GP Out of Hours Care

Becles

I felt unwell last week, and woke up on Saturday with a very high temperature and in a lot of pain. I tried the usual paracetamol, drinking water etc., but couldn't bring the temperature down. The painkillers were not even touching the pain.

By mid-afternoon, my other half was concerned and rang NHS Direct. He was put through to the GP Out of Hours service, and a doctor spoke to me. He said I needed to be seen by a doctor, but refused to do a house visit. He said I had to go to the Out of Hours unit in the hospital, which is a 20 minute drive from home. I explained I didn't feel well enough to go, so therefore couldn't drive myself and my boyfriend can't drive. The doctor again refused a house visit, and told me to either get a taxi or find someone to give me a lift.

My b/f contacted my Dad who took me to the unit. On arrival, I was seen by an Emergency Care Practitioner (ECP), which I later found out is a nurse with extra training to make diagnosis of common illnesses. He went through a series of questions, including was I allergic to anything. I specifically said I must never have penicilin due to a severe reaction to it, and this was noted on the sheet. I was examined and some tests were done, and he concluded that I had an infection and needed antibiotics. He said he couldn't write the prescription, but would go and see the doctor to get one.

I was given Co-Amoxyclav tablets. When I got home, I took one and lay on the sofa. Within minutes I felt like there was a huge weight on my chest, I had pins and needles all over and couldn't breathe properly. I then lost consciousness, so my b/f called an ambulance.

My next memory is waking up in A&E where I was told I'd had an anaphylactic shock due to penicillin. I was kept in A&E for a few hours for observation, then allowed to go home as the hospital was desperately short of beds.

My b/f has spoken to the doctor who wrote the prescription. He said the fault was with the ECP who never told him about the penicillin allergy and he never thought to ask. He claimed an ECP would not know that Co-Amoxyclav contains penicillin, although a nurse in A&E warned me for future reference that any drug name starting amoxyc... contains penicillin.

I just think it is absolutely shocking that an ECP has no knowledge of drugs and is able to hand them out without understanding what they are :mad:

Thankfully I'm ok - just weak and wobbly!

I'm keen to make a serious complaint to the NHS about this. It could have been a lot worse. I live alone, so if my b/f hadn't been here to ring an ambulance........ Who are the best people to contact to make them aware of this issue, and to make sure it doesn't happen to someone else.

I know the ECP team have already been shouted at by the A&E sister on Saturday night.

BWZN93

I really feel for you - that must have been awful. I was diagnosed as penicillin allergic when I was 3 and have always tried to ensure that drugs dont have penicillin in them by telling them I have the allergy every time. Unfortunately this cant always be possible as you have clearly shown, and it is quite disgraceful - imagine if this happened to a person who lived alone.

Penicillin allergy is quite common these days (I know 4 other people with it), and you'd have thought that all drugs containing penicillin would have some kind of specific label to show that - just in case there has been a mistake by someone. Maybe all drugs containing penicillin should have a mark on the packaging, similar to a nut warning on food, as the reaction is essentially the same. At least if I could check myself to ensure it is penicillin free, then maybe these kinds of incidents could be averted.

Have you thought about contacting PALS and making a formal complaint?? It sounds as if something is seriously wrong - shouldnt the doctor be reading the chart etc to see if the drug the ECP is recommending is suitable? I mean, they arent Pharmacists or Doctors are they!

Take care Becles, I hope you feel better soon.

Jo xx

Faith_2

My sister's allergic to latex. In some hospitals, the staff don't even know that the gloves they use contain latex.....

YorkshireBoy

Becles wrote:

I'm keen to make a serious complaint to the NHS about this. It could have been a lot worse. I live alone, so if my b/f hadn't been here to ring an ambulance........ Who are the best people to contact to make them aware of this issue, and to make sure it doesn't happen to someone else.

Here in West Yorkshire, our local paper recently ran a major story on the local NHS trust hospital. The hospital mistakenly filed away/lost some X-rays that had been taken as part of a cancer screening exercise. As a result, some patients were informed very late that they required treatment.

If you really want to make sure it doesn't happen to anyone else, the best people to get involved are the local papers. If the story's big enough it'll make the national press (a lot of the local rags are owned by the national papers).

However, if you're thinking of going down the compensation route, your best bet would be to keep it out of the papers.

Either way, and as a minimum, I'm sure you'd want to know that they'd tightened up on their procedures as a result of your experience and that it could not happen again.

Becles

I'm not keen on compensation. The NHS is terribly underfunded, and it seems wrong taking money out of it.

YorkshireBoy

Becles wrote:

I'm not keen on compensation.

I wasn't advocating it. I just couldn't tell from your post which way you were going to play it, so covered both options. Have to admit though, your experience is a little worrying.

Best wishes

surfcat

I think the penicillin thing is also complicated by the fact that there are antibiotics classed as a group of 'penicillins' and there is the antibiotic penicillin. Allergy to one doesn't neccessarily mean allergy to all etc, so in theory it would be possible to have been taking a penicillin for years but then get prescribed a different one and have a bad reaction.

madfrenchgirl

Becles

I am so sorry to hear about your experience!

Whatever you do, I hope they will make sure it does not ever happen again.

