Review of: NHS 111
Paid: No
Date purchased/used: Late February 2013
Cost: Free (NHS service)
Brief descrweren and technical specifications: NHS 111 is a non-emergency veappointmentf the 999 service. It's not quite a direct replacement for NHS Direct,
Website: http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx
This is a bit of an odd one to find myself reviewing. I'm mostly doing it as I came across an exchange between my MP (@SiobhainMP) and NHS Better Services Better Value (@NHS_BSBV). You can read it from here: https://twitter.com/SiobhainMP/status/374915474582405121
I said that I would write up my experiences with the NHS 111 service, as tweeting about it would take far too long. I think that this is a better place to put it than my main blog, as it's a review of something that I have used.
Our daughter was born in February 2013, and her birth was, all things considered, relatively without incident, at St Georges, Tooting. The one thing that did happen was that the STAN clip came off during the delivery, meaning that a second was required. The place where the first clip had been became infected, and when we came home, we were given antibiotics for her to treat this.
The first course of treatment helped, but didn't clear the infection completely, and when the infection came back, we took her back to St Georges, where she was looked at the next day in one of the paediatric wards. There they lanced the wound, and removed an amount of pus, and gave her more antibiotics. These once again seemed to clear things.
The infection once again flared up, not as badly this time, but having seen how fast it could go up, we were very wary. This time it happened on a Sunday, out of hours for our GP (and I suspect for most peoples). We decided that we shouldn't bother A&E with it, and so called NHS 111. The actual staff on the 111 service where fine, although we did feel a little pushed from pillar to post. They eventually decided that it was serious enough that I need to talk to their on call GP, who decided that it was serious enough that she needed to see someone that day.
This is where things went slightly off.
We live in Mitcham. The only hospitals that NHS 111 could send us to were St Helier in Carshalton, or to Croydon University Hospital. They could not refer us to our hospital of choice, the one that we knew well, the one that we had done all of our pre-natal checks at, the one where our daughter was born, St Georges, Tooting. This was due to some choices that had apparently been made by my GP practice. I'm not convinced that they themselves made that choice, I suspect it was in fact made above them, by whoever runs the Merton and Sutton Clinical Commissioning Group.
Getting to either of the other hospitals from Mitcham is difficult. There are two buses that go towards St Helier, but only one of them (the S1) actually goes to the hospital, the other (the 280, or N44 at night) drops you are the end of the road that leads you to it, leaving you with a 10 minute walk to the hospital. This is obviously not ideal with a small baby. These buses also leave from two different stops in Mitcham, meaning that you have to pick a bus, and hope, you can't just get on whichever bus comes first.
To get to Croydon University Hospital is even harder. There are no direct single buses. You can get a 118, and then change, with a small walk in between to get to a 60, which will then take you straight there, or you can get a 264 (which is a 24 hour bus), which will leave you with a 15 minute walk to get to the hospital. Once again, these buses all go from different bus stops in Mitcham.
Given the temperatures this February, and the fact that our daughter was just over 3 weeks old, at that point, both of these were (are) unattractive options.
If you compare it with getting to St Georges, Tooting, where there are at least 5 services to the hospital (the 280 and 264 (a 24 hour bus) directly to the hospital, the 270, 355, 127 and at night the N44 to within 10 minutes walk of the hospital. These buses all go from one bus stop, meaning that the wait time for a bus that will get you there is never long.
We are exceedingly lucky, we have a car. If we had not have had one, we would have been put in a very difficult position. It would have taken us a great deal more time to get anywhere, a large part of which would have involved standing about in freezing temperatures with a newborn. The service provided by NHS111 was not equipped to make allowances for this.
As it was, we where able to accept an emergency appointment at the St Helier Out of Hours GP service. We were given an appointment time, and I was assured that we would not be kept waiting. When we got to St Helier, the difference between it and St Georges was shocking.
At St Georges, as the parents of an ill and very young baby, we were immediately put into a consulting room to keep her away from any other infectious people (since we were in the children A&E unit, really only children), and were treated as a priority case. This gave us access to everything that we needed to look after her, and a place to feed and change her safely. We saw doctors who knew what they where doing with children, and understood our concerns and where able to reassure us.
At St Helier, despite the promises made to me on the phone, the GPs were running late. The waiting room was packed with a number of obviously unwell adults, and there were no obvious baby change facilities. Our appointment was the last of the day, and I believe that we where finally seen about 45 to 60 minutes late. The GP that we saw appeared to have no knowledge of paediatrics, seemed mostly uninterested, and wanted to go home. He re-prescribed exactly the same antibiotics as the paediatric doctors at St Georges had, and really seemed uninterested and out of his depth.
Having been given a prescription by the out of hours GP in St Helier, I asked the GP where I could get it filled, but he couldn't point me at anywhere still open as the appointment was pushed so late. We struggled to find an out of hours chemist that could fill it. I ended up driving to a 24 hour pharmacist in Croydon (ironically next to the University Hospital) to get it filled.
I have to say that I was sorely disappointed with the service that I received from NHS 111. Not being able to go to our closest hospital (St Georges is 2.1 miles away by road, St Helier is 2.3 miles away and Croydon University Hospital is 4.3 miles away) is ridiculous. I can honestly say that I don't think that I will use NHS 111 again, instead I will just take my daughter to the hospital of my choice out of hours. I might engage with them to the point at which they confirm that I need to see a health professional, but unless they can offer me access to a hospital and a service that I am comfortable with, I will pick my own path from that point onwards.
TL:DR? NHS 111 can only send you to a limited number of hospitals, which may not be ones that you can get to or that you are happy going to. They don't give a monkeys about this. If what they offer you is too hard to get to, seriously consider going somewhere else. And if you have a tiny baby, don't go to an out of hours GP.
