An NHS 111 call handler today tells how he quit after nine months of hell working for a helpline he claims is failing patients.
The whistleblower says distressed callers could wait up to an HOUR to get a call back from a nurse because of staff shortages.
He claims call handlers are put under pressure to make decisions that should be made by clinicians which helps cut the number of ambulances sent out.
And the ex-worker says the helpline is seriously failing patients with mental health issues as staff training is so poor.
The final straw for the whistleblower came when he was told off for spending 30 minutes trying to talk a suicidal man at a station out of throwing himself under a train.
“I was told the call was too long – over the six and a half minutes allowed – and I should have ended it,” he says.
“I couldn’t believe it. To me, patient care is more important than targets.”
But his deeper unease is over a new triage system introduced to help tackle the crisis facing ambulance services and hospital A&Es nationwide.
In the past, paramedics would always have been dispatched when the handler’s computer programme identified the caller as needing one with a ‘Green Two’ 30-minute response time.
Now the whistleblower claims 111 staff cannot request an ambulance for Green Two calls during peak times until the patient’s condition has been assessed over the phone by a nurse.
But there is an exception which our handler believes crosses a dangerous line. If a nurse isn’t immediately available and the call handler believes an ambulance is needed, it will be sent out.
But if the handler – who has no clinical training – judges an ambulance may not be needed, it is down to the next nurse available to decide whether to send one.
“It’s appalling,” says our source. “Call handlers are not clinicians and should not be making these kind of decisions.”
“Green Two calls are from patients who have problems like breathing difficulties, severe abdominal pain and diarrhoea and vomiting. We are not trained to know if they need an ambulance. That’s why we use a computer system.
“It’s inevitable that the pressure on call handlers to reduce the ambulances we send out will impact on these decisions. It is not safe.”
The ex-staffer, who worked for Derbyshire Health United which covers large areas of the Midlands, says: “Call handlers have personal targets that no more than eight per cent of calls we take must lead to an ambulance being sent. If it’s higher you will be told off.
“But it’s ridiculous. The computer system has been designed by medical experts. If it recommends an ambulance it’s because that’s the safest option.”
The ex-employee, who worked at 111 call centres in Chesterfield and Derby, added: “There aren’t enough nurses, so we have to tell patients one will ring back.
“I’ve known it take an hour. I had one pregnant patient bleeding heavily. Her husband wanted to take her to hospital himself, but the computer told me to send a Green Two. I couldn’t override the system without speaking to a nurse, but there wasn’t one available.
“So I had to advise them to wait at home for the call. No ambulance was sent and it took an hour for a nurse to ring. I will never know if that woman lost her baby because of the delay.”
He blasted the training for call handlers as inadequate. “You have to take a lot of very distressing calls,” he said.
“I had one from a teenager with mental health issues worried she would stab her grandma when she got home.
“You are expected to assess these patients in the way you would if someone had a cold. People think we sound robotic and don’t show compassion.
“It’s true. We are not allowed to show it.” The one time he did, he was told off. “The man at the railway station was desperate.
“He was calling from a phone box saying, ‘I just want to kill myself’. For about 30 minutes I talked to him like I would to a friend. At the end of the call he said, ‘You know what, I think you’ve saved my life’.
“When the call was audited by my manager I was told I exceeded my skill set and that the call was too long.”
Of the 10 people he trained with in June last year, only three are still working for the helpline.
“There is no welfare for handlers, even though we deal with life or death calls,” he said. “You get three seconds between calls, that’s it. It’s no wonder everybody leaves.”
The 111 target is that 95 per cent of calls must be answered in 60 seconds.
Figures circulated among call centre staff show for the week ending January 8, the England average was 82.4 per cent.
The worst performance was at East Kent NHS 111, run by Primecare, where 66.5 per cent of calls were answered in a minute.
Derbyshire Health United denied call handlers were asked to decide if an ambulance is needed.
A spokeswoman said DHU was asked to pilot the Green Two “re-triage process” to “reduce pressure on 999 and A&E”. She said: “Results were very positive with no clinical incidents.”
She denied there were call duration targets and said the response time for nurses to call patients back depended on “clinical severity”.
She said handlers were trained for “five to six weeks”, but admitted staff levels had been “under pressure”.
She denied claims that staff were not supported and said there was a free welfare service available. The latest Care Quality Commission inspection rated the call centres as ‘good’.