NHS 111 advice line 'still fragile'

The new NHS non-emergency 111 telephone service in England is in a fragile state in a number of areas ahead of bank holiday weekend, NHS bosses admit.

Reports have been emerging for weeks of calls going unanswered and poor advice being given, leading to hospitals being inundated with patients.

The problems plaguing the advice line will now be discussed at a board meeting of NHS England on Friday.

Officials are expected to agree to an urgent review of the system.

A board paper produced by NHS England says some of the problems have been "unacceptable" and, despite improvements, the system still remains in a "fragile" state in places.

There are 46 individual 111 services across England. They were supposed to have been in place by 1 April to replace NHS Direct, although ministers relaxed this deadline after it became apparent some areas were not ready.

Seven have yet to go live. And of those that have, several have subsequently been suspended because of problems, while a number are relying on extra staff and support brought in from other parts of the health service.

One of the areas that has seen a 111 service start and then abandoned is Greater Manchester.

Dr Mary Gibbs, a GP who was providing out-of-hours cover when the system crashed there, said: "Calls just weren't coming through. It was totally inadequate. Patients' health was put at risk."

"Delays"

Where problems are continuing, NHS Direct - the service 111 was meant to replace - is remaining operational. A contingency fund of £8.4m has reportedly been set aside to fund this until June.

It comes as the NHS gears up for the three-day weekend.

The 111 service tends to be busiest when local GP surgeries are closed.

Dame Barbara Hakin, the interim chief operating officer for NHS England, said the organisations providing the 111 services, which include ambulance services, private companies and NHS Direct, would face having their contracts revoked if they continued to fall below the expected standards.

"We will be relentless and diligent in making sure that this service is as it should be everywhere.

"I am confident it is a great service in the majority of the country. I am not comfortable with that, it needs to be a great service everywhere."

Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "We are still receiving reports that patients are facing unacceptably long waits to get through to an NHS 111 operator and suffering from further delays when waiting for calls back with medical advice should they manage to have their call answered.

"The quality of some of the information being given out appears, from anecdotal sources, to be questionable in some instances."

He added: "If any area of the country is failing to meet high standards of care then its NHS 111 service needs to be suspended. NHS England also need to be more transparent about how the system is functioning across the country."