What is the check-in process in your local a & e after being advised by 111 to attend.

[Oliviajoseph]

Just had a 111 experience with my 9 month old. Was advised to attend A&E. Going back to a previous incident, when we attended a&e, the receptionist asked us to check-in using one of the IPADs located in the waiting room. I said we were told to attend by 111 and was still told to check-in using the IPAD. On the IPAD, I pretty much repeated what was discussed with the 111 advisor plus there were a few extra questions about benefits, marital status of the child (thought this was weird but please enlighten me with the rationale) if the child attends nursery etc.
So now with this very recent 111 advisor, I asked if they can transfer the information they have just collected from me to A&E so i dont have to spend 10-15 minutes with an unwell baby at the IPAD screen, repeating his entire medical history. This is after driving to A&E and somehow parking and getting to the deartment, so we are talking minimum 45 minutes all together before we can officially begin to wait to be seen by anyone. Already spent 25 minutes going through 111 at home, but sometimes longer. Anyway, the 111 advisor said they can't communicate the information to A&E and that I'll have to follow whatever the check-in process is at the local A&E, I.e. repeat everything using the IPAD.
Is this how it is normally ? I find it weird that a GP can inform A&E that you're coming but a 111 advisor can't even though they are advising us to go to A&E. And will it be any different if you were to ring 999?

If you were to just walk in with a sick child, on your own, without going through 111, what is the procedure at your local a&e ?
Is there a person who checks you in or are you typing in to an IPAD ?

I like to think that if I were to walk in with a seriously unwell child, who requires time sensitive care, a medical team would come running in like on the TV shows.

TIA

It's exactly the same at mine (adult and child). They ask if 111 sent you, but what happens next is the same regardless of the answer.

It’s the same in my area. You still have to check in - our GP will give us a letter explaining why we’re there which reception will scan in but I still have to show to triage for some reason. They ask if 111 has sent us but it doesn’t make a difference to the process.

I will add that triage is very quick at our hospital so if they were really poorly you’d be prioritised and seen by a Dr quickly.

They don't have an iPad at ours, you go up to reception and they check you in.
DP was most put out when he took me in on the advice of 111, DP thought it meant we had an appointment at 2am😅 he was horrified at the volume of people waiting to be seen.
Tbh I totally understand why people wait so long in A&E now, I was in a cubicle for 12 hrs as there were no beds available.
I'd hate to go through it with a poorly DC.

At ours 111 tell you a time to go, so you think it's like an appointment and then when you get there they basically laugh at you and you queue and go through the whole process all o er again. So pointless calling 111!

Iwas once sent by my GP (with a letter explaining why and that he thought it was urgent) and - after going through the whole usual check in process - got told off by the doctor because apparently my GP shouldn't have done that 🤷‍♀

Same process at ours.
i hate the iPad things
Going when told by 111 doesn’t seem to make any difference or speed things up at all.

Doctors can’t inform the hospital prior to a patient going in. They can give the patient a letter summarising what the problem is that the patient takes with them. My daughter had an ambulance take her to hospital a few weeks ago and we still had to repeat everything we told the paramedics to the nurse/doctor on duty. Didnt think anything of it it’s just one of them things.

when I’ve been to a&e in the past we don’t have a iPad we just tell the reception at a&e and theh tell us where to go that’s it.

A GP is a trained clinician. A 111 operator is a phone/computer operator with very limited training in comparison. Which is why at some hospitals a GP can refer directly to a non A&E speciality, and a 111 operator can't. And 111 will be on a totally different computer system than A&E. About 15 - 20 years ago there was a massive project trying to come up with one computer system that could function seamlessly across the NHS. They spent billions on it (yes, billions, not millions) before giving up.

Thank you all for the responses. In a way, its reassuring that its the same process in other places too - there must be a good reason for it to be this way one likes to think. I had slight annoyance with the repetitive nature of the whole process, especially when youre trying to do medical admin and also see to your sick baby all at once by yourself.
My DH had a good experience recently with 111, he was given an appointment with out of hours and seen quickly for cellulitis, so they were expecting him at the out of hours clinic at the appointment time. This is why I was confused when 111 said they dont communicate with A&E. They communicated for my DH and booked him an appointment but for the baby we just had to go to A&E and wait. I didn't expect an appointment, but I would have liked it if the admin part could have been transferred across electronically.

