Trust's Managers - Deliberately Delayed Ambulances to up to 20,000 Patients who called 111: Potentially Putting Public at Risk


Decision to delay ambulances to patients calling 111

A secret decision by managers to delay ambulances to up to 20,000 patients calling 111 potentially put the public at risk, an NHS England Report (2015) has found (BBC, 2015). The report says managers at the trust ordered the policy, with no ‘risk assessment’ of the dangers it could cause (Donnelly, 2015). By way of reminder - the NHS 111 helpline was set up as an urgent but non-emergency number designed to replace the existing NHS Direct service and work alongside 999.

Trust deliberately delayed ambulances

South East Coast Ambulance trust authorized the secret operation which saw thousands of calls - including those classed as ‘life-threatening’ – downgraded, forcing patients to wait twice as long.

Under health service rules, calls designated as ‘life-threatening’ are supposed to receive an ambulance response within eight minutes - regardless of whether the caller dials 999 or the non-emergency 111 line. But the ambulance trust, which covers Sussex, Kent, Surrey and North East Hampshire, invented its own system to routinely downgrade calls which came via 111, giving paramedics an extra 10 minutes to attend.

An investigation by NHS England says the project was drawn up via a group which was established by the chief executive Paul Sutton, and overseen by at least four executives.

The secrecy meant that 111 call handlers assured patients in “life-threatening” situations that an ambulance was on its way, with no idea that it was not.

Instead, paramedics with just one day’s training in call-handling, were ordered to phone thousands of cases back to see if ambulances were really needed. As a result, life-saving cases forced to wait up 18 minutes, were still counted as hitting the eight-minute target, while non-life threatening cases were given an extra 20 minutes.

Because the 111 staff referring the calls were never told about the system, many remained on the phone to monitor patients – blocking the line for the assessment call (Donnelly, 2015; NHS England, 2015).

Independent review of harm to patients

Donnelly (2015) argues that a trust whistleblower says that an internal NHS investigation has been told of 25 deaths of patients affected by the policy.

Monitor (2015), the regulator for Foundation trusts, ordered an independent review of harm to patients, warning that not enough work has been done to identify whether patients were harmed. The NHS England Report (2015) examined seven “serious incidents” including five deaths.

Katherine Murphy, Chief Executive of the Patients Association said: “The findings of this report are very damning and paint a worrying picture…These decisions placed the public at risk and their actions were completely inexcusable. This is a…major scandal…The Patients Association express our deep concern with ongoing patient safety issues of this nature. There has been no accountability, no transparency in the investigation and absolutely no assurance for the safety of the public…The public deserve better” (Murphy, 2015).


BBC NEWS. (2015). Ambulance changes 'potentially put public at risk' 5 November. Available at:

Donnelly, L. (2015). NHS 111 scandal deliberately delayed up to 20,000 patients. The Telegraph. 2 November. Available at:

Monitor. (2015). NHS 111 scandal deliberately delayed up to 20,000 patients. Newster. 2 November.

Murphy, K. (2015). The Patients Association. Press Release. Response to NHS England report on NHS 111 scandal. 5 November.

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