In August 2010, people living in County Durham and Darlington became the first in England to have a new non-emergency version of 999. The new service, called NHS 111, was supposed to go live across the whole country by last month, but there have been teething troubles in some areas. Health and Education Editor Barry Nelson answers some common questions about the service

WHAT is the NHS 111 service for?

Everyone knows that if you have a medical emergency you should ring 999 for an ambulance.

Health experts came up with the idea of a similar, equally memorable, three-digit number for people who have urgent, but not lifethreatening symptoms. The aim is to ensure that anyone ringing 111 will be given appropriate advice.

DOES it cost anything to ring 111?

111 is entirely free to use 24 hours a day and seven days a week.

WHAT are the options you are likely to be offered if you ring 111?

The options range from offering simple advice, arranging a home visit, booking a patient in to see their local GP the following day, suggesting a patient goes to a walk-in 24 hours urgent care centre, suggesting the patient visits their local accident and emergency department or even calling an ambulance for them.

HOW is this different to the old NHS Direct helpline?

Unlike NHS Direct, 111 call handlers have the ability to directly book you an appointment to see your GP or call an ambulance.

WHAT sort of training have the 111 call handlers had? Are any of them qualified nurses?

Staff working at the North-East 111 call handling centre in Newburn, Newcastle, have all received training to deal appropriately with incoming calls. While not qualified nurses, they use a computerised call-handling system endorsed by all the Royal Colleges and the Department of Health, which allows them to ask the right questions to identify the type of service needed by the caller. However, there are qualified nurses on duty on the call-handling floor at all times.

THE Royal College of Nursing has criticised the new 111 service for not employing enough qualified nurses. Is this a fair criticism?

The old NHS Direct helpline had two call handlers to every qualified nurse. But, according to the RCN, in some parts of England the new 111 service has 15 call handlers to one nurse.

IN a recent unpublished report, GPs in the North-East have claimed that 111 call handlers are potentially putting lives at risk by despatching too many ambulances to patients who did not need them and making “inappropriate” clinical decisions about patients. What does the 111 service have to say to that?

The North-East Ambulance Service (NEAS), which provides the 111 service in the region – in association with Northern Doctors Urgent Care – said many people in the region were reluctant to seek medical help when they need it.

Having a free number like 111 gives these patients permission to seek help when they don’t want to call 999 for fear of being a nuisance.

The NEAS pointed out that when the 111 service was introduced in County Durham and Darlington in 2010, the number of 999 calls taken by the ambulance service fell by more than 14 per cent.

HAVE there been problems with 111 in other parts of the country?

At the weekend it was reported that three 111- related deaths were being investigated in the Midlands while a further possible 19 “serious untoward incidents” have been recorded elsewhere.

WHAT has been the NHS response to all these allegations of problems with the new 111 service?

NHS England, the national body which commissions some health services and oversees the quality of delivery, has said it will now carry out a review into the “unacceptable” performance of the new 111 urgent care helpline.

ARE there any examples of how 111 helped individual patients in the North-East?

Durham City printer Peter Wright called NHS 111 with what he thought was a minor ache but ended up being whisked to hospital in an emergency ambulance.

Peter felt a twinge the day he moved some rubbish at his mother’s home. The next day – which was Jubilee Day and his GP surgery was closed – he still felt store and decided to ring 111.

After revealing he had a family history of heart problems and explaining his symptoms, he was taken by ambulance to The James Cook University Hospital, in Middlesbrough, where doctors discovered that one of his three heart arteries was completely blocked.

He has made a full recovery and is very thankful to the 111 service.