NHS "Phone 111 Service"

[Dutto]

About twice a week, I visit an old schoolmate who is 75 years old, has had two major strokes, is in remission from prostate cancer, can only see dark and light, is a diabetic and bedridden.

Before you feel sorry for Mike, his brain and tongue are unaffected by his ailments and he can be a grumpy old sod when the mood takes him!

Anyway, today when I visited Mike I noticed that the bag leading from his catheter looked as if it was filling up with blood rather than urine. I asked him about it and he said that his Carers had mentioned it a few times but as he was in no pain he didn't think it was worth bothering about it. (Did I mention that he's also a tough old bugger!)

I went over to check his notes and discovered that blood had been seen in the bag for nearly 36 hours so I decided to seek advice and phoned the NHS 111 Service. The timing is as follows:

• 1200hrs phone 111 - a lady asks a load of questions, takes my phone number and tells me that within 2 hours a Practitioner will telephone me.
• 1415hrs phone 111 - a gentleman checks that I have phoned before and tells me that his manager will expedite the call from a Practitioner.
• 1515hrs phone 111 - a lady checks that I have phoned before and tells me that the manager will personally contact "the responsible person" in my area and to expect a call within minutes.
• 1545hrs phone 111 - a gentleman tells me that they are very busy and points out that the NHS 111 Service has answered promptly and carried out their duty; which is to ask someone else to phone me. I ask to be put through to the people he phones but I am told that their Customer Service people don't work on a Sunday! I point out that if he can't put me through to the person who is supposed to call me then the system is broken and I have a complaint with the NHS 111 Service. He takes my details and I'm to expect a phone call "sometime next week" to discuss my complaint.
• 1600hrs phone 999 - a lady answers, I ask for the ambulance service and request an ambulance.
• 1615hrs - the ambulance arrives, the paramedics take one look at the bag of blood and take Mike away to Pilgrim Hospital in Boston.

In the bad old days, I used to ring my own Doctor at his home and he would make a decision there and then whether to:

• Tell me not to worry and attend his surgery the next day.
• Come to my home immediately or the next day to deal with the situation.
• Arrange for an ambulance to come to my home for me and take me to the local hospital.

FOUR HOURS and not even a telephone call via the NHS 111 Service? By any standards, this service is not performing properly and yet we are being asked to use the service in preference to dialling 999! This is the way they describe the NHS 111 Service:

"NHS 111 is the free number to call when you have an urgent healthcare need. It directs you to the right local service, first time. It is available across the whole of England making it easier for you to access urgent healthcare services when you need medical help fast. It is available 24 hours a day, 365 days a year."

What a heap of rubbish! Surely, it's time we told this government that we are not happy with the way they are running the NHS and demand change.

At the moment I attend the "Skegness Hospital Watch" meetings and distribute "SOS" leaflets for the Pilgrim Hospital, which the government is attempting to downgrade. It's not much but it's "something".

I really do not care what political persuasion you hold, but PLEASE do something near where you live to support the NHS; and tell the government to start investing in it. :thumb:

 

[Chippy_Tea]

I feel for your mate Dutto I recently had to call 111 and to cut a long story short it took nearly 4 hours to get the doctor to our house.
(It wasn't a trivial thing that would have put us down the priority list)

 

[Dutto]

Today, Mike is still in hospital being drip-fed antibiotics to clear up what has been diagnosed as a massive bladder infection.

Apparently, his catheter was badly installed and caused some internal bleeding. The blood then clotted inside his bladder and caused the infection!

The hospital doctor removed his catheter and then twice flushed his badder out with a sanitising solution using using the "back-flow" method! Ouch!

The NHS 111 Service hasn't contacted me today to deal with my complaint.

 

[Dutto]

My mate is still in hospital and they are still trying to flush out the blood clots from his bladder! (OUCH!)

If you go to this website ...

https://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx

... you can find all you need to know about NHS 111 Service.

However, I discovered today that as far as NHS 111 Service, the town of Skegness does not exist!

Clicking on their “Feedback and complaints”section results in a 'drop down' lozenge which states …

“Each locally commissioned NHS 111 service has set up channels for you to provide feedback directly to them. Please check with your local clinical commissioning group (CCG) for details.”​

Clicking on the relevant link for the CCG takes you to …

“Find Clinical Commissioning Group services.”​

… and typing in the word 'Skegness' or 'PE25'results in …

“Sorry, we couldn't find any results. Please try again.”

So I phoned NHS 111 Service and got a number to phone - it came back "Number not recognised."

During one of my initial conversations with a gentleman at NHS 111 Service he insisted that they had done what they had contracted to do by telephoning the CCG; and therefore they were not to blame for the CCG failing to respond to my call for assistance.

The NHS 111 System is not working!

BTW, the Hunt who introduced the "not working" NHS 111 Service when he was Minster for Health has since been promoted to Foreign Secretary.

Oh joy! I wonder what he can ruin in that position?

