Further improvements are needed to the NHS 111 service in Somerset after a patients' survey found the quality of service it provides was "not consistent" across the county.

The NHS 111 service provides advice on non-emergency conditions, with those who call being assessed over the phone by healthcare professionals and then directed to the most appropriate facilities in their location.

The Care Quality Commission (CQC) inspected the Somerset service (which is provided by Devon Doctors Ltd) in July 2020, and found people were not being triaged or treated quickly enough.

A new report by Healthwatch Somerset has found that some improvements have been made since the inspection, but more work is needed to ensure all residents get the same quality and speed of diagnosis and treatment.

Devon Doctors took over the running of Somerset's out-of-hours GP service from Vocare in April 2018, and was awarded a new £7 million contract for both this and the NHS 111 service by the Somerset Clinical Commissioning Group (CCG) in February 2019.

While Devon Doctors runs the out-of-hours GP service directly, the NHS 111 operation is sub-contracted to Practice Plus Group, formerly known as Care UK.

Healthwatch Somerset, which campaigns for better health services on behalf of ordinary patients, surveyed nearly 200 patients across the south west between October 5 and November 20 2020 to get their views on how well the service was performing.

More than 40 per cent of those using the service rated it "very good" overall, and more than three quarters (75.81 per cent) said their initial call had been answered "in a timely manner".

However, many expressed concerns about how long the service had taken to call them back after their initial inquiry.

Nearly one in four (23.66 per cent) of people surveyed waited more than three hours for a call back – and more than one in five (20.43 per cent) were never called back at all.

More than one in 20 (7.59 per cent) said they had called 999 or gone to their nearest A&E because of NHS 111 failing to get back to them.

Nearly half (43.87 per cent) of respondents praised the attitude of the staff who answered their queries – but more than one in six (17.42 per cent) said there was "nothing good" about the service.

One respondent, who did not wish to be named, saidd: "I had a long wait. Rude person on the phone. Told I'd get a call-back then never did."

Another said: "The 111 service needs to be run by people who are more flexible and with actual medical knowledge. Not just people working through a tick box flowchart. It's so frustrating!"

When asked how the service could be improved, the most common response was improving the training being given to call operators.

A spokesman for Healthwatch Somerset said: "It is evident throughout the feedback that the accuracy and quality of the service people received was not consistent."

The report recommended the following improvements be made to the service:

• Reduce waiting times for both incoming calls and arranged call-backs
• Improve staff training around handling calls, including a more flexible diagnostic approach and better access to qualified medical support
• More consistent staff training to ensure the same standard is being provided across the board
• Review pre-recorded messages to reduce their length and ensure patients are connected quicker
• Be more empathetic towards callers with mental health issues
• Implement a call logging system, so if patients call back their previous call is available for the operators to access and review.

Healthwatch Somerset manager Hannah Gray said: "With essential services facing unprecedented challenges, it is really important that we, as the consumer champion for health and social care services, continue to listen to the community and share feedback with our stakeholders and key decision-makers on what is working well or not so well and what may need addressing.

"Your feedback from this report will be used to shape and improve the local NHS 111 service and really could make a positive difference."

Devon Doctors Ltd has welcomed the report and its recommendations but said it would be difficult to implement all of the proposed improvements without government support.

Martin Cordy, interim director of contract assurance, said: "We support the recommendations made within the report; however, many of these are unable to be implemented locally as it will require national changes in policy, process, and funding.

"We are working with Healthwatch to help the patient voice in relation to these issues be raised at a national level so that positive change can be made.

"We are currently delivering a programme of service transformation to ensure that the quality of the service provided, including patient experience, enables us to deliver the best possible clinical care to patients within Devon and Somerset.

"The feedback from this report has helped shape elements of this plan to ensure that improvements are made in the areas concerning members of the public as well as those identified internally.

"We are pleased to confirm that it will be working in partnership with Healthwatch in the coming months to understand the public's experience of urgent primary care services within Devon and Somerset and identify areas for future service transformation."