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Case study: Why the plug was pulled on NHS 111

Dr Teresa McDonnell explains what went wrong in Shropshire, where out-of-hours doctors had to take back triaging from NHS 111

I am in a small practice and, on the first day NHS 111 went live, we knew of three out-of-hours calls.

One was a frail, elderly lady whose daughter rang 111 and was put in a queue for an hour, gave up, then tried again and couldn’t get through at all.

Another was one of my patients – who would ring out-of-hours every night if he could – who was put down as a semi-urgent triage by NHS 111. He was re-triaged by the out-of-hours service which decided a visit wasn’t needed. If we didn’t have the re-triage, that would have been a wasted visit.

The other one was a 16-month-old and the advice was contact with primary care within an hour.

Three days later, there was an emergency meeting between the two Shropshire CCGs and they pulled the plug on NHS 111.

Now we have Shropdoc covering us again. The problem was that Shropdoc had to let its call handlers and experienced nurses go. It has had to get agency staff in.

The idea of one number for people to ring is a good idea. But you need local knowledge. We have two large-ish towns, Shrewsbury and Telford, but around them it is rural and the towns all have their own minor injuries units. It is a complicated county. One-size-fits-all doesn’t suit us.

Dr Teresa McDonnell is a GP in Shropshire and a member of the council for out-of-hours provider Shropdoc

Readers' comments (2)

  • Merseyside PCT and CCG againstgovernmental policy ran a mixed model with staff retained in out of hours for " clinical workflow allocation" and endured the abuse from central government for questioning the dogma 111 can do it all..
    The OOH locally where able to take back calls and hence this foresight has kept merseyside out of the headlines.

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  • Totally agree with Teresa's views on NHS Pr1m1t1ve.

    By all means, make it one number, but make sure that the patient is assessed (not 'triaged!!!) by a suitably experienced clinician.

    Locally!!!

    It's better for the patient - and better for the whole system...

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