To go to A and E instead of phoning NHS direct?

[fernie3]

I took my little girl to the doctors today she is 8 months and has had a pretty bad cold and temp etc for about 5 days. We tried to call our out of hours doctors a few nights ago but couldnt get through so we called NHS direct who told us dont worry shes fine just give her calpol for a few days etc etc which is what we did.

well she still wasnt better today so I decided to take her to the GPs anyway. The gp told us she has quite a nasty chest infection and then told us NEVER to bother with NHS direct if we need a doctor and cant get through to the out of hours and its for a child just go straight to A and E. She said that she has seen too many children get really ill after phonecalls to NHS direct!.

So we have antibiotics etc but we have also been told hat if her temp goes up anymore we take her up to A and E straight away.

Is this reasonable - I would have felt like I was over reacting but now Im not so sure??

i was told for my ds that if temp goes above 40 take them straight to a&e, i think it depends how high is the "high temp" really?

You're asking here instead of taking the clearly-stated advice of your GP, who has seen your ill daughter?

YABU.

NHS direct is great. The troubke is they can't see your DD and have to go off what you tell them. What could be a 'raspy' breath to you could be a 'wheezy' breath to a doctor. I'd prefer a hands on diagnosis and we have taken DS to A&E or the emergency walk in clinic rather than phone NHS direct

No. YANBU.

I would never ever phone NHS Direct again. They are a complete waste of time and generally useless. I really do not know what they are trying to achieve with the 'service'?

I phone/go to the GP or straight to A&E depending on the severity of the illness.

lol no i wasnt asking for advice I was clearly take her I was just wondering whether i was unreasonable BEFORE i.e when i DIDNT take her

You should complain about the lack of out of hours service

Fernie3 - you weren't being unreasonable before by not taking her because many people would feel they were over reacting and call NHS direct instead.

And you wouldn't BU to take her direct to A&E in future

I'm not sure "reasonable" is the word you're after, then fernie. I suspect that had you been truly terrified concerned about your daughter's health, you wouldn't have hesitated to call an ambulance or drive her direct to A&E. As you were only worried enough to call NHS Direct (and tbf, it was a few days ago, when the chest infection would not have been so well-established), that was the sensible, "reasonable" thing to do.

It's not reasonable to rush to A&E for just anything, but if you have an unconscious, delirious child burning up with fever which is not responding to Calpol, of course it's reasonable.

I have found that NHS direct are always the opposite and tell you always to go to A&E.

I found the Nurse i saw was more of the 'don't worry, it is only virus' type (my DD had gone purple all of a sudden and the Dr's is on my road)

I work in A+E and will say that that the whole of GP and A+E services need revising as people often dont understand when appropriate to go to A+E or not. I have never phoned NHS direct myself but I know they use a computerised system that helps them guide people as to whether or not to go to A+E, and if they have 'chest pain for example the computer will always tell them to go to A+E in case of heart attack!
Overall I think common sense prevails and if you think your child (or adult!) needs urgent attention then of course go straight to A+E, and of course A+E is for Accidents and Emergencies. What is annoying is when we are treating people who say I've had this pain for 3 years and its come back again and they haven't taken any pain relief and havent been to their GP who should be the person referring them to a specialist if needed! We can only refer to specialists from A+e if there is urgent need.I know people have alot of difficulty getting appointments which is disgraceful and urgently needs addressing.
I think people are also confused as to when to call an ambulance, we have people brought in with toothache etc...the ambulance service are allowed to prioritise calls but aren't allowed to refuse a call out AFAIK.

tbh i would never consult nhs direct or go to a walk in clinic, gp or a/e for me, and i am not a timewaster either

YABU to go the GP for advice and then to question it imo.

NHS Direct IS crap ime and would just go to A&E if my child was ill and very young.

NHS definitely has its place. For instance to ask advice about intervals of Calpol/Nurofen as it can be really confusing, and to ask about issues you don't want to go to the GP about, or just want to ask a few questions.

Think some people treat A & E as an out of hours GP surgery, but think it's always better to go and get it checked out. And have never heard any A & E staff say, 'well, that was a waste of time...'

Thing is I lovemydog When you call NHS Direct they want to know the ins and outs of a ducks arse before you can ask a question - I am sure it never used to be like this.

