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Care Opinion

Better call system needed

Posted By Hughie

"Better call system needed"

About: NHS 24 / NHS 24 (111 service)

(as the patient),

Whilst feeling ill at the weekend I wasn't feeling well at all and felt I needed assistance of a Doctor so got my wife to telephone NHS 24 where the person answering the telephone was told what was wrong. This isn't my first time of involvement with this service and whilst I appreciate they are very busy, I would like to know when whoever is making the call on behalf of the person who is feeling ill is asked to put that person on the phone so the assistant can speak to them and hear how they are feeling, before they tell the person that isn't feeling well that they will have to speak to a nurse who will then speak to them and give advice etc.

At the weekend it didn't reach that stage as explained at the end. As a former employee of one of the emergency services what I am raising isn't a flippant gripe over contact, but a very serious question from this last contact, and previous times.

The question is simple ''Why does in this system of operation do staff have to request to speak to the patient who is ill?'' If they were feeling well enough the patient would phone themselves in the first place. It does not make sense at all, could aggravate how the person is already feeling. What do they do if the person is in bed, has various problems and cannot or wont go on the phone, not because they are being awkward but simply don't feel up to it.

It is a very serious question from a former employee of the emergency services over a period of time including last weekend had to have this service called, and find the system where the assistant has to speak to the person who is ill quite unrealistic, putting unfair pressure on person not feeling well, and objectively looking at it, it is flawed with no doubt to me.

At the weekend my wife was asked if the telephone cable was long enough to reach where I was for me to speak, and that was when we gave up and ended the call, as the situation was totally ludicrous. Remember I speak as a former employee of one of the emergency services, and have always had respect for those on the front line put in pressurised positions of dealing with the public. I would not raise this unless I felt it necessary as I am concerned, not for first time that this type of procedure is adopted.

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Responses

Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 7 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24

Submitted on 12/04/2017 at 09:25
Published on Care Opinion at 15:03

picture of Shona Lawrence

Dear Hughie

Thank you very much for sharing your experience on Patient Opinion. I read your comments with interest and appreciate that from a patient's perspective speaking to NHS 24 staff whilst ill can sometimes be a challenge. I do wish you well and hope that you are feeling much better.

As NHS 24 clinical staff do not have the benefit of face to face assessment of their patients, it can be helpful for our Nurses to speak directly with the patient as this can inform the Nurse's overall assessment of the symptoms being displayed. Listening to the patient's breathing, tone and speech can greatly assist the Nurse to ensure an appropriate clinical outcome for a patient.

If a patient is unable to come to the phone because they are so ill, then this can also provide the Nurse with valuable additional information.

Whether the Nurse speaks directly to the patient or not, the assessment can still continue, therefore it is not imperative that we speak directly to the patient, however it can be extremely helpful.

I will share your valued comments with NHS 24 Senior Clinical Staff. Should you wish me to arrange to have your specific calls to our service reviewed to establish if we could have managed your care differently or better, then I would be pleased to do so. I can be contacted on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk

Thanks again for taking the time to post your story.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Hughie (the patient)

Dear Ms Shona Lawrence,

Whilst I respect you for taking your time to respond to my factual report of what took place I have never been in contact with NHS 24 staff that took the calls and had them ever deal with my wife when she reported the matters looking for assistance. The staff were always insistent that they speak to me even although my wife reported that I did not feel up to it. That was why when the Call Handler asked if the telephone had a cable long enough to reach me so I could speak we decided enough was enough in which I regard as a Flawed System where staff on on front line do their best.

As a former member of one of the Emergency Services I do not like making contact when it can be seen all emergency services are going through very testing times. My understanding with initial contact the patient speaks to an unqualied Call Handler who then decides to pass it on to a Nurse. My involvement in contact as a former employee of the system feel the contact with initial Call Handler should be kept to a minimum in taking what is being reported to them instead of them asking right away to speak to the person who is ill. If they are not qualified it should be sufficient for them to note down what is being reported and passing it to the Nurse etc.

