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Why not just rebadge 111 as 666



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I sincerely hope you didn’t read the recent headline, ‘All GP practices could see NHS 111 direct booking from April 2019’, at least not while your cranium was anywhere near anything made of brick.

True, at present, this is a trial, and participation is voluntary. But the plan is to roll this out ‘universally’ with NHS employers warning, ominously, that ‘lessons learned will inform next year’s contract negotiations’.

By which point, presumably, they’ll do the honourable thing and rebadge 111 as 666, given the level of persecution this will involve.

It’s literally impossible to envisage a future where 111 has access to our appointment systems without experiencing a sensation of utter dread. After all, this service is so risk averse and protocol driven that its threshold for calling an ambulance is the combination of words ‘chest’ and ‘pain’, even if that pain is localised post-coughing rib tenderness which even the patient realises is musculoskeletal.

It’s really unpleasant having unrealistic systems imposed on us and being held responsible for them

Presumably, that means the threshold for 111 booking a GP appointment would be set somewhere around the patient simply waking up that morning.

And therein lies another problem. Their stupid protocol may randomly decree that patient X with symptom Y might need an appointment within Z days, but what if my waiting time for non-urgent is three weeks, as it is now? And if the answer is that we have to reserve a certain number of appointments for 111 then that just runs the risk of some appointments being unfulfilled (granted, unlikely) and so wasted or, more importantly, of our current routine appointments being squeezed even further to accommodate the 111 requirements.

It’s a really unpleasant feeling having dysfunctional and unrealistic systems imposed on us and then being held responsible for the outcomes. And despite its increasing familiarity, the anxiety it creates is making me feel sicker by the day. I’d phone 111 for advice but I really can’t face all those questions about whether I might be pregnant.

Dr Tony Copperfield is a jobbing GP in Essex