So, perfectly nice, reasonable lady phones 111 because of her not nice, unreasonably painful knee. She is aware that it’s nothing catastrophic because she’s not injured it and it’s not that bad – but just bad enough to seek some help from a ‘highly trained adviser, supported by healthcare professionals’, to quote the NHS 111 website blurb.
Those who don’t really know what they’re doing have given a semblance of action by shifting the problem
Expecting a plausible explanation and some simple advice about NSAID gel to help her limp her way through the day, she is amazed to be directed immediately to A&E. She thinks it odd, realising it’s neither accident nor emergency, but, hey, highly trained advice supported by healthcare professionals is there to be followed, right?
So she does as she is told. And at A&E she is seen by someone whose exact qualification is unclear but who is obviously qualified enough to tell her she needs some urgent physiotherapy, and that the way to get this is to see her GP asap.
And that, of course, is why she is sitting, apologetically, in front of me in my emergency surgery. From 111 to A&E to me to physio. Typically, given the current system, those who don’t really know what they’re doing have given a semblance of action simply by shifting the problem elsewhere.
I give her a plausible explanation and some NSAID gel. You can see the pain in her face, pain much worse than that in her knee, pain which betrays that she is aware of how she has inadvertently become complicit in why the NHS is falling apart. And you can hear it, too – in her voice, when she explains why she phoned 111 in the first place: ‘I didn’t want to waste anyone’s time’. No. But the NHS has wasted hers, mine and another chunk of its own resources.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield