A rough guide to the 111 non urgent NHS call service.

Hangin’ on…

I’ve been very critical of the new ‘111’, service since it started in some regions in April this year.

Life has a habit of making fun of us all; I’ve had to use the service twice in the last month, which probably serves me right.

I’ve always been completely honest in my Blogs – so it’s time for an honest review of the service.

Although I’ve been doing the calling, I’ve been doing it on behalf of someone else, so there will be no details that could identify anyone. Wherever I’m a bit vague it’s because I was in an emergency situation and didn’t have doing this in mind at the time!

Call 1).

Answered: fairly quickly.

Description:

Call Centre operator about 10 minutes.

Separate call back from a Nurse lasting about 10 minutes.

Result: Attendance by emergency callout Doctors, which prevented an A and E attendance.

Call 2).

Answered: Fairly quickly.

Description:

Call Centre Operator: about 12 minutes.

Separate call back from a Nurse lasting 15 minutes.

Result: The Nurse carried out a complex calculation which indicated that an 999 callout and A and E attendance wasn’t needed.

 

You can (I hope) work out from this that the medical advice from the experienced Nurses was excellent, and in both cases prevented a difficult attendance by ambulance to A and E. This saved the NHS money, freed up two ambulances, reduced other peoples waiting time at A and E and improved life for patients, Doctors and Nurses.

Problems:

The service we got was pretty much the same as we used to get from NHS Direct which was entirely staffed by Nurses – because I ended up having two lengthy conversations with nurses.

The new system employs far fewer nurses, calls are taken by unqualified people, using a computer programme with a series of prompted questions which I am now getting very familiar with – all warning signs for serious problems which need help quick.

While this may have the effect of filtering out silly timewasting calls, I actually doubt that there are so many of these. All my research on A and E attendances tells me that the number of unnecessary attenders are exaggerated.

NHS Direct has just announced that the organisation is quitting its franchises to supply services to ‘111’, because the volume of calls breaches the terms of its contract.

The real reason is that the duration of calls and the need for fully qualified staff makes it uneconomic.

NHS Direct assumed that it would receive about £20 a call, in fact it’s been paid £8 to £12 and cannot afford to lose that kind of money.

If you look at my calls; I rang ‘111’, because I already had doubts that we needed an ambulance but I wasn’t qualified to make that decision.  As a result, both were long, both needed a qualified Nurse and both would have lost the provider money. It worked well for us, but in a real emergency I wonder whether the extra time spent on the first part of the 111 call could have unfortunate results?

Conclusion

Good quality service, time wasted on talking to unqualified staff is not a problem unless it is a real emergency.

Back-up Nurses are vital to the service – if there are enough it will be an uneconomic contract. If the provider reduces the qualified staff to save money, the service will become useless.

 

Neil Harris

(a don’t stop till you drop production)

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