Poor NHS phone service puts patients 'at risk'


NHS 111 in the South West is putting patients "at risk of harm", a damning new report has said.

The urgent phone line run by South Western Ambulance Service NHS Foundation Trust has been ordered to make improvements by health inspectors after they concluded that services were "inadequate".

Care Quality Commission (CQC) inspectors found that some patients were waiting too long to receive a call back, including one patient who waited for 22 hours, and there were often not enough staff to take calls or to give clinical advice where needed.

Calls were sometimes answered by staff who were not trained to assess patients' symptoms, and emergency and urgent patients were not always assessed for the severity of their medical needs in a timely manner, the CQC said.

The mother of a baby who died following a string of NHS failures, including being let down by the 111 service, said she hoped the report would lead to improvements.

Inspectors visited the Trust's 111 sites in March after whistleblowers and patients raised concerns about the safety of the service.

They found that the service - used by people across Dorset, Devon, Cornwall and the Isles of Scilly - was not caring for patients in a safe way.

Inspectors said there was a risk that staff may not recognise or respond appropriately to signs of deteriorating health and medical emergencies. 

Melissa Mead said that the service failed to triage her son William appropriately.

Earlier this year, a report into the death of the 12-month-old criticised GPs, out-of-hours services and a 111 call handler who failed to spot he had sepsis caused by an underlying chest infection and pneumonia.

Mrs Mead, 29, from Penryn, Cornwall, told the Press Association: "We have been waiting for a very long time with suspicions but now those suspicions have been confirmed obviously this shows that William's call isn't just a one-off error within the system. 

"Obviously when I called 111 I wasn't aware that William was seriously ill. We called them because we wanted reassurance, we wanted some kind of signposting guidance on what to do.

"111 is a faceless service, you don't have that interaction. The questions are blanketed and you are not able to expand upon your answers. I found it very blunt, very impersonal.

"When we called, as it transpired after William had died, the call had not been triaged as a priority call which it should have been. We should have spoken to a clinician.

"There were a number of issues but we didn't find these out until after William had died, but by then it was too late."

She added that she hoped the report would lead to improvements in the system, adding: "We won't be the only family that has been affected by this report. I should imagine there are a lot of disgruntled people out there, I hope not in the same tragic circumstances as us."

Professor Sir Mike Richards, CQC's 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.

"Despite the best efforts of staff - the service was not doing enough to identify why this was happening or what needed to be done to improve. The trust had known of these concerns but it took the staff to bring them out into the open to ensure that something was done."

South Western Ambulance Service NHS Foundation Trust's chief executive Ken Wenman said:  "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.

"We will not compromise on patient safety, and because we weren't confident a high-quality, sustainable and safe service could be delivered within the commissioned funds available, we gave one year's notice on the NHS 111 contract for Cornwall and Isles of Scilly, and Devon in March 2015."

He added: "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. We will watch with interest other CQC inspection reports of NHS 111 services across the country."

NHS Improvement said it will help make sure patients in Dorset, Devon and Cornwall receive improved NHS 111 services from South Western Ambulance Service NHS Foundation Trust.

Claudia Griffith, Regional director at NHS Improvement, said: "Most patients who use NHS 111 services provided by the trust are spoken to and helped in the right way by properly trained advisors.

"But we will work with the trust to address the CQC's concerns about whether patients using its NHS 111 services are getting consistently good quality care. We also want to help the trust reduce how long patients are waiting on the phone.

"We will support the trust's efforts with the improvements they need to make, but for the benefit of patients we will continue to scrutinise the trust until we're confident that the problems identified by the CQC have been addressed.

"NHS Improvement will continue to work closely with the trust to find out more about the problems it faces and ensure improvements are being made, and will take further steps if necessary for patients."