Aibu: 111 being the gatekeeper for a&e will result in deaths.

[MrsHookey]

Proposals are in place to ensure that A&E appointments will be made through 111 going forward. AIBU to think this is a disaster and many additional deaths waiting to happen? Their algorithms are not up to clinical nuances, diverse people, disabilities etc. www.theguardian.com/news/audio/2020/sep/28/did-the-nhs-covid-helpline-fail-hundreds-of-families

Well it doesn't sound a bad idea in theory but given it took from 11am to 4pm to get my poor DM seen after a fall due to the total ineptitude of 111 2 weeks ago I think it is an utterly terrible idea.

We rang at 11. Held for ages (over 30 calls before me). Told we would get a callback in an hour. It was more than 2 hours. The woman didn't have a clue, couldn't understand my answers (not a language issue just either wasn't listening or wasn't thinking or not capable). Agreed we should go to minor injuries. Gave me a phone number to ring. Nobody ever answered the phone.

So, I had to guess which a&e Dept to take her to as we couldn't wait another 2 hours. There are 2 huge hospitals in Leeds. Chose the a&e Dept which no longer has a minor injuries unit. Then went to the one that does. Got home at 8.30pm from a fall before 10.30am. My DM is 83. Utter chaos.

Should have just gone to the big a&e to begin with & sat it out.

On the plus side the actual clinical care when she did see someone was top notch - plastic surgery for her hand and thumb!

Every time I contact them they advise immediate trip to A&E or GP surgery first thing. 9 times out of 10 I've ignored this to no detriment. So yes I think YABU. The 111 service is decidedly over cautious in my experience.

@Whatdowehaveherethen

I was a 111 call handler. I'd love to say this will work but it won't. We had to read a script for every call. Sometimes it would work well. What I hated was that we were not permitted at any time to use our common sense. I know call handlers are not medically trained but there was zero room for deviation from the script. I had callers that I knew from the outset needed to go to A&E bit the algorithm made me ask more questions than necessary, sometimes meaning they needed to wait for a call back from a nurse or paramedic which could take hours.

I've had to call 111 myself and I'll be honest when I say I lied throughout most of the call just to get the result I needed.

Most people that I worked with were either thick and happy to be told what to do by a computer or using it as a part time job.

The long term staff were complacent.

There were a few really lovely people where I worked that were genuinely brilliant at their job but like I said, the algorithm.

I typed another paragraph of what it's 'really' like there but I'm wary of comebacks.

If you need to go to A&E, go. Ultimately, they have a duty of care once you arrive. I hope to God that will never change.

Absolutely. I had 3 calls with 111 when my DS was 10 . He had a high fever and I knew something was not right. I stupidly let them fob me off and remember telling my 'dh that I wanted to take DS to a&e. I let him convince me that it was an overreaction and a big part in that decision for me was that I had already called 111 x 3 times and been told there was no need to do anything and just to watch and wait. Within a few hours DS had experienced a seizure (at which point I called an ambulance - fuck 111) and he was admitted to hospital with meningitis.

@SusieSusieSoo

If you were advised to go to Minor Injuries, why are you annoyed that you chose to go to a hospital without a MI unit, just to have to go to another?

I have no faith , I have little faith in 999 either ,the script is totally uncompromising and a wrong answer at the beginning with an inexperienced controller can mean the wrong outcome .

They're utterly useless and unfit for purpose. Took them over 24hrs to send an ambulance when my 95 year old grandma had delirium from septicaemia. Mum tried dialling 999 but got put back through to 111! Still haunted by the story of someone on here who had to call them to get a GP to certify a death (was the procedure in her area, I think, or perhaps it was OOH/weekend practice). Waited over 24hrs with the body to get someone to come. 111 called back a couple of times and asked her if the patient's condition had worsened.

They were also utterly useless when I had severe vertigo from a nasty inner ear infection. After 48hrs of their "help" over the weekend, I was able to stay upright long enough (with support) to go to my GP when they opened on Monday. GP conceded infection was bad and I was lucky it hadn't been something nastier.

Yes I think it's a stupid idea.

Better to have a first triage at the actual hospital to turn away the time-wasters.

