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 absolutely hate 111. If it was a OOH GP receptionist booking system then I think it would be great. But as an ‘advice line’ - it’s utterly shocking.

I will never understand how normal functioning people need to ring for advice on cuts/splinters/minor illnesses. Take some responsibility, use common sense. Google if necessary! Remember what you would do prior to 111 ! Everyone knows it’s so risk averse, add to that the human tendency to overplay everything to ‘justify’ the reason for ringing.... = ridiculous increase in ambulance and A/E attendances for trivial rubbish. It’s existence has unfortunately also meant a few really ill people have waited hours to be signposted to what they obviously needed! Most people aren’t secretly really unwell- again, common sense would usually flag up serious concerns needing A/E without the input of 111.

Sorry to rant- but I live and breathe this nightmare daily. The reason 80 yr old ladies lie on the ground for hours freezing with their fractured hips isn’t ‘the cuts’, or ‘the government’. There have never been more staff in my environment. It’s purely and simply truly inappropriate use of ambulances and A/E by 111. Which is fed by people being unable to apply common sense prior to ringing.

@Kwkwjwkek that’s my point though, why is the system like that? Why can’t it be designed so that once the questions have been answered once a referral can be ‘passed over’ to a clinician without them having to start again?

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?! of 999 in such a situation?!

Booboostwo, I suppose it was the Brit thing about not wanting to make an undue fuss. . The ambulance paramedics did say we would have been justified in calling 999.

In this day and age you can easily google how to get a splinter out and decide on what sounds sensible. If you are not capable of removing it a nurse at a and e will do so for you. If you could leave it till normal hours you could try for an appointment at your own surgery. Some are great and will have appointments set aside for children as an emergency each day. You did not have to attend a and e , totally up to you if you want to attend.

I have used 111 up in Scotland and found it to be a fantastic service, they assess your symptoms, usually got a call back and an appointment to attend the out of hours clinic at the nearest hospital. Having an appointment time means you avoid sitting in a and e for hours and you do get seen quickly.

In my area we have massively reduced 111 transfers to 999 or A&E over the past 3 months by using paramedics as the clinicians on 111. All those on ‘light’duties, so pregnancy, injuries etc are put to work in 111. Added to that we have paeds nurses, mental health nurses, dental nurses and pharmacists. Road staff have already noticed a massive difference. I guess it makes a difference in that our local ambulance trust has the 111 contract so it’s a bit more joined up.
Obviously we do have to still rely on the public telling the truth.

I agree, they’re completely over cautious and it flies in the face of common sense much of the time.

My friend called 111 for advice when her 18 month old put a plug in air freshener in her mouth (literally snatched it off her as it touched her lips). They told her to go to A&E. She argued that that seemed like overkill and the operator told her she would be reported to social services if she didn't, so she went, waited 6 hours with 2 kids miles past their bedtime to be told she was fine and didn't need any treatment. A week later she got a call from social services - the operator had reported her anyway

There's being cautious and then there's completely wasting everyone's time and resources

111 is a substitute for people using their own common sense. It takes away people taking their own responsibility.

You have to understand that 111 is manned by medical untrained script readers. All they can do is ask you questions and give you the answer according to what you say. If you understand this, then you understand what 111 can do and what it's limitations are and therefore whether to trust its advice all the time.

If they ask you 'are you in a lot of pain' it's completely subjective and meaningless. How you and I define pain can be very different. What one person classes as urgent and can't wait until the morning is different to someone else's. 111 is supposed to aid that, but it isn't a substitute for a proper diagnosis from an actual doctor either.

A lot of assessments, particularly out of hours, are made on the assumption that if you've rung, you've already considered that it's too serious to wait for the next GP appointment. It's based on the assumption that people have enough brains to realise, without being explicitly told, that if they have a splinter that they can't remove they should go to the GP unless it happened some time ago and they are now displaying signs of a serious infection.

