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"Inability to access urgent care"

About: GPs in Medway Medway on Call Care OOH

(as a staff member posting for a carer/relative),

I've been a paramedic for 12 years. My father is type 2 diabetic. He forgot to take his meds for four days. When I saw him on the fourth day he was confused (thought I was his wife/referring to her in the present tense although she passed away last year), tired/drowsy (had been asleep all day everyday), decreased appetite and urine output, minor hallucinations (thinking he was holding something when he wasn't) and explosive bowel movements that left him incontinent of faeces. All abnormal for him, a fit 66YO who works full time in a physical job.

He re-started his meds but the symptoms continued/worsened until three days later he was so confused he was talking about teddies stuffed with drugs that he had been given to smuggle! The confusion wasn't constant, just intermittent, with some insight into the fact that he was confused.

I called 111 at 1500, they referred him for an appt with his own GP. They called back and said they had no appts and he would have to call the next day at 8am to try and get a same day appt. 

I called 111 again at 1630. They said they couldn't refer him to the OOH service until after 1830 when his GP closed, despite them having no appts. Advised a local UCC with walk in facility.

I returned from work and took him to UCC, arriving approx 1900. They advised they were full and closed at 2000 so could not see him. Told me to phone 111 and get a referral to the OOH. 

I did so, for the third time. Was assessed by a health advisor who told me a paramedic would call me back for an assessment. I told them I was a paramedic and just needed a referral (unable to refer directly to OOH). They said they couldn't do that.

15m later said paramedic called back. Again advised I was a paramedic, suspected a UTI and just needed a referral. "Can't do that, need to do a patient assessment". Unsurprisingly the assessment suggested they could refer him to the OOH service! They would call back in under 2hrs.

Approx an hour later an OOH Dr called, more assessment, and then offered an appt for 2230. By this time dad was exhausted. The confusion had abated temporarily. We declined and said would see his own GP in the morning.

I had to work the next day, I couldn't attend with him to give an accurate account of his behaviour over the past three days, so I had to write him a note to take with him. As if being confused and incontinent of faeces wasn't degrading enough, now his daughter has to write him a sick note to explain what's been happening! He's too confused to explain himself.

That night was everything that is wrong in the NHS. Appalling access to urgent care. Why would you not simply attend a&e? Despite not needing to be there. What members of the general public would even have tried half as hard as I did that night? Why not call 999?

All I actually wanted was a urine dip, then I could have asked for a prescription!  I'm extremely disappointed, frustrated. Poor show Medway CCG. You've failed me and my father tonight

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