From The Times 16.4.13, and since this was published I have received numerous emails and letters from Times readers berating their experiences when using 111. Even accounting for reporting bias, their experiences suggest the service may be in more disarray than I thought. Perhaps the most ridiculous complaint was that from a daughter of an elderly woman in a nursing home. The staff had contacted the out-of-hours GP service (run by 111 in that area) to speak to a doctor for some advice but ended up going through a set of questions with a 111 operator who promptly called an ambulance. The ambulance took the lady to the nearest A&E department where staff were perplexed as to why she was there and arranged for her to be sent back but the ambulance had been called elsewhere so she was admitted. A complete fiasco that could have been avoided with a two minute conversation with a doctor.
Anyway, if you have never heard of 111 – as many haven’t – here is an overview of what to expect. And, hopefully, your experience will be better should you ever need help.
The last thing a beleaguered NHS needs is more change but that is exactly what it has had thrust up on it in the spades this month. Not content with the biggest administrative reforms in the 65 year history of the service, NHS England has decided to try and introduce a new way of accessing urgent care – NHS 111 – and all in the week after the Easter Bank Holiday. What could possibly go wrong?
According to the bumpf accompanying the launch of the new 111 number will “make it easier for the public to access healthcare services when they need medical help fast, but it is not a life threatening situation”. And it provides a one-stop-shop “that ensures people receive the right care, from the right person in the right place at the right time”. Put simply, if your GP surgery is shut, your problem isn’t urgent enough to dial 999 and you are not sure if you should go to A&E, you dial 111.
Well that’s the theory anyway. Cynical doctors and nurses have been forecasting problems ever since the scheme was announced, and time has proven them right. The launch of the service has had to be aborted in parts of the country, including Manchester, Shropshire and South London, because the new service simply couldn’t cope, or wasn’t ready.
Indeed roll out has now been postponed in half the 46 regions across England after people have been left waiting hours for answers to their queries, and ambulance services have been overwhelmed as desperate callers resort to 999.
I have tried my local 111 service on several occasions and, to be fair, my call has been answered in seconds each time, but that was during working hours when staff are likely to be at their quietest. What concerns me about the recent teething troubles is that the service has struggled despite most of the public never having heard of 111 – if those running it can’t manage with a soft launch ahead of a national awareness campaign, then the future doesn’t look bright. Scotland, Wales and Northern Ireland must be watching with interest.
NHS England says it is aware of difficulties in some areas, but measures are already in place to deal with them and that roll-out will continue across the rest of the country, but only when everyone is ready. So, assuming initial wrinkles are ironed out, what can we look forward to?
Well the new service replaces NHS Direct (0845 46 47) and will be run by different organisations in different regions– everyone from GP out-of-hours cooperatives and local hospital trusts, to ambulance services and private companies, depending on whose tender was accepted.
Your calls will be taken by trained staff (although perhaps as not as well trained as some hoped) and triaged using a computer based system to assess your needs and determine the most appropriate action. Staff can refer on to qualified nurses where required, and resulting actions may vary from dispatching a blue-light ambulance, to providing simple reassurance and advice on self-care (take two paracetamol and go to bed). And all that goes inbetween including onward referral to out-of-hours GPs or the local A&E department (staff will, in some circumstances, be able to book appointments at GP surgeries and urgent care clinics while the caller is on the phone).
The idea is that you only ever need remember three numbers. 999 for life threatening emergencies such as chest pain, someone collapsing, or a serious road traffic accident. The number of your local GP surgery for routine problems like troublesome backache, an itchy rash, a sore hip or discussing the pros and cons of HRT. And 111 for everything in-between, or for when your GP surgery is closed (in my part of the country, Gloucestershire, out-of-hours calls to surgeries are now directed straight to 111).
To find out more about how to use the NHS 111 Service and to see if it is up and running in your area, visit www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx
The NHS 111 Service is accessed by dialing 111 from any landline or mobile phone. Calls are free and the service is available 24 hours a day, 365 days a year for people:
• Who need medical help fast, but it is not a 999 type emergency
• Who don’t have a GP, or know who to call
• Who think they need to go to A&E or another NHS urgent care service
• Or, who require health information or reassurance about what to do next
People living outside areas with the new 111 service will continue to use NHS Direct on 0845 46 47 (NHS 24 in Scotland 08454 24242).