(I thought they had that anyway at the moment to make sure they don't have potential covid cases walking in)

Actually I think this will increase A&E use. I know people who have said ‘I’ll go to A&E for this’ and then, when warned it’ll be a 4 hour wait, say ‘oh, don’t worry then, I’ll book a GP appointment on Monday’

I’ve had quite a lot of bad sprains and broken bones over the years and unfortunately it’s hard to tell the difference without an X-ray. If I have something like a broken ankle, I’m very happy to wait, I’ll turn up with a book and if I need to write off a day waiting while more urgent cases get seen first then so be it. What I don’t want to do is try and navigate a myriad of non-clinical staff and jammed phone lines only to be told to come in 2 days later.

I agree. Last December DS (then 6mo) got norovirus and got quite poorly. We phoned 111 and they said they would talk to a doctor and call us back to discuss if we needed to go to hospital. In the end we took him because he really looked to be getting worse. They never called back but the doctors at A&E said we were right to bring him in because he was quite dehydrated. Who knows what would have happened if I had waited for that call back. I'm so worried for this year.

defiantly - a and e by its very nature is urgent. you need to get to one, by the time i have gone through the endless questions then have to drive to my a ad e both 40 mins away in busy towns it could be too late.

111 does not work at the best of times.

I got through once, managed to get a docs appointment ( took all day from 1st call out of hours) saw my DD who had strep throat B. Gave her antibitics. 10pm at night by the time we got them and she puked them up. I could not just go back through 111 to out of hours! I had to answer all the questions AGAIN because they said being sick was a "change of symptom" it took several more hours of phones to get back to the doctor to simply prescribe new anti B that didn't make her sick.

it does not work.

Ds has severe asthma. We live 10 minutes from a and e so when he has a bad attack we can get him in the car and there quickly.

If I had to waste time phoning 111 to make an appointment I wouldn’t. I would end up needing to phone 999 instead.

What we need is for a and e triage systems to be such that after doing the checks they can send people to somwhere more suitable if necessary not a system that makes it harder for those who genuinely need to be there

YY to a and e triage and they triage well anyway -

I’ve used the 111 service a few times, and for me the situation has been dealt with appropriately.

I called for MIL who had Alzheimer’s and suddenly became doubled over in pain. Due to the Alzheimer’s she couldn’t explain what was wrong. It turned out she was quiet badly impacted and in need of medication.

Called for FIL who turned out to be having a stroke. He very nearly got diagnosed with a water infection and fobbed off as other than confusion wasn’t presenting with typical stroke symptoms. Amazingly somehow FIL perked when the ambulance crew arrived and I momentarily worried I may have over reacted but luckily he was whisked off to hospital where he received excellent care.

DD2 had an incident at school during a swimming lesson, went under the water and had to be fished out. Was only told when I collected her, they said she had been coughing as had swallowed a fair bit of water. Having not seen the incident myself and given by the time I got her home and later that evening she was still coughing and wheezing I became concerned about secondary drowning. DD was checked over and monitored and while she turned out to be fine, I’m so glad she was seen.

Both my elder DD’s were referred to hospital as babies when they were unwell with viruses that caused dehydration. Though as far as babies go I think the service airs on the side of better safe than sorry.

All that being said I would not hesitate for a moment to disregard 111 if I felt the situation to be more serious than they believed. I would easily do this for my children or another person however, I think I would struggle to do this for myself. Without another person to advocate for me I think I would be easily fobbed off and worried about wasting time if 111 didn’t think it was serious.

It’s a double edged sword, could be good at reducing needless A&E trips but could just as easily miss situations that don’t necessarily appear acute over the phone but need medical intervention. Sometimes there is no way to correctly assess the situation over the phone and relies on the correct questions being asked and the correct answers being given and sometimes that’s much harder than you might think.

@Elsewyre sorry if I wasn't clear. No, 111 told me to go away and contact my GP on Monday. If I had followed their advice I would have ended up in hospital as an emergency case.

I called 111 for my ex when he had a toothache. I was told this was necessary to get an emergency dentist appointment. 111 spoke to him and said someone would be in touch. 15 minutes later an ambulance crew rocked up. When informed he had a toothache, they rolled their eyes and said "Not again". They stayed for about 30-40 minutes. This is not a good use of public resources.