NHS 111 contractor told to act to prevent more people dying

That is the stark warning from a coroner after an inquest revealed GPs working on the service had no requirement for induction training and were confused about how systems worked.

The warnings came to light following the death of a Tyneside woman who passed away after a GP thought he had requested her an ambulance but had not done so.

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Carol Leeming died aged 77 on October 3, 2022. The previous day she called for an ambulance complaining of a racing heart, the inquest heard.

She asked for help and to be admitted to hospital, but her call was triaged for a call back by an out of hours GP, an inquest at Newcastle Coroners Court.

A doctor working for private contractor Vocare called back that evening and believed he had requested an ambulance for Carol via an electronic system. There was no such facility on the system and no ambulance was requested.

The GP was unfamiliar with the systems in place, had only recently started working for Vocare and had not completed any induction training. There was also no requirement for him to have completed induction training before starting work.

Carol - who had a number of medical conditions - died of natural causes, the inquest ruled. Her medical cause of death was listed as coronary artery atheroma, and COPD.

Senior coroner for Newcastle and North Tyneside, Georgina Nolan, has since raised concerns over systems at Vocare, owned by Totally Urgent Care, warning more patients could die.

She said in a report: “In my opinion there is a risk that future deaths could occur unless action is taken.”

The prevention of future death report, known as a regulation 28, to Vocare lists a series of concerns about its processes.

It reveals there was no requirement for the out of hours GP to have completed induction training prior to starting work for Vocare, not was there any way for online induction training to be made available to new joiners who were unable to attend in person training.

The inquest also heard evidence of confusion among staff about the functioning and capabilities of the systems in place at the call centre, and of a regular turnover of GPs working for Vocare for short periods as part of their training.

Vocare will have to respond to the report by November 21 detailing action taken or proposed to be taken.

John McMullan, Medical Director at Totally plc, Vocare’s parent company said he takes the coroner’s concerns “very seriously”

Mr McMullan said: “Firstly, we would like to extend our condolences to the family of Carol Leeming.

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“After every incident, we thoroughly review our internal processes and not only learn but also make any necessary changes to ensure our services are safe and effective to deliver high-quality patient care.

 “We have taken the extra recommendations of the coroner very seriously and have introduced additional steps for induction training to give more reassurance that individuals have completed and understood the critical parts.”

In January Vocare was given a £10m contract to provide further NHS 111 contingency services for a year.