"emergency services"

About: NHS 24 / NHS 24 (111 service) Scottish Ambulance Service

(as other),

My 72 year old neighbour came to my door in great pain and very distressed. She is wearing a knee brace for a broken kneecap and fell, landing on her shoulder and badly hurting herself. My first thought was thst she was going to go into shock and neither myself or my husband would be able to help her. I dialed 999 and was advised that her condition wasn't life threatening so wasn't eligible for ambulance. was put through to 111 where we were asked a million questions and advised to go to a&e.   we dont have a car, dont drive and with our own health issues felt unable to deal with this. tried to get a lift but couldn't physically get her to the car. Phoned 111 again advised to go to a&e. asked about rapid response. Told much the same as before. At least a four hour wait for ambulance or even rapid response. Explained that lady was 72 years old, history of osteoporosis and in a bad way with pain. Advised to get her to a&e. Diagnosis. broken arm and dislocated shoulder.

What could be improved? Greater discretion when dealing with elderly.

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Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear Mena

Thank you for sharing your story. I was very sorry to learn that your elderly neighbour suffered a fall and was subsequently diagnosed with a broken arm and dislocated shoulder. I understand that for this to happen on top of her already having a broken kneecap would have been extremely distressing. I am sure she was very grateful to have caring neighbours to help her at this time.

I understand that your first call was to the ambulance service who determined that your call was safe to be passed to NHS 24 for assessment. I note firstly your comment in relation to the number of questions asked by NHS 24 staff and I am sorry if this caused any additional distress. NHS 24 staff are required to ask questions to ensure that we access the appropriate NHS 24 electronic patient record and we ask additional detail for patient safety purposes. As we do not have the benefit of face to face assessment of a patient’s symptoms, we are also required to ask questions to establish a patient’s current symptoms and situation. This assists our clinical staff in determining the most appropriate management of a patient’s care. During the assessment of a patient’s symptoms, their age and previous medical history is also considered.

You have explained that your neighbour was advised by NHS 24 to attend at A&E, however you had transport issues. I was sorry to learn of this and I appreciate that this would have exacerbated an already difficult situation. We are keen to explore your feedback in more detail to enable us to establish exactly how the contact with our service was managed to determine if we could have done anything differently or better. I would be pleased to hear further from you and can be contacted on 0141 337 4582 or by email at patient.affairs@nhs24.scot.nhs.uk

Your story has been shared with the Scottish Ambulance Service who I am sure will be keen to also explore the contact with their service.

Feedback such as yours is very welcomed and enables us to review and, where appropriate, improve the service we provide for patients and callers. I will ensure that your story is shared more widely with NHS 24 Senior Clinical staff. Thank you again for taking the time to tell us your story.

I do wish your neighbour well, however I appreciate that, due to her injuries, this make take some time.

With regards


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Response from Colin Crookston, Patient Safety Manager, Clinical Directorate, Scottish Ambulance Service

Dear Mena,

Thank you for taking the time to share your experience with us. I too am sorry to learn of the severity of the injuries received after your neighbour fell and also the frustration you experienced accessing help.

Scottish Ambulance has a triage system similar to that of NHS 24 so that we can get the most appropriate care to the right person. If a call is determined to be of low acuity, either one of our Clinical Advisors would call you back for further triage or your call forwarded to our colleagues in NHS 24 for further assessment.

Sometimes based on the information we receive, we can get it wrong. What I would like to do is review your case and learn from your experience so that we can improve our service and share the outcome with our staff. I would be grateful if you could please contact me at c.crookston@nhs.net

Once again, thank you for sharing your story. All feedback received informs us of how we are doing or how we can do better as a service. I do wish your neighbour well on their road to recovery.

Kind regards,


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