However since some people are turning up at A and e for stupid reasons like a stubbed toe that hurt for 2 mins and now is fine and it's not even bruised, then I guess 111 serves a purpose of filtering out some of those cases and back to the gp.

My point is that 111 is not some sort of medical gospel which people think it is and its not a substitute for people employing their own brains. Dr Google has a bad reputation but it does also have a place too and often isn't any worse or any better than 111.

If your child (especially if under 5) is struggling to breathe for any reason, then A and E is appropriate and you don't have to ring 111 to confirm you have a legitimate reason to go.

I'm not sure blaming 111 for being crap is helpful because that's a removal if responsibility too. Ultimately the expectations people have from it are unrealistic and lacking in understanding of what it's limitations are.

The problem ultimately is an over reliance on 111, particularly as an out of hours service. This is the result of GPS no longer having to deal with providing an out of hours service, having to deal with a rising number of people with more complex health conditions as they age and having to deal with rising health anxiety as people go to the doctors for things that really don't need a doctor (the doctor can't give you antibiotics for a virus).

We need more access to GPS across the board, but we also have to have a better idea of want will just get better on its own and doesn't need medical intervention at all too.

@Shinygreenelephant What did your friend expect to get out of calling 111?
They gave her sound advice if a child has potentially ingested something dangerous- go to a&e. If she thought it was overkill, why even ring?
If she has rang and they had said, don;t worry about it, then the child had fallen ill, they would have been blamed.

I needed a dentist at the weekend. Rang my own and the recorded message said to call 111.

So I did. And had to go through the whole "is the patient breathing" thing...
The call handlers clearly didnt have a script for emergency dental help!!

Agree, always told us to seek urgent GP or A&E ...except when I had sepsis last year and operator was a bit arsey cos I said I felt too ill to drive the other side of the city for a G.P appointment. Luckily took myself to A&E eventually.

If you decide to refuse there advice they report you to children's services

which is why I ended up waiting over 8 hours for an ambulance when there is a gp led unit down the road there justification for this was he ticked one box for meningitis (he has tonsillitis I was trying to get him to the out of hours gp down the road as he needed antibiotics and it was a Friday night) now we have a flying doctor service that should be used in those circumstances but they decided that a child with a potential life threatening condition should sit and wait for an ambulance the doctor went ballistic at them then we finally got down there (ambulance assessment was tonsillitis and we needed to go see the gp down the road) he said in a genuine emergency he should have been called in there was a lot of noise on the phone about him sat doing bollock all the entire night and they needed to use common sense and use appropriate services this could have been FUCKING SERIOUS and you LEFT THEM WAITING FOR A BASTARD AMBULANCE while I was sat on my arse FIVE MINUTES AWAY

He then came out all smiles and said all sorted the entire waiting room scraped their jaws off the floor but I can see his point he has given up time with his family on a weekend and has done nothing to earn his money the more he is seen to sit on his arse the less they think that particular service is needed and it will be first in line for cuts

7 (?) years later we still have the same service and it is used so its worth complaining if you feel you have had poor service because complaints on the internet dont go to the nhs they are just posted on mumsnet

Why did you even phone 111 for a splinter under the nail? It was 10PM when did she get the splinter? Personally I'd have stuck some antiseptic gel or spray in it, give calpol and bed. If I couldn't get it out myself in the morning I'd have got an app with the nurse.

See 111 might be unhelpful at times, however, it is hard to diagnose some things over the phone and some symptoms and illnesses mimick more worrying things. For example it would not be possible in some cases to tell over the phone whether you were having a panic attack or a heart attack because they can present the same. But if you're going to ring for something stupid in the first place I dont know what you expect

@mrsnoodle55 YES THANK YOU. I am in total agreement with you. I’m a GP and I have totally had it with the current ‘risk averse/ cant think for themselves ’ culture - the uk general public have no self responsibility anymore or Tolerance to put up with anything. We are busier then ever - we offer more appointments, more home visits/telephone calls etc but the waiting lists are longer and longer because of time wasters. People who don’t understand they should self treat minor ailments, people who want ‘checking just in case’, or social problems that are nothing to do with a GP but the public expects someone to ‘fix’ for them as they are used to handouts.

