You usually know if something is seriously wrong...
THE M.E.N. MEETS STAFF TAKING YOUR CALLS AT NHS 111 CENTRE
The diagram reveals prompts and questions for clinicians to ask callers as part of their assessment.
Carole seems puzzled until there’s mention of a dirty nappy that was a much darker colour than usual.
It sounds like melena, which can be a symptom of liver problems.
As a clinical adviser, Carole isn’t allowed to diagnose a patient. But she advises the baby girl sees a doctor that evening. The call is one of many from concerned parents that evening.
It’s the time of the day when kids are home from school, and their parents are home from work. Typically the NHS 111 call centre will see a surge in calls in the evening.
Health advisers take the initial call and assess what each person needs using an online ‘triage’ system.
Some callers are simply unsure where to get the right treatment, particularly if they need help outside of GP opening hours. Others with more serious queries, or young children, are handed over to a clinical team made up of experienced nurses and paramedics, like Carole.
If the patient is ‘symptomatic’ they are usually referred to an out of hours doctor or pharmacist.
Carole was a paramedic for 31 years before she became a clinical adviser at NHS 111. One of the biggest challenges of the job is assessing a person over the phone rather than face-to-face.
“It’s really quite a feat, telephone triage,” says Carole, as she scans up and down the long list of patients waiting for call backs.
Another call is a dad who’s concerned about his nine-year-old son’s leg injury. Carole runs through a list of questions to assess the pain, and they establish that the best option is to visit the nearest walk-in centre.
The next call is more concerning. A mum has been in touch about her five-month-old who has stopped feeding. Carole runs through all of her symptoms and asks for the little girl’s temperature.
It seems abnormally low at 32.8C but before anyone has a chance to panic, Carole has a suspicion the thermometer is faulty. A reading of the parent’s similarly low temperature confirms she’s right.
Carole deems the little girl ‘generally unwell’ and not seriously ill. The mum is advised to take her baby to a GP as soon as possible.
Carole’s colleague, Emma McLaughlin, is a former A&E nurseturned-clinical adviser at NHS 111 who is dealing with some of the lower urgency calls. She calls a mum with a query about a rash on the bottom of her 11-year-old son’s foot.
A pharmacist has told her it could be hand, foot and mouth but Emma isn’t convinced.
She pulls up pictures of hand, foot and mouth disease on the NHS website as she chats to the mum about when her own children had the infection.
“A lot of things you know from having your own children,” says Emma. “Rashes are really difficult