 

[Clint]

Hmmm...a couple of months back I popped round to see my parents. My mum was home alone,dad was at his friends talking pigeons. Mum wasn't well and very upset...I phoned the 111 line,spoke to someone,got a call back within the hour,went through some things over the phone,they weren't happy so arranged an emergency doctors appointment,it was a Saturday afternoon,at the surgery with the shortest waiting time. This was around 20 miles away. I rounded up father who would prefer to talk pigeons and off we went. Seen a very nice doctor within an hour got a prescription which we picked up locally and finally went home. Thankfully it wasn't serious but enough to make mam feel poorly but she soon got right again within a few days.
A bit of running about on my part and I'm glad I was off and visited when I did as they don't drive...so for us a better experience.

 

[MarkBowie]

I’ve used it numerous times through work and for my daughter. It’s all done on a risk assessment that assesses the risk and then places in the line of people, same as A and E. Sometimes they get it wrong, other times they are woefully understaffed and only human.

 

[Chippy_Tea]

so for us a better experience.

Glad it didn't happen late at night or your experience may have been a lot worse.

 

[Dutto]

............. Sometimes they get it wrong, other times they are woefully understaffed and only human.

I agree wholeheartedly that the NHS 111 Service is woefully understaffed (aka. "under-funded") but I cannot accept the premise that "Sometimes they get it wrong, .." and that the staff are "... only human."

The staff should be working to set procedures that are designed, produced and implemented in a manner that eliminates these aspects of the workplace. The people themselves and the procedures should then be monitored to ensure compliance; and revised whenever they are found to be wanting.

We are talking about real lives here so there should be no room within the system for human error! Sorry.

 

[MarkBowie]

I agree wholeheartedly that the NHS 111 Service is woefully understaffed (aka. "under-funded") but I cannot accept the premise that "Sometimes they get it wrong, .." and that the staff are "... only human."

The staff should be working to set procedures that are designed, produced and implemented in a manner that eliminates these aspects of the workplace. The people themselves and the procedures should then be monitored to ensure compliance; and revised whenever they are found to be wanting.

We are talking about real lives here so there should be no room within the system for human error! Sorry.

Whilst ever there are humans answering the phone or being part of the process, there will be human error. No matter what the procedures and monitoring fail-safes. It is horrible when that affects a loved one (I know from personal experience too) but the people involved work damn hard and are just trying to pay the bills like everyone else.

 

[Dutto]

Working hard and working well are two different things.

These "human errors" are a direct result of a system that is underfunded, understaffed, badly managed and not properly monitored.

I have highlighted what I consider to be the main element! :thumb:

 

[Sean C]

The 111 service will have put your call details through to the GP out of hours service. Depending on where you are, there may be 1 or more GPs who will have to triage telephone calls, home visits, and base visits (calling people in to see them). I can appreciate some complaints about 111, but in this case their role was to triage the call, recognise the need for help/escalation, and they did both of those things. The problem in the scenario is that the GP out of hours service was either under-staffed or swamped with higher triage calls. Sorry you guys had a bad experience

 

[Dutto]

I know what SHOULD happen but what ACTUALLY happened is nowhere near!

I implore you to take a look at this link ...

https://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx (*)

It states:

"They will ask questions to assess your symptoms and, depending on the situation, will then:

• give you self-care advice
• connect you to a nurse, emergency dentist or GP
• book you a face-to-face appointment
• send an ambulance directly, if necessary
• direct you to the local service that can help you best with your concern"

NOWHERE in this description of the NHS 111 Service is there any mention of a "triage" system or that a caller may be ignored.

In this case I was calling because:

• My mate's catheter bag which normally contains urine was filled with blood.
• There was no physical reason for the bleeding. (i.e. he hadn't had his catheter changed in the previous 24 hours.)
• From his Carers Notes I could see that the "blood in urine" situation had been getting worse for at least 36 hours.
• FOUR HOURS after my original call to the NHS 111 Service, NONE of the above promises had been fulfilled.

There are many examples where the reality of a situation is nowhere near what is being promised by government, councils, businesses etc.

Nowadays, the system seems to be:

1. Underfund an element of society on the basis that "we" can't afford it. (**)
2. Promise to develop a revised (and cheaper) system.
3. Fail to put in adequate resources to fulfil the promise.
4. Explain that the new system has "teething problems" or it is being over-used.
5. Agree with everyone but refer all complaints to 1. above as if it was an explanation.

(*)
Using the site, please try and find the CCG for Skegness and you may get an indication as to how much the NHS 111 Service is underfunded. Tip - you will need to use the "Feedback and Complaints" section at the bottom of the page.

(**)
This doesn't prevent "us" from spending loads of money on weapons of mass destruction, new aircraft carriers, new submarines etc or failing to collect taxes from big businesses.

This latter contention is best illustrated by today's BBC report that states:

"Online retail giant Amazon's UK tax bill fell last year despite a near-trebling of profits.
Amazon UK Services bill was £4.6m down from £7.4m a year ago, accounts show.
But the division, which operates the warehouse "funfilment centres", was able to defer £2.9m.
It meant that the company has paid £1.7m in tax for now, even though pre-tax profits jumped from £24.3m to £72.3m. Amazon said it paid all the taxes required by UK law."​

It's time for change! :thumb:

 

[Dutto]

A lass from the NHS 111 Service phoned me today ... :thumb:

... and was surprised to learn that no-one had called me back after 4 hours; which is why I complained!

