a few seconds then they re treated as unconscious. I do understand what you mean. You can’t tell a baby to keep awake especially when it’s their bed time. However, we can’t seem them in person. We do get a lot of calls about people who think the person they’re calling about is sleeping but turned out to be unconscious. Therefore, we have to make sure patient is awake for the assessment.

@CrohnicallyEarly
It’s not just about the cost of staff. There isn’t enough medically trained people. It’s a triaging service, we do not diagnose over the phone as we cannot see you. Even clinicians who call back still have to go through the questions again anyway. With thousands of people calling everyday, the clinical queue has to be prioritised. It’s not just reading from a script as people might think. It seems that way but it really isn’t. I’d like anyone of you to do a shift and then you’ll see about reading from a script!!

Also regarding the uti, sometimes I have triaged those who have frequent utis and it’s said to refer to pharmacy to get something over the counter. This is most likely if they don’t have a fever, no flank pain etc. I have had many say to me but the chemist can’t give me antibiotics, I get these frequently so I know. I understand this so I will refuse it and get a clinician to call. 111 isn’t perfect and we know that. The pathways system is designed by doctors and medical experts. They get updated regularly as there are always new evidences.

YANBU to think the system is a bit ridiculous, at times, but equally I’m baffled as to what advice you needed. Unclear as to why you even phoned them. That’s part of the problem.

I went to A&E when I got a piece is wicker form a wicker basket embedded under my fingernail into my finger. It was exactly the right thing to do and they were able to extract it and dress it for me. It was an accident so I was justified in going. I think they gave you the right advice.

It's a pointless service in an underfunded system.

In France I can call the equivalent service but I actually get to speak to a doctor (pretty much immediately, the longest I have waited was 7 minutes) who gives actual medical advice and an administrator who can then book appointments directly if you need them. At different times I've had them send us to out of hours GP who saw us (DD) within 20 minutes of the original call (appointment made by telephone service), send me to A&E with what turned out to be an emergency, and give advice on the phone on medications for DS which avoided an A&E visit (with that one the doctor called me back twice during the night to check that things were still progressing OK).

This kind of service makes sense, but you have to have the money to fund it.

tinysnickersaremyfavourite
Do you not get asked where you are and whether you could attend? Our region will generally say "there's an appointment at Town Hospital at 7:30pm, would that be possible?" Or "are you able to get to... There's an appointment at..."

I'm starting to realise our area's services are much better than some areas based on this thread.

@booboos it’s not just about funding -the brilliant thing about healthcare in France is that the patient has a lot more responsibility. They are given a copy of results for example and expected to follow up on anything that’s been raised - rather than in the uk we waste countless resources chasing patients up and spoon feeding them. In France, if you miss an appointment - that’s on you, in the uk, as your Gp I have to chase you up, rearrange it and if you still don’t bother to attend and something goes wrong somehow it’s still my fault. The NHS infantilises people and completely strips away personal accountability. I prefer the french way!

@lolasmiles they tell that child needs to see doctor within 2 hours and to attend oog gp in the city. When I point out that be t Town over is far closer they usually just tell me that the screen is telling them the city one. Noy many seem able to bypass the default computer response and chose a more sensible location.

I phoned them in the early hours, and they said it was highly likely DD had an appendicitis/blocked bowel. We were told to bypass doctor, straight to A&E. By the time she was operated on she had a badly infected appendix and ended up being in hospital four days. Glad they convinced me to go to A&E.

DD now 18 and phoned them on Sunday (she's at uni) and they told her to go to A&E. She was seen, given ABs and painkillers. In agony today, despite treatment so she's been seen again and now on two lots of ABs. I'm so glad she didn't leave it for a doctor on Monday.

Personally, I'm glad there's another option than going straight to a doctor, A&E. I think they have to be cautious sometimes as it must be hard to decide what's best unless you've got a patient in front of you.

I've heard them called NHSRedirect because eve answer to anything is Go to A&E

They sent an ambulance for DS when he was a baby because he had an upset stomach. I was mortified and told them to cancel but they refused. Even when I said I would take him myself.
He laughed the whole time and loved the attention from the nurses and Doctors.

