Less than 17 per cent of staff working on the NHS 111 pilot in the north east of England are qualified nurses, Nursing Times has learnt.
Health minister Simon Burns told the House of Commons earlier this year that 38 per cent of staff involved in the pilot for the new 111 urgent care service were registered nurses. However, of the 167 full time equivalent staff, just 24 - 16.8 per cent - are clinicians including nurses.
The pilot, which started in August, is being run by NHS County Durham and Darlington and delivered by the North East Ambulance Service from a call centre where the same team triages both 999 and 111 calls using NHS Pathways software.
It is receiving an average of 3,500 111 calls a week.
Programme lead at NHS County Durham and Darlington Berenice Groves said combining 999 and 111 was more economical as it meant staff had little down time.
However, Howard Catton, head of policy at the Royal College of Nursing, said the low level of nurses on the staff was “extremely concerning”.
He said: “We would be worried about safety implications of that dilution of skills mix.”
A spokesman for North East Ambulance Service said NHS 111 call handlers underwent the same training as 999 staff and used the same systems.
He added: “We use a safe and robust clinical system that has handled 999 calls for more than four years and 111 non-emergency calls since the summer of 2010.”
Under the north east pilot, calls that come through requiring health information, such as medicines advice, are transferred to NHS Direct.
But on average only six calls a week are put through to NHS Direct - almost half of which is staffed by nurses.
Ms Groves said: “The reason why there are so few calls transferred to NHS Direct is that people still know the [NHS Direct] number. We do expect to see that increase over time.”
About 38 per cent of the 137 staff working on the three other NHS 111 pilots in Nottingham, Lincolnshire and Luton are registered nurses.
NHS Direct is providing the call handling in these pilots. The Department of Health is evaluating them to determine the appropriate skill mix.
A spokeswoman said: “Using the clinical assessment system means a smaller proportion of calls need to be referred to a nurse adviser.”