Susan Longden
18 Dec 2018 · Coroner Peter Harrowing · Avon
The coroner's concerns
1. lack of question about recent procedures
“The NHS Pathways algorithm does not include a question with regard to recent surgical or interventional procedures where a patient is reporting severe abdominal pain. The close association in time between such a procedure and the onset of symptoms may well be significant in ensuring prompt action is taken to investigate the cause of the symptoms.”
2. reliance on caller information
“Where the caller to NHS 1114 is not the patient then the Health Advisor continues to follow the algorithm by obtaining information from the caller and not the patient. There should be greater emphasis on trying to speak with the patient and the reason(s) why the patient cannot came to the telephone. The information provided by the patient themselves and the manner in which that information is provided may well affect the outcome of the triage process.”
3. repeated concerns not acted upon
“During the course of the Inquest I heard evidence (ror EE Medical Lead, SW111 Care UK,that concerns have been raised with y; organisation on previous occasions. The case references provided y are P130273, P132849 and P133040”
Responses
2018-0394-Response-by-NHS-Digital.pdf ↗· NHS Digital
Stated action · 1st May 2019
“NHS Pathways is built on a clinical hierarchy of symptoms, meaning that life-threatening symptoms are prioritised and assessed through our initial set of questions (known as module 0). Within these algorithms we specifically look to identify the symptoms and signs of life-threatening conditions, including bleeding, by asking about conscious level, fitting and choking, breathlessness, cool, cold, clammy skin and pallor. Specific questions about the many individual conditions that could lead to”