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CQC brands NHS 111 provider inadequate as patients put 'at risk of harm'

The CQC has branded an NHS 111 provider ‘inadequate’, after finding that some calls taken by staff who were not trained to assess patients’ symptoms, which was putting patients ’at risk of harm’.

A report by the regulator of health and social care in England on South Western Ambulance Service NHS Foundation Trust, which runs NHS 111 for Plymouth, Devon and Cornwall, said that calls were taking too long to be answered and there was a problem with understaffing.

It is the latest in a series of problems affecting the helpline.

The report said: ’Inspectors found that there were often not enough staff to take calls, or to give clinical advice when that was needed. Staff reported working long hours, many feeling high levels of stress and fatigue.’

It highlighted the ‘high staff turnover and high sickness rates’, adding: ’Too many calls were abandoned, and patients were waiting too long for their calls to be answered and to be assessed, or to receive a callback with appropriate advice.’

The report also said: ’Calls were sometimes answered by staff who were not trained to assess patients’ symptoms and there was a risk that patients needing urgent attention were not given priority or could be put into a long queue awaiting call back.’

The trust has been told that it must make significant improvements by 8 July, including:

  • Review staff numbers to ensure patients can get timely care and treatment when first calling the service and when receiving a callback.
  • Review the roles and responsibilities of Non Pathway Advisors (call handlers who are not trained to use the NHS Pathways triaging system) ensuring callers consistently receive the correct level of advice.
  • Ensure that call queues awaiting initial assessment and call back are robustly monitored and managed by staff with clinical authority to intervene and allocate resources.

Professor Mike Richards, chief inspector of hospitals, said: ‘We found that patients were at risk of harm because the triaging system was not good enough. Too many people whose call was urgent were not being assessed in relation to their medical needs in a timely manner. A lot of people needing less urgent advice might have to wait all day for a call back.’

A statement on the trust’s website from its chief executive, Ken Wenman, said: “The trust has always been open and transparent and welcomes the CQC report into the delivery of NHS 111 services. We treat every patient as our only patient and we want every patient that makes contact with us to have a first class service from an outstanding group of highly committed staff.

’Nobody knows our organisation and staff like we do and there were no surprises in the main findings of the report as we have already been working collaboratively with our commissioners, NHS Improvement and NHS England colleagues to make improvements.

’We are never complacent on patient safety. Could we do better? Of course we could. Will we learn from this inspection? Of course we will.’

GPs have called for NHS 111 to be scrapped, saying that non-medically trained call handlers should not be giving patients advice.

In January, a report found that NHS 111 call handlers were unable to identify potentially fatal cases of sepsis because the algorithm used by NHS 111 is not sensitive enough to pick up red flags, according to a report into the death of a 12-month-old boy in Cornwall in 2014.

Readers' comments (7)

  • No excrement Dr. Holmes?

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  • wondered how long it would take them ... they were too busy targeting GPs but after a lot of negative press re: 111 they have obviously been pushed to criticize a government initiative (111). why? look out GPs - the price of the savior 5YF will be enforced OOH.

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  • When the service goes to the cheapest bidder .. then what do you expect

    what a lot of corporate bull from the chief ..
    A statement on the trust’s website from its chief executive, Ken Wenman, said: “The trust has always been open and transparent and welcomes the CQC report into the delivery of NHS 111 services.

    Then why does it require CQC to expose them?

    We treat every patient as our only patient and we want every patient that makes contact with us to have a first class service from an outstanding group of highly-committed staff.

    If every patient was the only patient .. they would not have to wait all day for a call back


    Nobody knows our organisation and staff like we do and there were no surprises in the main findings of the report as we have already been working collaboratively with our commissioners, NHS Improvement and NHS England colleagues to make improvements.



    We are never complacent on patient safety. Could we do better? Of course we could. Will we learn from this inspection? Of course we will.’

    No wonder the staff are suffering stress
    I am sure that there is plenty of scapegoating of individuals rather than organizational responsibility

    This is why Doctors indemnity is rocketing

    You better learn or you'll be shut down
    before someone gets hurt.

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  • Nobody knows our organisation and staff like we do and there were no surprises in the main findings of the report as we have already been working collaboratively with our ... Perhaps the chief should resign if the problems have been known and not resolved

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  • as long as we have the most junior ,untrained people on the front line, doing one of the hardest jobs in the nhs, then whole service will continue to be chaotic. AS we seem to be trying to destroy the traditional GP model, then similar stories will emerge from large organisations attempting to do daytime general practice in the same way.

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  • GPs were involved in the pathways and triage system.

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  • Its okay saying that the 111 is useless and use untrained Health advisors but NHS England have set this up and the questions and to say 111 are too blame for not picking up the child who had sepsis so if they cant pick it up why didn't the GP's pick it up too I believe they saw the child at least 8 times prior to the family ringing 111 so people glass houses etc. The Ambulance services across the country should run the 111 as this can be all connected with which area of health care the patient should be getting from a 999 call to just general health information. When the service in the west midlands was run by WMAS and this was run efficiently since Vocare have taken over it seems to be run on shoestring with poor management.WMAS It is not best for the 111 to be in the private run sector it should be all in house and run by NHS. They could have left it as NHS Direct and just changed the number that's seems more sensible than wasting the Tax payers money all the time,but that's what the NHS do.

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