Anger over out-of-hours doctor delays

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THE out-of-hours GP service has been criticised for not doing enough to respond to people in need – with one patient saying a delay has led to him needing his bladder removed.

Dan Holland, 29, of Broadacre Place, Fareham, called the NHS 111 service after he was experiencing severe pain and suspected he had kidney stones.

Dan Holland

Dan Holland

But his condition was not detected until three days later, which he says means he will need an operation years earlier than expected.

Mr Holland said: ‘I first called the service at 12.45am on a Sunday because of this pain.

‘I have spina bifida, which has caused me problems with my bladder and I need to use a catheter, so I am familiar with this pain.

‘After speaking to NHS 111, I was told an out-of-hours doctor would call me back in a couple of hours. But when I didn’t hear from them I called NHS 111 again at 9.23am and went through my symptoms again.

‘This time I was called back about two hours later and was told to see an out-of-hours doctor at Queen Alexandra Hospital.’

Mr Holland visited QA later that Sunday and was told he had a urinary tract infection (UTI), despite him expressing concerns about having kidney stones.

He added: ‘I was told I had a UTI and was sent home, but the following Tuesday I did pass a kidney stone. The stone damaged the tube between my bladder and catheter and as a result I need to have my bladder removed.

‘This would have happened in a few years’ time because of the problems I have, but because this stone was missed the procedure is being moved forward which has left me very angry.

‘I didn’t call 999 because I didn’t want to take away an ambulance from someone who may be having a heart attack or been in an accident.

‘Doctors take the Hippocratic oath to protect patients, but I feel that didn’t happen in my case.’

The Hampshire Doctors on Call – or Hdocs – service is run by firm Care UK and covers the south-east Hampshire area.

Care UK said Hdocs last year helped more than 182,000 people in the area and received 91 complaints. The majority of these complaints surrounded the service missing response timescales that they give to patients.

A Care UK spokesman said: ‘We have not received any kind of complaint or question from Mr Holland and would like to invite him to get in touch with the Hdocs manager so that it can be followed up to see if any lessons can be learnt for the future.

‘Clearly we would like everyone to be fully satisfied but sometimes, particularly on weekend evenings, an unexpected demand for our service outstrips the ability of our clinicians to see or speak to everyone within the time periods which are set.’

The service said it has seen a rise in demands.

In January, Hdocs responded to 17,484 cases – a 24-per-cent increase compared to this time last year.

The service is funded and monitored by Clinical Commissioning Groups.

Suzannah Rosenberg, director of quality and commissioning for the Portsmouth CCG, said: ‘We have regular monthly meetings with service providers to discuss any issues.

‘Patient safety and commissioning quality services are two of our biggest priorities.

‘When we learn there have been quality or safety issues or patient experiences of the service is not as it should be, then we take this very seriously and work with the provider to ensure actions are being taken.’

Last month, The News revealed how Ann Walters died from heart failure in her home, with an out-of-hours GP arriving 12 hours after she had called the 111 line for help.

Apology after doctors fail to meet call-back response time

A COUPLE were left angry when they could not get through to the out-of-hours GP service.

John Hayes, of Greyfriars Road, Fareham, called NHS 111 shortly after midnight on Sunday, March 1.

The call was made when his wife Frances was suffering from chest pains after she had fallen over earlier on the same day.

Mrs Hayes said: ‘I could barely breathe or move and was in so much pain – I thought I had a collapsed lung and so my husband called NHS 111.

‘Although they called back at about 1am, we could not get to the phone and when we called back, no-one picked up.

‘We also missed two more calls from them, but it didn’t ring out for very long and it takes us a while to get to the phone.’

The Hampshire Doctors on Call service said it tried to call the couple back, but also admitted it did miss its target for a first response.

A spokesman said: ‘We called the patient’s home number four times between 1.30am and 7am and did not receive any reply.

‘We understand the patient’s husband did call NHS 111 at around 1.50am but sadly, that call was not passed on to our clinicians.

‘We have already apologised for this shortcoming and agreed to work with the provider to understand how this oversight happened.

‘The initial call was passed to us at 12.10am and we have also apologised to the patient as we missed the one-hour deadline to call back by 20 minutes because it was a very busy time for our clinicians.’

Ambulance trust explains the process of passing on 111 calls

THE NHS 111 number is run by South Central Ambulance Service (Scas).

The ambulance trust employs call handlers who use an electronic triage system to see what service a patient may need.

One of the outcomes could be to send an out-of-hours doctor.

A Scas spokesman said: ‘Once the NHS 111 call handler has completed their assessment, the patient is signposted to the most appropriate service or care pathway, including GP out-of-hours services, within the designated time frame, to deliver onward care or advice.

‘The details of the NHS 111 call are passed electronically to the service.

‘Once the referral has been generated, it’s the responsibility of the service to call the patient back within the time frame.’

The CCG said it has regular meetings with health trusts to address problems.