NHSD almost killed my baby! or How to access your GP OOH service
GP OOH Services
At evenings and weekends your doctor's surgery will usually be closed. Rather than a GP from your surgery staying up 'on call' all night, surgeries in your local PCT (Primary Care Trust) will usually be contracted out to an OOH provider. These are centralised services, often based at local hospitals, Primary Care or Urgent Care Centres (PCC and UCC) who have a staff of doctors and call-takers. If you need a doctor when the surgery is closed you will need to call your OOH service. You may be triaged or you may get straight through to the UCC/PCC, they will arrange to see you if necessary. home visits are rare and usually limited to the terminally ill or housebound. OOH services prefer to bring the mountain of patients to Dr Mohammed, so you'll be advised to visit them at the PCC/UCC. You'll be assessed, treated, and medicated if necessary.
Sadly many people don't understand this. They remember the days when they 'called out' a GP. They remember this with rose-tinted specs, forgetting the long wait as one GP treats the whole community, the inability to fill the prescription he wrote you until Boots opens on Monday, the sound of breaking glass as someone broke into the GP's car. Ahh, halcyon days indeed.
Joe Public - "I need a doctor out now"
Me - "NHSD offers nurse assessment and advice only. To access your GP OOH service you need to call them"
JP - "But my doctor is closed, they put me through to you!"
But - they put me through to you
No. Just no. I'm fed up of hearing how "NHSD almost killed my baby" because people cannot follow instructions. If you call your GP when the surgery is shut in 99% of the cases you will hear this message on the answering machine:
"The Surgery is now closed. In case of emergency please dial 999 and ask for an ambulance. For medical advice only please call NHS Direct on 08454647 (this bit often repeated, up to three times!). If you have a medical problem that cannot wait until the surgery opens, please call [OOH Number]".
Variations on this include:
"The Surgery is now closed. In case of emergency please dial 999 and ask for an ambulance. For medical advice only please call NHS Direct on 08454647 (lather, rinse, repeat). If you have a medical problem that cannot wait until the surgery opens, please hold to speak to an operator"
or
"The Surgery is now closed. In case of emergency please dial 999 and ask for an ambulance. For medical advice only please call NHS Direct on 08454647 (repeat ad nauseam), If you have a medical problem that cannot wait until the surgery opens, please press #1"
If you're very lucky, dialling your surgery number at weekends may automatically divert you to your OOH provider.
See. No-one was put through to anywhere. In virtually all cases the caller will have taken the very first non-emergency number given to them (ours) and hung up. I'll verify it myself if necessary. I do wonder why they feel the need to give our number twice (or even thrice!) and then hastily garble out the OOH number, no wonder people get confused. Ahem.
I called to get someone's OOH number once, the message gave our number three times, then there was a 'click' sound as if the line had gone dead, but no dial tone. How curious! After waiting 90 seconds the speaker came back on the line and gave the OOH number in a disaffected, barely audible fashion. The original caller wasn't the only one who was upset, I reported the practice to my supervisor and the complaint was forwarded to the relevant PCT. Another fairly frequent occurrence is that the receptionist at the practice will forget to put the answering machine on over the weekend. Even GP receptionists are only human (no, it's true!). If this happens it's easy enough for us to find the relevant OOH service for the caller.
So now you know, if you want your GP then call them, not us! If you want your GP then call them. Don't call us and then scream and shout because you had to wait for a callback. Like I said, if the receptionist at your surgery has forgotten to turn the answering machine on then just call us and ask for the OOH number. Ask at your GP surgery, and keep the number in your mobile in case of emergencies. A GP is the only way of getting a prescription or a diagnosis. We are here to provide 'Health information and advice'.
I've posted this because I'm fed up to the back teeth of people saying "I called NHSD and they made us wait 4 hours for a doctor" or "They failed to diagnose my baby's [illness]" We have no doctors, we don't diagnose, and (the most important thing of all) we can only go on the information that you, the caller, gives us. We don't have access to your medical notes or history. If you fail to disclose something, or exaggerate your symptoms (you'd be surprisd, trust me), we cannot be held responsible if an inappropriate outcome is reached. While we can pass your details to your OOH provider after an assessment if you need to see someone urgently, it's easier for you to access Out of Hours services, and you have a right to use them if you need to. Don't waste their time with ingrown toenails and cold symptoms, but it will almost always be quicker than calling us for advice if someone is genuinely ill. Even if you know it's your local NHSD that deals with your OOH provision, don't call on the 0845 number, use the dedicated OOH number. It might get through to the same place (it probably won't now that NHSD has gone national) but it's a different service and the calls are treated differently.
Even unregistered patients or visitors from other parts of the country can use their local service if they need to see a doctor.
What a load off my chest. Hopefully I won't have to live in fear of hearing "NHSD almost killed my baby/granny/dog!" Then we can get back to the business of giving information and advice, not delivering babies and saving the world!
