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'.

@CrohnicallyEarly
Most likely to confirm your symptoms. And If there is a trigger question where the outcome can be changed they will try to change it and give a more suitable outcome. For example, if someone is saying theyre urinating more frequently and it’s painful with no other symptoms. The clinician will be wondering why the pharmacy in the original assessment isn’t appropriate. So will need to re confirm in case they have missed anything out.

Because for a lot of people those experiencing the same symptoms can just get something over the counter. For example, as I said if you don’t have a fever, blood in urine, side pain. Then that’s probably why you were told to see a pharmacy .You can get those sachets for uti. Not everyone needs antibiotics. Any person should mention about their medical history if it’s relevant so we can note it down. Don’t see what is wrong with interrupting the assessment if you’ve got something important to say.

If you don’t agree with the outcome then that’s fair enough. But health advisor can’t change it so the clinician who is medically trained will have to do it.

The questions as people say it’s like a flowchart. But it’s based on scientific evidence! It’s not 100% perfect but it gets updated every time there new improvements.

Saying that my friend was in a&e the other day and there were lots of kids who just needed calpol (one parent openly sayibf they didn’t have calpol so went to a&e). Maybe if they had rung 101 they would have been directed to out of hours pharmacy

Tbh I found them helpful when I had to ring out of hours for DS who had an ear infection, I rang the GP surgery first to see if they used an OOH service but was redirected to 111.

Phoned and spoke to someone, git a call back and advice to take DS to the OOH service at the hospital. DS seen, examines and antibiotics prescribed....home within two hours of initial call.

Great service.

I wouldn’t call again. I called when dh had flu, but also has diabetes. He’d messaged me at work to say it’s sugars are out of whack (but no detail). When I got home he was asleep surrounded by his blood kit. I called because I had no idea how having flu would affect his results and aware that I could get his blood sugar up or down but not sure what the best course of action was. 111 told me that they didn’t deal with calls about flu and people with flu should stay away from the drs. No matter how many times I said diabetes, don’t know if he’s up or down, they kept saying to get off the phone. I googled it in the end and he lived to tell the tale but it was dumb luck he didn’t end up in a diabetic coma.

Back in the day when there wasn't an NHS 111 service or an NHS direct, how do you think you might have handled a ceramic tile splinter under a child's finger nail?

I think if it's anything to do with a baby, they don't want to be the person who says it's fine when it isn't so they ALWAYS tell you to go to a&e, just to be on the safe side.

Shropshire has its own service, weirdly. The doctors seemed more competent on that.

I've had mixed experiences with 111. Our area doesn't have an out of hours GP number to call any more, you have to go via 111. I have a chronic illness that means I get infections really easily, I can generally tell when I have one and need AB's. It can be quite difficult to convince the call handlers that I don't need an ambulance, nor A&E, I just need to see the OOH's GP.

On the other hand, DS had ongoing bleeding from a tooth extraction a few months ago so I phoned 111 as the dentist was shut and again, no OOH's. The emergency dentist on call called me back and talked me through what I should try (tampon and cold compress) and called me back every 15 minutes for an hour and a half until it had stopped. She was on her last call back before sending us to A&E when it finally stopped thankfully but she was absolutely amazing. Calmed me down, which in turn calmed DS down. Reassured me I was doing the right things and it would eventually stop, made sure he was alert and not dizzy etc. She saved us a trip to A&E.

@Kwkwjwkek I did tell them about my medical history at the end when they asked if I had any questions. But it’s only by chance that I did- I didn’t realise that they don’t have access to my summary care record (I thought that was the point in having one). As they didn’t ask about relevant medical history, I assumed they must have that information on record somewhere. I even mentioned ‘my medication’ whilst on the phone and they didn’t ask any further questions about it, so I think it was a reasonable assumption to make that they already knew.

They had already processed the pharmacy referral based on the flowchart answers. When the clinician phoned back they repeated the flow chart. At the end I said ‘you do have my medical history as I already mentioned it to the previous person?’ and no, they still didn’t have it noted, so the clinician then realised why pharmacy wasn’t appropriate and got me an OOH appointment.

When I got the dr appointment and a prescription, I went to the pharmacy and she asked if I’d gone through 111, I explained the whole situation and she said they should definitely have asked me about medical history, and had I turned up as 111 recommended she would have had to send me away to make an OOH appointment. The pharmacist recommended I feedback to 111 so that’s what I have done.

It just seems an incredibly inefficient system compared with being able to speak with someone at your own GP when needed! I spoke to 2 people on the phone with 111, plus an OOH appointment (which took far longer than when I’ve had a UTI on a weekday and went to my own GP), plus the pharmacist’s time... if it were my own GP it would be a case of one phone call, maybe drop a sample off at the surgery, and prescription sent through.

im an a+e nurse and despise 111

@Kwkwjwkek and wouldn’t it save time if the clinician had asked ‘I see you spoke to my colleague who recommended a pharmacy visit. May I ask why you don’t think that’s suitable?’ then she would have got the information she needed in about 30 seconds rather than having to repeat the whole flowchart again and still not get the information!

@CrohnicallyEarly

That does sound frustrating. In order to send a referral to the ooh, the assessment has to be completed. It presents itself at the end which you select to send the referral.i don’t believe the clinician can bypass the questions and put you straight to the ooh. They can override the outcome however.

Yes it would be a lot easier if you could speak to a gp or hcp directly. But they just don’t have that service and I don’t think that they would even have the staff for it. There’s not even enough doctors at a gp surgery, that’s why it’s so difficult to get an appt. if only there was a more efficient way.......

