"Not asking the right questions"

About: Kings Cross Hospital NHS 24 / NHS 24 (111 service) NHS Tayside

(as the patient),

I phoned NHS 24 to state that I had intense pain in one part of my leg and numbness in my buttocks, genitals and part of the back of my leg. This was following on from my GP's advice earlier in the week when I had gone to him for a suspected trapped nerve in my back. He had advised me that if there was any change when wiping myself, I was to contact either them or out of hours urgently. Despite stating my symptoms, I was called back from someone who asked when my vaginal pain had started! ! I explained again and eventually was advised to attend the out of hours, but not to drive if I was numb. Remember this word, numb.

I get to Kings Cross to be seen by a Nurse who neither examined me, nor took any notes and who told me that I had sciatica, and people with sciatica go numb. I'd never had sciatica before and discussed the genital numbness and was told this was normal. If I needed more pain relief, I was to see my GP.

Long story short, after not being happy with this diagnosis, I went to my GP who referred me for an MRI. I was admitted for emergency surgery for impending Cauda Equina. The surgeon told me he would have liked to have seen me 24-48 hours after my initial presentation rather than weeks. There was nothing on my notes from the out of hours service about numbness - numb was never mentioned by them.

When you self refer to the physio on the national number they ask several questions regarding numbness, difficulty passing urine, etc which, obviously, are flags for Cauda Equina and demand urgent medical attention. Why on earth are these questions not asked by NHS 24? ? ? If I had been asked them when I had phoned, I may have had a better outcome than I have now. I find it incredible that these are not standard questions for all the services helpline staff. This needs to be addressed as a matter of urgency. I have no faith in NHS 24 at all now. I could have been left doubly incontinent if I hadn't had the impetus to go back and say something isn't right here. It is frightening and completely unacceptable.

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Response from Tracey Passway, Clinical Governance and Risk Team Leader, Clinical Governance and Risk, NHS Tayside

Dear Astiforme, thank you for taking time to share your experience. I am sorry that you feel the Out Of Hours Service did not examine you sufficiently or ask the right questions on this occasion, and this delayed your diagnosis. If you would like to discuss this further please contact the Complaints and Feedback Team by telephone on 0800 027 5507 (freephone) or via email to feedback.tayside@nhs.net.

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Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear Astiforme

Thank you for your feedback which I read with concern. I would firstly like to say that I am very sorry to learn that you required to undergo emergency surgery. I do appreciate that this will have been a very worrying time for you.

Here at NHS 24 patient safety is our top priority and we welcome and seriously consider all feedback. I will be sharing your particular story with NHS 24 Senior Clinical staff.

Calls to our service are progressed on the symptoms described by the patient and additional questions are asked to inform a clinical assessment. NHS 24 Nurse Practitioners have available to them a wide range of evidence based support tools to assist their assessment of a patients symptoms.

I am very keen to arrange to have your call explored in detail to understand more fully how your contact with us was managed and to establish if there is anything which could have been done differently. However in order to do so, I would require some additional information. I would be pleased if you would be kind enough to contact me on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk

With kind regards


Shona Lawrence

NHS 24 Patient Affairs Manager

0141 337 4582

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