For general info like you mention it would be a great service but I get riled the minute they start asking futile questions the last one being "is the person you are calling on behalf of breathing?" WTF???? I am calling about me!!! And on the occasions I have been calling about DC's - I would have called 999 not NHS Direct had it been serious!

The "advisors" I have spoken to have been complete numptys.

I think it depends on how old you child is. When my son was ill at 10mo, NHS direct gave me advice, but insisted that with a young child/baby, mum knows best. They said if I was at all concerned I should take him straight to A&E. As it happened, he did get worse and by sunday eve we took him in. There was nothing too serious, but the doctors were lovely and said they'd rather see him 20 times with nothing wrong than miss seeing him when he is very sick.

I'm in the medical profession and we don't call it "NHS Re-direct" for nothing!

If you want a sensible answer then see your GP. The out-of-hours service will always see children sharp-ish if you're concerned, because there is nothing better than assessing a child in person.

I had to ring our out of hours service to get a doctor as my stitches had burst after i had our dc.
I was asked where the stitches were: me-perineum.
operator- whereabouts on the body is that?
oh dear

I thinks it's unfortunate that the out of hours service is so crap. When DS1 has been ill & I've been uncertain how ill, we've always ended up in A & E, on the telephone advice of NHS Direct or our out of hours service. Every time DS1 has basically been fine. A & E is not where you want to be with a baby if it's not an emergency, especially if you have to drag another child along with you. A 5 minute house call by a GP would have been less stressful for us and probably more cost effective for the NHS.

Thanks I think maybe I should have taken her up to the hospital in the first place I just didnt think that it was bad enough. I did try the out of hours doctor before calling NHS direct but it just kept ringing and ringing with no answer.

If she gets any worse over the weekend I will try the out of hours again and if I cant get through again I will take her up to the hospital.

She is still not well temp this morning was 39.5 but did go down with calpol and shes still wheezy but hopefully the antibiotics will have an effect soon!

NHS direct is generally good, it has trained and expierienced dr's and nurses working for them.
however they do need to know everything about the ill person because they can't see them. this takes time. they also have to use thier own expierience and intuition to ask the right questions, and people have to supply the right answers, to get the appropriate care.
A&E is for emergentcies only (the name gives it away) and people with colds and fl use it as they think that they aare going to recieve a magic cure the minute they walk in. if my child was ill, A&E would be the last resort, as I don't want to expose him to more germs.
so fernie3 if your dc's temp is not responsive to calpol or calprofen, get her down to A&E

I phoned NHS direct last month and had to sit through a very long message about swine flu hotlines/websites before I eventually got to speak to someone. Don't see why they couldn't have just had "if you are phoning about swine flu press 1" and a redirection to the recorded message, instead of making everyone else hang on for so long.

I do think NHS Direct is useful - there is a place for calling, and on occasion I've been very pleased to have it there with someone to reassure me.

If my child was ill enough for me to be seriously concerned, I would go (and have gone) straight to A&E, though - as this is usually what NHS Direct advise when a small child is described as unwell. And I can see why - they can't take the risk when they haven't seen the child.

They are brilliant on some things, crap on others. When my DS had a serious chest infection at that age, the woman at NHS direct told me to call an ambulance. I never would have had the balls to do that on my own.

But their computer triage system just isn't equipped to cope with some things. To be honest, you'd be better off doing it yourself on the NHS direct website - much quicker.

I think you may be confusing A&E with the walk-in GP clinic which is often in, or near to A&E. NHS Direct often refer you to the walk-in clinic (which isn't actually always walk-in, as NHS referrals usually get appointments IME). I have had experience of GP out of ours service and it was very good. I believe NHS Direct can get your local one to phone you if they think you/your child need to be seen by a doc as a non-emergency. If it is obvious what is wrong (ha!) then hey can get the GP to send a prescription direct to your local pharmacy (e.g. I have had this for anti-bs for cystitis)

I have never spoken to a duff NHS direct person, I have only ever phoned for ds except once for the cystitis, and they were always kind and reassuring. Mind you I have not hadto phone them since swine flu has been around, and I can imagine that things are a bit different now.

Would not hesitate to go straight to A&E with a very small child whose temp was over 40degrees though. But thankfully have never had to.