DH needs urgent prescription for UTI

[Tulipomania]

DH woke up this morning with a UTI. He urgently needs antibiotics. Happy to pay to get a prescription privately - but how?
Our health insurance can't offer a GP consultation until Tuesday.
111 said go to A & E - clearly we don't want to add to the NHS burden for a relatively minor ailment, nor have to wait 12 hours to be seen.
Most online private appointments seem to be linked to health insurance providers.
Anyone got any helpful advice please?

That's great OP hopefully he feels better soon 😊

Walk in centre?

good news
dh had to go to ooh for this.
glad you are sorted.

definitely get him seen by a doctor. UTI in men can turn very complicated. My neighbour had one, and we thought he was getting better and he ended up in hospital with sodium deficiency (he was elderly, but even so). Good for you and your husband for trying to sort this out - I know how reluctant men can be with anything medical.

Great news, hope he feels better soon

Just because it's unusual and requires investigation, doesn't mean it's urgent.

Any other HCP wondering why two doctors have just treated supposed simple UTI in this man in the space of ?two years without any further investigations/STI screen etc?

One of the symptoms he has declared in his 111 assessment has given them sufficient concern to redirect to ED rather than to the out of hours GP. So unless he elaborated his symptoms on the assessment with them, then ED is the right place.

(Used to work as a 111 clinician, now work in Out of hours GP and Emergency Department.

OP he needs further investigations. Dehydration (plane travel) does not typically trigger UTI in men like it does in woman. He needs to rule out renal stones, prostate issues to name just two.
please consider a follow up with your own GP.

@Pinkyandtwerky I listened in to the conversation he had with the GP. They asked a lot of questions and concluded the infection is e coli due to him being unable to go to the toilet as he was stuck in his seat on an overnight plane journey; he asked specifically about his prostrate and they said it was unlikely to be that.

Thank you for your concern, it was not due to dehydration it was due to being unable to pass water because he was stuck in his seat. We will certainly consider a follow up appointment with the GP but also don't want to waste NHS resources unnecessarily.

Fair enough. I have professional experience so felt wrong not to at least pass that on. You are of course welcome to ignore it.

One of the symptoms he has declared in his 111 assessment has given them sufficient concern to redirect to ED rather than to the out of hours GP.

There are 2 versions though

One where 111 advised A&E and another where 111 said wait for a GP call back.

111's initial advice was to go to A&E. DH said he did not want to do that so they said they would arrange a GP call back instead, but it could take up to 24 hours.
So we started looking at private options.
In the event, the NHS GP call back came within 3 hours which we were very surprised and relieved about.
He has started his course of antibiotics.
Again, thanks to everyone who has posted their advice on here. I have taken it all on board and am grateful for everyone's support.

If you won't get a refund on the private GP, I would keep the appointment, and get another prescription, then keep those antibiotics for an emergency, such as if he ended up with a UTI after an outward bound flight.

So lots of areas now have an “ED Clinical Assessment Service” designed to redirect patients away from ED to a more appropriate pathway.

When a 111 clinician reaches an Emergency Department dispositions they then send the call through to ED CAS and tell the patient “if you don’t hear back within 20 minutes make your way to the emergency department”. These calls then go into a queue (usually at the out of hours GP service) where an advance practicing nurse or GP rings them back and will try to do some fine tuning on the original assessment and come up with a better plan - I.E. prescription, direct to appropriate speciality, eye casualty, GU Med, pharmacy and then a lot of the time self care!

It’s really successful - my service redirects 85% of cases that 111 would otherwise have sent to an A&E dept to an alternative place/method of care. But it exists as a sticking plaster for the fact that a lot of 111 call handlers are very young, lack life experience or health knowledge and are expected to operate a very risk averse decision support tool with no idea of the clincial meaning of the questions they’re asking. The other issue is that a lot of 111 clinicians have been out of f2f practice for years, and also apply another level of risk aversion on top of that which the system has already accounted for. Prime examples being patient rings with a random bruise on their leg (might have banged it, can’t remember) by the time that the system, the patient, the call handler and the nurse have all added their own layer of risk-aversion to the assessment - they’re sending 999 ambulance as they’ve concluded that the patient is practically moribund from Disseminated Intravascular Coagulation.

But it certainly could be true that they were told ED and then also got a GP call back.

Walk in centre locally?

That’s a very dangerous and dumb suggestion.

Why? Exactly. In detail please.

1. The sheer absurdity of OP’s DH going through an assessment as a man named Phil or Dave (or whatever), answering questions about whether he has any vaginal discharge or irritation (to exclude thrush as a cause of dysuria), when his last period was, is there any chance he’s pregnant (because that changes antibiotic choice), etc etc.
2. The fact that a summary of his care in the private sector will get sent to his normal NHS GP and will detail his assessment where he apparently became a woman for the day.
3. For the online private GP to use the electronic prescribing system to make his antibiotics available to collect from a pharmacy they will need to match up his record with his corresponding NHS number on the National spine - and the PDS look up won’t find him if his sex is listed as female.
4. Because the anatomy and prevalent pathogens commonly causing UTI’s in men and women are different - and thus anti microbial guidelines advise different first and second line antibiotics for both sexes, different lengths of courses and different suggestions for follow up.
5. It also introduces a huge amount of clinical risk for both the clinician and the safety of the patient, if the clinician is being told they’re assessing a woman, they’re not going to ask the OP’s DH about any potential symptoms of Epididymitis, Prostatitis, Meatitis, Urethritis, BPH, etc etc.
6. Last of all, should the OP’s DH start on the wrong antibiotics, become septic and die, does she really want to have to live with the knowledge that it all could have been avoided by just telling the truth and doing what 111 had suggested in the first place?

@YouWithoutEnd The antibiotic to treat a simple UTI will be the same. Your last point (not the correct abx to treat his particular organism) is exactly the same as if prescribed by a dr. You can't know what it is sensitive to from a simple dipstick. OP's DH would know if it was the same abx he was given for his previous infection and therefore not allergic to it. If it was different he wouldn't take it.

If the alternative is to go 24-48 hours without treatment where the risk of sepsis is far higher, then I'd own up to a white lie to my GP and take a known antibiotic.

To clarify. I would lie on the assessment if it meant I was given the same antibiotic as I'd previously had. If a different one I wouldn't fill the px.

I would only do the above if I couldn't get help from 111 and was looking at a 24 hour wait to see a GP.

I really hope you're not an HCP.

Hi op

Glad ur DH is on the mend.
My DH had 2 UTIs on the third our GP sent him.to urologist as true UTIs in men are uncommon. Turns out my DH has prostatitis.
Hes had 10 months on antibiotics and we now have some at home all the time.
If he gets another UTI I would ask for your DH to be referred.
We had a scary time with the third, they thought it was sepsis but luckily just a bad water infection.

The alternative was never “to go 24-48hrs without treatment”, it was to get in the car and go to A&E.

I’m afraid you’ve absolutely no idea what you’re bloody talking about and your advice is simultaneously dangerous and laughable, no mean feat.