When Kim Green’s husband lay dying of cancer last week, she expected to spend his last hour holding his hand. Instead, she passed that time stuck on the telephone to the new NHS helpline number, 111, trying vainly to arrange for a nurse to come and administer him pain-relieving drugs. Sadly this is not a solitary scandal but one of 22 so-called “serious untoward incidents” being investigated in relation to the helpline, which was set up to replace the old NHS Direct and out-of-hours numbers for GPs.
Like so many botched health reforms, the idea behind the introduction of NHS 111 – to ease pressure on 999 services and cut the flow of non-emergency patients to A&E departments – sounded reasonable. Too many people with non-threatening conditions have started heading for their nearest A&E as a first port of call. The problem with NHS Direct, among other things, was that staff were unable to summon ambulances on behalf of callers.
But the gap between a good idea and its execution has turned out to be wider than anticipated. The British Medical Association warned in late March that the system was not ready. In a letter to the NHS chief, Sir David Nicholson, it expressed concern about “reports of patients being unable to get through to an operator or waiting hours before getting a call back”. The GPs’ magazine, Pulse, said some 111 helplines were so understaffed that operatives were being hired at a moment’s notice, which will not have reassured callers about the worth of the advice they were likely to get. The Government should have paused.
Instead, it pushed ahead with the scheme. Not before time, NHS England has ordered a review – too late for those who may have died as a result of wrong advice, delays or the system crashing. The case for a more joined-up service than NHS Direct was able to provide remains strong. It is ruined if patients fear that quality is being sacrificed to the needs of an arbitrary timetable.
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