2 examples to back my argument are 1. At surgeries there are staff who take calls note what is wrong if house Call is required then Doctor is sent. If patient can attend surgery and appointment can be given then that takes place. 2. If an incident occurs and someone is stabbed and Matter is reported to the police it is noted where it occurred and police attend along with other other emergency services. The person who has been stabbed most certainly isn't asked to be put on the phone like all contact we have had with NHS24.

I most certainly am not being facecious but I do not accept a Nurse, no matter how good she/he is can tell over the phone how bad the patient is. That is after several contacts I have raised this matter as each time of contact try to tie patient down to a single entity of reason for the call on that particular time whilst in reality even if the patient is having to call for assistance for a problem it is being aggravated by other health problems which should be noted to give the Nurse the bigger picture and that would save him/her listening to how patient was breathing or what was attempted to being reported for them by worried relative.

I appreciate Staffs time can be wasted by frivolous callers but that is a fact of life in the emergency services and to me NHS 24 are the only section of the Emergency Services where the initial Call Handler prolongs what is being reported by family member and asking to speak to person who is ill. That is why from my experiences I state procedure is flawed.

Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 7 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24

Submitted on 17/04/2017 at 12:04
Published on Care Opinion at 19:30

picture of Shona Lawrence

Dear Hughie

Thank you very much for your response. Please be assured that I appreciate your strength of feeling in this regard and that your valued comments have been shared more widely within NHS 24.

It does form part of the NHS 24 process that staff members should try to speak directly to patients. Our highly trained Call Handlers undertake a crucial role in capturing the patient demographics, the call reason and by asking patients a series of patient safety questions. This enables us to effectively manage the types and volumes of calls received by NHS 24. I would advise however that the progression of a call is not determined by the Call Handler. Call Handlers follow strict processes and utilise evidence based system support tools. They also have senior clinical staff available at all times to provide guidance and support. Patients may present with a range of symptoms, however the symptom which is causing most concern is captured as the main call reason. All other symptoms are documented and can inform the priority awarded to a call.

Thank you for sharing examples of how other services manage contacts. NHS 24 staff speaking directly to a patient only forms part of the overall assessment and is considered relevant in a non face to face setting. I would reiterate however that calls can be progressed should the patient be too ill or unable to come to the phone.

I remain keen to explore your contacts with us directly. Please do not hesitate to contact me by phone or email.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Hughie (the patient)

Dear Ms Shona Lawrence, I thank you for your honest response to my involvement with NHS 24.I have taken in all you say but I cannot change my opinion with my involvement in the past. I have already received an apology from the General Manager at the beginning of this year regarding contact which I accepted. Unfortunately the problem then has continued to be very troublesome to this very month and did not help when my wife attempted to telephone again when I felt ill again. I stand by what I say regarding spending too long with the Call Handler, one of whom advised me she was not qualified and had to speak to the Nurse. As a former member of one of the emergency services I don't see the point if the person is not qualified medically that he/she should take up so much time asking a list of questions and trying to tie the person calling to one thing for Call that particular time. I appreciate these Call handlers work under pressure with all the calls they deal with. I won't change my mind from experience of what has occurred with my contact there is a flaw in the system and I wonder how many people have contacted NHS 24 like myself. As I am attending my GP with various problems including reason for calling last time which this entry refers to I am also discussing the problem that caused me problems at near end of year and I was given medical advise that nothing could be done at that particular time, which was later proved wrong. The past months the problem worsened and aggravated the other problems. However I do not see the point of continuing contact regarding the matter when you have discussed it with others in NHS 24 as I appreciate from Senior Management to Call Handlers you all work under pressure. The emergency service I worked for fortunately staff taking calls or attending didn't have to stick to list to ask questions. Again I thank you for taking the time to respond as it is much appreciated. This brings to an end the contact.

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