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CNO Jane Cummings claims NHS 111 service is 'improving' after chaotic launch


There have been “significant improvements” in the service provided by the new NHS 111 phoneline, according to the chief nursing officer.

The new service, which has replaced NHS Direct’s 0845 number in England but uses far fewer nurses than its predecessor, has been dogged by troubles since its planned launch at the start of April.

Providers covering around half of the country missed the 1 April deadline to go live with the new non-emergency phone number, while in many areas where the service did launch, patients struggled to get through.

Problems were particularly acute over the Easter weekend, with claims that patients were facing very long waits to get through and for calls back with clinical advice. Questions have also been raised about the quality of some of the information being given out.

Speaking yesterday on BBC Radio 4’s Today programme, CNO for England Jane Cummings said the situation had improved since Easter, though she acknowledged NHS 111’s performance over Easter “was not particularly good”.

“We have seen some significant improvements over the vast majority of England,” she said.

Ms Cummings noted that lack of staff had been one of the problems with getting the new service up and running, and that was now being addressed.

“The main issues is we’ve got more people, more call handlers,” she said. “The providers that are delivering the service have been able to recruit additional staff, train them and have them sitting, ready and willing to take the many calls that are coming into 111 at the moment.”

The CNO also said that the quality of advice being given by the service had improved but cautioned that more needed to be done to “make sure it’s the right advice on offer for all of the patients that use it”.

“We need to look at individual cases where perhaps advice was incorrect or not as good as we would have wanted it to be,” she said. “But I think overall the message we are getting is that while in some places there is still some way to go, it is better.”

Over the Mayday bank holiday, Ms Cummings said NHS 111 had received over 113,000 calls.

“That’s a lot of people who are ringing up for advice and guidance,” she said. “The vast majority of those can be helped with self-care or given access to an appointment, for example. Some of those need urgent care and need to be transported to A&E departments quickly,” she added.

NHS Direct nurses who stepped into the breach and helped provide a contingency service following the chaotic launch of NHS 111, despite facing redundancy, were praised at the Royal College of Nursing’s recent annual congress in Liverpool.


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Readers' comments (10)

  • It will be interesting to see where they go from here because any model which includes only a very low proportion of nurse input will fail. Non medical call handlers cannot safely give advice or direction on medical problems to the public no matter what they do to tweak the overly lengthy diagnostic tools those staff are currently being asked to follow.

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  • The move away from initial Nurse input on the new 111 Service was always going to lead to a certain outcome. That is a huge increase in referrals to A & E and to GPs & more Ambulance call outs.

    More nurse input at the initial stage means many fewer and much better quality referrals.

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  • "significant improvements" ??? are they having a laugh??
    By being given "access to an appointment" with an out of hours GP or nurse practitioner is missing the point. 98% of the referrals to out of hours by 111 are completely unnecessary, and waste precious time and resources that should be spent on urgent and emergency cases that cannot possibly wait until their GP opens in the morning (or after a weekend) which was why the out of hours was set up in the first place.
    By using the out of hours as an alternative appointment option for patients who are using the service as a convenience, is costing the tax payer an enormous amount of money and is unsustainable.
    Meanwhile tragedies have, and will, continue to happen as ambulances rush to toothaches and sore throats and people queue out of the doors of emergency departments as they "have been told to present there" by some untrained idiot behind a computer using an algorhythm.

    Again, I have to go to work tonight, to see a steady stream of people who are generally well and do not even need to see a GP as a routine measure let alone in an urgent out of hours capacity. Occasionally people comment that "they think they are wasting my time" but lament that 111 advised them that they needed to attend.
    111 is setting a dangerous, unsustainable precedent by making routine and non-urgent cases immediate and necessary.
    I object to my taxes paying for this and it is unsustainable for the nation's overburdened tax payers.

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  • Jane Cummings is surely having a laugh at the public's expense. Below is an article from the "Bedfordshire on Sunday" 05/11/13.which gives a real indication of the state of NHS 111

    "Brand new Bedfordshire NHS helpline already on the critical list"

    Written by RUPERT MARQUAND

    IN CHAOS is the only way to describe the ?proposed replacement service for NHS Direct.

    More than 100 people were being trained by the East of England Ambulance Service (EEAST), in Bedford, as it was expected to take over the scheme, now called 111.

    As late as Monday staff were informed that after a training and induction period of 12 weeks, permanent contracts would be offered.

    On Tuesday they were told that EEAST had lost the bid, so they would all be out of work.