It is so hit and miss here. Last Saturday I woke up with tonsillitis and spoke to 111, had a call back from a pharmacist, then a call from the admin team to say I could see a GP at the local minor injuries unit. All in about half an hour.

However I called for DS on a Monday night because he was beside himself with a suspected ear infection and heard nothing for nearly 5 hours. We had called 111 back to cancel the nurse's callback, since he had been asleep for a while, and she still phoned at 11.45pm. When the ear infection came back a couple of weeks later on a Sunday I was told there was not a single OOH appointment anywhere within 25 miles so I'd have to go to A&E for penicillin.

I found 111 great last December. Early Saturday evening I developed a painfu rash. DH, who’s had it, reckoned it was shingles which I know is highly contagious. First call handler said after questions that a clinician would call me back. Clinician did so and reckoned I needed to be seen in person. Offered an appointment at oohs in 45 minutes time! Arrived early, went straight in and was getting into the car again by the time of my original appointment clutching prescription for acroclovir (sp?).

Just to be totally clear - I would never have phoned about a splinter, even a ceramic splinter. It was DH wot done the deed, while I had gone to bed early. I got woken up by DD who was in a right state because she thought DH was phoning for an ambulance....

By the time I could attempt to assert some rationality into proceedings 111 had already told DH to go to A&E.

There's no chance he would be talked out of following medical advice....

In the end we got seen by a random emergency nurse who'd was just clocked off and who'd seen the 111 info come through and felt sorry for us.

He said he thought the call handler hadn't understood the difference between mm and cm in the size of the splinter....

bizarrely he apologized to us for 111 wasting OUR time...we were just pathetically grateful to him for sparing us the wait till OOH reopened at 1am.

I like them.
They sent an ambulance when DH told them I was lying on the bed quietly dying with an ever decreasing heart rate.
Pacemaker fitted the next day.

They probably thought if someone is phoning about a splinter then it must be bad probably an element of self responsibility in making decisions, but I guess not everyone is capable of that. As a number to call to access an out of hours GP appointment it's great, if you know you don't require hospital treatment but need to see someone. It would be better to invest more money in taking on and training more emergency call handlers probably though for anything remotely diagnostic. The thinking behind 111 is great, the reality, not so much.

I'm waiting for allergy testing, something is making bits of me swell up randomly. A few few weeks ago it was my tongue, lips and under my tongue, swelling was coming up fairly slowly though, not all at once. DS rang 111 because I had called a cab to a&e, and he thought that I should get an ambulance. 111 said I should try and see my GP that day instead

I got a taxi, the 7 miles to our closest a&e because it was quicker, and was put straight on oxygen and injected with steroids and antihistamines. Was fine within an hour and a half. Allergy testing appointment has recently arrived, and is in July ( 35 miles away this time!). I cannot work out what the hell is setting it off though (I have been keeping a diary of food/personal care products/cleaning stuff used). It was the sole of my foot, spreading up to my ankle yesterday, and was so bloody painful.

TrickyD while I am really glad you got the help you needed, why the hell did your DH call 111 instead of 999 in such a situation?!

I once ended up in a&e with my son with a toenail splinter when he was little as the walk in clinic couldn't remove it. He ended up needing IV antibiotics as the whole toe had become infected and it started to spread. I suppose the problem with 111 is they can't see what is going on.

@Letsallscreamatthesistene

I imagine you probably don't want to "talk shop" but what do you despise about 111 and how would you improve / revamp the system?

We have doctors, out of hours surgery which they question you thoroughly before you can go in (20 miles away) and 2 a&e equal distance away. One is a superb service for breaks and minor trauma and the other is a big one, long waiting times but we have never been without being redirected by the OOH or Doctor so they are expecting us.
Called 111 three times. They have to do the best with what they have. They are damned if they do and damned if they don't.
There is no way I would have called with a splinter. Clean it up, put a blob of magnesium sulphate on it then if there is no sign of it shifting, down to the nurse for removal.

Just to be totally clear - I would never have phoned about a splinter, even a ceramic splinter. It was DH wot done the deed, while I had gone to bed early. I got woken up by DD who was in a right state because she thought DH was phoning for an ambulance...

You should be blaming your husband for being an idiot then not the call handler. Fancy calling 111 for a splinter

They saved my dad’s life. I’d been to visit him and he didn’t seem himself, nothing obvious, seemed overly tired but snapped at me really badly when I said I think he needs to see a gp (I just couldn’t put my finger on it but I knew something wasn’t right) he said he’d kill me if I called the doctor (he would never have spoken to me like that). I got home and called 111, just for advice (gp had closed by then) after I’d answered their questions they patiently listened to why I had called and told me not to worry they’d take it from here. Next thing I knew they’d managed to speak with him and arranged an ambulance, he had sepsis and spent a week in hospital. The doctor there said if it had been left he wouldn’t have survived the night, honestly with everything I’ve read about sepsis symptoms I wouldn’t have guessed that. They’ve also helped greatly with a few “minor” situations. I’m wondering if it might be regional or simply down to the individual receiving the call on how they process it.

oh don't worry I was and am blaming him, not least for terrifying DD.

I feel like its not even safe to take a nap of an evening!

I think it probably is a matter of region variability or call handler to call handler variability.

tbh I have had reasonable advice a couple of times too...I'm just furious that I sat there telling DD not to worry because 111 would just give him some advice on soaking it out etc, and then they bloody sent us to the hospital.