3. DNA and the Patient’s Experience


I have had several people contacting me regarding my posts on DNA’s.

The first blog I did was the impact DNA appointments have on Hospitals and Surgeries.

The second blog was in response to a comment made by a Reception Team Leader and how her surgery is proactive in dealing with this problem, which I might add I think is a great system.

This the 3rd blog on DNA’s is from a patients point of view.

Someone contacted my regarding DNA’s and how this impacts on the health service resulting in people having longer waiting times for appointments.

This lady had a hospital appointment a couple of weeks ago, she realised the week before that due to unforeseen circumstances she was unable to keep the appointment the following Monday afternoon, and working in the healthcare sector knew how important it was to cancel the appointment and give someone else the chance of the appointment.

On the Wednesday the week before her appointment she tried to call the consultants secretary to cancel the appointment.

She was greeted with a recorded message saying that the secretary was on holiday and the secretary actually said in the recorded message there was no facility to leave a message. She asked that people call back on her return in 10 days time.

Obviously this would be too late to cancel the appointment. So this lady phoned the hospital and asked for outpatients department, the switchboard put her through and it rang and rang and no one answered. So she had to phone the main switchboard back again. She explained that no one was answering in outpatients, but she was put through again anyway – and again no one answered. So, she had to phone back yet again, she explained about wanting to cancel her appointment, before she could say much more she found she was put through to the “secretary” again, and heard the message she originally heard – and the fact she couldn’t leave a message!

She gave up at this point and left it until the next day when she tried again. She said that she was put through to several different departments, no one wanting to take responsibility for the call she was even told to phone the secretary on her return in 10 days time. She explained that the appointment was in fact in 4 days time and wanted to cancel it and not have a DNA against her name.

She got nowhere – so tried again on the Friday – the same run around.

Monday morning the day of the appointment she phoned the hospital and finally got put through to someone – she explained that she was unable to attend her appointment that afternoon and could they cancel it and ask the secretary to send her out a new appointment.  After taking the woman’s name said she would.

Two weeks went by and this lady had heard nothing so she telephoned the consultants secretary who was not back from her holidays – and to no surprise she found that they appointment had NOT been cancelled, she in fact had a DNA against her name, and the secretary did not get the message about her wanting another appointment made.

To say she was fuming was an understatement.

So, in order to get the DNA rates reduced it takes time and effort from all involved.

Patients have to be more responsible for cancelling appointments and this needs to be dealt with in a delicate manner.

Surgeries and Hospitals need to ensure that if a patient does cancel their appointment that it is recorded and cancelled and the patients does not received a DNA against their name.

Hospitals and Surgeries cannot moan about the amount of DNA’s they have unless they have a policy in order that will actually deal with this when the patients requests to.

And systems have to be in place that these messages are getting through to the right people.

The lady involved felt that no one wanted to listen to her – the operator just didn’t listen to what she was saying which resulted in her being put through to departments that if she had been listened to could have been avoided.

I would suspect that most patients after the first 2 or 3 phone calls would have simply given up trying to cancel the appointment.

Does Your Practice have a 999 Policy


Does your Practice have a protocol on calling 999?

What is your Practice policy if a patient telephones the surgery and it is identified that an ambulance is needed?

Why do you need to have such a policy?

You owe it to your staff to have the correct procedures in place. No one likes to get something wrong – and delaying in getting an ambulance to a patient can have dire consequences.

When I was a supervisor managing a team of Receptionists we did deal with calls that were a matter of urgency – and needed an ambulance. If a Doctor (or in the Doctors absence a nurse) was in the building they would deal with the call.

But there were times that a call would come through and there would be no healthcare professional on the premises. The Receptionist had to deal with the emergency call and quickly.

A good receptionist will pick up on the urgency of a call and in a split second know that an ambulance is needed.

But what happens in your Practice?

  1. Does the Doctor/Nurse/Receptionist ask the caller to call 999 and request an ambulance?

or

2.  Does the Doctor/Nurse/Receptionist call the ambulance?

I fought for our practice to have a protocol put in place for such calls. The Doctors at first did not see a need for it.

