Monday, February 19, 2007

Oh noes!

Fear not readers. I haven't perished, or been sacked, just been having some awful family problems. Yes, the NHS strikes again! A family member had a botched procedure and ended up very ill, so there's been a couple of weeks of very tense bedside visits, trying to get time off work to get my head round it, and lots of sleepless nights.

I'll be back very soon.

ps - an NHSD colleague posted on a message board I'd glanced at that someone called in about their sick son. /his name? Voldemort. *ahem*

Posted by Sick Sad Minion at Monday, February 19, 2007 | | Comments

Thursday, February 01, 2007

How can I help?

No, really. How can I?

The pressure and fall-out following NHS 24's fatal cock-up is increasing. Different organisation, different country, but the service is similar. Confusion is mounting, tempers are frayed, and people are leaving in droves because working for NHS Direct is becoming an impossible task. Call volumes are up, staff numbers are down, staff sickness is enormous. There is little help available staff-side, so people are leaving. It's heartbreaking to say goodbye to different people every week, dedicated staff who are leaving the NHS entirely to do any other job they can get.
I'm increasingly finding myself wanting to go back and listen to my calls, make sure I did everything right. Self-reviews have turned from a useful tool to an agonising nightmare, as you hope the random call you picked to analyse is worthy of a high score. I fret if my self-review and peer-review scores are less than 100%.

We hung on last year, through the daily news announcements of site closures, staff redundancies and cuts to the service. After a year of uncertainty we were given the all-clear at my site, and even earmarked for expansion. We were safe. The relief didn't last long. It's a different organisation since the 'Transformation'. There is mistrust on all sides, staff have to cope with the chaos caused by recruitment freezes and budget cuts while still trying to deliver the best service we can. The amazing camaraderie that once existed between all grades of staff has disappeared. The agency staff who seem to be infiltrating some of the call centres are disinterested, aloof, ever-mindful that their stay here will be a temporary one. The worker-friendly rostering policies have been thrown out of the window, consideration for disabled employees and those with families no longer exists, and a draconian new system is in place. Anyone who has better options is leaving for them, anyone who doesn't is forced to stay put and grow more resentful and stressed until they're ill themselves and have to go on sick leave. I'd hate to think what it's like at NHS 24 right now. Anyone?

The callers are no better. People want a safe service, everyone thinks they have meningitis or a DVT, so we have to rule out important symptoms, especially on third-party calls. If you are calling on behalf of someone else, you are with them, but they can't/won't talk then you will be asked six standard questions, no exceptions, no ifs or buts.


  • Is the patient awake, alert, and responding to you normally?
  • Has there been a change in their colour, especially a grey or blue tinge to the face and around the lips or mouth?
  • Are there any new or worsening breathing problems?
  • Has the patient's skin become very cold and sweaty to the touch?
  • Has the patient fainted or passed out?
  • Are there any clusters of tiny purple spots on the skin, or any rash that looks like bleeding, or bruising under the skin?

We have to ask them. Whether you're calling about a broken toe, a headache, a foreign body in the ear, it doesn't matter. If the patient is symptomatic then these questions have to be asked. Don't whine, don't be sarcastic, and don't lie. If I think you've misunderstood the question, or merely answered "Yes" or "No" to shut me up then I'll ask again until I get a definitive answer. I'm only trying to do my job. I don't want anyone to die. I don't want to turn the news on and hear that we've 'killed' someone.

If you're calling for yourself you'll be asked most of these questions too, if you're a female between the ages of 12 and 55 then you'll also be asked if you could be pregnant. We have to be very careful. Telephone triage is difficult, we can't see the patient, and callers can't have it both ways. A symptom that you might think is not important could be fatal, and that vomiting that you think is the worst thing that's ever happened to you, is probably not as severe as that crushing feeling in your chest and the pins and needles in your arms.

No service can be 100% safe but don't blame the staff, blame whoever thought it up.

Hi, you're through to NHS Direct, how can I help?


*The tone is 'annoyed' again because while I'm paid to be given grief from rude, arrogant, petulant callers, I'm not paid to sit here while my mouth bleeds relentlessly and makes everything taste like pound coins. No, I don't know why I'm bleeding. If I faint at my desk I'm sure someone will raise the alarm.

Posted by Sick Sad Minion at Thursday, February 01, 2007 | | Comments