"Poor advice received from the NHS 111 service"

About: Charing Cross Hospital / Accident and emergency Harmoni / NHS 111

(as a relative),

One Saturday morning a few weeks ago my husband (aged 69) suddenly said he felt unwell and then his speech got all jumbled up: he could say some words properly, but then the syllables would become jumbled, or completely the wrong word came out, or he stammered and couldn't get the word out. I was concerned that he might be having a stroke so I called 111 for advice. The person I spoke to asked about other stroke symptoms (face muscles, arm raining etc) and if his speech was 'slurred'. I said not slurred but jumbled up, which seemed hard for her to understand. They then asked me many questions about his mental state - was he depressed, suicidal, dangerous, etc, all of which seemed to me to be irrelevant to his physical symptoms. The person then advised my husband "to see a GP in the next 24 hours". My GP doesn't work on Saturdays, so I asked where else he could go and she suggested Charing Cross Urgent Care Unit, which is our nearest A&E. I was very concerned at the advice about 'within 24 hrs' and so we went immediately to A&E.

When we arrived with his symptoms, the emergency Stroke Team rushed into action with a CT scan of his brain (with subsequent other tests) and they were relieved that we'd got to the hospital within 4 hours. Their diagnosis was that he had had a TIA. His speech recovered in a few hours, but he was admitted to the Stroke Unit and kept under observation for 3 days. The service at A&E and in the Stroke Unit was fantastic and exemplary. My purpose in writing is to draw attention to the fact that the advice we received from 111 was wrong and far too casual, and could have resulted in him being severely impaired as a result of a stroke. I also felt that if I, with no medical training, could suspect a stroke, then how could a trained person, with presumably some sort of questionnaire in front of them, not suspect one and advise us to go immediately to A&E, and so I think a change needs to be made in their training. Having said that, we have previously had excellent advice from the 111 service in the past. I would be grateful if you could please pass this on to the appropriate person.

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Responses

Response from Christine Cornell, PALS manager, Imperial College Healthcare NHS Trust

Imperial College Healthcare NHS Trust welcomes your feedback. We are sorry to hear about your experience of NHS 111 but we are delighted that your husband received the care he needed at Charing Cross Hospital. Thank you for your kind expression of appreciation for our A & E and Stroke service.

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Response from Amanda Mayo, NHS 111 Service Director, Harmoni

Thank you for taking the time to post your recent experience with NHS111.

In view of what you have detailed in this posting, I would like to investigate the call you made to NHS111 when your husband became ill so that I can analyse where the service did not support your husbands needs,

In order for me to do this, I would be very grateful if you could email your name and contact details, your husbands name, date of birth and date of the call to me, via the secure email address, harmoni111.feedback@nhs.net.

Thnak you in anticipation

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Response from Stroke Association, Stroke Association

It was really good to read that you recognised the symptoms that your husband had with those of a stroke and reacted quickly by getting him to hospital as both TIA's and strokes are medical emergencies. It was positive to read too that your husband received very good service whilst in A&E and on the Stroke Unit.

We noticed your post and thought you may be interested to hear that the Stroke Association's Stroke Helpline is there for anyone who has been affected by TIA or stroke in any way. You may want to know more about TIA's or simply someone to talk to. The Stroke Helpline is open Monday to Friday from 9am to 5pm on 0303 30 33 100. You can also email us at info@stroke.org.uk.

We were sorry to hear of your husband's TIA and that you feel you did not receive the right information from NHS 111. It sounds as though the Service Director of Harmoni is willing to look into your concerns, so I hope that you receive feedback on their findings soon.

Stroke Information Service

info@stroke.org.uk

Stroke Association staff are not medically trained and the information provided does not replace information given to you by your own healthcare provider.

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