"I fell between dentistry and General practice"

I phoned NHS 24 looking for analgesia. I have mouth and nerve pain coming from a known issue. Namely a wisdom tooth that was reviewed two weeks previously. I was referred at that time to the dental hospital and understand review and excision could take a year or more. 

I had contacted my own Dentist on Thursday and Friday requesting analgesia. I received a phone message on Thursday, saying my dentist was in the following day. I recontacted my dentist on Friday and eventually received a phone message detailing I would require to contact my GP as they could not provide analgesia. Unfortunately I did not pick up this message, until after 5pm on the Friday. I did however have a small supply of co-codamol 30/500 from previous surgery. I was utilising this having tried lower level analgesics without affect or relief. My supply was limited and despite rationing ran out on Saturday evening. 

I contacted NHS 24 and selected dental, however despite a pleasant call handler and then dental nurse it became clear that I fell between two clinical disciplines, dentistry and General practice. Dentistry could not prescribe analgesia that was sufficient to meet my pain and as the pain related to dentistry it was not not suitable to General practice as a dental issue. I was told I would dually be taken down two paths dentistry and GP by NHS 24. In the end I spoke with eight people three call handlers , two nurses (one dental) a dentist who I was appointed to meet at University Hospital Wishaw, a pharmacist another call handler and finally a GP. On each occasion, whilst in severe nerve pain radiating up the left side of my face, having to again provide personal details and explain again and again all my symptoms and history. It made me wonder if anything I said was recorded or passed on.

The dentist was sympathetic though at a loss as to what they could do as they were unable to prescribe the level of analgesia required and was neither in a position, as I knew, to offer any additional treatment. Therefore the appointment was a waste of time and could have been utilised by someone requiring urgent dental treatment. They acknowledged my situation was common place where upon the NHS 24 protocols, for situations such as myself, were inadequate. Indeed all to whom I spoke with were aware I fell between the processes.

The pharmacist was helpful, though I missed several calls from him as I was instructed to leave the dental hub at Wishaw when I arrived, and to phone them from outside the hospital. Given the reception area had protective glass and I was socially distanced I found this ridiculous particularly given I explained why I needed to keep the line clear. When though I did speak to the pharmacist he was straight forward and agreed I required strong pain killers. However I would still need to speak to a GP.

Unfortunately I missed several calls from the GP as I was with the dentist when they called. I then spent 35 minutes trying to get through to NHS 24, spoke with another call handler complaining about a now 5 plus hour journey to get analgesia! I appreciate toothache, even when severe or debilitating, is incomparable to many of the treatment requests and needs NHS 24 required to deal with. However there is innately something wrong with a system to deal with someone’s pain when it requires five health professionals and three others to provide for it and that’s before it’s dispensed by another pharmacist. The fact that those within the system admit this is a known problem when pain is related to dentistry is also of concern and that Dentist are seeing people not out of need but the need to satisfy the system should again highlight flaws within the system that require to be urgently addressed. 

Fundamentally I was given 100 strong Painkillers that are equivalent to opioids, that are addictive and that I may need to take for more than a year whilst I await to be treated. Whilst the pain affects daily function, so will these tablets inhibit my daily life inclusive of concentration and ability to drive. I understand COVID has affected all treatments and again my situation is incomparable to delays in cancer care and other life threatening conditions whose care has been curtailed, nevertheless we now require to invest in returning these services to normality and putting resources in place to increase them to deal with the backlog. I therefore ask what waste is there in the NHS 24 resource when eight folks have to deal with my one issue. Is this repeated for, or reflective of,  all interactions with the service?