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News : Many Patients Call the 111 NHS Hotline and End Up at A&E
Sept 15, 2014 -- Hundreds of extra patients a week are being sent to North Staffordshire's under-pressure A&E unit – by a new NHS hotline designed to keep them away.
The 111 service was launched last year to help people suffering from non-emergency conditions who wanted medical advice.
But new figures show the hotline is to blame for an increase of up to 50 extra patients ending up at the University Hospital of North Staffordshire's accident unit every day.
Now NHS officials from the region's clinical commissioning groups (CCGs) have started eavesdropping on people's calls to 111 to find if they are being wrongly directed to the hospital.
The extra workload is one of the reasons why the university hospital is falling short of Government targets to treat or admit 95 per cent of A&E patients within four hours.
Doctors in charge of the CCG believe the 111 operators needlessly call an ambulance or send to A&E because they are too afraid of the consequences of not doing so.
GPs are to sit in the Stafford control centre to try to stop it happening.
CCG operating officer Sandra Chadwick said: "These all seem to be unintended consequences of the 111 service.
"There is un-validated data suggesting that its launch has increased A&E attendances and ambulance journeys to UHNS by 40 to 50 a day. Work is going on to understand exactly what is going on there."
Goldenhill GP Dr Chandra Kanneganti, a CCG clinical director, said: "NHS 111 is still a new service and we are studying it closely to ensure it provides the best possible service for patients.
"We have carried out a number of pilots which have included having GPs based in the call centre, and while we recognise that NHS 111 has had some impact locally, it is not the sole contributor to the increased activity.
"Following a review of the calls by clinicians we found that in some cases the script used by call handlers is too risk averse, triggering an ambulance call or A&E outcome when it isn't always needed.
"We have now recommended that a number of changes are made to ensure people get the most appropriate advice, while maintaining clinical safety at all times."
The 111 service was launched in Staffordshire in April last year by NHS Direct which then pulled out for financial reasons. It was taken over by GP out-of-hours agency Staffordshire Doctors Urgent Care (SDUC) and re-launched.
Health campaigner Ian Syme is not surprised by the issues.
The North Staffordshire Healthwatch co-ordinator said: "Since NHS Direct was dismantled and effectively replaced by 111 there have been considerable teething problems. "It's quite obvious to me that the people who are being trained to answer the phones do not have sufficient clinical knowledge to take those calls.
"If the operator feels uncomfortable about giving advice, they are more likely to send people to A&E in greater numbers.
"A better degree of training is needed to improve the 111 service.
"The NHS Direct service did offer clinical advice and they had a higher degree of local knowledge. I know one person who rang the number to find the operator didn't even know about the walk-in centre in Leek. Improving training and resources will improve its effectiveness."
Posted by Veronica Silva Cusi, news correspondent
Today's Tip of the Day - Where Is The Problem?
More Editorial From NHS Direct
About NHS Direct:
NHS Direct is a 24 hour health advice and information service provided by the National Health Service (NHS) in England. NHS Direct provides confidential access to medical information, guidance and reassurance through a range of interactive services. These include an expert telephone advice line and detailed web resources.
Published: Tuesday, September 16, 2014