Paid: No
Date purchased/used: Late February 2013
Cost: Free (NHS service)
Brief descrweren and technical specifications: NHS 111 is a non-emergency veappointmentf the 999 service. It's not quite a direct replacement for NHS Direct,
Website: http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx
This is a bit of an odd one to find myself reviewing. I'm mostly doing it as I came across an exchange between my MP (@SiobhainMP) and NHS Better Services Better Value (@NHS_BSBV). You can read it from here: https://twitter.com/SiobhainMP/status/374915474582405121
I said that I would write up my experiences with the NHS 111 service, as tweeting about it would take far too long. I think that this is a better place to put it than my main blog, as it's a review of something that I have used.
Our daughter was born in February 2013, and her birth was, all things considered, relatively without incident, at St Georges, Tooting. The one thing that did happen was that the STAN clip came off during the delivery, meaning that a second was required. The place where the first clip had been became infected, and when we came home, we were given antibiotics for her to treat this.
The first course of treatment helped, but didn't clear the infection completely, and when the infection came back, we took her back to St Georges, where she was looked at the next day in one of the paediatric wards. There they lanced the wound, and removed an amount of pus, and gave her more antibiotics. These once again seemed to clear things.
The infection once again flared up, not as badly this time, but having seen how fast it could go up, we were very wary. This time it happened on a Sunday, out of hours for our GP (and I suspect for most peoples). We decided that we shouldn't bother A&E with it, and so called NHS 111. The actual staff on the 111 service where fine, although we did feel a little pushed from pillar to post. They eventually decided that it was serious enough that I need to talk to their on call GP, who decided that it was serious enough that she needed to see someone that day.
This is where things went slightly off.
We live in Mitcham. The only hospitals that NHS 111 could send us to were St Helier in Carshalton, or to Croydon University Hospital. They could not refer us to our hospital of choice, the one that we knew well, the one that we had done all of our pre-natal checks at, the one where our daughter was born, St Georges, Tooting. This was due to some choices that had apparently been made by my GP practice. I'm not convinced that they themselves made that choice, I suspect it was in fact made above them, by whoever runs the Merton and Sutton Clinical Commissioning Group.
Getting to either of the other hospitals from Mitcham is difficult. There are two buses that go towards St Helier, but only one of them (the S1) actually goes to the hospital, the other (the 280, or N44 at night) drops you are the end of the road that leads you to it, leaving you with a 10 minute walk to the hospital. This is obviously not ideal with a small baby. These buses also leave from two different stops in Mitcham, meaning that you have to pick a bus, and hope, you can't just get on whichever bus comes first.
To get to Croydon University Hospital is even harder. There are no direct single buses. You can get a 118, and then change, with a small walk in between to get to a 60, which will then take you straight there, or you can get a 264 (which is a 24 hour bus), which will leave you with a 15 minute walk to get to the hospital. Once again, these buses all go from different bus stops in Mitcham.
Given the temperatures this February, and the fact that our daughter was just over 3 weeks old, at that point, both of these were (are) unattractive options.
If you compare it with getting to St Georges, Tooting, where there are at least 5 services to the hospital (the 280 and 264 (a 24 hour bus) directly to the hospital, the 270, 355, 127 and at night the N44 to within 10 minutes walk of the hospital. These buses all go from one bus stop, meaning that the wait time for a bus that will get you there is never long.
We are exceedingly lucky, we have a car. If we had not have had one, we would have been put in a very difficult position. It would have taken us a great deal more time to get anywhere, a large part of which would have involved standing about in freezing temperatures with a newborn. The service provided by NHS111 was not equipped to make allowances for this.
As it was, we where able to accept an emergency appointment at the St Helier Out of Hours GP service. We were given an appointment time, and I was assured that we would not be kept waiting. When we got to St Helier, the difference between it and St Georges was shocking.
At St Georges, as the parents of an ill and very young baby, we were immediately put into a consulting room to keep her away from any other infectious people (since we were in the children A&E unit, really only children), and were treated as a priority case. This gave us access to everything that we needed to look after her, and a place to feed and change her safely. We saw doctors who knew what they where doing with children, and understood our concerns and where able to reassure us.
At St Helier, despite the promises made to me on the phone, the GPs were running late. The waiting room was packed with a number of obviously unwell adults, and there were no obvious baby change facilities. Our appointment was the last of the day, and I believe that we where finally seen about 45 to 60 minutes late. The GP that we saw appeared to have no knowledge of paediatrics, seemed mostly uninterested, and wanted to go home. He re-prescribed exactly the same antibiotics as the paediatric doctors at St Georges had, and really seemed uninterested and out of his depth.
Having been given a prescription by the out of hours GP in St Helier, I asked the GP where I could get it filled, but he couldn't point me at anywhere still open as the appointment was pushed so late. We struggled to find an out of hours chemist that could fill it. I ended up driving to a 24 hour pharmacist in Croydon (ironically next to the University Hospital) to get it filled.
I have to say that I was sorely disappointed with the service that I received from NHS 111. Not being able to go to our closest hospital (St Georges is 2.1 miles away by road, St Helier is 2.3 miles away and Croydon University Hospital is 4.3 miles away) is ridiculous. I can honestly say that I don't think that I will use NHS 111 again, instead I will just take my daughter to the hospital of my choice out of hours. I might engage with them to the point at which they confirm that I need to see a health professional, but unless they can offer me access to a hospital and a service that I am comfortable with, I will pick my own path from that point onwards.
TL:DR? NHS 111 can only send you to a limited number of hospitals, which may not be ones that you can get to or that you are happy going to. They don't give a monkeys about this. If what they offer you is too hard to get to, seriously consider going somewhere else. And if you have a tiny baby, don't go to an out of hours GP.
