"Poor information given for treating my baby"

About: NHS 24 / NHS 24 (111 service) Queen Margaret Hospital / Minor Injuries Unit

(as a parent/guardian),

I wanted to share my story as I'm a true believer that you can't expect things to change if you don't flag when something is wrong

My experience involves feedback on both NHS24 and Queen Margaret Minor injuries.

First of all, I think the NHS is an amazing service that as a country, we're incredibly lucky to have access to. However my recent experience made me loose faith a little.

Twice I've been given what I feel to be poor/innaccurate information with respect to treating my baby son. The first time when I called to get advice on his eyes that were very gunky and green. After explaining that, I was told to bathe them regularly in sterile water. The issue got worse rather than better and in the days that followed I went to my doctor who said that I shouldn't have been told to bathe his eyes as he had conjunctivitis which needed drops. The doctor said bathing the eyes could have spread the infection and that anytime his eyes were green, to go straight to the doctor.

On the second occasion I called NHS24 for advice as my son woke up with a very swollen lip with a huge white blister on it. His nursery had experienced an outbreak of hand foot and mouth so I assumed that's what he had. I called NHS24 for advice, explaining the full story to an operator including my concerns it was hand foot and mouth. I was then put through to someone else who didn't seem to have the notes on that and was only aware that he had a swollen lip. I was advised to give my 11 month old son anti histamine to reduce the swelling. I asked what to give as I didn't know and I was told to check the back of the packet and give him what was suitable for his age. I asked about hand foot and mouth and was told they could only treat the symptoms I'd explained so couldn't talk to me about hand foot and mouth. I didn't have any anti histamine at home so had to go to the supermarket in the early morning to get them. I'm a single parent on my own. I didn't want to drag my son out in the cold so early when he was unwell so asked my dad to come to my house to look after my son whilst I went to the shops. On getting to there I discovered that there's no off the shelf anti histamine you can give to an infant. I called NHS24 back to explain and express my dissatisfaction and was given an out of hours doctors appointment for later that morning. This to me is totally unacceptable. Firstly because I was given poor advice, and secondly because I got my family member who is in their late 60's from their bed so I could go and buy medicine that wasn't even suitable for my baby.

On attending the out of hours appointment I was given cream for his lip and advised it was unlikely hand foot and mouth. I was happy enough with the service at the hospital but frustrated and disappointed with the advice from NHS24. It's worth noting that on getting to the hospital, the nurse didn't have the detail id explained (twice) to NHS24 and instead had notes saying I'd been referred by a pharmacist at the supermarket! Totally inaccurate.

The following week my son got ill again. He started waking from midnight on the Friday and woke crying multiple times each hour, then crying solidly for a further few hours. Nothing would console him other than me pacing the house holding him. He had a higher than normal temperature and I knew he wasn't right as he's not a baby who cries.

His nappies were fine and although he wasn't taking solid food, he was drinking his bottle. For that reason, I was reluctant to call NHS24 as knew they'd advise calpol and keeping an eye on him. However I know my baby and knew something was wrong. Also, following my previous experiences, I had no confidence or faith in the service.

I decided to take him to the Queen Margaret minor injuries to get him seen by an out of hours doctor. On arriving I was given a leaflet explaining I should have called NHS24. I explained why I didn't and was told that if o wanted my son seen it'd be at least 4 hours later. The whole conversation was frosty and it was made clear that I was inconveniencing them. Whilst I understand I didn't follow the process, I think under the circumstances it was understandable. I said I was unhappy with waiting 4 hours as he was clearly unwell and only an infant. The receptionist spoke to the nurse who agreed to triage my son. The nurse was very cold, unfriendly and didn't show any understanding or provide any reassurance. I'm guessing they were also peeved at my insistance on seeing someone. I felt very uncomfortable and was on the verge of tears as I'd been up all night and was very worried about my son. I understand the pressure and challenges NHS staff are under but I'm not a neurotic time waster and expect to be treated with respect and understanding.

The doctor looked at my son 20 minutes later and confirmed his ear was very red and he had an infection which needed penicillin. At this point I burst into tears - mainly due to relief as I knew something was wrong. I didn't feel listened to at all as part of that visit and felt really upset even after I left. I feel I was treated quite badly given I was clearly just a concerned mother who had an obviously poorly baby on her hands. The doctor was very kind and understanding when they diagnosed my son and when I was upset which I was grateful for.

Like I said at the start. I fully understand the challenges faced by the NHS and their teams and I appreciate that unfortunately there's a population of people who abuse the service m. However, I don't expect that to create cynicism for all patients. Every single patient should be treated in the right way and their issues and concerns listed to.

I wanted to take the time to provide this feedback as think that whilst it's a fantastic service, there's parts that feel quite broken.

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Responses

Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear Ms Dunf

Thank you for your feedback via Patient Opinion. I would firstly like to thank you for your overall positive comments in relation to the availability of the NHS.

You have referenced contact with NHS 24 which you feel was not managed appropriately. I was sorry to learn of this. Here at NHS 24 we take feedback extremely seriously and always strive to provide an excellent seamless service for persons who require to call NHS 24.

I note that in your first paragraph, you reference inappropriate advice being provided and we would very much welcome the opportunity to explore this further.

On your second call to NHS 24 when your son had a swollen lip, I note that you have explained that not all of the detail you provided was passed to the NHS 24 Nurse Practitioner. Again, we are keen to explore exactly what was captured by the Call Handler and what information was passed to the Nurse and whether this impacted on the assessment of your son's symptoms. On this occasion you were advised to obtain antihistamine and I was sorry to learn of the challenges you have explained in doing so. You also reference the hospital not being made aware of your attendance by NHS 24. It may be helpful if I explain that Pharmacists can refer patients to the Out of Hours service, however again, we would be keen to explore this in more detail from an NHS 24 perspective.

It is disappointing to read that you were reluctant to contact NHS 24 when your son was ill again. Clearly this is not the experience we wish to provide to persons who require to call our service.

I am sure my colleagues within NHS Fife will respond to you in relation to your experience at Queen Margaret Hospital.

In summary, NHS 24 would very much welcome the opportunity of exploring further your calls to our service to establish if there is anything we could have done differently or better. Please do not hesitate to contact me further on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

0141 337 4582

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Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dera Ms M Dunf

Thank you for taking the time to give us your feedback, we agree that you can't change something if you don't know there is a problem and for that reason we welcome your feedback. I was sorry to hear that your son had been poorly and of your need to access help. You speak very highly of the NHS and so it is understandable that you feel disappointed by your recent experience, which has left you lacking in confidence. I see that Shona has alread picked up on the issues relating to NHS 24 and similarly, I would be happy to ask staff to look into the specifics of your son's hospital attendance if you would like us to do this. You can contact me directly to dicuss this further is you wish. In the meantime I will make sure your post is shared with the relevent people so that staff have an opportunity to reflect on the way in which they communicate and the importance of a caring and sensitive approach. The staff will also be able to see your positive comments concerning the doctor which helps to re inforce the importance of kindness and understanding. Having a sick child is a worrying time and it is so important that staff recognise that and respond appropriately.

I do hope your son is now back to full health and strength.

Kind regards

Louise Ewing

01592 648069

patientrelations.fife@nhs.net

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