Another time he had a blister that was causing him some pain. I was hoping to get an OOH appointment as I thought it might be infected and I could grab antibiotics.
Nope. We had to go to A&E. I told the call handler that was ridiculous and I'd wait until the GP opened.

She said that because it had all been logged I'd be reported if I didn't take him! It was a small blister that turned out wasn't infected.

I won't be calling them again. Absolutely useless.

It’s thanks to 111 that my friends child is still alive. Fobbed off by GP and a&e. Needed emergency neurosurgery.

They're a waste of time. The last two times I've taken my children to A and E and been dealt with before I've had the call back from a doctor with advice. I don't get the point of being told to wait 7 hours for a call back and then told to go to hospital.

I rang them when I was suicidal 4 years ago. I just wanted help and the Samaritans where useless. The call handler told me to pull myself together. Several times. Zero faith in them.

bobbypinseverywhere I agree with you that there are other aspects of the French system that work well. I would add the direct access to specialists (there was a thread on going directly to a gynecologist on here recently and quite a few people questioned how that could possibly work, but it does!). I do think though that in this case specifically having the funds to employ doctors makes a huge difference to the efficacy of the system. And the funds to have OOH GPS that can see people within 20 minutes. All of this changes the entire system and the pressures on A&E.

I've had some really helpful advice and on two occasions call handlers gave absolutely amazing advice and did totally the right thing.
The last two times I called were abysmal. The call handlers were fine but on both occasions the nurses weren't very good. Not sure if they were overworked but they weren't really listening. Asking quite bizarre questions and one was pretty unfriendly.

111 is an excellent service and we should be grateful for it

I've used it for myself twice when over weekends I came down extremely ill with urinary tract infection that could wait for the GP on Monday.
Once I was sent to out of hours GP the other time they just faxed a prescription to a chemist and my husband went to collect!

In December I rang because my 8 week old spiked a temperature. Was told to go to A&E. Within 24 hours she was in intensive care with severe Bronchiolitis

I once rang them as I had come off my bike and had a cut that looked a bit odd. They told me to go and A&E which was 30 miles away and at the time I didn't have a car so they suggested I ring an ambulance!

Cases like this (and several other examples on the thread) - why don’t you take a bit more responsibility for yourself? Instead of blaming the call handler who has suggested an ambulance did you suggest you could get yourself there in a taxi?

Honestly if you call 111 as you have a cut that looks “a bit odd” what are you expecting? Why not go to a walk in minor injuries clinic?

Some people are really lacking any ounce of common sense on this thread.

They are awful. I've worked as a nurse in A&E / urgent care for (too many years) and the advice they give is laughable! If their sole purpose is to arrange out of hours appointments then that could be done at a fraction of the cost with dedicated call handlers rather than "clinicians"

111 Dispatch criteria.

@Kwkwjwkek if it isn’t a script, why did the original call handler and the clinician who phoned back ask me exactly the same questions? When I say ‘script’ I presume it’s something like those decision trees you used to get in teen magazines... if patient answers ‘yes’ then ask this question next... if patient says ‘no’ then skip to question 5...

And what criteria do you use to determine if a patient should be referred to pharmacy or given OOH appointment? Do you ask about relevant medical conditions/medications or do you rely on the patient interrupting the flow of questions to mention it?

You could use your common sense and not take her. You don’t have to take their advice.
We’ve only had exemplary care via 111 and the NHS. Not really sure what you expect, there’s only so much they can do over the phone at that time of night, so persoLy I think it’s better than no advice at all and worrying at home.

With children they will always be over cautious and surely that’s usually a good thing?

I agree an absolute liability, I've called them 3 times. Twice they sent an ambulance as DC was breathing 'heavily' (once it was a viral infection with a temp and we just wanted reassurance and once it was croup and needed steroids but we said we had a car to take him to A&E). the other time DS had bumped his forehead and I called for advice they told us to go to A&E. I know now I should have went to a pharmacy for a butterfly plaster. I would be very hesitant to call 111 in future.

I just wish there was a nornal out of hours GP service. I rang them once and spent so long explaining the problem to what felt like person after person who was clueless, I knew what I needed (antibiotics but it was a bank holiday), I finally spoke to a GP who sorted the prescription straight away but so many people were involved!