More harsh words come today for the NHS’s 111 helpline, this time in the form of a damning critique on page two of The Times. A study by the University of Cambridge, the results of which feature in the paper today, involved recruiting a GP to review the outcomes of 1,474 cases that had been dealt with by the NHS 111 service, and resulted in the call handlers sending the caller to A&E. The outcome of the investigation was alarming; with the team revealing that the GP would have sent only 400 of the callers to the hospital, with the other 1,074 cases more suited for a referral to the local pharmacy or their local out-of-hours GP service.
This story follows a comment made earlier this year by Dr Clifford Mann, president of the Royal College of Emergency Medicine, blaming the 111 service almost entirely for the rise in A&E admissions in 2014.
Introduced in early 2014, the service replaced NHS Direct, due to what the Department of Health called ‘confusion’ over what service to use in a non-emergency medical situation. Since its roll-out the scheme has faced much criticism, from health officials and the public alike. In June this year it was the target of a Telegraph undercover investigation which revealed that not only had the medically-unqualified call handlers been altering answers provided by patients to avoid having to send ambulances, they had also been fiddling with the computer data to make it appear that their ambulance response times had been met.
The investigation went further. The Telegraph found that overworked, exhausted staff were missing serious symptoms, the computer software used as a checker for these symptoms often didn’t match the call handler’s opinion of the scenario and staff were watching films and television programmes between calls.
It begs the question: is the service fit for purpose? The idea behind utilising a non-emergency helpline is to create a patient filter for NHS provisions, instead of the injured or unwell directly visiting Accident & Emergency, overburdening hospitals when their condition could be more effectively dealt with by their GP or a pharmacy. The 111 service, however, appears to be not just ineffective, but also dangerous. Indeed, one call handler without medical qualifications was caught telling an undercover Telegraph journalist “if it’s a sure-fire heart attack you would send it [the ambulance], but…you can get out of sending ambulances with chest pain quite easily”.
A streaming system for the NHS is fundamentally a good idea, if it successfully reduces the pressure on Britain’s hospitals whilst ensuring the best outcome for the patient. But the NHS 111 service has shown itself to lack both qualities, so we have to ask, is it time to call time on the scheme?