The non-emergency NHS 111 service came under scrutiny this winter after claims it was referring more people to already over-stretched A&E departments. Reporter SOPHIE WYLLIE experienced a Friday evening at the Norfolk 111 centre.
On December 28 last year, amid the so-called NHS winter crisis, the Norfolk 111 phone line received 3,000 calls.
Because of unprecedented demand, the Hellesdon control room had 40 call advisors on duty – 56pc more than the previous year.
To cope with all the calls there would have had to have been 98 advisors in the 24/7 control room, run by the East of England Ambulance Service Trust.
Rob Mackie, clinical operations manager for the Norfolk 111 service out of hours GP service, said: 'It was very difficult for everyone. It was public demand. People were not wasting our time. In Norfolk, we have an elderly population where people are surviving longer because of advances in medical science. As a result, the NHS is struggling to cope.'
When a patient contacts 111 advisors ask a series of questions, the first of which rule out a life-threatening condition requiring a 999 response.
Advice can then be offered through the NHS Pathways triage system.
This could include handing over patients to the out-of-hours GP service, where a professional calls back offering a home visit, over the phone advice, or an appointment at an out- of-hours surgery.
Katie Hufton, 111 call centre manager, said the service demand had gone up over the past two months.
The busiest periods are weekends and when GP surgeries are shut.
'At the weekend, none of our seats will be free,' Mrs Hufton said. 'We get everything. It could be a call about a broken finger nail or a dental problem to a cardiac arrest.'
On average, there are 600 calls a day Monday to Friday, 1,500 on Saturdays and 1,300 on Sundays.
There has been a rise in calls from people suffering with mental health problems.
From next month, two mental health nurses will be based in the control room and call handlers will receive specialist training in dealing with these types of calls. Despite not being medically trained, the advisors go through 10 tough weeks of pathways training and can seek medical advice from clinicians.
Mr Mackie said: 'The birth of the 111 system wasn't easy, but it is an evolutionary process.
'We check the decisions being made are appropriate and if not, we make them better.
'Norfolk is really lucky. It has the best 111 service in the country at the moment.
'We are working hard and people are passionate about making it a success.'
Out of 46 English areas, Norfolk recently came out top in relation to calls answered within one minute over one day, scoring 99.93pc.
Mr Mackie added: 'What we need to do is properly direct each patient's demand to the appropriate areas so their problem can be solved and that is why the 111 service is important.' He said the Norfolk base was successful because of its integrated nature.
Set up in December 2012, it shares a relatively small space with the ambulance trust's 999 call handlers, clinicians and out-of-hours GP service.
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