NHS 111. Again. Is it THE problem? And how much is it costing?

Two things to me seem obvious. No doctor likes NHS 111. Secondly if you open another gate to the NHS, more people will go through it! It’s worth remembering that NHS 111 replaced NHS Direct which had one medically trained person to every two call handlers. According to the Royal College of Nursing, NHS 111 has 15 call handlers to one nurse. Inevitably someone working from a script with no medical knowledge is not going to be able to draw on experience or intuition when assessing and signposting callers, and this process will inevitably result in more false positives i.e. thinking there is something wrong with someone when there isn’t.

There are already known core reasons to the problem of more people going to A&E when it’s not an accident or an emergency

  • They go because there is a 9 out of 10 chance they will be seen and sorted within four hours
  • They go, because as an immigrant they come from countries which don’t have good GP services and going to hospital is where they are used to going (One London hospital recently found that 20% of it’s A&E attendees had no registration with a GP)
  • They go because they can’t get a GP appointment for 2 weeks
  • They go because they are elderly and worried and have not had the reassurance or management or care that they needed
  • They go because they have drunk too much and have become ill or had an accident

NHS England have responded to the criticism of NHS 111 by saying: “Doctors and nurses in A&E work incredibly hard to provide patients with the urgent care and treatment they need and have managed significant pressures as demand for urgent care grows.” We totally agree.

They also said: “However, what emergency doctors such as Dr Mann do not see is the even greater number of patients who are treated effectively and efficiently using the 111 helpline. Last year 111 received over 12 million calls and as a result offered treatment to over two million people who would otherwise have visited A&E,” (Do they know this? Were people actually asked whether they would have gone to A&E, or visited their pharmacist, dentist, GP, optician, practice nurse etc?)  “and another 580,000 who would have called 999 for an ambulance, reducing a significant amount of unnecessary pressure on our urgent care services.” Again, were they asked if this is what they would have done, or is it extrapolated from the figures? And if they would have, yet they didn’t need A&E, or 999, why did they call NHS111 and not their GP?

The one question no one seems to be asking, is why are we keeping the public dependent on professionals instead of promoting self-care through technology? If I can see my GP record online (promised to all of us from April 2015), if I can have digital health technology (from free apps to a telehealth system to self-monitoring devices), if I can call a doctor via DrThom (£15 a call) or Babylon Health (£8 a month) or DoctorToday (£45) then why isn’t the NHS helping the public to help themselves?

I wonder how much NHS111 is costing us….does anyone know?


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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