I know that the words ‘shooting’, ‘fish’ and ‘barrel’ spring to mind when criticising those lovely NHS 111 Pathways Reports. But, just when you think you’ve reached the absolute pinnacle of f***wittery – in my personal experience, a man who had noticed that, on stretching his rib cage, he experienced a twinge in his sternum, and ummed and ahhed for eight weeks before phoning our favourite 24/7 healthcare helpline, at which point the words ‘chest’ and ache’ bypassed all logic and common sense, rang reflex, protocol-driven alarm bells and resulted in a bewildered-looking patient being corralled into an emergency appointment with an annoyed-looking Dr Copperfield – it manages to completely and utterly surpass itself.
Specifically, we receive an NHS 111 report giving a patient with unscheduled vaginal bleeding – who, for the avoidance of doubt, is not pregnant, collapsed, on fire, etc – the following advice:
‘Contact your GP practice during normal surgery hours’ (good) and ‘Keep any towels etc that were used to mop up the blood – they will need to be checked’ (bad) and furthermore, ‘If bleeding becomes heavy and you start passing clots, save everything passed in case it needs to be checked’ (really bad, especially if they phoned right at the beginning of a bank holiday weekend).
And if that’s the advice with vaginal bleeding then, for infant gastroenteritis it’s bound to involve used nappies, for adult vomiting a bucket, and in cases of haematospermia, well, frankly, I don’t even want to think about it. I just pray that this particular NHS 111 pathway does not end with the last appointment before lunch.
Dr Tony Copperfield is a GP in Essex. You can email him at email@example.com and follow him on Twitter @DocCopperfield.