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Need a doctor out of hours? Don't call 111!!! - Carers UK Forum

Need a doctor out of hours? Don't call 111!!!

Share your ideas about the practical side of caring.
I've recently had the misfortune of requiring a doctor's visit out of hours, for my elderly mother. The service was so bad I felt I should document it here, in the hope that others can avoid using the service if at all possible.

Chistmas Day: Visited 87yr old mother. Left foot swollen and hot to touch in comparison to other foot. Mum had been scratching both ankles and the room was hot, so I bathed her feet and put some soothing cream on, then put her to bed, hoping things would settle down overnight and knowing that getting a doctor out on Christmas day would be nigh on impossible.

Boxing Day: Visited and found foot no better. Decided in view of previous history (cellulitis infection in leg some years ago) foot is probably infected and needs anitbiotics. Rang 111 service at 8pm. Was informed a doctor would call back to assess situation and then a doctor would visit if necessary, but it may be up to 6 hours waiting time. Was prepared to live with 6 hour wait rather than leave situation to worsen all over weekend.

Chased up by telephone around midnight and 2am. Each call involved repeating all information ad nauseum and being told how busy they were.

27 December, 2.50am. Doctor rang. I reiterated everything and it was agreed foot is probably infected. Doctor offered me three choices - go to A&E, or accept appointment at out of hours clinic (opens 8am in morning) or wait for doctor, which could be a wait of up to 6 hours more!!! It was obvious they would do anything to avoid visiting! :angry: I said that I was not taking an 87yr old to sit waiting for hours in A&E, especially after waiting over 6 hours already!!! I said that the clinic appt might have been an option if it had been offered in the first place, but all things considered I was shattered from lack of sleep, so I'd not be fit to get her to an early morning appt now and I insisted on a home visit. They asked if we had a key safe, I said yes and they said the doctor would be happy to let herself in if I gave them the code. I did so.

4am, still no show from doctor. Decided to drive home and left note for doctor pinned to front door.

27 Dec, 10am. Doctor finally arrives, 14 hours after first call. Diagnoses infection - no shit Sherlock!!! Leaves antibiotic tablets for Mum.

So, I could have flown Mum to Australia in the time they took to act! :angry: I did complain to the call centre, as I was furious that they misled me with the whole 6 hour total wait thing. What it boils down to is this - they have to call back within 6 hours to assess the problem, but then if you still need a doctor there is another wait of 6 hours or more on top! Ludicrous! I know it's the busiest time of year for the NHS but it's no wonder the A&E depts are so packed when really there is no such thing as an out of hours GP service any more. :angry:

All very stressful, especially as my father had been in hospital fighting pneumonia and I didn't want Mum ending up there too. What makes it worse is finding out that a couple of days previously the carer had noticed the problem and offered to get the doctor out, but Mum had declined and played down the symptoms! Even now she's grumbling sbout taking the tablets. I reminded her she'd previously been in hospital for 6 weeks with this and had nearly lost her leg. She's taking them now.

So, unless you just want a bit of advice on the phone (which anyone intelligent could find online anyway) I'd suggest you forget 111 and take your chances with A&E, but take along a flask and magazines/books to while away the hours.

Having experienced so many issues with our NHS lately it is clear that the whole system is at breaking point. Never mind, the MPs recently got a pay rise of 9.5%, so they've got their priorities sorted! :angry:
Oh Shewolf,

How stressful and ludicrous.

A&E are too busy dealing with drunks out binge drinking.....
And the UK simply refuses to increase the number of places in medical schools, despite the incredible competition to get in (so the student talent is out there), so we end up with insufficient UK doctors (and nurses) so we have to hire them in 'ready trained' from abroad. Insanity. Oh, and then we pay interim NHS managers £300k a year apparently as well!

Re foot infection - I know this is too late now, since your mum is finally on the antibiotics, but one possible treatment you can do yourself is to soak her foot in hot, salty water to help draw out the infection.

Hope things are improving now she is on antibiotics.
Hi SheWolf

What an awful time you’ve had of late; what with your dad being in hospital over Christmas, and then that stuff with your mum’s infected foot and the run-around with the so-called “out of hours” so-called “111 doctors service.”

I was horrified reading your account. It made me realise what a post code lottery it all is, how wrong that is, how lucky I am, and how “luck” shouldn’t come in to it.

For instance, I have two numbers I can call for home visits from our local health/docs centre: one is from 9-5 Monday to Friday; the other is all other times.

A few weeks ago mum had a funny turn at about 2am, so I called the night-time number. About 15 minutes later, a doc turned up in his car with a green light flashing on top (a bit like a police car only without the noise.)

He managed to calm mum down (mum was having a full blown panic attack), stop her heavy nose bleed, said he’d liase with the heart nurse (which he did) and prevented mum from being packed off to A & E.

He didn’t do much, but what he did prevented so much :-???
Jeez Sajehar, that sounds like 5 star service you've got up there! :shock: Clearly the north south divide is still in evidence, but seemingly the situation has now reversed - it's grim down south!

Jenny, thanks for the tip but I don't feel that would work, because there is no obvious wound/cut with any pus or anything near the surface, the infection seems to be more generalised and deep seated - it's probably cellulitis. I went over tonight to give her the night time tablet and had a look at the foot - still no better but she says it doesn't hurt.

