to think that nhs direct is crap and that my doctors should have a proper out of hours service

[pud1]

my dd is 9 months and had a bowel intersesection in jan. this is when your intestine slips into your bowel. she had an op to pull it out and cut the bad bit off as well as some colon and her apendix. she has recovered realy well and is a very happy baby. she is a good sleeper but last night she was a nightmare. she screemed for 4 hours between 7 and 11. the only time she has been like this is when she was ill in jan. i called my doctors to get the out of hours number and when i called it i ended up talking to nhs direct. the guy on the phone had no idea what a bowel intersesection was and i was left to wait 45 mins for a nurse to call me back who understood her illness no more than the first guy. by the time they had called back she had settled and in her cot asleep. she is fine this morning so i am thinking that it may have been realy bad teething or looking at her nappies more likley contipation i am goign to the doctors this afternoon to get her checked.
when she had the illness in jan she was pooing blood and when i called nhs direct then they just told me to wait 5 hours for the doctors to open. i did ignore this and took her to the hospital and she had to have an emergancy op.

I do think pcts need to sort out their out of hours gp services. We are lucky, we have a good one.

If you think you need to see a gp (particularly at bank holiday weekends when 3 days is a loooong wait sometimes) then you phone up and a nurse triages you. If you need to see a gp then they tell you to come down to the centralised out of hours area. Last time we phoned we were advised that actually it was a&e we needed after all. oops.

I'm really sorry you had such a stressful time. You should be able to give feedback to NHS Direct, which in your cse, if done constructively, will be of help to the service and may make you feel less aggreived. I personally had a very positive experience with NHS direct last week with regards to my 2yr old - the nurse was very helpful and supportive - and i will be giving positive feedback.

Sorry you had a bad experience, but YABU to generalize - and to put it in perspective, if you had phoned in the daytime you would probably have had to wait for an appointment for a few hours as well

IME we've actually been seen quicker through NHS24 in the middle of the night, and even at the OOH 150 miles away when we got caught out on our way to the airport

NHSD treats every call individually, and if it is a symptomatic call you are asked some safety questions to rule out any potential emergencies (as we get a lot of calls from people in immediate danger that require an ambulance straight away), after the safety questions we ask some more questions and prioritise the call, if it is urgent you will be put straight through to a specialist nurse advisor, if it is urgent but also clinically safe, you will wait up to 1 hour. However if it is not urgent or life threatening then you will normally wait 2 hours, 4 and even up to 8 during our busy times. There's NHSD centres all over the country with so many staff in each, but due to the amount of calls we get we literally have seconds between each call, that should give you an idea of the amount! So that is why it can be such a long wait.
If it is obvious that you need a GP we will arrange it for you, if it is not obvious then you will be assessed by a nurse first. If it is important for you to go to A&E or MIU then we will suggest that, a lot of the time you will have to be put through to, or wait for a nurse call back.

People need to remember it is just an advice line call back service, and we get a lot of difficult and emergency calls from heart attacks, to suicidal ideation, and with some symptoms, of course it will be difficult to understand and assess over the phone, as we are not there face to face with the patient.

I am not surprised that a pregnant patient got sent to A&E, a rash could potentially be life threatening, and could of harmed mum or baby.

It may seem like ''just a rash'' until someone dies from it, which in fact, has happened, and was in the news because the parents of the child has caller NHSD about the rash.

And I am afraid, if your problem is not urgent then you will be told you have to wait, if you don't like the advice given then you don't have to follow it, but you should understand NHSD receives a huge volume of calls, varied in so many ways you can't even begin to imagine, and the staff are very well trained.

With regards to the child who fell, depending on if the child had any symptoms NHSD would likely tell you to go to A&E, a fall from more than your height can be potentially very dangerous, NHSD airs on the side of safety.

The PCT I worked for a couple of years ago was in the process to move the Out of Hours telephone service to the local NHS Direct call centre for triage as they had much better staffing levels and IT. There was still an OOH doctor for those who needed it though.

If you want to be mad about the service then don't blame the PCT, blame the BMA and the government who negotiated the deal that allowed GPs to opt out of providing out of ours services without taking into account the significant cost of providing it elsewhere. Of course your local service could be specially bad, but the issue tends to be about funding.

I hope you get some help and assistance from your GP - it does seem strange to have no follow up.

Come on people - of course NHS Direct is crap, especially when you think about what it has replaced ie a REAL QUALIFIED GP coming to your house to look at your child.

GPs should be ashamed of themselves, sitting on high salaries and allowing fatalities to occur because people are at the mercy of a nurse/God knows who diagnosing them on the end of a telephone line.

If Cameron had any balls he'd sort out the GP pay by either capping it/cutting it or forcing them to offer house calls. It is ridiculous that they earn 100k plus all the ir bonuses when the PM is on c.150k.

YANBU - Its your experience that has formed that opinion and im sorry to hear you had such a rough time with them.

Doctors out of hours services are not much better though - my surgery has one and last week we had to call them about our 2yr old as she was waking up coughing, wheezing and struggling to breathe and then going back to sleep, so we were unsure what to do - id never heard a cough like it in my life and both myself and dh were rather concerned for her.

We phoned the out of hours at around 11.45pm and were told that a doctor would call us back shortly.... 2am finally a doctor returns the call, by which time she was fast asleep (but still wheezing in her sleep) and says 'oh well if she doesnt have a temp, and she doesnt have any other symptoms just leave her to sleep and if she wakes up again take her down A&E' I explained that we had 2 other children in bed and no way of getting to the hospital which was a good 7 miles away
and his reply was 'well ring an ambulance then'!!!!

I was rather shocked at this considering our out of hours service is for home visits?? Surely it would cost the NHS more to send an ambulance (when someone else could very possibly need it more) than to send a doctor out to my daughter??

Madness. I dont think it is either of the services which are crap, i think there are just a few people working within these systems who are crap

Out of hours is in a real state. There's no quality control at all.

we have a good out of hours service here so yanbu to want that, although nhs direct are okay and better than nothing but the other weekend i called up out of hours and was able to take ds to go see a dr straight away in hospital (not going to wait in a&e, a seperate area) which i thought was pretty good,so if you ever had that before then moved to only having nhs direct understandably would find that quite frustrating

NHS direct hasn't replaced GPs doing house calls. Most GP practices stopped doing house calls many years ago, and moved to out of hours services (often co-operatively run by a group of GPs). There are some quality controls, but they are variably applied. NHS Direct was not brought in to replace but to supplement such services, and has since been expanded. Oh and GPs aren't paid £100, they aren't paid salaries, but on a contract basis. Some GPs run very large practices, sometimes several, and as a result they are paid a significant sum, but that is used to fund the practice (which may include other GPs, nurses etc). I think that the contract was negotiated very badly by the government, but some of the press stories are very inaccurate.