Don't put our hospitals under undue pressure this winter

Professor Julian Redhead, NHS national clinical director for urgent and emergency care, says up to 40 per cent of patients who turn up at A & E don't really need to be there. In most cases these patients would have been better treated elsewhere in the health service.

A separate report also identifies that a significant number of patients who arrive at A & E are repeat visitors, whose attendance could have been avoided had their problems been dealt with earlier. This is not only unsatisfactory for the patient, but it also clogs up emergency units at a time they can ill afford it.

There is much logic to making more use of NHS 111 to ensure only those in real need end up in A & E. But the flip side is that the telephone service must well and truly be up to scratch. The last thing we want is to be reporting on a tragedy because somebody who needed urgent care was left waiting on a telephone line. 

Health minister Karin Smyth says 85 per cent of calls are answered within a minute, which sounds encouraging. However, to someone anxious about their health,. a minute can seem a very long time indeed. And if more people are going to be told to use the service, it really needs the resources to cope with this.

We all have a duty to be responsible in our use of emergency services, and to only dial 999 or turn up at A & E when totally necessary. But there can be no excuses if the 111 telephone line does not provide the required level of service.