NHS111: 24 hours to get a Doctor to visit a 93 year old partially deaf and blind man who had internally bleeding.
Over the course of this weekend our family has received the most appalling service from NHS111. I’ve made a formal complaint on the telephone and am awaiting the results. I’m typing this today because the GP (who eventually came) told me too, on the basis that if you don’t complain no one will know and nothing will get better and also because by the end of it, I may well have calmed down and put it to the back of my mind, because frankly I’m still seething.
My dad is 93. He recently lost his wife, my mum, to cancer and now lives alone in Hereford in his apartment. He’s old, he’s frail, he’s almost deaf and registered blind. He never bothers anyone. He’s had his fair share of medical problems over the years, but by and large, he never complains and doesn’t ask for much.
So when I arrived at his place on Saturday morning and the first thing he said was that he needed a doctor, I knew something was genuinely wrong. He was bleeding from his backside. He was quite agitated and embarrassed in case he had made a mess and in a bit of a state.
I rang his Doctors surgery and they were closed for the weekend. I googled what to do and the number 111 seemed to be the answer .
At 11am on Saturday I made the first call to NHS111
Press 9 to continue. Listen to some classical music. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. The person I spoke to was very helpful. We did a telephone triage type thing and agreed that he didn’t need an ambulance, but did need a Doctor visit. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’. If he got worse, call back, or call an ambulance. Fine – I was happy to proceed on that basis.
Fast forward 8 hours
7pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . If he got worse, call back, or call an ambulance.
8pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . The Doctor had three or 4 calls to make and then he would get to my dad.
I think this was the moment when I completely lost my temper and I also think this was the first time they put the phone down on me
8.30pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . The Doctor had three or 4 calls to make and then he would get to my dad.
Told that they had just tried to call back ‘because I was cut off’ but that my line was engaged. Yes…because I was on the phone to you again.
At this point I think I just started to repeat “Where’s the Doctor – Is there a Doctor?”
9.00pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . The Doctor had three or 4 calls to make and then he would get to my dad.
Would I like an ambulance? No I would not like an Ambulance. That’s a waste of money and I won’t have him tipped into a corridor in A&E with all the Saturday night drunks. He’s 93 for god’s sake, just tell me when the Doctor is coming.
Me repeating “Where’s the Doctor – Is there a Doctor?” And I think this was also the point where I started to use some industrial language.
10.00pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . The Doctor had three or 4 calls to make and then he would get to my dad.
Me: “Where’s the Doctor – Is there a Doctor?”
I think this may have been the call where the person asked if I would like the phone number for the out of hours Dr service to try them myself. No thank you.
Ask to make a formal complaint. Line goes dead.
At this point dad has got himself off to bed. I told him I would wake him if the Dr arrived. I decided to stay over and keep an eye on him. He went to bed with toilet roll shoved up his back passage just in case.
11.00pm on Saturday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit. They could not confirm the time, but that it would be ‘today’ . The Doctor had three or 4 calls to make and then he would get to my dad.
It is not our fault. We just handle calls and cannot help what the out of hours Doctor service then does.
The person said that the Dr was still coming, but I think she used the word ‘allegedly’, or ‘supposedly’ which I think was the point where I really lost the plot.
Put me through to a manager please.
The manager, Roz, said she would see what was happening and call me back and to her credit, even though I told her that I didn’t believe her, she did.
11.30pm to 12.15am. Saturday night Sunday Morning
Ros the manager told me that the Dr started work at 8am on Sunday and that Dad was now a priority and that they would arrive between 8 and 9am. The conversation was a lot longer than that, but that’s all I remember.
I bet Ros £10 that the Dr wouldn’t turn up and that I would start ringing again at 10am. She promised the Dr would be there between 8 and 9.
8-9am Sunday morning
No Doctor, obviously, but if you’ve read this far you knew that was coming didn’t you?
10.00am on Sunday. No Doctor. Ring 111
Press 9 to continue. Listen to some classical music. Press 4 to talk about a previous call. Listen to a message about teeth. Listen to a message telling you to ring 999 if it’s urgent. Listen to some classical music. We are experiencing high call volumes at the moment and you may like to call back later. Your call will take approximately 10 minutes to connect. Listen to some classical music.
Get through. Date of birth. Address. Postcode. Who I was. Symptoms. I was told that he was scheduled for a visit.
They could not confirm the time, but that it would be ‘today’ .
I explained that I had been promised 8-9am. They said ‘today’ again then changed to ‘this morning’
Put me through to a manager please.
They guaranteed a Dr before noon
11.05am Sunday. 24 hours and 5 minutes since the first call.
Dad, you’re not going to believe this. The Doctor is here. There were in fact two of them. Presumably they sent two to witness me being stroppy. Which for about 2 minutes I was. The Doctor that saw dad was fantastic. He spent the best part of an hour with the old man and talked him through his problem and confirmed that it was probably ok, but that he should have a more in-depth internal examination which he would arrange. I have nothing but praise for the Doctor – and until that point I don’t think I realised how worried dad and been, because he visibly lifted when the Dr was speaking to him. He had a burst vein – not enough to kill him. Had it been an artery the outcome may have been very different.
The Dr told me to make sure I went ahead with a formal complaint because somebody had to. He also told me that the call centre I had spent the previous 24 hours speaking to were on their final shift because they had lost the contract. (Don’t know whether that is true or not, but it may help explain everything).
Today. Monday morning
Having made a formal complaint on Saturday night, someone called this morning to ask whether or not I still wanted to proceed with it. I said I did. They said that they had already started to listen to the tapes of all the conversations. Good luck with that.
Nothing will come of it. Nothing will change. They’ll listen to the hideous tapes of a 56 year old son being progressively ruder to their staff as the day went on - and for which I do, and did at the time on more than one occasion, apologise. But for what it’s worth I think it worth recording that as far as I’m concerned their performance was lamentable. They came on shift. Did nothing but repeat the same words, put the phone down at least twice, promised call backs that never came. Never arranged the ‘comfort calls’ throughout the day to check progress, (which I found out at the end should have happened). And then went home.
There don’t appear to be any standards of performance, a service level agreement, or a process which flags up when something has clearly gone wrong. I spoke to at least three managers or supervisors. None of them grasped the nettle or took responsibility. Perhaps that was because they were angry at me for being horrible. Perhaps they are trained to ignore people who cause a fuss. Perhaps they are trained to make things just go away. Or perhaps they’re not trained at all. Perhaps they’re just badly paid people who don’t give a toss. I asked more than one of them…how would you feel if it was your 93 year old dad? I didn’t start off stroppy though. When they said a Dr would come the first time I believed them. I have the upmost respect for the NHS and health care professionals generally. My mum was a nurse and health visitor her entire career. But this call centre system is in my view completely broken. It is absolutely not fit for purpose. What if he had died in his sleep with loo roll shoved up his backside? What if it was your Dad?
And finally. I mentioned earlier that my mum died of cancer a while ago. Earlier this year when she was very poorly I was with her at the (fantastic) Renton centre in Hereford talking about her treatment with the consultant and the consultant said “whatever else happens, try not to be ill at the weekend” We thought she was joking. Clearly not.
p.s. There may have been 9 calls or 12 calls, or somewhere in between, but here today I’ve tried to set out this sorry episode as clearly as I can remember it. But if you happen to be the person carrying out the promised review please don’t bother calling me back to tell me it was actually only 8. Try instead to focus on the 24 hours and 5 minutes it took you to provide a Doctor for a 93 year old man.
This has been posted on my website, twitter and facebook. If I receive an explanation, satisfactory or not, I will post that too.
Mike Packwood
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