"Liaison between NHS111 and Northern Doctors"

About: North East Ambulance Service NHS Foundation Trust / NHS 111 Northumbria Specialist Emergency Care Hospital Vocare

(as a relative),

I finished a long career in the NHS as a Complaints Officer in an NHS Trust. So in mid January when my daughter received a poor standard of care from NHS111 and Northern Doctors (initially wrongly believed by us to have been Urgent Care at Hexham Hospital) I felt comfortable in complaining, believing that my issues would be addressed appropriately.

I Googled to find the correct details for the NHS111 service and for the Hospital. I clearly identified the postcode called from so that the issues could be sent speedily to the correct departments. 

  At approximately 07.40 one morning in mid January 2019 my daughter telephoned NHS111 and explained that she was 15 weeks pregnant and had experienced a bleed. The excellent person who took her call listened carefully, asked appropriate questions and directed her explicitly to the "Urgent Care Unit at Hexham General" explaining that they had made an appointment for her at 08.30.  

A little after 08.45 a doctor called my daughter to go through, using a surname which has not been hers since 2016 We queried this and the doctor explained they had to use the details ‘on the system’ (Adstra). Her details on the system used a surname and address which she has not had for over two years. At her  GPs and at the Hospital she is attending for her antenatal care, all details are up to date and correct. The doctor's  comment was that it was a 19th century system still in use in 21st century and that they were unable to update it – my daughter would have to do this. 

My daughter had brought her antenatal care record with her but this was not looked at. The doctor took her temperature and blood pressure and dipped her urine then explained she should not have been directed to Hexham as there are no antenatal scanning facilities there and that we would have to go to Cramlington (our nearest 'full' A&E) for this. I asked why we had been told to attend Hexham given the 99% chance that a scan would be required and the answer was that many patients calling NHS111 with i.e. breathlessness, symptoms of heart attacks or strokes, pregnancy problems were incorrectly signposted to Hexham when they all need to go to Cramlington.  

 We queried whether we would be better going to the hospital responsible for her antenatal care but the doctor said they would not advise this as they did not know if they had the facilities at weekends.  We set off for Cramlington but at my request my daughter telephoned (while I drove) her Pregnancy Assessment Unit for advice. They looked at her notes in their system and advised her to go home and rest. 

 They said that if she had further bleeds she should attend her nearest 'full' A&E (which is not Cramlington) where she could be scanned 24/7. 

They subsequently called back to say they had not understood that she had not been examined and arranged an appointment that afternoon. She has now been properly examined, and all is well.

I believe that:

She should have been immediately signposted to her nearest A&E where she could have been scanned at once. (NHS111 issue) or to her own Pregnancy Assessment Unit (by NHS111)

Her history, available in her pregnancy record, could and should have been looked at and a call made BY Urgent Care to the Pregnancy Assessment Unit made so that joined up thinking and care could have been put in place. (Urgent Care issue) 

Her record should immediately have been updated with her current name and address. (?by those responsible for “Adstra”)

So long as there is no joined-up thinking between organisations patients will continue to be sent to the wrong places which will inevitably result sooner or later in a serious incident, potentially quite avoidable loss of life.

I raised several other peripheral issues but these are the crucial ones.

I received a response from an Admin. Assistant at the Trust responsible for the Urgent Care Centre which said that my daughter had not attended any of their services, and that they hoped the 111 service were helpful.

I contacted them immediately and explained that they were perhaps not able to see her name was because they did not have her correct details on their system and asked for further investigation.

A Complaints Manager then responded to explain that although we had been seen in the Urgent Care Centre the care had been provided by Northern Doctors to whom they had kindly forwarded the correspondence.

I then received a consent form allowing "Vocare" (the private company managing Northern Doctors) to correspond with me, and a time frame by which they hoped to respond.

I have NEVER received a response from NHS England but my emails have all been received (automated response).

Today I received an email that simply thanked me for the paperwork and confirmed they were using correspondence from the NHS 111 service to lead an investigation. It consisted of three sentences riddled with spelling mistakes and grammatical errors.

