IT Hiccups of the Week: New NHS 111 Helpline Needs to Call 999

It has been an unusually quiet week in regard to IT-related problems. Of greatest significance seems to be the ongoing technical and training issues associated with the new UK National Health Service (NHS) 111 patient helpline service.

NHS 111 Healthcare Helpline in Meltdown Mode?

Earlier this month, the UK National Health Service began its England-wide roll-out of a new helpline service; to access it, NHS patients can simply dial 111. The service is meant to provide one simple number that people can call to get timely and appropriate information about non-life-threatening but still important medical issues—especially after normal business hours. The plan is that a patient calling in will be quickly connected to a trained call-handler who will assess the patient's request for information and then use a directory of medical services available in the caller's area to provide specific advice on which NHS services could best meet his or her healthcare needs. If the call taker assesses that immediate care is required, an ambulance will be summoned. Patients with life-threatening or other urgent medical emergencies are still able to call 999 to get an immediate emergency service response.

The NHS 111 telephone service is replacing NHS Direct, which was started in 1997, and is staffed primarily with NHS nurse advisors. But to reach NHS Direct, the patient has to dial an 0845 number and incur a charge for the call. Calls to the NHS 111 line are free, but the service uses non-clinically trained call takers who are supposed to be supported by a much smaller number of experienced nurses. This change—along with a setup whereby the provider of the NHS 111 service is contracted for and operates locally rather than the service being provided for by the NHS nationally—is seen as a bid to save the NHS money.

Last month's soft roll-out of the 111 service in the London, Manchester, and Birmingham areas went poorly, according to various news outlets. The weekly medical publication Pulse, for instance, reported of doctors warning that “patient care [was] being hampered by the service due to improperly trained staff, a lack of personnel, long waits and out-of-hours GPs having to take on extra work.”  The BBC reported that in the Greater Manchester area, the entire 111 system crashed, which meant that an unknown number of patient calls went unanswered.  

The British Medical Association was so concerned at the scope of the initial problems being experienced that it said, “The Department of Health needs to reconsider immediately its launch of NHS 111 which clearly is not functioning properly. They must ensure that the system is safe for patients before it is rolled out any further.” In response, the NHS said the April rollout, despite the “teething problems,” would go on as planned, but that it would “carry out thorough testing to ensure that those [111] services are reliable.”

Well, in light of news reports last week, it looks like even more 111 system testing is called for.  The London Telegraph reported that there were long delays in responding to patient 111 calls in 30 out of the 37 areas across England where it has been rolled out. In some instances, instead of a patient's call being routed to a central triage center where the medical issue would be prioritized, a vaguely described “system error” caused patient cases to be automatically closed instead.  The Pulse reported that despite the NHS insistence that things were going well with the 111 roll-out, “more than 40% of calls to NHS 111 [over the Easter weekend] were abandoned by patients in some regions [because they couldn’t get through], while elsewhere one patient had to wait more than 11 hours for a call-back.”

The Daily Mail reported, in its usual understated manner, on emergency services workers' complaints about the staff handling the 111 calls. The call takers are so poorly trained, say the ambulance crews, that they have sent ambulances to deal with obvious non-emergency situations,  e.g., an ingrown toenail. In some cases, ambulance crews complained that their workload has doubled since 111 was introduced (researchers last year identified increases in "emergency ambulance incidents" as a possible consequence in an evaluation of four NHS 111 pilot programs (pdf)).  One hospital trust in Kent was even said by the Mail to be so overwhelmed by patients being sent to it via the local NHS 111 service that it had to declare an “internal Major incident,” which usually only happens when there is a major traffic accident, fire, plane crash, or other emergency event that threatens to overwhelm its care-giving capacity.

The NHS 111-related chaos has spurred a Parliamentary review of all emergency services by the House of Commons Health Committee. The review is supposed to be completed by mid-July.

Alberta’s Energy Resources Conservation Board Computer System Down for the Last Two Weeks

Alberta’s Energy Resources Conservation Board (ERCB) website says it is an independent agency that regulates the safe, responsible, and efficient development of Alberta's energy resources such as oil, natural gas, oil sands, and coal as well as the province’s energy-related pipelines. According to a story last week at the Calgary Herald, on 2 April, after a routine hardware upgrade to its computer system servers, “ERCB staff discovered that some ERCB production servers were unavailable.” The next day, when the ERCB IT staff tried to fix the affected servers, “additional servers developed problems” which led to a decision to shut the system down to prevent data loss.

The affected ERCB system, the Herald says, is used to accept “electronic applications filed by industry through an automated process for wells, facilities, pipelines or oilfield waste management facilities” as well as to generate ERCB reports.

And according to the latest ERCB press bulletin posted last Friday, “Outside experts have been brought in and are working with staff around the clock to restore operations. It is unknown how long the service interruption will last.”

As of this morning, the ERCB system still looks to be unavailable.

Georgia Department of Driver Services Goes Dark Again

Georgia’s Department of Driver Services (DDS) computer system was reportedly down statewide for all of last Tuesday (typically the agency's busiest day of the week) because of “faulty network hardware” at its support vendor, MorphoTrust USA, Fox News Atlanta reported.  Little if any DDS business was transacted, the article indicated. Things were back to normal by Wednesday, although customer wait times were long.

Last month, Fox News highlighted two additional statewide computer problems at the DDS, one on 4 March and the other on 19 March. The more recent of the two incidents involved the system being unable to accept customer payments, e.g., for license renewals, for several hours; in the earlier case, a “mainframe issue” caused problems for most of the morning. The DDS suffered computer-related issues last summer as well.

All 1500 at New Zealand School Put on Detention

Finally, “most if not all”  parents of the 1500 students attending Waimea College in Nelson were mistakenly sent multiple text messages last week telling them that their son or daughter was on detention and to contact his or her tutor for further information, the Nelson Mail reported. The school’s principal attributed the problem to an unknown “software glitch.”

As I said, all in all, it was a quiet week.

Other News Items of Interest

Computer Problem Enables Emergency Weather Siren in Indiana

King Fahd Causeway Linking Saudi Arabia and Bahrain Shut Down by Computer System Failure

Chinese Daily Reports Spoof Claiming Windows 8 Problems Are Delaying North Korean Missile Launch as Fact
 

Photo: sturti/iStockphoto

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