In UK, NHS medical emergencies calls are often answered by nurses or call advisers who have completed a brief training course. They are used to help reduce cost, visits to hospitals and family practice. Today, various newspapers have criticized NHS emergency because a study found the number of calls to ambulance service and visits to hospital has increased. I find this is unethical because the service will offer false reassurance, delay in diagnosis that result in complications and also increase avoidable anxiety for referring common medical symptoms.
http://www.dailymail.co.uk/news/article-2227374/Dial-111-A-E-shambles-Flagship-new-NHS-phoneline-actually-INCREASES-ambulance-outs--PM-savaged-closures.html?ito=feeds-newsxml
With regards to call centres the advice given will always tend to err on the side of caution. This may well increase the referrals / attendances at local hospitals and GP practices. From my experience working in Yorkshire for five years after the introduction of NHS direct did not lead to and reduction in inappropriate attendances. If anything they seem to increase. I would much rather that hospitals are adequately resourced including placing a senior doctor in Triage with the triage nurse. A lot of conditions can be managed extremely efficiently in this manner, fractures can be excluded, inappropriate attenders can be turned around with minimal impact on the health service and they can be educated on this. When I worked in West Yorkshire we showed that the average waiting time for all patients was reduced by at least one hour by placing a senior doctor in Triage to deal with the minor cases. Of course the minor patients benefitted the most but even major cased benefitted by one hour. Regards Richard
With regards to incorrect advice, treatment or diagnosis: The culture in recent years head been one of open disclosure to the patient regarding any errors which might cause harm. The question is who informs the patient and when.
In my opinion it depends on several factors; what is the severity of harm which has or is likely to occur? is the staff member still working in that unit? Urgency of situation, Is the the person likely to be receptive to being informed that they have made an error? Who should tell is also important: The person who has erred, the person who identifies the error, senior management or medical director. There are so many permutations that it is important to have a policy in place so that everyone is treated equally, regardless of position, and not feel like they are being victimised. I hope this gives an insight to my personal views. Richard
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