As you may imagine to read a virtually illiterate response does not give me a great deal of confidence in the way my complaint is being treated. The jury is still out - and you may be assured that I shall receive an adequate response whether soon, or after further 'work' on my part.

Meanwhile I am distressed and upset at the completely fragmented nature of our NATIONAL Health Service. Once the pride of our nation and all who worked in it, now little more than a laughing stock and an organisation most employees are embarrassed to work for. I am certainly relieved to have found the escape tunnel four years ago.

Responses

Response from Northumbria Healthcare NHS FT

Dear Former Complaints Manager and Worried Mother,

I am very sorry to read about your daughters recent bout of ill health during her pregnancy. I am also sorry that you and your daughter experienced conflicting information about where best to go for treatment, I can only imagine this must have been frustrating and confusing for you both.

As this experience was very complex we would like to ensure it reaches all of the departments you mention, we would really be grateful if you would continue to work with us so we can get to the bottom of what happened. We would urge you to email us with further information and your contact details so we can begin looking into this straight away and put you in contact with the most appropriate teams. Our email address is Patient.Experience@northumbria.nhs.uk

We wish your daughter all the best with her pregnancy.

Looking forward to hearing from you soon.

Jan

Janice Hutchinson – Service Improvement lead

On behalf of Patient Experience

  • Former Complaints Manager and Worried Mother doesn't think this response is helpful
    {{helpful}} other {{helpful == 1 ? "person thinks" : "people think"}} it is helpful

Response from Annie Laverty, Chief Experience Officer, Patient Experience, Northumbria Healthcare NHS FT

picture of Annie Laverty

Dear worried mother,

I am sorry to read that you have found our above response unhelpful. We are keen to respond as effectively as possible and we would like to get this right for you. Please let us know if there is more we could be doing and how best we can help you.

Many thanks,

Annie

Annie Laverty

  • Former Complaints Manager and Worried Mother doesn't think this response is helpful
    {{helpful}} other {{helpful == 1 ? "person thinks" : "people think"}} it is helpful

Update posted by Former Complaints Manager and Worried Mother (a relative)

Dear Ms Laverty, thank you for your comment. As I have already said I don't think the initial response CAN be helpful because I have been clearly told (as I have stated twice now) that my complaint is being handled by another of the NHS's many management strands - namely Vocare for Northern Doctors. I wrote to your colleague FULLY immediately on receipt of her comment forwarding correspondence explaining this and asking her to let me know if she could assist in any way or needed any further information. The email was received into your organisation on Tuesday 5th February. It was sent to 'Patient.Experience@northumbria.nhs.uk'. I feel there is little I can add other than to reiterate that I don't think your organisation is placed to respond but that it would be helpful to know if you think differently or if there is any assistance you can provide. At time of writing I am still waiting to receive any actual ANSWERS from anybody.

Response from North East Ambulance Service NHS Foundation Trust

We’re sorry it’s taken us so long to reply. This was due to a system change that did not alert us to your post on this website. If we can still help with your complaint, please email patient.experience.team@neas.nhs.uk. We are sorry for not getting in touch sooner.

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

Update posted by Former Complaints Manager and Worried Mother (a relative)

I met with NEAS Complaints Manager Ms Longstaff, Northern Doctors Urgent Care Clinical Service Manager Ms Oldfield and Senior Medical Lead Dr Herscovitz in April 2019 in the UCC at Hexham General Hospital. The meeting was recorded by NEAS at my request and all parties (as far as I know) have copies of the recording. It was entirely satisfactory in regard to dealing with the issues I raised although at the bottom of it the problems with NHS computer systems was acknowledged as being a huge issue. From the one year delay in seeing this post it appears nothing has changed in this regard! However I DO have faith that the patient care issues were going to be addressed by Dr Herscovitz, the reception issues by Ms Oldfield and the 111 service by NEAS. Ms Longstaff was particularly kind and has been in touch to enquire about the birth of my grandson which was on 30th June 2019. He is now a thriving boy 6 months of age. My daughter and I remarked only yesterday that this whole awful experience is now a year behind us! So no, there is absolutely no need to contact me further.

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