Doctors say NHS 111 giving wrong advice and not enough patients being tested for virus

This article is more than 6 months old

This article is more than 6 months old

NHS doctors have told the Guardian of their experiences of the government’s handling of coronavirus, warning that they have concerns about how patients who may have been infected are being managed.

James*, a GP in Derbyshire, where one of the latest British coronavirus cases is thought to have been located, described the Department of Health’s response to the virus as “ridiculous” and “negligent”.

He said none of his patients who had travelled back from at-risk countries had been given any information at airports or sea ports on what to do if they developed symptoms of coronavirus.

James said his practice had seen patients arriving back from affected areas, some of whom had been on cruises around many regions experiencing coronavirus outbreaks, who had not been given any information on what to do if they developed symptoms.

Other patients reported flying back from the affected countries and finding there was no information on arrival at Heathrow regarding public health advice.

The lack of information has led to many booking appointments with their GP, which risks infecting other patients with weaker immune systems. “It’s a no-brainer, the government need to tell those who are coming back what to do,” James said. “They’ve missed almost everyone at this stage of arrivals.”

Despite his surgery website and posters clearly instructing people who have travelled to affected regions in recent weeks not to enter the GP practice, James said some patients have “breezed past our bright yellow posters suggesting they stay at home”.

“There seems to be an attitude of: ‘We don’t care if we infect a whole GP surgery full of people,’” he said.

Q&A How can I protect myself and others from the coronavirus outbreak? Show Hide The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the coronavirus, for which there is no specific cure or vaccine. The UN agency advises people to: Frequently wash their hands with an alcohol-based hand rub or warm water and soap

Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing

Avoid close contact with anyone who has a fever or cough

Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers

Advice about face masks varies. Wearing them while out and about may offer some protection against both spreading and catching the virus via coughs and sneezes, but it is not a cast-iron guarantee of protection Many countries are now enforcing or recommending curfews or lockdowns. Check with your local authorities for up-to-date information about the situation in your area. In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

While many patients had followed Public Health England’s advice to stay at home and call the NHS helpline 111 after returning from affected areas, “some had been told to go into the GP practice”, James said.

“The helpline later claimed this advice was given in error, saying that the patient must have selected the wrong telephone answering choice,” he added.

Online bookings were proving a further obstacle in the practice’s attempts to prevent the spread of the virus.

James’s GP surgery is contractually obliged to offer online booking services, which means they cannot prevent those with symptoms from getting appointments at the practice.

James and his colleagues contacted Derbyshire’s clinical commissioning group to try to stop online bookings until after the outbreak had passed, but were told they could not do so until a coronavirus case had been confirmed in the region. It is unclear how Thursday’s confirmed case will impact the practice.

“It strikes me as closing the stable door a decade after the horse has bolted,” he said. “The whole approach is as leaky as a sieve.”

In south London, one GP practice criticised the government’s response to the virus, after two parents – one of whom had travelled to a number of affected areas in Asia and become sick for a short time afterwards – called the practice after the infant developed symptoms of coronavirus.

A GP at the practice called NHS 111 on the parents’ behalf, but was told the family must call themselves to get help. When they called the helpline, the family were told to attend a GP hub centre, a service to which 111 regularly refers callers, which is not specific to coronavirus.

“They could absolutely have infected other people there,” said Sarah*, a GP who works at the practice where the family first arrived.

On arrival, the family were turned away as no appointment had been booked. After calling the helpline again, they received the same advice, but were again turned away after arriving at the centre.

The doctor they saw on their third attempt reportedly neglected to consider the family’s travel history and diagnosed the infant with a different illness – without testing them for coronavirus.

“It’s a catch 22,” said Sarah. “The government aren’t doing one thing or the other. They’re not containing it, like they did in China, and they’re not testing for it. They have no idea of the problem.”

“It’s the worst of both worlds, and they’re causing panic,” she added.

Emma*, a doctor at a hospital in London, recently returned from a holiday near northern Italy, where the coronavirus has broken out.

Her daughter, Alice*, developed symptoms of the virus, and she called the 111 helpline three times. They eventually told her to attend her GP surgery – advice that contradicts Public Health England’s guidance to stay at home.

The GP instructed them to visit A&E, but the hospital where Emma works refused to test Alice for the virus because their holiday destination fell just 50 miles outside of the affected area. Alice eventually tested positive for the flu, but Emma fears their reluctance to test for coronavirus could facilitate its spread.

“The affected areas change all the time, so how can you refuse to test on those grounds?” Emma asked. “When I first became worried about Alice, northern Italy didn’t have an outbreak at all. You won’t be able to catch the virus and isolate people if you don’t test them.”

A spokesperson for the Department of Health and Social Care said: “We have been clear from the outset that we expect coronavirus to have some impact on the UK and a global pandemic could have a pronounced effect on the NHS, which is why we are planning for every eventuality.

“Public safety is our top priority and we have a team of experts and scientists working round the clock to make sure the NHS and UK is fully prepared.

“We have introduced enhanced monitoring at airports and health advice leaflets are available for every flight into the UK. The public can be assured we are following tried and tested procedures to protect the public, NHS staff and patients.”

*Names have been changed.