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Why not just rebadge 111 as 666

Copperfield

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I sincerely hope you didn’t read the recent headline, ‘All GP practices could see NHS 111 direct booking from April 2019’, at least not while your cranium was anywhere near anything made of brick.

True, at present, this is a trial, and participation is voluntary. But the plan is to roll this out ‘universally’ with NHS employers warning, ominously, that ‘lessons learned will inform next year’s contract negotiations’.

By which point, presumably, they’ll do the honourable thing and rebadge 111 as 666, given the level of persecution this will involve.

It’s literally impossible to envisage a future where 111 has access to our appointment systems without experiencing a sensation of utter dread. After all, this service is so risk averse and protocol driven that its threshold for calling an ambulance is the combination of words ‘chest’ and ‘pain’, even if that pain is localised post-coughing rib tenderness which even the patient realises is musculoskeletal.

It's really unpleasant having unrealistic systems imposed on us and being held responsible for them

Presumably, that means the threshold for 111 booking a GP appointment would be set somewhere around the patient simply waking up that morning.

And therein lies another problem. Their stupid protocol may randomly decree that patient X with symptom Y might need an appointment within Z days, but what if my waiting time for non-urgent is three weeks, as it is now? And if the answer is that we have to reserve a certain number of appointments for 111 then that just runs the risk of some appointments being unfulfilled (granted, unlikely) and so wasted or, more importantly, of our current routine appointments being squeezed even further to accommodate the 111 requirements.

It’s a really unpleasant feeling having dysfunctional and unrealistic systems imposed on us and then being held responsible for the outcomes. And despite its increasing familiarity, the anxiety it creates is making me feel sicker by the day. I’d phone 111 for advice but I really can’t face all those questions about whether I might be pregnant.

Dr Tony Copperfield is a jobbing GP in Essex

 

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Readers' comments (6)

  • I had the same feeling of dread. 111 is unfit for purpose. This has to be the line in the sand for the GPC in next year's contract negotiations

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  • Just Your Average Joe

    No problem drop all appointments and adopt a walk in system.

    Alternatively a 100% triage system - where they book into a triage slot where you can assess the patient yourself properly and decide what needs to be done.

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  • I LOVE the idea of 111 having to book into a triage slot, but:

    1. Can we trust 111 not to take the attitude of 'we are the triage service so we shouldn't be booking a triage, we should be sending them to see the clinician face to face'?

    2. Can we trust 111 to choose the triage slot rather than 'squeezing them in to see the ECG/minor illness /immunisations nurse'?

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  • "I LOVE the idea of 111 having to book into a triage slot, but:

    1. Can we trust 111 not to take the attitude of 'we are the triage service so we shouldn't be booking a triage, we should be sending them to see the clinician face to face'?"
    In OOHrs we already have this - the usual dross. However "the Rule" is that if 111 have clinically triaged a patient we have to accept that triage and are not allowed to re-triage!
    Heaven help the practices.

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  • So long as they are trained to spend all but the first hour of their days telling patients that they should have an appointment but can’t because all the appointments are filled and have a alternative source for those people- that won’t include us because we have no more availability. I suspect the sheer volume of patients outrage will scupper that plan much more quickly than our opinions.

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  • locally, I think 111 is being advertised as equivalent to 999. no wonder patients can't work out what they should do, and turn up to emergency surgery with 2 hours of coryza, but pre-book next week for a week's worth of exercise induced chest pain!

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