Until we had this in place and a patient called in an emergency it might be the Doctor that would call an ambulance or  the Doctor might phone out to Reception and ask a Receptionist to call an ambulance or the Doctor might ask the caller to call 999.

If a Receptionist took the call depending on who took the call and she identified that an ambulance needed to be called she might tell the caller she would phone for an ambulance or another Receptionists might advise the caller to phone 999 them self.

But one thing for sure was that there was no procedure whereby everyone was doing the same.

DOES THE DOCTOR/NURSE/RECEPTIONIST ASK THE PATIENT TO CALL 999?

When I brought this up at a Doctors Meeting they were very keen that we as Receptionists ask the caller/patient to call 999. They felt that this would be less pressure on the surgery staff – and they felt that the ambulance control could phone and speak to the caller/patient if needed.

I disagreed – I asked what if the patient was there on their own and we asked them to phone an ambulance and then they collapsed before making the call – we as a Surgery would have thought it was being dealt with and the patient would not have made the call therefore no ambulance being despatched – leaving the patient in danger.

They suggested that if the caller was on their own then we would make the call. If the patient had someone with them then we would ask them to make the call.

Again, I disagreed – this was not fair on the Receptionists – to ascertain if the patient had someone with them at the time of call – this would take up valuable time and that person might be needed to be at the aid of the patient.

DOES THE DOCTOR/NURSE/RECEPTIONIST CALL THE AMBULANCE?

Yes, I say – every single time.

What I did learn from taking such calls is people are often in a panic – if  a caller is calling on behalf of someone else they might not necessarily have all the patients’ information at hand ie medication they might be on. The caller might be a neighbour and might know very little about the patient.

They often will give you details and THEN you ask them to call 999 and they have to give the information all over again. This delays time when the caller can be with the patient – especially if the patient needs assistance.

Or, if the patient is on their own they are often in a panic. Elderly patients have been known when they put the phone done after being asked to call 999 that they don’t “think” it is necessary and the call has not been made. They often do not like causing a fuss.

You might have a mum with a young child that needs the mother to be with them – asking her to phone for an ambulance takes her away from the child for longer.

In my experience I felt that the caller/patient was happier when we at the surgery phoned 999 on their behalf – it gave the caller time to go back to the patient – or the patient to prepare for the ambulance calling.

The Doctors felt that Ambulance control would rather the call come from the patient – so I contacted them on behalf of the practice. I explained what had been discussed at our recent meeting and ambulance control agreed that they would prefer it if the Surgery was to call in the event of an ambulance being needed.

They felt the Surgery would have all the patients’ records that they needed such as

  • Name
  • Address
  • Date of Birth
  • Telephone number
  • Medical History / Medication
  • Any other relevant information they might require.

Not all of the above might be know to a caller if they are calling on behalf of the patient.

Ambulance control felt that they could get this information quickly from a Doctor or Receptionist, get the ambulance despatch quickly and if they needed to speak to the caller/patient for further information they needed to.

Also, to make a note on the patient records that an ambulance had been called, the date and time the call was made. This could be useful for any of the healthcare professionals when dealing with the patient in the future.

To get this protocol right was important – and for me I had an example of just how this can fail if there is not policy in place

“True Story”

I have a cousin – she and her partner were due to go on holiday the following morning. My cousin’s partner started feeling unwell that afternoon, by tea time he was decidedly a lot worse and seemed to be very unwell – my cousin started to panic as her partner was in a pretty bad state.

She got through to the Surgery, by this time she was really panicking as her partner was drifting in and out and not with it at all.

My cousin spoke to one of the Receptionists – she gave her the details – the Receptionist put her straight through to the Doctor, my cousin went through everything again with the Doctor, the Doctor asked her to phone an ambulance immediately – but what she thought he said was that HE would phone an ambulance for her. She said that her head was all over the place and she was certain that he said he would phone.

