Ambulance service stretched to breaking point by increase in call-outs from 111 service (From The Northern Echo)
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Unions and GPs say strain on services with one in ten calls to 111 resulting in ambulance callouts
AMBULANCE crews in the region are being stretched to breaking point after one in ten calls to the NHS “non-emergency” 111 helpline resulted in paramedics being dispatched, The Northern Echo has learned.
Unions and GPs have expressed fears that the introduction of 111 has placed the ambulance service under such strain that they were unable to get to critical emergencies.
Figures showed a five-fold increase in calls generated by 111 than with the previous out-of-hours services.
One paramedic in a rapid response vehicle said he had to wait half an hour for a two-man ambulance crew to attend a road traffic accident.
And Joel Byers, Unison regional organiser for the ambulance service, said he had been told of a patient who had to be taken to hospital in a fire engine because an ambulance crew took too long to arrive.
The North East Ambulance Service (NEAS) is understood to have asked for more cash for front-line crews to combat the problem – even while it is forced to make efficiency savings of £23m within five years.
The 111 service, which was devised and piloted in County Durham and Darlington from 2010 by the NEAS and was last month rolled out across the country, was designed to cut down on the number of calls to 999.
The NEAS said Sheffield University research showed 999 calls had fallen by 14 per cent in the pilot area after 111 was brought in.
The calls are handled initially by non-medically trained staff who run through a series of questions to decide the most appropriate care for patients.
But GP Dr Ken Megson, secretary of the NHS North East medical committee, said one in ten calls to 111 resulted in an ambulance being sent out – a five-fold increase on before 111 was introduced, when the figure was just two per cent.
And he said 80 per cent of people calling were referred to see an out-of-hours doctor, rather than 50 per cent previously. This was putting strain on the out of hours system.
He added: “In some areas 50-60 per cent of calls coming from 111 to the out of hours services are being marked as urgent, which is three or four times what we are normally used to.
“The problem is the risk-averse nature of 111. We are getting a lot of evidence that ambulances are being delayed for GP emergency admissions, which is normally pick-up within one hour.”
Union representative Mr Byers said: “Our workload has increased dramatically. It increased when NHS Direct was introduced, and it increased even more when 111 was introduced.
“Our members are working 14 hours instead of their 12-hour shifts. This shows how stretched the service is. The Trust is now going to commissioners asking for more money for extra resources to deal with it.
“We have had cases where fire engines have taken patients in because they have waited that long for an ambulance.
“It doesn’t show up in the figures because as soon as the rapid response car gets to the scene, the clock is stopped. It doesn’t show how long it takes for the ambulance crew to turn up.”
British Medical Association (BMA) regional chairman Dr George Rae said: “The idea of 111 is an excellent one. But it has been rolled out a bit too quickly.
"I think it would be much better if you had medically-trained people taking the calls. Far too many calls are being labelled as urgent which will put significant stress on out of hours and ambulance services.”
A spokeswoman for NEAS said all performance targets were being exceeded, responding to potentially life-threatening calls within eight minutes in 75 per cent of cases.
“The difference now is that emergencies come through on NHS 111 where previously they stemmed from 999.
“111 calls can be potentially life-threatening as anything dealt with via 999. Our region has a history and culture of patients who are reluctant to seek medical help when they need it. Having a free-to-call number like 111 gives these patients “permission” to seek that help when they don’t want to call 999 for being a “nuisance”.
“We also share some of the public concerns raised regarding some waits for back-up transport after a rapid response paramedic has arrived on scene.
“It is for this reason that we called a summit of NHS leaders across the North East in February to address the system-wide issues that have caused lengthy ambulance delays at some hospitals.
“The meeting was extremely constructive although some of the ideas and plans will take time to implement with others in the system. There is nothing to suggest that these issues are related to NHS 111.”
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