There will be someone on now saying ‘oh I’d rather get every cold checked as I once had pneumonia 10 years ago’ but what people don’t understand is it floods the system and that person with an actual problem is delayed.

You’ll all be pleased to know I actually quitting as I can’t stand working with the general public anymore. Yes there have been government cuts which make the nhs difficult, but it’s actually patient entitlement that’s got out of hand.

@shinygreenelephant similar happened to me, they insisted DD go to hospital in an ambulance, which was total overkill in the circumstances (she had licked the top of a bottle of facial toner and I rang them to fin out whether it had anything nasty in it as they used to have access to toxbase. Turned out it was just very dilute aspirin). They then refused to allow me to take her to A&E on the bus (she had no symptoms) threatened to report me to SS because I refused a referral to a HV and 'clearly wasn't coping'.
I already had a HV, which was why I told them not to bother referring me. What a waste of resources.

When it came to me though, with what turned out to be a severe concussion, alone in the house, they told me I didn't need to go to A&E and gave me the stellar advice 'be sure to ring us back if you lose consciousness'. Helpful.

I don't bother with them any more.

Its a lack of self responsibility and a measure of risk aversion that is all too apparent across all sectors of life in 2020.

We want to to remove all risk and insure against anything bad happening.

As a kid, if I banged my head (as kids do) so long as I didnt lose consciousness and was not bleeding to death, my mother gave me paracetamol and watched me for signs of concussion.

Now, people tell them to go to A and E or call 111 just in case.

I really value the 111 service. I agree they are very overcautious in sending people to A&E (and of course I understand why). But I have used it for myself when I got a UTI which came on suddenly and required antibiotics and also many times when worried about my baby and they will often get you an out of hours GP appointment and/or callback from a GP. Given that GP practices themselves don't have out of hours availability nowadays, I think it's an invaluable service.

But why can we not just book an OOH appointment without having to go through 111?!

I don't want to go to A&E but sometimes I do require a Dr that can't wait until Monday.

I don't want to speak to some jobsworth who needs to make the moronic decision that I need to spend 7 hours in A&E with an exhausted child for jackshit or get reported to SS when I just needed some antibiotics.

The absolute piss take is for us our OOH department is literally next door to A&E! We use the same entrance and then just veer right.
So why not let me make the call. Go to OOH and then the perfectly competent and qualified Dr can decide if I do infant need to go to A&E!

Because knowing the averting British public, the OOH appointments would be taken up by people who could happily wait until tomorrow.

See the calls for splinters and just in case.

It unfortunately is a side effect of it being free at the point of use - too many people abuse it

@LochJessMonster she wanted advice as she believed one of it's functions to be an advice line - what to look out for in terms of her becoming ill, advice on cleaning out her mouth and confirmation that it couldn't poison her if she hadn't swallowed any, as she couldn't find any information on google and was a panicking FTM. By the time she was finally seen by an exasperated a&e doctor who couldn't understand why on earth she had been sent to them, it was all pointless anyway as it had been nearly 7 hours with no ill effects, so she was basically told she shouldn't have come and sent straight home.

@whydobirds that's terrible! I think it does depend on the operator as they've been really helpful to me many times, but I'm definitely wary of them now.

I just wish there were more walk-in centres. I had shingles about 13 years ago and went to the walk-in centre in central Bath. Waited half an hour, said "I have shingles," Dr said "Yes, you do!" and wrote a prescription. Now, I'd have to call 111 and be referred to the "Urgent Care" centre next to A&E at the hospital which is only reachable within a decent time by car or taxi. It shares a car park with Maternity and A&E so is a) extortionate for a potential wait of hours and b) always always full. Last time it was mentioned to me by 111 they said nobody can prescribe til 10am so don't go until after that.