"111 out-of hours care"

About: Harmoni / NHS 111 London Ambulance Service NHS Trust

(as a relative),

I have used this service a couple of times recently, but will not bother again. In the days before 111 existed, Harmoni used to send a doctor, who would actually come and examine the patient, but, it seems, not any more.

The first time was about two months ago, over a weekend. My partner has Parkinson's, which gives him very high levels of anxiety - he often thinks he is dying. That weekend, as well as a rattling cough and constant nausea, he had had constipation overflow for 36 hours when I finally gave in to his demands to call a doctor. This was about 6. 30 on Sunday evening. After two phone calls from non-medically qualified people asking endless questions from a script they finally agreed to send a doctor. By 1 am no doctor had arrived, but I got a call from someone saying he was the After-Midnight Doctor - he had two patients to see before my partner and would be with us around 3 am. By now my partner was wearing an incontinence pad and was beginning to doze, so keeping him awake until three seemed crazy - I phoned his doctor first thing on Monday morning for a home visit, after a Sunday from hell.

On the second occasion I was the patient myself. This was in May and on a Monday, when a red rash had spread all over my body until I looked as if I had been scalded. Although my skin was burning, I was frozen and shivering and ached in every limb, and on Monday evening when my temperature had risen to 99. 6F I began to worry I had pneumonia. Again, when I phoned 111 I spoke to call centre staff with a script. They asked if I could attend an all-night surgery some way away, but I explained I was the sole carer for my partner who was immobile. Eventually they agreed to send a doctor.

The doctor, when he phoned around midnight, said I had one of two conditions I'd never heard of, both of which were dangerous, and told me to call an ambulance. (When I explained about my partner, he said: "Oh, the paramedics will sort that out" - a comment that amused them when they came. ) The paramedics were wonderful and reassured me that I didn't have pneumonia, despite my high temperature, but I felt ashamed to have called them out in vain.

But of course in any further crisis that is what I shall have to do from now on. I have learnt that there is no point in calling 111 and that the emergency services are the only care on offer out of surgery hours.

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Response from Simon Mills, NHS 111 Clinical Lead, NHS Wandsworth CCG

I'm really sorry to hear about the experience that both you and your partner received from the 111 and Out of Hours (OOH) GP service. It is very important that your concerns are looked into in more detail, so that any areas for change or improvement to the service where appropriate are addressed. Harmoni provides 111 and OOH GP Services across a number of areas of London, so I would be grateful if you could contact them on harmoni.feedback111@nhs.net with your full contact details and your concerns. This will allow them to conduct a full investigation of the issues you have raised. Alternatively, if you are a Wandsworth resident, you can contact the Wandsworth CCG Customer Care manager by emailing WACCG.wandsworthpals@nhs.net, and your comments will be forwarded to Harmoni for further investigation.

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Response from Amanda Mayo, NHS 111 Service Director, Harmoni

Thank you for taking the time to write your experiences with NHS111 and the out of hours service.

I am very happy to look into the concerns you raise above and contact you directly to discuss the issues if you would be kind enough to email me at harmoni111.feedback@nhs.net with the name of yourself and husband and the dates you called NHS111. In the meantime, could I suggest you ask your General Practitioner to provide your local out of hours service with information on your husbands clinical condition to allow NHS111 and the out of hours service to manage him effectively in the future?

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