27.02.13
NHS 111
Guest blog by Ron McDaniel
We are now only one month away from the national roll-out of the much publicised NHS 111 service. But with only a few weeks to go before full implementation, is the NHS really prepared for the introduction of this service?
Many of us will be aware of the objectives of NHS 111. The new service is designed to improve patient care and reduce the pressure on urgent care services and the emergency care system. Having worked in emergency dispatch for many years, I welcome the concept and what it is aiming to achieve.
My concerns around NHS 111 are focused primarily on its implementation. As a provider of clinically tried and tested ambulance dispatch software that is used by most ambulance trusts in the UK I feel qualified and sufficiently experienced to comment on this issue.
Over the past 18 months I have repeatedly called for further testing and proper consultation prior to implementation to ensure the NHS 111 service is delivered effectively and safely to members of the public. The emergency health system is too important to rush into reforms that could realistically have a large impact on patients’ lives. It is encouraging that in recent months GPs have also raised concerns about implementation.
However, despite these growing concerns it remains frustrating that the NHS remains committed to rolling-out the NHS 111 line without sufficient testing and engagement with key groups. I continue to be surprised that ambulance services are left out of the conversations about NHS 111 despite the undoubtedly considerable impact its implementation will have on their ability to deliver an effective service. In my view, engagement with ambulance trusts should have taken place months if not years ago to gain vital, on the ground input.
It is well-known that NHS 111 will employ fewer medically-trained call handlers who will not always have the medical expertise to correctly assign ambulances for genuine emergencies. There is a risk that public safety will be compromised due to the high chance of inappropriately referring patients to another service
NHS 111 should not impede on an ambulance service's job of dispatching emergency ambulances to patients requiring the service. But a review of the outcomes of the NHS 111 pilot schemes by the University of Sheffield suggests the new service will do just that.
The findings from the report suggest that pressure on the ambulance service significantly increased and a worryingly high volume of patients referred to Out of Hours throughout the pilots indicates this pressure could be even larger when Out of Hours is supposedly absorbed by 111.
Following the report’s findings, I must question the rationale in continuing to rush the rollout of this service in 2013. The University of Sheffield report raises some important questions and concerns about NHS 111 which remain unanswered and unresolved. Surely those must be addressed before implementation commences at a national level?
Ron McDaniel is senior vice president at Priority Dispatch.