She waited over an hour – no ambulance arrived. She phoned the surgery again and it was closed. She was in a fit of panic by this point  – instead of phoning 999 she phoned the out of hours number on the answer machine and had to go through everything with them. She now blames herself that she did not phone 999 instead. The out of hours contacted ambulance control who confirmed that no ambulance had been requested earlier but despatched an ambulance immediately.

The ambulance arrived too late – my cousins partner had died of a heart attack.

 

Had her surgery had a 999 protocol the ambulance would have been called.

Discuss such events at your next Practice Meeting – get everyone following the same procedure.

How do you give out repeat prescriptions at your Surgery?


Do you keep your repeat prescriptions in a secure box? Are they kept near to the reception desk for easy access to give to patients when they are collecting them? Do you lock or secure your repeat prescription box  during the lunchtime and at night? If not you should.

There have been occasions  (not many I am pleased to say) where the prescription box was kept in easy reach of the reception desk and they have been snatched – so always ensure that the box is kept a good distance from the desk to avoid this from happening.

Do you give our prescriptions to people other than the patient? Of course you do – prescriptions are collected for patients by family members, neighbours or carers. In today’s society people work or might be housebound and often cannot get into collect their own prescription – so we all accept that people other than the patient will come in to collect a prescription.

We all like to make things easier for our patients – after all that is what we are there for – we get to know our patients and will often go out of our way to help in any way we can. But sometimes you might think you are doing the right thing – but perhaps you are not – you need to stop and thing before you maybe “offer” that extra help.

Here are two true stories that actually happened to me when I was a Receptionist. On both occasions I thought I was doing the right thing. I thought I was being helpful when in fact I wasn’t – it actually could have backfired and cause a problem. Let me share them with you.

True Story  1

Mrs Joan Morgan came into the Surgery one morning to collect her normal repeat prescription. I went to the box to get the prescription and seen that her daughter Miss Catherine Morgan’s prescription was there too waiting to be collected. Mrs Morgan did not ask for her daughter’s prescription, but had in the past collected a prescription for her as did her daughter for her.

 I knew that Mrs Morgan and her daughter had a good relationship and lived together and they were often in the surgery at the same time. So I had no hesitation is asking her did she want to take Catherine’s prescription at the same time. She said she would.

I gave her the two prescriptions – she looked at the prescription and with a gasp she looked at me and said “I didn’t know Catherine was taking the birth pill”. I realised then that Catherine had not asked her mum to collect her prescription for a reason – the reason being she did not want her mum knowing she was on the birth pill. I realised I had actually broken patient confidentiality. I spoke to my Reception Supervisor and she advised me to telephone Catherine to explain what I had done. Thankfully Catherine was extremely good about it and said that she would speak to her mother when she got home.

It is times like this when you have a good relationship with the patients that you are able to telephone them, explain what has happened and they will understand that you were only trying your best.  I found that by having a good relationship patients they are far more understanding. They know that you are trying to help. You will also find there will be fewer complaints.

True Story 2

Mr Joe Allan came in again one morning asking for his repeat prescription. I went to the box and seen that his son Ben Allan’s repeat prescription was there too.  Aware of what had happened before I checked Ben’s prescription – it was for his asthma inhaler – and again his dad had often picked up this prescription for him. So I thought this time I would be safe – there was nothing confidential on there so I asked Joe if he wanted to take Ben’s prescription as well. He said he would.

Then at 12.55 (five minutes before we closed for lunch) Ben came flying into reception. He asked for his repeat prescription for his inhaler – he had run out and was feeling a bit poorly and needed it. My heart sank – there was no Doctor on the premises as they were away doing their home visits. Ben explained that he was come up to the surgery in his lunch hour and would not have time to go home to get his prescription from his dad.

Luckily enough we had a very good understanding with the chemist across the road from the Surgery and I telephoned them and they said that they would issue Ben with an inhaler as he was a regular customer there and had his records, but on the understanding that he or his dad dropped his original prescription in to them the following day.

Ben dashed over to collect his inhaler

So there are two different examples where I thought I was helping a patient but in fact it led to them having problems because of it.

