"Poor advice from NHS 111"

About: North West Ambulance Service NHS Trust

(as a relative),

My husband has recently had a hip replacement. The lower part of his wound became red hot inflamed yesterday, and our surgery number advised calling 111. The girl I spoke to was very nice and pleasant, arranged for a GP visit, but finished by advising that he should try elevating his leg. Orthopaedic advice is not to raise the affected limb above 90degrees for 6 weeks. As a nurse I would never follow this advice, because of the risk of dislocation of the prosthesis. An another example of an algorithm which gives incorrect advice?

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Responses

Response from Deborah Gallagher, Patient Experience Support Officer, Patient Experience, North West Ambulance Service We are preparing to make a change

picture of Deborah Gallagher

Thank you for taking the time to share your experience of using NHS111 on the Patient Opinion website.

I am sorry to hear about the concerns that you had about the advice that you were given. The NHS111 Clinical Governance team have looked into the details that you have outlined above. The situation that you have described would have meant that the health advisor followed a pathway which gives advice on inflamed wounds and swelling of the limbs that does give advice to keep the limb elevated. However the feedback you have shared has highlighted how this may not be appropriate in the case of a post-operative hip replacement.

As a result of the feedback that you have shared the team will be raising the issue with NHS Pathways to look at the advice that is given and see if changes need to be made in the specific scenario following a post operation hip replacement.

If you would like to discuss this issue further then you can contact the NHS 111 team either through email Nwasnt.111Clinical-Governance@nhs.net or by telephone: 01204 428007.

Thank you again for the feedback.

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Update posted by ketchup (a relative)

That is excellent news, I hope this will soon be resolved. Thank you

Response from Deborah Gallagher, Patient Experience Support Officer, Patient Experience, North West Ambulance Service We have made a change

picture of Deborah Gallagher

I just wanted to share with you that NHS111 Pathways have decided where there is a postoperative wound following a hip operation such as total hip replacement, the care advice should mention not lifting the leg above 90 degrees from the horizontal to prevent risk of dislocation whereas in other situations limb elevation is helpful to reduce bleeding or swelling.

This advice is something that will be updated in the next planned update to the system that NHS111 use as they do need some time to make sure that the questions asked lead to the correct advice being given.

Thank you once again for sharing this with us.

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Update posted by ketchup (a relative)

Excellent news, so pleased that I was able to highlight this problem before any mishaps may have occurred

Response from Peter Denton, Healthwatch Manager, Healthwatch Tameside

Thanks 'Ketchup' and North West Ambulance Service.

It's great to see patient feedback result in changes that can improve care for others.

Peter

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Update posted by ketchup (a relative)

Thanks Peter and NWAS for listening and responding, it's great to know we have a voice! Best wishes to all