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CQC finds improvements but further progress is required to NHS 111 services in Dorset and Cornwall

27 April 2017
South Western Ambulance Service NHS Foundation Trust
  • Media,
  • Ambulance services,
  • Remote clinical advice

The Care Quality Commission has found that South Western Ambulance Service NHS Foundation Trust has made further improvements to its NHS 111 services. 

The trust provides a 24-hour telephone-based service to a population of 1.3 million people living in Dorset, Cornwall and the Isles of Scilly.

During an inspection in March 2016 CQC told the trust it must make improvements to protect people’s safety. Inspectors found that there were often not enough staff to take calls, or to give clinical advice when that was needed.  A follow-up inspection in August 2016 found there had been improvement. 

As a result of the latest inspection, in December 2016, the service has now been rated Good for providing safe, caring and responsive services and Requires Improvement for providing effective and well led services.. Overall the service is rated Requires Improvement.  A full report of the inspection has been published on our website.

During the two-day inspection in December, CQC found that the trust had taken steps to make further improvements:   

The trust had improved the systems in place to deal with safety risks and the NHS 111 service and was now aligned to the trust’s overall vision of safety and quality. 

Callers were receiving a safer, more effective and responsive service although performance on call answering and abandoned calls was still below national targets. 

Staff were trained to ensure they used the NHS Pathways system safely and effectively. (NHS Pathways is a computer-based system for triaging telephone calls from patients based on the symptoms they report).

The trust had responded to concerns about the use of non-pathways advisors (call handlers who are not trained to use the NHS Pathways triaging system where no longer being used ).

The number of staff had increased: call handlers said the service was now safer, with clinical advice and support readily available.

The opportunities for learning from internal and external incidents were identified and discussed to ensure improvement. 

The trust has responded effectively to complaints and to patient and staff feedback, although, at the time of the inspection there was still a large number still being investigated.

Senior staff demonstrated a much improved understanding of governance and how to effectively run a NHS 111 service. 

Professor Steve Field, Chief Inspector of General Practice, said:

"I am pleased that South Western Ambulance NHS Foundation Trust has continued to build on the progress that we had identified in our previous inspection."

“People who call the NHS 111 service are entitled to quick and easy access to healthcare advice and information, or access to urgent attention when that's appropriate."

“Previously we had been concerned that the triaging system was not good enough. Some people whose calls were urgent were not being assessed in relation to their medical needs in a timely manner."

“On this inspection we saw some excellent examples of good practice and improvements. But, we would now like to be confident that these measures are fully embedded. The trust themselves have recognised that their performance needs to improve further to achieve the expected standards for the NHS 111 service."

“We found that there were still some calls which were not dealt with promptly or effectively. The trust must continue to work on this – and monitor the performance of its call handlers to help them get this right.”    


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Last updated:
29 May 2017

Notes to editors

The NHS 111 provided by South Western Ambulance Service NHS Foundation Trust covers people in Dorset, Cornwall and the Isles of Scilly. 

NHS 111 is a telephone-based service where callers are assessed, given advice and directed to a local service that most appropriately meets their needs. This could be a GP service, walk-in centre or urgent care centre, community nurse, emergency dentist, emergency department, emergency ambulance, late opening pharmacy or home management.

For details of the CQC inspection in March 2016 – see our website

To get to the heart of people’s experiences of care, we always ask the following five questions of services.

  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?

For every NHS GP practice and out-of-hours service, we will look at the quality of care for the following six population groups: Older people, People with long-term conditions, Families, children and young people, Working age people (including those recently retired and students),People whose circumstances may make them vulnerable, People experiencing poor mental health (including people with dementia). 

Providers are required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.