Working up close with NHS 111

A Patient Representative working with the Integrated Urgent Care Workforce Development Programme gives his views on the workings of an NHS 111 call centre:

I have only been a patient of the NHS since 2010, needing intense cancer treatment and care.

Prior to that I was a fit and healthy Naval Officer for 30 years and I never had a day off sick – I reserved any minor illnesses for Bank Holidays and leave periods!

I became involved as a representative for ‘patient experience’ in September 2014. Following my recent NHS experiences I felt it was important to make sure the patient voice is heard and listened to, so that the plans, policies and work of the NHS represent patients’ needs and wishes as far as possible.

As part of that I recently joined the Executive Board of the NHS Integrated Urgent Care Workforce Development Programme.

Have you ever been in an environment where everyone is an expert apart from you? This was one of those environments and I was way beyond my comfort zone.

The team, however, were kind and listened to me. They acknowledged my hesitant input to such an extent that I now feel a member of the team.

The Programme began in April 2015 and is due to run for three years. It is a joint Programme of work with Health Education England and its aim is to develop the NHS 111 / Integrated Urgent Care (IUC) call centre workforce for the future, all the while improving care, services, experience and outcomes for patients.

A worthy job and one that holds a multitude of challenges, not least due the misconceptions and poor representation that some unnamed media outlets might have us believe.

I’d like to share some insights from my first contact with NHS 111 frontline. I visited South East Coast Ambulance Service’s NHS 111 call centre and IC24 NHS 111 call centre, both of which are based in Ashford, Kent, but provide NHS 111 services for a much wider geographic area.

I feel I have gained some useful insight, albeit at a fairly superficial, first impression level.

My first impression of the staff working in the call centre was very positive. They seemed keen, knowledgeable and confident about the NHS Pathways system and other IT systems which they were using.

During the demonstration they gave us, the software seemed effective. I was able to listen in on a few calls, with both health advisors and a clinical advisor (a nurse). During each call the advisor was helpful, considerate and the call was always ended with a course of action – mostly making a GP appointment, or to attend a walk-in clinic. The people I spoke to told me that training and subsequent mentoring was important to them and the managers I met also seemed approachable, flexible and respected.

However, when speaking in more detail about information handling, there did appear to be a lack of integration across the wider system. For example, staff particularly mentioned frustration about the lack of a feedback route from out of hours services to NHS 111. At the moment it seems that the information flow is mostly one-way.

I have heard much about the development of Integrated Urgent Care, largely through my involvement in the work of this national Programme. I sense that right now the vision of integration is a future vision rather than current reality.

This Project is so needed and I am very hopeful that future users of this service will see increased benefits and improvements in care will become evident.

Iain Upton

Iain Upton is a Patient Representative on the Integrated Urgent Care Workforce Development Programme.

He served as an Officer in the Royal Navy for 34 years before his medical discharge in 2015 following naso-pharyngeal cancer. Significant radiotherapy-induced nerve damage leaving Iain unable to speak, see, or swallow properly.

He joined the Navy at 17, trained as an engineer and worked across an enviable array of employment fields – systems engineering at sea to workforce and resource planning.

Despite his recent disabilities, Iain injects the patient perspective into all levels of healthcare. Passionate about communication, he has also set up his own business to train presentation skills, as well as speaking himself wherever he can to whoever will listen.


  1. Beverley Murphy says:

    I spoke to a lovely lady at 8.25 on the 30th Dec 2017 she was amazing she talked me down from a massive panic attack which I’d had for 2 hours. She was calming and very professional without her today I could have been panicking all day. I don’t no if this the correct place to complement an advisor but couldn’t find another form to do it. Unfortunately I don’t remember the nurses name hopefully you can trace her from my time and date added to this form. What a lovely soft spoken caring person she was I’m very grateful to her for helping put my panic into perspective she helped me get on top of my attack. Well done to her she a great asset to your team and was an amazing help to me now and going forward with my panic disorder thank you so much just wish I could remember your name.

  2. ian says:

    Why somebody out there is trying to make mad ness out my name in england stupied.ian joseph michael upton there is only one of us in the world.

  3. Kasander says:

    ”… Iain injects THE patient perspective into all levels of healthcare.”
    … Iain injects ONE patient’s perspective into all levels of healthcare.

    Or did I miss the hustings and the ballot?

  4. Kasander says:

    Mr Upton is a member of the
    ”Executive Board of the NHS Integrated Urgent Care Workforce Development Programme”.
    where he claims to be
    ” …a Patient Representative …”

    ​Tony Benn ” .. ​developed five little democratic questions ”
    which Mr Upton may care to answer:

    ​”​What power have you got?
    Where did you get it from?
    In whose interests do you exercise it?
    To whom are you accountable?
    And how can we get rid of you?” ​
    Do now the Watched appoint the Watchers who watch them​?
    ​(​Vigiles, qui custodiebant autem et constituam ut observetis eos?​)​