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NHS 111 risks increasing pressure on A&E and urgent care

  • 6 Comments

Unions have urged the government to slow down the roll out of the new non-emergency NHS telephone service amid fears a lack of nursing input could increase pressure on other services.

NHS 111 is due to replace NHS Direct from April 2013. But unlike NHS Direct, which is a national service, contracts for NHS 111 are being offered to providers on a regional or local basis and at cheaper cost.

The RCN and Unison claims it will mean fewer registered nurses are employed to provide advice, which will increase pressure on accident and emergency departments and other parts of the urgent care system.

Latest data from NHS 111 pilots shows attendances at A&E departments have actually risen at three out of the four sites – increasing by 12% in Nottingham City, 6% in Luton and 4% in Lincolnshire. The longest running pilot in County Durham and Darlington has seen a 3% decline.

Unison national officer for NHS Direct Michael Walker said: “The Department of Health’s rush to implement the 111 service, without a full evaluation of the pilots, will have a catastrophic impact on A&E Departments [and] GP surgeries, who will be deluged with thousands of patients unable to secure professional nursing advice.”

Meanwhile, unions also claim up to 300 frontline staff at NHS Direct, including a high proportion of disabled workers, are at risk of losing their jobs due to changes to working patterns. Those unable to work the revised shifts will be dismissed with the option to reapply for the remaining shifts.

Managers claim the changes are vital if the organisation is to survive by winning some of the NHS 111 contracts.

Royal College of Nursing chief executive and general secretary Peter Carter said: “We know that NHS Direct is in a difficult position at the moment, however many of the staff have worked there for years and are naturally very worried and upset about the future.”

In a statement NHS Direct chief nurse Tricia Hamilton said there were “enough spaces for everyone to be allocated to a new roster pattern” without the need for job losses.

  • 6 Comments

Readers' comments (6)

  • Amazing since they continue to be recruiting nurses!

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  • Enough spaces for everyone to be allocated a new roster pattern? I bet there are but in reality how many people will be able to work the pattern they have been shoehorned into? Single parent of school age children? Yes of course you will be able to start work at 6am/work until 2am. Disabled? Yes of course you can work shifts detrimental to your health. Got a life outside of work? Forget it.

    Huge folly.

    And before the wider NHS colleagues say they work a 24 hour rotation, I bet you are easily able to swap shifts/have a request book/reasonable managers.

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  • You don't need a nursing qualification to redirect people to their G.P. or to A&E - in fact nothing I learned in 3 years of pre reg training would enable me to enact any first aid other than CPR or to telephone triage.

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  • Anonymous | 27-Jan-2012 1:58 pm

    You don't need a nursing qualification to redirect people to their G.P. or to A&E - in fact nothing I learned in 3 years of pre reg training would enable me to enact any first aid other than CPR or to telephone triage.

    You are right, you don't need a nursing qualification to do that BUT what you do need to do is not direct those patients to 999 A&E or GP if they don't need it and that's where nursing adds value in these services. Nurses are able to critically assess symptoms, using their POST-QUALIFYING experience, therefore potentially giving home care instructions to patients and saving them (and 999/A&E/GP) an unnecessary, time-consuming and costly visit to any of these facilities.

    It is rather sad, however, that do you not feel you learned anything other in your 3 years other than CPR or telephone triage. I am certain telephone triage isn't on the pre-registration curriculum though .....

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  • I also think this new 'access to health care advice' will increase attendances to UCC and to A&E. Even when the phones were manned by properly qualified nurses able to interpret the algorithms in context, we got flooded with the worried well.

    Thus, having a bunch of non medical staff trained in going thro an algorithm but not qualified to interpret that information or to over ride the 'final disposition' and to justify such a decision - we can safely assume with some confidence that UCCs and EDs are going to be awash with the flotsum and jetsum of the worried well.

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  • Well, the rosters are published. Early shifts start from 04:00, night shifts finish at 10:00 am. Lone working on night shift. Staff leaving in droves. Well done NHSD!

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