So from then on in – unless someone  specifically asked for someone’s prescription it stayed well and truly in the box until it was requested.

Telephone Call From a 4 year old


When I was a receptionist I answered the forever ringing telephone early one Monday morning.

I gave the surgery name and followed this with my own name. I was not expecting the reply I received. A young voice came over the telephone asking me “who is that”.

I gave her my name again and straight away asked for her name. She gave me her first name – Holly.  I was very friendly towards her and told her my full name and asked her full name thankfully she gave me this – I was speaking to Holly Smith.

I took a note of the name and tried to keep her attention. I asked the girl where her mummy was and she replied that her mummy was “asleep” upstairs. I asked her if there was anyone else in the house besides her mummy and herself  – she confirmed that her uncle Dave has just left and it was just her and her mummy in the house. Holly seemed to be happy and not upset.

I asked what her mummy was called – she replied “mummy”.  I asked her if her mummy had another name – she replied “yes” “Mummy Smith”.

I asked the girl how old she was and she told me she was 4 years of age. I asked her if she went to school and she told me that she always went after lunch.

I asked Holly where she lived – and she said that she lived “down the road, the house with the blue gate”.

I realised at this point I was not going to get any more information out of Holly – I asked her to go and check her mummy again and to keep hold of the telephone as I wanted to talk to her some more.

She came back on the phone and confirmed that her mummy would not wake up. She then quickly said to be “I have to go now” and put the phone down.

While having the telephone conversation I put Holly’s name into the computer, she was a patient at our surgery and the records showed that she was in fact 4 years of age. It also confirmed that her mum was also a patient at the surgery. We had an address – but there was no telephone number listed.

I went into the duty doctor and informed him of the conversation, he said that he would go around to the house immediately – I also informed the Health Visitor. She said that she would go with the doctor. The Health Vistor knew the family and felt she could be support if needed.

While the Doctor and the Health Visitor were on their way I phoned directory enquiries to see if they had a number listed for that address – they did.

I phoned the number and Holly picked up the phone – I told her who I was and she remembered me. I asked if her mummy was still asleep and she replied “no mummy is taking a bath now”.  I asked her to tell her mummy that I was on the phone – but she replied with “I have to go now”– and put the phone down.

The Doctor and Health Visitor arrived shortly after and found one very embarrassed mum in her dressing gown. They explained what had happened and pleased that all was ok. Mrs Smith said that she would make sure that it didn’t happen again.

Questions:

1.        As a Receptionist would you have done anything differently?

2.       What do you think was important in this incident?

3.       What could be done to make a similar situation easier to deal with?

Answers:

1.        As a Receptionist I felt that I did as much as I could have done in this situation. I  got the information that was needed and from that we were able to confirm that the patient (or her daughter) was not in any danger.

2.        The most important thing is to get a name, a contact telephone number and an address – and if you can a date of birth. Try putting this into the computer as you get the information at the same time to see if they match up.

Try to get as much information as you can.

Speed on such an incident is vital.

Once you have sufficient information ensure that you pass this onto the correct person to deal with (ie duty Doctor / Nurse / Ambulance Control)

If Holly had continued talking to me I would not have disconnected the call – I would have passed this on to another Receptionist to deal with whilst I continued to chat to Holly – it would be better her talking to me rather than being perhaps on her own with a poorly mum to deal with.

If there had been a health care professional in the reception area at the time I would have got them to have taken over the call – but in this instance that was not possible – so I had to deal with the call.

3.        The most important thing from this was to get a telephone number for the family. I had the girl’s name, but no address and if I had not been able to obtain a telephone number we would have been powerless on what to do next – and would have probably had to report it to the police.

The lesson from this was I made notices to put up in the surgery and left leaflets on the reception desk asking patient to update us with their telephone numbers. It was quite scary just how many patients we did not have telephone numbers for – and quite a few that in fact had changes their telephone numbers. 

Also when patient phoned in to make appointments or with any queries I got in the habit of checking if we had a telehpone number for them and updated their records if we did not.

This incident was before we had phones that had caller id– but of course not all numbers come up – some are withheld – so do not rely on this alone.

Have you ever had such an incident in your surgery?

 

 

 

How do you give out repeat prescriptions at your Surgery?


Do you keep them in a secure box? Are they kept near to the reception desk for easy access to give to patients when they are collecting them? Do you lock your repeat prescription box  during the lunchtime and at night? If not you should.

There have been occasions  (not many I am pleased to say) where the prescription box was kept in easy reach of the reception desk and they have been snatched – so always ensure that the box is kept a good distance from the desk to avoid this from happening.

Do you give our prescriptions to people other than the patient? Of course you do – prescriptions are collected for patients by family members, neighbours or carers. In today’s society people work or might be housebound and often cannot get into collect their own prescription – so we all accept that people other than the patient will come in to collect a prescription.

We all like to make things easier for our patients – after all that is what we are there for – we get to know our patients and will often go out of our way to help in any way we can. But sometimes you might think you are doing the right thing – but perhaps you are not – you need to stop and thing before you maybe “offer” that extra help.

Here are two true stories that actually happened to me when I was a Receptionist. On both occasions I thought I was doing the right thing. I thought I was being helpful when in fact I wasn’t – it actually could have backfired and cause a problem. Let me share them with you.

True Story  1

Mrs Joan Morgan came into the Surgery one morning to collect her normal repeat prescription. I went to the box to get the prescription and seen that her daughter Miss Catherine Morgan’s prescription was there too waiting to be collected. Mrs Morgan did not ask for her daughter’s prescription, but had in the past collected a prescription for her as did her daughter for her.

 I knew that Mrs Morgan and her daughter had a good relationship and lived together and they were often in the surgery at the same time. So I had no hesitation is asking her did she want to take Catherine’s prescription at the same time. She said she would.

I gave her the two prescriptions – she looked at the prescription and with a gasp she looked at me and said “I didn’t know Catherine was taking the birth pill”. I realised then that Catherine had not asked her mum to collect her prescription for a reason – the reason being she did not want her mum knowing she was on the birth pill. I realised I had actually broken patient confidentiality. I spoke to my Reception Supervisor and she advised me to telephone Catherine to explain what I had done. Thankfully Catherine was extremely good about it and said that she would speak to her mother when she got home.

It is times like this when you have a good relationship with the patients that you are able to telephone them, explain what has happened and they will understand that you were only trying your best.  I found that by having a good relationship patients they are far more understanding. They know that you are trying to help. You will also find there will be fewer complaints.

True Story 2

Mr Joe Allan came in again one morning asking for his repeat prescription. I went to the box and seen that his son Ben Allan’s repeat prescription was there too.  Aware of what had happened before I checked Ben’s prescription – it was for his asthma inhaler – and again his dad had often picked up this prescription for him. So I thought this time I would be safe – there was nothing confidential on there so I asked Joe if he wanted to take Ben’s prescription as well. He said he would.

Then at 12.55 (five minutes before we closed for lunch) Ben came flying into reception. He asked for his repeat prescription for his inhaler – he had run out and was feeling a bit poorly and needed it. My heart sank – there was no Doctor on the premises as they were away doing their home visits. Ben explained that he was come up to the surgery in his lunch hour and would not have time to go home to get his prescription from his dad.

Luckily enough we had a very good understanding with the chemist across the road from the Surgery and I telephoned them and they said that they would issue Ben with an inhaler as he was a regular customer there and had his records, but on the understanding that he or his dad dropped his original prescription in to them the following day.

Ben dashed over to collect his inhaler

So there are two different examples where I thought I was helping a patient but in fact it led to them having problems because of it.

So from then on in – unless someone  specifically asked for someone’s prescription it stayed well and truly in the box until it was requested.

Disability Awarness and The Reception Desk


Back in 2010 I worked for a private hospital. All the staff from cleaners, receptionists, nurses and Doctors was all just so lovely – a great bunch of staff who all have exceptional customer care skills.

What did surprise me was that very few Receptionists (and some nursing staff) knew what the “nicely designed” reception desks were really for.

When I say “nicely designed” receptionists desks I mean the desks that were there to help assist the disabled, especially people in wheelchairs.

As you can see in the pictures the desks are designed in such a way that a disabled patient, can have easy access to the desk at all times.

The “modern” receptionist desks are usually quite high – this enables the receptionist to sit on a high chair or stand so they are at the same level as the person they are dealing with.

Can you see how difficult it would be for a wheelchair user at this desk?

So why should a disabled person be any different?

By having a lower desk it gives the disabled patient the option to sit at the lower part of the reception desk if they need to complete any necessary forms, or just to talk to a receptionist that is sitting on a low chair face to face rather than the receptionist standing and talking down to them. Its far more patient friendly doing it this way – and asking anyone that is either a receptionist or a disabled patient will both tell you it is a much nicer way to communicate. It is also excellent for confidentiality when the receptionist might be asking the patient some questions.

It is not just wheelchair users that may need this facility – people on crutches would be unable to stand at the higher desk to complete necessary forms, and of course there are others that are disabled that have no signs that they are – but they still may need to sit down to complete necessary forms or just to book future appointments.

So, to my dismay I actually witnessed a Receptionists standing talking down to a patient in a wheelchair at the highest part of the reception desk. The patient was asked to complete a form whereby the receptionist gave the patient a clipboard to balance on their lap whilst they completed the form. Other standing patients were crowding around the patient in the wheelchair and I am pretty sure they must have felt very uncomfortable.

I didn’t want to embarrass the receptionist or the patient so I let it go. But as soon as the patient had finished I asked the receptionist why she though the low part of the reception desk was for. She replied she thought it was just the design of the desk. She then laughed and asked was it was for sitting on!

I had to point it out it was actually there for disabled people to use – to enable them to complete any necessary forms at ease and the receptionist could speak to them at this point and avoid having to stand over and talk down to them – sitting on a low chair they would be talking to them face to face – as they would do with a patient that would be standing at the high part of the desk.

She was amazed and agreed it was a great idea. I asked several other receptionists after this and a good 30% of them were exactly the same and thought that it was just a design factor instead of being there to help the disabled.

Because of this the lower part of the desk designed to assist the disabled had no information leaflets like they had on the higher part of the desk, or pens that were needed to complete necessary forms.

So, do not take it for granted that a new member of staff will be aware of what this part of the desk is for – get your Supervisor or Team Leader to use this in their Reception training and always ensure that the lower desk is as well equipped as the higher part of the reception desk.

Does Your Practice have a 999 Policy


Does your Practice have a protocol on calling 999?

What is your Practice policy if a patient telephones the surgery and it is identified that an ambulance is needed?

Why do you need to have such a policy?

You owe it to your staff to have the correct procedures in place. No one likes to get something wrong – and delaying in getting an ambulance to a patient can have dire consequences.

When I was a supervisor managing a team of Receptionists we did deal with calls that were a matter of urgency – and needed an ambulance. If a Doctor (or in the Doctors absence a nurse) was in the building they would deal with the call.

But there were times that a call would come through and there would be no healthcare professional on the premises. The Receptionist had to deal with the emergency call and quickly.

A good receptionist will pick up on the urgency of a call and in a split second know that an ambulance is needed.

But what happens in your Practice?

  1. Does the Doctor/Nurse/Receptionist ask the caller to call 999 and request an ambulance?

or

2.  Does the Doctor/Nurse/Receptionist call the ambulance?

I fought for our practice to have a protocol put in place for such calls. The Doctors at first did not see a need for it.

Until we had this in place and a patient called in an emergency it might be the Doctor that would call an ambulance or  the Doctor might phone out to Reception and ask a Receptionist to call an ambulance or the Doctor might ask the caller to call 999.

If a Receptionist took the call depending on who took the call and she identified that an ambulance needed to be called she might tell the caller she would phone for an ambulance or another Receptionists might advise the caller to phone 999 them self.

But one thing for sure was that there was no procedure whereby everyone was doing the same.

DOES THE DOCTOR/NURSE/RECEPTIONIST ASK THE PATIENT TO CALL 999?

When I brought this up at a Doctors Meeting they were very keen that we as Receptionists ask the caller/patient to call 999. They felt that this would be less pressure on the surgery staff – and they felt that the ambulance control could phone and speak to the caller/patient if needed.

I disagreed – I asked what if the patient was there on their own and we asked them to phone an ambulance and then they collapsed before making the call – we as a Surgery would have thought it was being dealt with and the patient would not have made the call therefore no ambulance being despatched – leaving the patient in danger.

They suggested that if the caller was on their own then we would make the call. If the patient had someone with them then we would ask them to make the call.

Again, I disagreed – this was not fair on the Receptionists – to ascertain if the patient had someone with them at the time of call – this would take up valuable time and that person might be needed to be at the aid of the patient.

DOES THE DOCTOR/NURSE/RECEPTIONIST CALL THE AMBULANCE?

Yes, I say – every single time.

What I did learn from taking such calls is people are often in a panic – if  a caller is calling on behalf of someone else they might not necessarily have all the patients’ information at hand ie medication they might be on. The caller might be a neighbour and might know very little about the patient.

They often will give you details and THEN you ask them to call 999 and they have to give the information all over again. This delays time when the caller can be with the patient – especially if the patient needs assistance.

Or, if the patient is on their own they are often in a panic. Elderly patients have been known when they put the phone done after being asked to call 999 that they don’t “think” it is necessary and the call has not been made. They often do not like causing a fuss.

You might have a mum with a young child that needs the mother to be with them – asking her to phone for an ambulance takes her away from the child for longer.

In my experience I felt that the caller/patient was happier when we at the surgery phoned 999 on their behalf – it gave the caller time to go back to the patient – or the patient to prepare for the ambulance calling.

The Doctors felt that Ambulance control would rather the call come from the patient – so I contacted them on behalf of the practice. I explained what had been discussed at our recent meeting and ambulance control agreed that they would prefer it if the Surgery was to call in the event of an ambulance being needed.

They felt the Surgery would have all the patients’ records that they needed such as

  • Name
  • Address
  • Date of Birth
  • Telephone number
  • Medical History / Medication
  • Any other relevant information they might require.

Not all of the above might be know to a caller if they are calling on behalf of the patient.

Ambulance control felt that they could get this information quickly from a Doctor or Receptionist, get the ambulance despatch quickly and if they needed to speak to the caller/patient for further information they needed to.

Also, to make a note on the patient records that an ambulance had been called, the date and time the call was made. This could be useful for any of the healthcare professionals when dealing with the patient in the future.

To get this protocol right was important – and for me I had an example of just how this can fail if there is not policy in place

“True Story”

I have a cousin – she and her partner were due to go on holiday the following morning. My cousin’s partner started feeling unwell that afternoon, by tea time he was decidedly a lot worse and seemed to be very unwell – my cousin started to panic as her partner was in a pretty bad state.

She got through to the Surgery, by this time she was really panicking as her partner was drifting in and out and not with it at all.

My cousin spoke to one of the Receptionists – she gave her the details – the Receptionist put her straight through to the Doctor, my cousin went through everything again with the Doctor, the Doctor asked her to phone an ambulance immediately – but what she thought he said was that HE would phone an ambulance for her. She said that her head was all over the place and she was certain that he said he would phone.

She waited over an hour – no ambulance arrived. She phoned the surgery again and it was closed. She was in a fit of panic by this point  – instead of phoning 999 she phoned the out of hours number on the answer machine and had to go through everything with them. She now blames herself that she did not phone 999 instead. The out of hours contacted ambulance control who confirmed that no ambulance had been requested earlier but despatched an ambulance immediately.

The ambulance arrived too late – my cousins partner had died of a heart attack.

 

Had her surgery had a 999 protocol the ambulance would have been called.

Discuss such events at your next Practice Meeting – get everyone following the same procedure.