Worryingly I found that she was sat in soiled pants again and it's clear she had been sat in them for hours. The toilet is only 8 steps away with grab rails en route but she still can't be bothered it seems. When I prompted her to use the toilet she went in there and just ran the tap for a while, trying to kid me she'd used the toilet! I was having none of it and insisted she check her panties - that's when I found the awful mess. :( So, not only is she getting lazy again (carers' notes indicate she has been "declining toilet" regularly), but she is being sneaky and unco-operative with me/the carers. Cue another pep talk from me re the fact that toilet hygiene is the one thing she MUST do if she wants to avoid hospital/care home. I'm so tired of all this.

I guess I will need to get the GP out to her soon if the tabs don't work. Maybe they will have to take her into hospital to give her antibiotics via a drip, like Dad had. If that happens she'll only have herself to blame. When a person refuses help with washing/bathing/showering/toilet hygiene, but then doesn't do any of that for themself and sits in their own mess for hours, infections are almost inevitable. I'm mentally drained with it all. If I could fly off to a desert island and escape all the worry I'd do it.
Hi Shewolf,
Your Mum sounds very hard to help, I'm not surprised you feel as you do.

Others have faced this problem with elderly/ sick relatives refusing support with toileting and personal care.

Does your Mum ever have respite? I just wondered if a period of respite would get her back into the routine of having to do these things regularly again.

Just sending ((hugs)) Shewolf. Bad enough coping with one parent but,you have double trouble :roll:

Just a note of warning as I too am in the grim South with hospital under special measures etc. when mum's leg was swollen, the hospital said it was infection. The nursing home doctor suspected a broken bone and indeed was right. The hospital missed it as mum said she was in no pain. If at all possible, might be worth asking for an X-ray while mum is in hospital,
Oh, SheWolf - that is so grim. Horrible, horrible, horrible. It's the sort of thing that well, just makes me want to 'explode' with the awfulness of it all (ie, dementia, and what it does to someone). I guess the only 'solution' is a care home, isn't it? Somewhere where she doesn't get a choice in whether to go to the loo or not. Or is just put into nappies and changed regularly. But oh, what a situation for any human being to be in - just dreadful, dreadful to come to such a pass. And to have to cope with it as you do.

Anne, it seems odd that the hospital staff should have 'believed' someone with dementia who says she feels no pain! Or, in fact, when it comes down to it, believed anyone elderly at all (since we know that the elderly don't like to admit pain and are very often brought up to 'not make a fuss'!)

Re 111 issue - ....I noticed yesterday in Boots that the pharmacist was in constant demand being endlessly consulted by customers walking in and wanting medical advice - I suspect that is hecause, again, people can't get to the GP over the holidays.

(But it doesn't help the NHS when idiots phone 999 spuriously - I heard on the TV last night a recording of some stupid woman phoning 999 to report that the ice cream seller had only put sprinkles on one side of her icecream. It was utterly unbelievable, but clearly there are people like that - the woman didn't even sound drunk, which surely is the only way anyone could be quite that stupid and irresponsible.....)
I called 111 on New Years Day for me disabled son (they think he has pancreatitis) and the doctor took 2 hours to get here and the ambulance took 3 and a half hours.

Eun, that's awful! In hindsight both of us would have been better off calling an ambulance straight away, but on the surface of it, it seems OTT to call an ambulance for an infected leg or what may have appeared to be just a stomach ache to begin with. No responsible person wants to burden the ambulance service with things that might seem fairly minor, compared with broken limbs/heart attacks etc. But I won't call 111 again, it's quicker to google all the symptoms and then make a judgement call as to whether it's an emergency situation or not. The trouble is, a non emergency situation can turn into an emergency while you wait 14 hours for a doctor!

. I guess the only 'solution' is a care home, isn't it? Somewhere where she doesn't get a choice in whether to go to the loo or not. Or is just put into nappies and changed regularly.
Well, that thought has occurred to me many times lately. She wears incontinence pants but they seem to have made her lazier. When we moved her sofa etc upstairs to make a bedsit type arrangement, it was so that she would not need to climb stairs to get to the toilet. At first Mum reacted well and started visiting the toilet regularly without being prompted, but I knew that after a few weeks she would slip back into her old ways and decide that even just a few steps was more than she could be bothered with. When she dies I will ask the doctor to record 'CBA syndrome' on the death certificate... Can't Be Arsed Syndrome!

Many times I've wondered if I'm doing her a disservice by letting her stay in her own home (what she wants) instead of moving her to a care home (what she needs). She is very antisocial and would hate to be surrounded by lots of other old people and carers. Maybe a small care home would be the answer, with enough staff to instigate regular toilet trips and enforce personal hygiene, but only a few other residents to irritate her? I have POA but I feel I can't force it upon her until/unless she tips into crisis point (which probably won't be long anyway). It's worrying and frustrating to have the responsibility for her care, but no real power or control over her future, unless I want to be brutal and force her into a home - which I can't square with my conscience. I'm seriously considering pushing her to have a trial period in Dad's care home, just to see how they cope with her on the hygiene front and how she responds. She has no interest in seeing Dad, but they have an upper floor where Dad never goes due to his poor mobility, so she'd not need to see him if she stayed in her room. The staff there are very patient and have "ways of making you wash" (in my mind I say that with a German accent, in the style of scenes from old WW2 films involving torture by the Nazis, because so many elderly people seem to regard washing/bathing as a form of torture treatment).

Back on topic, I intend to have a discussion with the GP about the whole 111 fiasco, and challenge them on the fact that they offer no out of hours service at all. In fact, at that surgery, you have to phone early in the morning if you need a home visit that day, because if you phone late morning you get told it's too late to add you onto the home visit list for the afternoon so you need to phone early the next morning! So, you can really only get a home visit from the GP if you get on the phone by 9.30am, which means if symptoms develop later in the day you get no help from the GP until the next day. Again, a ludicrous situation.