Dial 111 for A&E shambles: Flagship new NHS phoneline actually INCREASES ambulance call-outs... as PM is savaged over closures

One vision: An NHS poster promoting the new phoneline

A new non-emergency telephone number to relieve pressure on 999 has increased the number of ambulance call-outs and failed to reduce the number of people attending A&E departments, according to an official report. The planned national roll-out of NHS 111 for non-urgent calls has been one of the flagship health policies of the Coalition Government. It believes the move will shave millions off the health budget by phasing out the costly £123 million-a-year NHS Direct.

The Coalition also hopes the new 24-hour freephone number will save money by directing patients to GPs or urgent care services rather than clogging up casualty units. But the official independent report commissioned by the Department of Health a year after the first pilot schemes were introduced has found they have not delivered as hoped. The report also says that NHS 111 could actually increase costs for the taxpayer as, in the pilot schemes, it directed more patients to use emergency and urgent care services.

 

Threat: 14 casualty departments have either closed or are threatened with closure

In the four pilot sites alone, it is estimated the helpline costs the NHS £307,000 a month. If rolled out nationally – as planned by Ministers for 2013 – it could save taxpayers £2.5 million on the health budget. But – in a worst case scenario – it could cost as much as an extra £7 million, the study said. The report, by academics from the University of Sheffield’s School of Health and Related Research, said: ‘An expected benefit [of NHS 111] is that efficiency in the urgent and emergency health care system will be improved by directing people to the right level of care.

 

Threat: 14 casualty departments have either closed or are threatened with closure

'For example, directing people with urgent problems away from emergency services to urgent care services that are more appropriate to clinical needs. There is evidence of an increase in emergency ambulance incidents, which requires investigation by NHS 111. Otherwise, the expectations that NHS 111 would shift use from emergency to urgent care when appropriate appears not to have been achieved in the first year of operation.’

The study looked at the number of calls to ambulances and attendances at A&E at four pilot sites in Darlington and Durham, Nottingham, Luton and Lincolnshire before and after the introduction of NHS 111. In three of the four sites, there were up to ten per cent more calls to the ambulance service and more ambulance attendances after NHS 111 was brought in. Janette Turner, who led the research, said: ‘The significant findings of the report were that calls to NHS Direct were going down.  But what we didn’t expect was that the number of 999 ambulance journeys was increasing. We don’t know why that is but I’ve recommended it’s looked at in more detail.’

The British Medical Association has previously warned that NHS 111 could put further pressure on health services and said it is still concerned that the helpline is being rushed through to the detriment of patients. A BMA spokesman said: ‘We need to be certain that patient safety is not put at risk before NHS 111 is implemented. From the conclusions of the report it seems there is still more work to do before NHS 111 is fit for purpose.’

NHS Direct, which currently offers an alternative to 999, was launched in 1998 and costs £123 million a year to run. Around half of the staff are trained nurses who give health advice to callers who do not believe they need an ambulance. But the new 111 number employs ‘call advisers’ who have completed a brief training course – leading to accusations that they could fail to identify life-threatening conditions.

There are now 13 pilot sites around the country and the most recent figures released on Friday show there were 92,578 calls to the new service during September. But the national roll-out, scheduled to take place before April 2013, has been delayed in some areas because doctors warned it was happening too fast. A Department of Health spokesman said: ‘As NHS 111 becomes more established, we expect patients to use it more for their urgent medical needs instead of emergency services. Clinically trained staff are always on hand to assess a patient’s needs and make sure they get the right care. NHS 111 will only call an ambulance for a patient when it is clinically needed, but where this is the case, then the local NHS must ensure patients have access to an ambulance.’

 Source: Daily Mail UK 

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