NHS 111 crisis concern

nhs_11109:26 Tuesday 29th September 2015
BBC Radio Cambridgeshire

PAUL STAINTON: An investigation has revealed that the helpline for non-emergency care is in meltdown in certain parts of the UK. The investigation reveals that places like Derbyshire and Leicestershire, Nottinghamshire, Northamptonshire just over the border, up to 75% of calls are going unanswered during busy times. It says in some cases there’s just one nurse for every 2 million people, and the hotline has missed answering targets for the last seven months. So we want to know. If you’ve used it, what’s your experience been like? We had a stark warning from the Royal College of Nursing this morning. It says the non-emergency number will be completely overwhelmed this winter, if Government fails to act. Well Sandy Smith is from Healthwatch. Sandy, morning.
SANDY SMITH: Good morning Paul.
PAUL STAINTON: Are these reports accurate? Are they a fair reflection?
SANDY SMITH: Well I am quite concerned about other parts of the country, but we haven’t been told this by patients in Cambridgeshire. Healthwatch Cambridgeshire did a survey earlier this year, and whilst people didn’t .. not a lot of people seemed to be aware of 111. Those people that were using it in Cambridgeshire were quite pleased with the service they got.
PAUL STAINTON: Yes. The problem is so many numbers, isn’t there?
SANDY SMITH: Exactly. 101, 999, 11 .. it is difficult for people. Yes.
PAUL STAINTON: It really is, and there’s nothing to mark it out is there? Even I .. we were talking about it this morning, and we were getting confused with the numbers and we work in this thing. We’re supposed to know it all.
PAUL STAINTON: Karen Webb is with us as well. She’s the Regional Director for the Royal College of Nursing. Karen, morning.
KAREN WEBB: Good morning.
PAUL STAINTON: Is it a fair reflection? Sandy there saying we don’t really have a problem in Cambridgeshire. Is that true?
KAREN WEBB: Well I think that what’s happened is that in line with all the other cuts across the NHS, we’ve talked about nurses being missing from hospital wards, nurses are sadly very missing from the NHS 111 service, because they’ve been cut out and replaced by cheaper staff who can just follow a script.
PAUL STAINTON: So they can’t actually help, really.
KAREN WEBB: Well they can follow a script, and so the service is going to be as good as the person following the script can make it. Whereas any member of the public who has talked to a nurse on the NHS 111 will know that an expert nurse can step outside of a script, and ask key questions that will elicit the answers that can get treatment much more quickly and much more accurately for the patient.
PAUL STAINTON: You see this is the thing Sandy, isn’t it? If I’m elderly, my mum is 77 today, if she’s ringing 111, she wants to have full confidence that she’s talking to a health professional, doesn’t she?
SANDY SMITH: Absolutely. Absolutely. And that’s how you make the service work. And we really want to hear from people. So if people are not getting that sort of information, good information when they need it, at Healthwatch we really want to hear about that, because we can feed those patients’ views directly in, so that when services are planned and bought and delivered, they need to have that feedback right the way through it. So if that sort of thing is happening, we really want to know about it.
PAUL STAINTON: I’m not sure what we can do to simplify all of these numbers, and simplify the service. But we can start by having nurses answering the phones, couldn’t we? Karen, the Royal College of Nursing warning this morning that this number could be completely overwhelmed this winter.
KAREN WEBB: Well that’s the worry, because we know that patients are experiencing delays in some areas getting appointments with their general practitioners. We don’t want them turning up in Accident & Emergency Departments. So 111 really must be fit for purpose, if we’re going to stem the flow of patients in the wrong directions over the Christmas period.
PAUL STAINTON: Yes. And we look at some of the things this newspaper investigation has uncovered. A tick box computer culture, call centre workers missing vital symptoms, babies dying after staff failed to recommend treatment that could have saved them, nurses told to prioritise routine calls over advising on serious cases so they can hit targets. Are targets on a service like this actually helpful Sandy?
SANDY SMITH: Well no because it’s about people, and a service that’s about people has to be flexible to the demand that’s coming through and what that person needs. So you can have targets as a general indication of how the service is doing, but at the end of the day this is why the experience of people is so important, because the targets are just numbers. But the people’s stories and their experiences are what really count. They’re simply not getting what they need. They really need to tell Healthwatch or somebody else about that.
PAUL STAINTON: .. Karen, is there a better way of doing this?
KAREN WEBB: I think fundamentally we need more nurses across the NHS, so in every workplace, whether it’s community nursing, hospital nursing, or on the phone lines at NHS 111. We need nurses in GP surgeries and all over the Cambridgeshire area.
PAUL STAINTON: So we’re saying it’s not the system, it’s just what staff we’re putting into that system.
KAREN WEBB: Yes. There’s nothing wrong fundamentally with NHS 111. It’s a fantastic idea and as a service it’s really well evaluated. But you have to have enough nurses in that system to make sure that patients have confidence in the care that they’re receiving.
PAUL STAINTON: We’ve had a couple of positive comments already this morning, but this is from Dan in Kings Lynn. It says, “Paul, it’s a joke. I know when I need antibiotics due to my condition, but to get an appointment with an out-of-hours doctor takes about four hours. I’ve spoken to three different people at times. You have to answer stupid questions totally unrelated to your problem, then they normally send you to A&E. It’s a ridiculous waste of money.” says Dan just over the border in Kings Lynn, Sandy.
SANDY SMITH: Yes well we’d like to hear about that. The Clinical Commissioning Group that commission the 111 service, I know that they are looking to redesign that at the moment, and we have heard similar stories about people that simply need to speak to their out-of-hours GP going through too long a pathway of questions. Could I just say Healthwatch would like to hear from people as well. Could I give our number?
PAUL STAINTON: Of course. Go. Yes.
SANDY SMITH: It’s 01480 420628 or via our website which is healthwatchcambridgeshire.co.uk.
PAUL STAINTON: We all want to get to the bottom of this and make it better, don’t we?
SANDY SMITH: Absolutely.
PAUL STAINTON: We’re all in the same business here, aren’t we?
SANDY SMITH: Absolutely.
KAREN WEBB: Paul, can I just say that the Royal College of Nursing really support the work that Healthwatch do. They are a fantastic organisation. I would appeal to the public to make contact with them to tell them about their experience, good or bad, of care. We really need the feedback from patients to make this system work.
PAUL STAINTON: How was it for you when you rang NHS 111? Does it work at the weekend? Does the system work, or does it need more professionals? Your thoughts. 03459 252000. 81333 on the text. Peter from Huntingdon says, “I can’t comment on Cambridgeshire personally. When I forgot part of my medication whilst on holiday in Cornwall they sorted me out within the hour. It was a top service.” Christine from Cherry Hinton: “NHS111. Brilliant when I was ill. I rang them in January. They had to come from Bury St Edmunds so it was about an hour’s wait, but that was absolutely fine. I was so pleased with their help and I was rushed to hospital.” Do you recognise what this investigation is saying about out-of-hours service? Is it something that’s creaking at the seams and about to be overwhelmed, or does it work well for you?