I'm now waiting for someone to call me back from my Clinical Commissioning Group after they have investigated my complaint!

With regard to the schoolmate who was the reason I called the NHS 111 Service, he is still bleeding badly into the bag that holds the products from his catheter.

The medical staff at the hospital wished to fit a canula to give him a blood transfusion and then fit drains and stents in the tubes to or from his kidneys so that they drained into different bags.

My mate decided that he didn't want them to carry out any more interventions (i.e. "mess him about") and was brought home yesterday.

He seems quite depressed because someone in the hospital told him that he had Vascular Dementia that had been caused by his strokes. I can believe that, but in the last month alone we have sat and discussed, amongst other things, such diverse subjects as The Boer War, Haemophilia in the Royal Family and the Life and Loves of Winston Churchill so his brain is still very active even if he speaks slowly and forgets things.

Today, he explained to me that he's "resigned to dying' because he can't do anything for himself. Bugger! Me and a few other old school friends, as well as his family, will miss him for sure if he manages that.

 

[Dutto]

WOW! They really don't like investigating a complaint!

....
I'm now waiting for someone to call me back from my Clinical Commissioning Group after they have investigated my complaint! ....

That was the status yesterday but this morning I get a letter from the NHS 111 Service which states that, because I was calling in behalf of a problem being suffered by my mate, they need him to sign a Release Form before they can investigate MY complaint. (Alternatively I can send them a copy of MY "Power of Attorney" to discuss his medical problems!)

So, after ignoring MY request for a consultation for more than four hours, they now need a man who has just been told he is suffering from Vascular Dementia to sign a Release Form! If it wasn't so serious it would be laughable but:

1. Even his wife doesn't have a "Formal Power of Attorney" so she can't sign anything.
2. I don't wish to bother my mate in his current state of health to get him to sign anything.
3. I don't wish to do anything illegal like forging his signature on the Form they have sent me.

It was ME that called the NHS 111 Service and it was ME that needed their advice as to what I needed to do; but now this outfit are trying to hide behind "confidentiality" on the basis that it was my mate who needed the advice.

Any suggestions people?

 

[AdeDunn]

I hate to play devils advocate here bud, but that's DPA taking effect there. They literally can't handle a complaint without his consent, or you having power of attorney. My advice though would be to get his signature. Your mate might not feel he'll get anything from it, but the other poor sods in your region just might. The only way change is ever effected is if people complain. This is something that we used to make very clear to our clients and their relatives back when I was a nurse when they were reluctant to make a complaint. I've worked in healthcare bud, and your ass is literally in a sling when it comes to confidentiality, there is literally ZERO wiggle room. I once even had a PC try to threaten me when I refused to give him information held in a clients nursing notes (it was the clients parent's home address...) and told him to ask medical records, or go get a court order ordering me to give him this information.

As to the rest, underfunding, post-code lottery. Fun times eh? The one time I called 111 they told me to phone my GP for an urgent appointment. I phoned my GP, they told me to go to the nearest walk in. I went to the walk in, they sent me to A&E... A&E finally sorted me out (I had a micro ulcer on my cornea).... lol I bet if you go to a more well to do region, with a lower population density, you'd get the best service ever. This isn't even anything new, even The Black Report/Inequalities In Health covered this decades ago now.

 

[Dutto]

I don't mind the "Confidentiality" aspect but I do think the NHS 111 Service is trying to use that as a smokescreen to hide behind.

I've just had a phone conversations with:

• The 111 Complaints Officer who is currently seeking permission to pursue MY complaint against the CCG rather than 111. In all fairness, if the 111 Service did what they told me they had done, then they passed the details of my mate's ailment on to the CCG on at least three separate occasions; so the failure and any investigation should be with the CCG.

• The CCG Complaints Officer was already aware of the problem (via my County Councillor) and promised an investigation that won't include ANY details of my mate's name or his ailments, but will concentrate on the failure of the CCG system to let ME know what I should do for him or to have come out and see him.

So, a bit off progress made, but both organisations asked for time (up to six weeks) to carry out their investigations and I suspect that my mate may not be with us that long.

I dearly hope that my suspicions are unfounded, but as us optimists say "Life's a bitch and then you die."

 

[Dutto]

............ I once even had a PC try to threaten me when I refused to give him information held in a clients nursing notes .......

On a lighter note, I played chess one evening with a stranger at a local Chess Club. At the half-way interval (after he had thrashed me at chess) we got talking about the "British Public" and we all agreed just how abusive they could be.

Well, "all" except my opponent who announced "No. I cant' agree with that. Over the years I've worked with Lords, Ladies, Businessmen, Labourers, Fishermen and all kinds of men an women from every type of life you can possibly think of for over thirty years; and not one of them has in anyway tried to abuse me."

The rest of us were amazed but he seemed genuinely puzzled by our attitude.

The penny finally dropped when one of the group asked him what he did for a living. He replied "I work in the local VD Clinic as a nurse." and we could all understand why no-one would want to upset him; ...

... especially as "the hockey stick" was still in use at the time!

Happy Days! :thumb: