For health advice it’s not 111, it’s “Phone First”…

 

There’s an important transformation happening to our emergency health care. You might have heard about it on the local news/radio but it’s possibly been drowned out by the sheer volume of other headline-grabbing news. It’s not deliberately in the background or being introduced by stealth. It’s just got a lot of competition like the vaccine and Brexit innit.

This change is something called “Phone First”, part of No More Silos, an initiative borne from how our health service came together in an unprecedented way just a few short months ago to face the huge challenge of COVID-19.

The concept is that instead of always calling 999, in some cases we are being asked to phone first (geddit?) and get advice on what is the most appropriate course of action to take. It’s not region-wide yet, it’s being rolled out in the Northern Trust area & Southern Trust area.

This handy infographic is from The Northern Health and Social Care Trust website, I’m using this as an example so please check what’s happening in your local area.

Eyes down, look in, read and digest.

No, it’s not just NI’s version of 111, your call will be triaged by a medical professional and you’ll be directed to the most appropriate place for treatment. Still not sure? Read the infographic again. Search online and on social media to see what’s happening. Keep going until you get it.

This is such an important change and needs our close attention. We collectively somehow have to understand the new system and file this crucial and perhaps confusing information away for speedy retrieval, should a medical crisis arise.

So, are you with me so far? Are you any the wiser, or is it as clear as mud? I didn’t make the policy up, I’m not implementing it, I’m just a middle-aged woman sitting writing this piece, who is starting to regret ever thinking she could explain this, asking you to notice this, do your research and figure it all out.

You may be under the impression that a blind man on a galloping horse could spot a medical emergency. Actually it isn’t always glaringly obvious and unless you’re a medical professional you may not necessarily recognise an emergency without the theme tune to “Casualty” playing in the background. I have personal experience of this and without the advice of the GP on the Out Of Hours phone line I wouldn’t have known how serious it was. It was before the days of Phone First and it happened in the evening so I phoned the Out of Hours service.

The conversation went something like this,

Me: lists symptoms

GP: questions

Me: answers

GP: GET THEE TO THE HOSPITAL PRONTO QUICKO.

So we got there, emergency surgery was needed and a few hours later we were back in the ward. All hail the HSC! (This is your regular reminder that we don’t have the NHS in NI.)

Here’s an “Phone First” explainer taken From the Northern Trust online,

“Head of General Medical Services at the Health and Social Care Board, Dr Margaret O’Brien, explained why the roll out of the Phone First service was so important. Dr O’Brien said: “With the impact of the COVID-19 pandemic in our community, it is more important than ever that patients who need emergency treatment aren’t asked to wait in crowded waiting rooms where they may be exposed to the virus.

The ‘Phone First’ service aims to keep our over stretched EDs for emergencies, whilst ensuring rapid access, assessment and treatment on a 24/7 basis for patients who need urgent care.” Dr Mark Jenkins, an Emergency Medicine consultant at Antrim Area Hospital added: “The rollout of the Phone First service will improve patient safety in terms of preventing overcrowding and reducing long waits in our EDs and Minor Injuries Service. It will also help reduce the risk of Covid-19 infection and transmission.

“We need your help at this extremely difficult time and I encourage patients to please ‘Phone First’ if your condition is not life threatening. However, if it is an emergency, if the situation is critical or life threatening then please always ring 999 immediately.” Emergency Department Consultant from Belfast Trust, Dr John Maxwell, who is co-chairing a major drive to enhance emergency and urgent care, alongside Dr O’Brien said: “No one working in an Emergency Department wants to see overcrowded waiting rooms full of sick and injured people many of whom could be treated elsewhere in a more appropriate setting.  That is particularly true right at this minute when everyone is so aware of the need to maintain infection control standards.”

You may be wondering about costs and budgets. This is a new service, which obviously costs money, so will other services be reduced due to having to cut costs? Is this the end of A&E as we know it? Well, I don’t know but it would appear that this move is to try and streamline emergency services, not to close them down.

So what about the GP Out of Hours service? Again, this is from the Northern Trust,

“What’s the difference between Out of Hours and this new service?

The Phone First service is available 24/7 for people with conditions that may cause them to consider travelling to the Antrim Area or Causeway Hospital Emergency Departments EDs or the Mid Ulster Hospital Minor Injuries Unit.” Don’t ask me, I didn’t write it.

I’m biased so without shame I’m going now to share with you what’s happening in my local area, The South Eastern Trust. In particular my local doesn’t-have-an-accident-and-emergency-hospital, The Downe. But wait, we have this-it’s an Urgent Care Centre, that you phone first. *SOUNDS THE KLAXON OF CONFUSION* ….THIS IS NOT THE SAME THING AS “PHONE FIRST” AND YES, I AM SHOUTING!!

From the SE Trust website,

“The Emergency Department is currently closed due to Covid-19. From 19 October 2020 , a consultant-led Urgent Care Centre will open in the Downe Hospital’s Emergency Department. This will operate from 8am-6pm, Monday – Friday on an appointment only basis, with nurse-led minor injuries services continuing at weekends from 9am to 5pm. The telephone number for the Urgent Care Centre is (028) 4483 8091. Those contacting the service will be triaged and offered an appointment within the urgent care service or directed to the most appropriate service. Access is by the same entrance, clearly marked and to the right of the main entrance. Medical patients can be admitted to the Downe Hospital by doctors staffing the Out of Hours service.

If you are seriously ill, phone 999 for an ambulance, as normal. The ambulance will take you to the Ulster, or another appropriate hospital.”

I’ve been more aware of this initiative due to my involvement as a service user/punter on various Health and Social Care groups. In my last piece about this type of work I mentioned how one of the current soundbites is to “unmute the voice of the service user”. It might surprise some Slugger readers that unmuting the voices of service users is at times only acceptable if those voices are ones of superficial compliance. A churlish/fun behaviour would be for me to change my Zoom/Webex/Teams profile photo with its handy reference to having a hidden disability to an image of me in a box with a big tick over my face. But that would be childish, right? Despite my cynical approach I do have hope, I wouldn’t be involved if I didn’t think it was worth it. Involvement is developing and growing and we all have the opportunity to help shape and support our local and regional health care facilities.

I didn’t write this to confuse or bamboozle anyone. If I have inadvertently done that I can only apologise, send you back to your internet search engine of choice and wish you luck, you’ll need it.