Abuse and staff shortages forcing NHS call handlers to quit or go off sick

Staff handling urgent medical calls on the NHS 111 service are leaving in large numbers due to heavy workloads, staff shortages and abusive callers, says UNISON today (Friday).

Figures provided by six ambulance services in England and Wales show almost half (46%) of staff left their jobs in the three years to April 2024.

UNISON says the snapshot of the system also revealed employee sickness is a significant concern, with 300,000 days lost to ill health at the six organisations from 2021 to 2024.

The union found there were 91,681 days lost in 2023/24 – the equivalent of six working weeks or 31 days’ sick leave for every call handler. This compares to an average of just four days for UK workers more generally*.

In the year to April 2024, the service for Yorkshire had the highest staff turnover (76%), followed by South East Coast (62%) and South Central (44%).

South East Coast Ambulance Service (SECAmb) had the highest average number of sick days per worker in 2023/24. Figures provided by the trust show 17,389 days were lost that year, the equivalent of 64 days per call handler.

The report also includes a survey of more than 200 staff. Call handlers said the volume of calls (82%), staff shortages (75%), and aggressive and abusive callers (66%) were the worst challenges they faced in the job.

As a result, almost three-quarters (72%) said they had considered quitting in the past 12 months, while 39% said they would not recommend working for NHS 111.

When asked what would improve things, 72% said better pay, while a similar number (69%) said extra staff would make them more likely to stay.

UNISON says call handlers should be moved up a grade on the NHS pay scale to make a difference to low wages.

Where 111 services are contracted out, they should be brought back in-house to allow greater integration of 111 and 999 services, says the union. That would benefit both patients and staff.

UNISON national ambulance officer Sharan Bandesha said: “NHS 111 is a lifeline for patients and their families. The service provides vital advice and access to care when they urgently need it.

“But staff are under immense pressure and it’s no surprise many don’t stay in the role. Bringing 111 services back in-house, paying staff properly for their work and employing enough staff to alleviate pressure would help ensure NHS 111 is fit for the future.”

Notes to editors:
– The report is available here. It is based on data from Freedom of Information (FoI) requests submitted to NHS ambulance trusts in England and Wales.
– UNISON received relevant data from six NHS ambulance trusts: London, North West, South East Coast, South Central, Wales and Yorkshire.
– Trusts were asked to supply data on 111 control room worker numbers, call handler turnover, vacancies and days lost to sickness from April 2021 to April 2024.
– A total of 298,276 days were lost to sickness in 111 control rooms from 2021 to 2024.
– * Based on Office for National Statistics data.
– UNISON surveyed 213 workers in 111 call centres in January and February 2026.
– NHS 111 call handlers provide advice for non-life-threatening medical conditions by assessing symptoms and directing patients to the most appropriate service.
– UNISON is the UK’s largest union, with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.
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