Those mistakes are usually made by people who think they can treat patients as numbers, and the paperwork is just... paperwork. it gets lost, people dont file them properly, etc and in the health business, it means serious consequences.

What seems to happen in ANY health institution is that they live in their own world and do not relate to you when it is all about you. Or they actually think of themselves as all-knowing-gods.

I did not get my periods until i was 18. The only reason for that being a tumour on my pituit that was forcing it to secrete some hormons blocking me from having a normal cycle. This tumour could also render me blind as it wa splaced right underneath my optic nerves.

My mom and I spent 8 years going from GPs to GPs (I was "formed" at age 9, so was my mom and my grandmom who both had their periods at 9), telling them the thing. Most of them related it to a "lack of maturity", "stress", "psychosomatic syndrom", name it, I have heard it all.

When i finally had a swanky 3d CAT Scan, the radiologist looked at us and said with alot of disdain, "it is about time you take care of this". it hought I could have killed him. Same with the hormones specialist, when he said they had to operate, we asked how they were planning on doing it and he laughed at us saying "we go through the sinuses, i dont have time to explain, look it up in a biology book".

Just to prove. People go on and on about the NHS here, but the French system has its flaws too (and is bloody too expensive and ruining the country).

I know what was done to you was awful and yout hink that you might have died if you were alone. But consider every option carefully, because once you have decided to claim for compensation, there is no going back.

WHA

Why does everyone think that people want to complain only to get compensation? I have had cause to complain about various NHS matters and not once have I been motivated by money, I've never asked for money, and never been offered it. The reason I have complained is because I want my family to receive a reasonable quality of healthcare and would like to think that the NHS would learn from its mistakes.

LondonDiva

Becles wrote:

He was put through to the GP Out of Hours service, and a doctor spoke to me. He said I needed to be seen by a doctor, but refused to do a house visit. He said I had to go to the Out of Hours unit in the hospital, which is a 20 minute drive from home. I explained I didn't feel well enough to go, so therefore couldn't drive myself and my boyfriend can't drive. The doctor again refused a house visit, and told me to either get a taxi or find someone to give me a lift.

Out of Hrs services obviously did not fit in with your requirements at the time. The point of the Out of Hours unit was possibly to maximise the GP service provision not to provide convenience. Yes, it was inconvenient for you get a taxi, but you were able to access appropriate services without the GP having to make a visit, so technically the GP was right to judge you not to need him there. If you still believe that the GP should have visited you, you will need to ask your GP who holds the Out of Hours contract – the practice or the PCT, then complain to them.

Becles wrote:

My b/f contacted my Dad who took me to the unit. On arrival, I was seen by an Emergency Care Practitioner (ECP), which I later found out is a nurse with extra training to make diagnosis of common illnesses. He went through a series of questions, including was I allergic to anything. I... When I got home, I took one and lay on the sofa. Within minutes I felt like there was a huge weight on my chest, I had pins and needles all over and couldn't breathe properly. I then lost consciousness, so my b/f called an ambulance.

I just think it is absolutely shocking that an ECP has no knowledge of drugs and is able to hand them out without understanding what they are :mad:

This was obviously terrible & I’m glad that you’re now well enough to contemplate trying to get this sorted. :T:T I would take the doctor’s comments with a large pinch of salt. Yes there was a c*ckup :mad: of enormous proportions, but I happen to know the training that nurses & ECP go through & for him to suggest they have no knowledge of drugs is just a lie.

Becles wrote:

I'm keen to make a serious complaint to the NHS about this. It could have been a lot worse. I live alone, so if my b/f hadn't been here to ring an ambulance........ Who are the best people to contact to make them aware of this issue, and to make sure it doesn't happen to someone else.

I know the ECP team have already been shouted at by the A&E sister on Saturday night.

Not meaning to be facetious, but I would suggest that the 'best people to contact to make them aware of this issue, and to make sure it doesn't happen to someone else', would be the organisation concerned so that they can actually do something about it. If you write to the Complaints Manager of the trust, with dates, details and names, that's the quickest way to get it sorted. List your main areas of concern so that they can systematically go through it rather than several pages that can be confusing to respond to. PM me & I’ll forward you a template letter that you may find useful. You may also want to indicate that as part of the investigation and response, you may be interested in a meeting with the staff team that provided your care to talk things through. I know from the other side that this is often a valuable learning tool for the staff involved.

In response to the suggestion that you bypass the 3 stages of the NHS complaints procedure (2 of which are impartial and external, carried out by Govt agencies) in favour of the press... :rolleyes: Please, please do not go to the press in the first instance as this does nothing to help staff or the organisation learn. How would any of us like to have the first thing you hear about a potential serious mistake you made, be an article in the Sun, with no way of responding to allegations and innuendo and more importantly no way of actually saying & meaning Sorry without it being about who shouts and strops the loudest, rather than who actually had a valid cause for concern.

The point of the NHS Complaints procedure is to learn proactively from mistakes, provide explanations, explain what changes or action has been taken to ensure it does not happen again and to encourage people to admit to mistakes and to look at how things can be made better. The press route is often used by complainants who do not want to hear what happened, or to help the organisation learn - It is almost, almost always about money, scapegoating and bloodymindedness.

Diva