The Tories’ cut-price version of NHS Direct is causing chaos for emergency services… and may already have cost lives.
A nurse with 26 years’ experience today exposes how the new 111 service, which replaces trained medics with cheaper call centre staff, has led to disaster.
Health Secretary Andrew Lansley hopes to shave millions off the health budget by phasing out the popular NHS Direct – which was set up in 1998 and helps 27,000 people a day – and replacing it with 111.
But the whistle-blower nurse, who worked on a trial of the service for three months, reveals how cost-cutting has led to a culture of incompetence that will horrify patients. She tells how:
Unborn twins may have died because of advice given by 111.
Call-takers with just 60 hours of training failed to spot the symptoms of life-threatening strokes and epileptic fits.
Panicked 111 staff have sent ambulances to dozens of non-emergencies, including patients with indigestion and nosebleeds.
The extra ambulance call-outs leave genuine 999 cases at risk and put a huge strain on A&E units.
Staff, some still in their teens with little training in confidentiality rules, have access to the GP records of millions of patients – one worker was fired for hacking into a celebrity’s medical file.
Mr Lansley sparked a backlash when he let slip in August that NHS Direct – which costs £123m a year – could be replaced by 111 within three years.
Forty per cent of NHS Direct staff are qualified nurses who give 24-hour expert health advice to callers who feel they may not need an ambulance or a visit to A&E.
The new 111 service – on trial in County Durham and Darlington, Nottingham and Lincolnshire – aims to cut costs by replacing many of the trained medics with call advisers who have completed a 60-hour training course rather than a degree.
The experience of the nurse who spoke to the Sunday Mirror appears to confirm the worst fears of doctors and patients’ groups who warned the under-resourced 111 service would lead to confusion and life-threatening mistakes.
She told how 111 staff are thrown in at the deep end – taking calls after a two-week crash course in anatomy, physiology and health which ends with a simple multiple-choice exam.
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She said 111 bosses encourage call-takers to rely heavily on the same NHS Pathways computer system used by 999 dispatchers with a full six weeks’ training.
The computer program prompts them with questions to ask callers and suggests advice depending on their answer.
But the nurse said that NHS Pathways cannot cover every scenario – meaning inexperienced staff are missing life-threatening conditions.
The situation is made worse because the system has been flooded with genuine emergencies by people who think 111 has replaced 999 as the number for an ambulance.
She said: “A lot of the call centre staff are simply not up to the job. There are teenagers whose last job was in a supermarket and grannies who knit while they take calls. but they can be hired on £15,000 a year, while a trained nurse costs twice that.”
The nurse claimed that sometimes only one or two nurses are on duty in a centre with 25 untrained call-takers.
She said: “on one occasion a call-taker put a woman through to me – he said he didn’t know what to do with her but that she sounded drunk.
“within seconds I could tell she was having a stroke and sent an ambulance. The woman had been on the phone for more than six minutes. That time is crucial with stroke victims.
“we had another call from someone who was having an epileptic fit. When the operator put the details into the computer it told them to advise the patient to see their GP in the next three days.”
In another tragic case last month a mum-to-be is believed to have lost twin babies due to confusion among call-centre staff.
She said: “When the woman arrived at hospital, doctors were furious and complained to 111 bosses. There was an inquiry – but the bosses seemed more concerned about covering themselves.”
The nurse also said staff have been guilty of over-reacting by sending ambulances to non-emergencies, and said she overheard worried bosses discussing how call-outs had risen by 23 per cent since 111 started.
She also raised concerns about patient confidentiality after staff abused access to records. She said: “In the end I had to quit. I felt lives were being put at risk.”
The North East Ambulance Service said: “all nurses, clinical supervisors and call handlers who use our systems undertake an extensive training programme.”