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News : New Row over Wiltshire 111 Health Line Call Outs
Feb 26, 2014 -- Paramedics in Wiltshire say they can spend their entire 12-hour shift attending inappropriate 111 calls.
The non-emergency 111 telephone line is for the public to get advice about a medical problem.
A year on from its launch in Wiltshire, paramedics say they are still being sent to patients who call 111 but who do not need an ambulance, as they are suffering from ailments including rashes, sore throats, constipation and headaches.
Last month it was revealed that in Wiltshire South Western Ambulance Service had failed to meet response time targets for life-threatening calls for nine consecutive months.
An experienced paramedic working in Wiltshire said before 111 was introduced a typical 12-hour shift would have about five jobs. Now, paramedics could be attending up to 15 jobs, with a significant number being 111 calls.
The paramedic said: "During a shift all the calls that paramedics attend can be 111 calls, other times it can be 80 to 90 per cent.
"Weekends is the worst time, we can get 50 per cent of calls as 111 calls but every day we are being sent to 111 calls that are classed as emergencies and they are jobs that a doctor should be doing. The odd one is appropriate.
"Even though we shouldn’t be going to these patients we still have to do tests on them. It can take 40-50 minutes to do all the checks meaning we are unable to respond to genuine 999 calls. 111 is an absolutely dreadful system. Morale is horrendous. Staff are leaving because they cannot cope with the volume of work. People are burnt out.
"I fear that patients who require a 999 response could die because the crews are dealing with inappropriate calls."
Ian Whittern, chairman of Unison for Wiltshire, Avon and Gloucestershire, said his information was that 35 per cent of calls to the ambulance service at weekends were 111 calls. He added: "We are concerned that 111 doesn’t necessarily have the staffing at weekends."
In Wiltshire, 111 is operated by private firm Harmoni from a call centre in Bristol.
Dr David Lee, National Medical Director for Harmoni, said: "Our ambulance dispatch rates are carefully monitored by local commissioners and at a national level so there is a very strong structure in place to identify if ambulance dispatch rates become higher than expected.
"I cannot comment on the anecdotal and unsubstantiated views of individual paramedics. We are in very regular contact with our commissioners, reviewing performance and making amendments to the service as and when deemed necessary to promptly remedy any unwelcome trends which may develop.
"This ongoing communication is an essential part of ensuring the service performs efficiently and within national guidelines.
"Data shows us to compare favourably with other 111 providers in the respect of ambulance dispatches. Locally, during the past three months, our ambulance dispatch rates have averaged around the 10 per cent mark, which is the national benchmark.
"It should also be remembered that a fundamental element of the NHS 111 service is to be able to dispatch an ambulance without delay when deemed the appropriate response."
A statement from South Western Ambulance Service NHS Foundation Trust (SWASFT), said: "The number of calls transferred from NHS 111 to the ambulance service remains an issue, particularly since the majority of these transfers occur during periods of peak activity, such as weekends.
"On average 15 per cent of all 999 calls received by SWASFT in Wiltshire are NHS 111 calls, although this figure increases at weekends to 25 per cent on average and up to as much as 40 per cent during peak hours. An internal audit of NHS 111 transferred calls suggests that a number are inappropriate and need not be transferred."
The spokesman added that the trust was working with Harmoni to review and agree arrangements for call triage and transfers.
The Clinical Commissioning Group, which jointly commissions the 111 service from Harmony, said it could not comment on the validity of anecdotal remarks made by ambulance personnel.
Its spokesman added: "However there are some concerns about the proportion of calls to 111 transferred to the 999 services and Harmoni has been made aware of those concerns.
"Commissioners acknowledge that Harmoni is taking steps to address its performance on the numbers of calls transferred to ambulance service and they are being supported in this by the CCGs.
"In order to ensure on-going patient safety and quality of service, commissioners have asked Harmoni to demonstrate that their actions will contribute to the improvement of the ambulance dispatch rate."
Posted by Veronica Silva Cusi, news correspondent
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Published: Monday, March 3, 2014