    Nobody has won the bid, and Milton Keynes will run NHS Direct until a provider is found.

    And yet again the new hospital management is refusing to be open and accountable.

    We put a series of questions to EEAST and the new local NHS body, Bedfordshire Commissioning Clinical group.

    These were: Were EEAST told that they would have this contract by NHS England? How many people did you train? How much did this cost? Have EEAST now been told that they will not be awarded this contract? And if so why?

    The answers we received were:

    ‘Bedfordshire Clinical Commissioning Group wants to offer local people simple access to urgent care, which 111 offers.

    ‘However, we will only put 111 in place when we are assured it is safe and effective for local people. Meanwhile, people in Bedfordshire continue to have access to NHS Direct (0845 4647).’

    An EEAST spokesman said: “We do not hold the contract to run the 111 service in Bedfordshire. Any queries around 111 need to be directed to the local CCG.”

    One of the people employed by EEAST to start this new service said: “It was an intensive training course but we were promised work at the end of it. As of Friday I am now unemployed. I feel badly let down by EEAST and the hospital service generally. Apart form ?anything else it must have cost a small fortune, which has now been completely wasted.”

    Says it all!

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  • I heard Jane Cummings, Chief Nurse for England, on Radio 4 on 04/05/13, defending NHS 111. The interviewer pointed out that the old NHS Direct had one nurse advisor for every two callers, whilst NHS 111 only has one nurse advisor for every fifteen callers. The interviewer also asked why something that wasn't broken needed to be fixed. Jane Cummings didn't satisfactorily answer any of the questions asked. It made me wonder why exactly Jane Cummings was answering questions on NHS 111, is she now the official government apologist and poodle for all things to do with the NHS? Mind you she has form, with her failure to speak out on chronic nursing shortages in hospitals and her support for Mr Hunt’s daft idea of making student nurses work for a year as healthcare assistants. Peter Carter said he thought Mr Hunt made this idea up on the back of a napkin. Similarly, Jane must have conceived her 6c's on the back of an envelope. They obviously have a lot in common

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  • re: 3.18pm

    Totally agree. I have lost any respect for Jane Cummings, the CNO, who is nothing but a lap dog for Hunt.

    It must be a very long time ago that she worked as a hands on nurse as she is so out of touch with what nurses are thinking on the ground.

    She is no support to nurses or the NHS; is not an advocate for nursing, and should be ashamed at her inactivity regarding the onslaught against nurses in the media. Despite all her handwringing she has the imagination of a gnat if all she can come up with is the pathetic "6 C's" . If she really thinks this will cure the ills of the NHS, she must have written them on toilet paper not an envelope.

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  • It must be wonderful to view the world through Jane Cummings rose coloured spectacles, nothing wrong with NHS 111, no shortage of nurses on the ward, Mr Hunts idea for student nurse training is welcome, all we need is her "6c's. Welcome to La la land.

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  • We front line staff are getting sick and tired of jumping up and down and trying to point out the obvious problems that will occur when trained staff are cut only to be proven right, still ignored and no one takes responsibility for the poor decisions and hair brained schemes that are thought up by managers charged with saving money - just get rid of the people who come up with these schemes and all their helpers and surely the NHS will make significant savings and can afford trained staff on the frontline.

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  • Agree with ALL above comments.
    There are a lot of people making a lot of money out of the NHS, with their commissioning for out of ours/111/help lines etc; look at any OOH provider now and see how many "directors" "managers" "co-ordinators" etc there are, all raking in huge salaries; and then compare them to the clinical staff on the ground, often struggling to cope with the large numbers of routine and non urgent cases that are sent by the useless 111.
    Many of these organisations are in total disarray. "directors" and "managers" are often on salaries in 6 figures. They rely heavily on agencies as appropriate staff are often hard to come by. Even if the "directors" of these companies are doctors, their salaries and bonus' are extra to their salary as an actual GP.
    And Jane Cummings is on a highly inflated salary for what she actually does. How much does one actually NEED to be the simpering lap dog of the Health Secretary?

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  • I work for OOH as a nurse practitioner and the phrase@ain't broke don't fix it' springs to mind. Nurses used to triage for the OOh calls now they have gone to 111, what comes to base? Somebody with a sore throat that started when they got up that morning referred to base before 12.00 what have they tried? Nothing. Babies with nappy rash, and any one requesting medication because they forgot to request a repeat prescription is marked as urgent. Where is Jane Cummings? Perhaps she & Hunt need to sit in on an OOH base to see what really is happening at grass routes level.

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