* The information in this post applies to England only. Scottish OOH services are now handled entirely by NHS24 (the Tartan NHSD) and Welsh services are often handled by NHSD Wales.
Labels: NHSD killed my baby, OOH, urgent care
The situation in Scotland is different. I've just called my GP Surgery telephone to double check that I was correct. The recorded message confirms that the surgery is closed and advises that for any urgent medical situations to call NHS24 (the tartan NHSD). Any non-urgent medical situations - call when surgery is open.
NHS24 would deal with calls and pass on to local OOH service.
Don't think that this level of variation helps understanding. If the situation was the same across the country it would help education on what to do in emergencies.
Posted by
bairnsblue |
10:25 pm
NHS24 is a different beast altogether. They are the 'gateway' for all OOH services across the Border. I'll edit my post to reflect that. It changed when it evolved into NHS24, so things are different. Maybe an NHS24 blogger will pop up to help us out?
Posted by
Sick Sad Minion |
11:01 pm
Hi. Today i called nhsd and when called back i was told that my son should be seen by a doctor as he has a very bad case of chicken pox which has spread to the inner eyelids which can be harmful to the cornea.
She said that she would send the details straight through to my GP surgery that if i wasn't called by the doctor within the next hour to ring my surgery myself,she was very nice and i was happy with the service until 2 minutes after the phone went again and the woman said that she also was a nurse with nhsd so i said that someone had just called and she practically made out that i was lying as i was still on her screen so couyldn't have been called back! So i told her what had been said in the last phone call and she actually asked me if "I WAS SURE I HAD TALKED TO SOMEONE?" To which my reply was "Yes i am sure,I am not thick!" Eventually she believed me after i asked her also who the hell was it who could have called thenas i hadn't rang or asked for anyone elses advice besides nhsd!
She then said that the advice was wrong that the details wouldn't have been sent to my gp as they are shut,that i couldn't get a home visit as there wasn't anyone to do home visits! To go to casualty but as i seemed like a mother who doesn't oer react that i could wait until the morning to see the gp,which i don't really want to do as he is still contagious and he is covered from head to foot. Anyway i rang the gp helpline myself,rang the number from the answer service...NOT nhsd and a DOCTOR rang me back within 5 minutes and said to call my surgery first thing to be seen and that he would send a message thrugh to them to say he had talked to me and had advised me to call them first about my son being seen.
It was good advice and fast i don't see nhsd advertising that they charge ONE POUND PER MINUTE for your call! Also Read this...Government watchdog ICSTIS last night indefinitely suspended the licence of health helpline NHS Direct following the reporting of more than 3 million complaints in the last 2 years.
The Premium Rate service offers callers the chance to speak to NHS staff about any concerns they have regarding their health at only £1 per minute* leading to an overall 0.002% reduction in visits to GP surgeries over the past 4 years, while also being linked to a 600% rise in hypochondria.
"We've suspected for a long time that NHS Direct uses this phone system to exploit the insecurities of the weak and line its own pockets," stated ICSTIS's Gregory T Mullet. "But now we have collected a dossier of evidence that suggests their only function is to make as much money as possible by keeping you on the phone for as long as possible."
The dossier includes a list of tactics for prolonging people's phone calls (without necessarily prolonging their lives), which include:
Using an automated touch-tone 'screening process' consisting of upwards of 100 questions ranging from "do you feel nauseous" to "have you, or a member of your family, or anyone within a 100km radius of you, recently travelled by boat from the Niger delta to Bamako in Mali and so been exposed to tsetse fly or their larvae, subsequently developing symptoms of African trypanosomiasis?"
Asking deliberately confusing and technical questions such as "has your left fronto-pyramidal cortex experienced an increase in its QT interval leading to electrostasis beyond 1.112 millimoles per microgram?"
Requesting that callers hold whilst they go off to perform "some tricky emergency surgery or something".
ICSTIS claims that some questions asked in the diagnostic phone interviews have answers that are so obscure that they are nearly impossible for the callers to get right. "One caller was asked whether there was anything unusual in his stool samples. He had no idea that the correct answer was a beige 1.4 litre 1975 Austin Allegro and spent 5 hours attempting to guess an answer they would accept," said Mr Mullet.
He also alleged that the public were still being encouraged to call NHS Direct by being given the impression they would be able to speak to a doctor or nurse, when in fact all performance targets had been met months before and everyone was on holiday. "In my opinion people who suspect they may be ill should go to their GPs or local A&E departments. That's all that NHS Direct will tell you to do anyway, after fleecing you for an hour or two."
When asked to respond to these allegations, Dr Douglas Ramsbotham of NHS Direct said, "We are well versed in dealing with complaints and will give you a full diagnosis of the problem after we've asked you a few questions to clarify your enquiry. If I could just pop you on hold for a moment I'll be right back..."
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SAYS IT All REALLY and yes i was asked the questions even though i have had 3 children with pox before and am pretty sure it wasn't anything else!
Posted by
Unknown |
10:11 pm
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