"111 Gateway. Not everyone signed up."

On Sunday 3rd August 2014 I rang the 111 service because I suspected that I had developed a deep vein thrombosis (DVT). They arranged an appointment in the Out of Hours Department of the University Hospital of North Durham which I attended and where I was seen by a medical practitioner. The conclusion was that I probably had a DVT. I was given an injection and an envelope to take to RAMAC (Rapid Access Medical Assessment Centre) the next day. I was told that they would arrange an ultrasound scan and then treat me if necessary. When I arrived at RAMAC a nurse told me that I should not have been sent there and took me to Radiology. After I had an ultrasound scan I was told to take a report of my results to my GP straight away and if the receptionist would not let me see a GP I should stand there and refuse to move until she did. That sounded a bit ominous so I asked about RAMAC and I was told that I was on the 111 Gateway procedure and that I should go to my GP and not RAMAC. The radiographer who had carried out the scan agreed. I was on the 111 Gateway procedure and I should go to my GP. I went to my GP's surgery where the receptionist said she had never heard of the 111 Gateway but she read the ultrasound report and other documentation and arranged for me to see the GP on urgent referral duty. He saw me about 10 minutes later, read the documentation, asked a few questions and as he was printing off a prescription he asked if I had visited a ward at the hospital. I said that I had initially gone to RAMAC but apparently I was on the 111 Gateway and should not have been sent there. As I said this his shoulders sank as he let out a big sigh. He then explained that the surgery had not signed up to the 111 Gateway and I should have been dealt with by RAMAC. I was now going to have to go to a chemist and get some pre-filled syringes and inject myself in the stomach every day until I had an appointment with the Warfarin Clinic. Now I have no problems with the actions of the staff that I saw but it seems to me that there is a problem with staff training in RAMAC in as much as it does not seem to be known that some surgeries have not signed up to the 111 Gateway. Of course it is possible that it has been decided that there will only be the 111 Gateway and GPs and the Out of Hours Department do not know but the hospital management needs to sort this out.