When my DC was born in 2011, I was in labour and all the ward staff and midwives were in a right pickle because of a new system going live - I think it might have been the one you describe.

I remember saying I needed to push and the midwife came in and said “no - the computer said no” 🤣

Wow that's interesting. I guess that's were the challenge is, finding one system for all the communication and medical reporting.

It doesn't matter if you are brought in by an ambulance, sent by GP, advised to go in by 111 or walked in of the street - the check in and triage is exactly the same for everyone.

When my baby had bronchiolitis, my GP phoned Paediatrics, who agreed to see DC - but we still had to go via adult A&E, we were then triaged straight away as day time and under 1 - a nurse had me strip the baby down to check for a meningitis rash. THEN we were allowed (!) to go to Paeds A&E where they took the GP letter and still checked us into the queue (paper form). But we did get seen more quickly after that.

What a bizarre way of getting to that critical assessment point. Glad things didnt take too long after that.

Exactly this.

Here 111 say go to A&E, they’ll know you’re coming etc etc, and then you turn up and A&E say no chance, get in the queue with everybody else…

I recently went through a whole load of questions on online 111, the end result of whcih I was advised to dial 999, where the operator went through the same set of questions before calling an ambulance. The paramedics asked the same set of questions again, and I was then asked most of them them for a fourth time following their handover of me at A&E.

At the Trust I work at the data from the 111 system is sent into the ED system, and a "pre booking" is automatically made which is converted in an actual attendance on the ED system. You do usually need to be triaged and won't necessarily be seen any quicker, but they will have the data which 111 recorded. They may be two different systems but interfaces and good system suppliers can and should make them talk to each other. There is Booking and Referral Standard (BaRS) which describes how this is all supposed to work.

I’ve a child with severe asthma and know my local a&e well. Usually, even if you’ve phoned 111, they give you an appointment - which doesn’t exist, and in reality you first have to queue to be triaged in adult a&e, where you check in and then are sent/given permission to walk to peads a&e, where you wait to be seen and triaged again (admittedly this time for bloods, weight height temp etc.)

However, often when I’ve brought my daughter in, she has been v poorly. I’ve skipped the queue at adult triage - a nurse has taken her name, either brief obs or sats, and then ran with me to kids a&e. Where again we skip the triage/wait process and take a HDU assessment bed and she goes straight on Nebs.

As good as it sounds to skip straight in, I can’t explain how glad I am that we now have better control and can spend 6-8 hours waiting on plastic chairs for attention. The emergency emergency admissions were horrid (but even during those, often as they were stabilizing DD, they would still need to get the admin details from me - including a timeline of events - even if shared with 111 while on route to hospital). Same applies if brought in by ambulance.

I’ve done all 3 in the last month and the ambulance you go straight on a bed into care, where they cannulas, bloods and BP while you are waiting to be seen, it may still take a while but you are offered pain relief and it’s a quiet room or area not plastic chairs.

111, turning up and GP advised all just walk in and wait in the waiting room, in my case 5 hours and then I was admitted again.

When I was sent to minor injuries at our local hospital by 111 I was given a time to attend. Whilst I wasn’t seen exactly at this time, I wasn’t triaged either.

And no iPads 🤣

This is what I am trying to get at, not necessarily asking for priority but reducing the amount of repetitive medical admin involving digital interfaces. Everythings even more frustrating when it involves typing into a machine. Somehow I find it less frustrating talking to an actual person, even if there's a lot of repetitive questions, especially when you are attending a&e with a child as it gets a little overwhelming.

Must have been scary for you each time, sometimes the biggest battle is just getting heard. I totally understand the need to get timeline of events even if 111 has them.

So if you are brought in unconscious on an ambulance or having a heart attack they’d still expect to enter your details fit 10-15 minutes into an iPad? I sincerely hope that’s not the case! 🙄

I completely agree OP. No one should have to do that when dealing with the stress of attending A&E. Not everything is improved by technology. Sometimes you just need some human contact.