"Liaison between NHS111 and Northern Doctors"

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.