Some thoughts on out-of hours NHS

At 9 am Saturday I was talking to a chemist in Tesco who told me what drug I needed to ease my pain. But he was unable to prescribe it. He said phone 111 to get an out-of-hours appointment.

I phoned 111. The automated message said “the service is exceptionally busy — please call back later”. Just as I was absorbing the automated message the phone was answered. I was told I would be called back by a doctor.

I was called by a doctor about 3 hours later. After I described my symptoms she said to go to an out-of-hours surgery.

I drove to the surgery for 6pm. The parking was confusing. The spaces were numbered like staff parking. So I spent 10 minutes driving around to find one with number Pxx not Sxx. I assumed P was patient, S was staff. Imagine a stressed parent arriving with a sick child — trying to work out the parking code with no sign to help. What was even more confusing was the sign said Patient parking at the front. To get to the front — you had to drive around from the back. By this time most sick patients needing out-of-hours are deeply stressed pulling their hair out.

At reception people were told their appointment was an arrival time — not an appointment time. So most people waited over 1 hour to be seen. The waiting room was full of sick young children with parents. But the queue system was first come first served — with no priority for children or the elderly. This meant parents with sick children nagged the receptionist — adding more stress to her job. Eventually the doctor came for my appointment.

The doctor had my medical records and seemed critical of the minimalistic information my own GP had completed. The out-of-hours doctor seemed to be going down a different route to the chemist — so I suggested what he had said. So he wrote out that prescription.

After seeing the doctor at 8pm I drove back to the chemist in Tesco for 8.15 pm. By 8.30 I had my drugs. The same drugs the chemist said I needed — almost 12 hours earlier.

It doesn’t take a process analyst to work out the easy to fix procedures that could easily replace the current slightly chaotic ones.

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