Patient safety watchdog launches investigation into NHS 111 advice to Covid patients

Patient safety watchdog launches investigation into NHS 111 advice to Covid patients
March 25, 2021, 12:24 pm

An NHS 111 call centre in Ashford, Kent.

Review will study whether failings by the telephone service and poor advice to stay at home cost lives

The NHS patient safety watchdog has launched an investigation into failings by the NHS 111 telephone advice service which may have cost the lives of people with Covid-19.

The Healthcare Safety Investigation Branch (HSIB) has begun looking into what advice the service gave to several callers who rang during the pandemic seeking its help because they were unwell.

The inquiry follows a series of disclosures in the Guardian last year by David Conn about serious problems with NHS 111’s performance, some of which are claimed to have led to deaths. He revealed that:People who were critically ill with Covid died after they were wrongly told to stay at home rather than seek medical help at hospital.

Call handlers did not seem to recognise that conditions such as diabetes and multiple sclerosis made patients more likely to fall seriously ill with Covid.

Nurses who worked for NHS 111 said the service was unsafe because staff were not able to make clinical assessments about how ill patients were, and had been given only four hours’ training.

The Covid-19 Bereaved Families for Justice Group believes that several hundred of its members had a relative die after calling 111 and being told that they should stay at home. They have demanded a public inquiry into the service’s record during the pandemic.

At the time NHS 111 was far busier than usual, answering up to 3m calls a month, as the government and NHS urged people to ring it rather than go to A&E or to see a GP.

The Guardian reported that there were particular problems with the quality of advice given by call handlers working for the Coronavirus Response Service which 111 set up, and that was run by the South Central ambulance service (SCAS). An intensive internal audit found that “over 60% of calls have not passed the criteria demonstrating a safe call”.

Concerns were also raised early in the pandemic last spring that the service could not cope with the sudden sharp increase in callers and that some people waited a long time to speak to a call handler, with some ringing off

HSIB usually decides to inquire into an alleged lapse of safety in the NHS when it receives a “trigger case” which causes its investigators concern that a problem may be common. In the case of NHS 111, however, the agency is now examining the helpline’s handling of several cases.

The watchdog said in a statement: “Following concerns brought to us via the chair of our Citizen’s Partnership we undertook focus groups with members of the public to explore the issues raised around the NHS 111 response to callers with potential Covid-19 symptoms.

“These initial focus groups have helped to shape the direction of the investigation and we are now looking at several reference cases, rather than a single incident, to establish what the national learning is for the NHS 111 service.

“As the investigation progresses we will carry out further focus groups to ensure that the public perspective is integrated fully into our investigation.”

It gave no further details and expects to produce interim findings and then a final report.

NHS England and South Central ambulance service have been approached for comment.

source: Denis Campbell

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