Casualty in crisis: A&E - a service in meltdown

Damning report says NHS Trusts were pressured to introduce new 111 service before they were ready

Doctors were placed under “unprecedented pressure” to go live with the new NHS 111 helpline before some were ready, contributing to the A&E crisis in Britain's hospitals, documents seen by The Independent on Sunday reveal.

Paramedics have been sent out to treat patients who did not feel ill enough to need an ambulance and were "more than willing" to see a GP instead, according to a damning assessment by the NHS Alliance, which represents GP surgeries and other primary care trusts.

In a separate official report by NHS England, presented to the Health Secretary Jeremy Hunt 10 days ago, officials told him that A&E performance has "deteriorated significantly over the last six months" as a result of increased numbers of patients arriving at casualty, job losses and social care pressures leading to elderly people remaining on wards.

The introduction of NHS 111 last month has exacerbated the crisis, the officials said. Mr Hunt now faces questions in Parliament over his handling of the crisis in emergency care.

The NHS Alliance said warned in its report that providers of the new non-emergency telephone number did not feel prepared to "go live" with the service on 1 April but felt they were put under "unprecedented pressure" by the Department of Health.

In one incident in Bristol, because of 111 call mishandling, police were called to a palliative care patient despite an attempt by a doctor to intervene.


Mr Hunt has insisted for the past month that the growing crisis at accident and emergency units is a result of Labour's 2004 GP contract, which allowed family doctors to opt out of out-of-hours care.

Yet both the NHS Alliance and the report by NHS England – the quango overseeing the delivery of the newly restructured health service – say that the introduction of the 111 service has piled pressure on Britain's emergency units.



Despite the Health Secretary's repeated claims about the 2004 GPs' contract being the driving force behind the A&E crisis, nowhere in the 23-page NHS England report does it list this as a factor.


"For weeks, Jeremy Hunt has sought to blame the 2004 GP contract for the pressures on A&E. We now know that the official advice he was receiving in private from NHS England did not support his claims.

This embarrassing revelation will damage confidence in the current incumbent. Jeremy Hunt needs to remember that he is the Secretary of State for Health, not his department's spin doctor-in-chief."

NHS 111 was launched in some pilot areas last year before being rolled out in most parts of England on 1 April. But since its introduction, there have been warnings that the failure of call handlers to deal with patients correctly has triggered an influx in people arriving at A&E.