Blanka Aldridge, a nurse who has worked at our NHS 111 contact centre in Bedford since 2019, tells us more about the important role Clinical Advisors like her play within the NHS 111 service as part of a wider team. And what did it mean to her to be a part of HUC’s vital contribution the country’s COVID-19 response?

When a patient makes contact with NHS 111, there is a team of clinical and non-clinical colleagues on the other side of the phone to support them with their healthcare need. They will speak to a non-clinical call handler first, a Health Advisor, who asks them a series of questions, taking them through an initial assessment using the NHS Pathways algorithm. Based on the answers given, they will help the patient get the right care in the right place for their healthcare need.

Health Advisors, who are comprehensively trained and continuously audited, are supported by nurses and paramedics like Blanka within the call centre. They are called Clinical Advisors.

As part of her role, Blanka speaks to patients who need a clinician, taking over from the Health Advisors after the initial assessment, and triages them further. This means she will use NHS Pathways and her own clinical experience to decide what is the best and appropriate action. “I was looking for a challenge… I know everybody says that,” she says candidly, “but I do have vast experience in the clinical field, and I like what I to within the NHS 111 service. You need to think quickly and use your knowledge and the information available to you.”

She explains how every day is different as you never know what calls you are going to receive, or the health problems patients need support with. “We have some fantastic colleagues who take the initial calls but as a Clinical Advisor I spend much of my time floorwalking. This means that anytime someone is unsure of something the patient is telling them, I assist them or even jump in and take over the call.”

On the phone vs In-person consultation

Blanka’s career in nursing spans over 25 years but when she started out, this style of healthcare delivery over the phone didn’t exist. “When you see a patient in a traditional face-to-face setting there are so many visual cues and signals that you can work with. If you administer medication to a patient, often you can see it working right in front of you and you can reassure them that they’re going to be fine. And of course, you are reassured that you’ve done your job well in caring for them and that they are going to be fine,” she explains.

“But when working in a contact centre setting, the bedrock is strong listening skills to understand the patient and to assess the background situation as well. You have to ask questions that might prompt the patient to tell you something which they might not have even thought of or considered relevant to their ailment.”

“As experienced practitioners, we are used to spotting symptoms that help build up a complete picture of what may be wrong, and we have to tease out vital information. Other clinical colleagues further down the line can then use this information to diagnose the condition later,” Blanka elaborates. “The patient doesn’t always understand why you’re asking so many questions, so it requires a bit of diplomacy and tact. I have had incidents when patients have called thinking they just need some advice on how to manage a troubling pain, but after a short chat, the best course of action turned out to be to send out an emergency ambulance to them because I suspected something far more serious was going on,” she recalls.

A rewarding career

Blanka likes how her job role varies depending on the issue at hand. “It is really rewarding when you can help someone with a calming talk. Sometimes, they just need some advice about where they should go to get treatment, but I can also book them in to receive specialist care elsewhere. On other calls, it’s just a quick trip to the chemist – like a child might appear very unwell and the parents are distressed but it’s a minor illness that can be quickly resolved by a quick talk with a pharmacist.”

“I’ve worked with all of kinds of patients over the years, including oncology, cardiology and ophthalmology. My role at HUC has helped me understand the breadth of my experience and learning. This is one of the most satisfying things about this role – it brings together all of that. It’s also quite collaborative: I interact with a whole range of medical professionals. I do have to talk to colleagues who are in A&E quite regularly and we share any emerging trends, or advancements in patient care,” she elaborates about her learning process.

Operating during the pandemic has not been easy, but HUC has supported in every way, she says. “From the beginning, we’ve been constantly updated on the information and advice regarding COVID-19. It had been changing on a day-to-day basis previously and we’ve were getting a lot of emails, which was very helpful.”

Working as a team

Blanka enjoys working with her colleagues and learns a lot from them as well. “I work with some brilliant people, especially the ones who pick up the phones and take the initial call. They do a top-rate job of keeping our patients calm and though they may not realise that it is also an area of expertise,” she says.

“I try to encourage them by letting them know when they’re getting it right and also building relations with them so that they trust me. It’s important that when they do get that difficult call or it’s a total emergency and they are not quite sure how to respond, they should be able to talk to me and ask me questions. In that respect I see myself not just as support to patients but a support to the team who then offer that support to patients,” she says, “I think it’s one of the best teams and organisations I ever worked with – everyone is equal – no differential treatment towards clinicians, doctors, receptionists or health advisors. We all support each other, and that’s the best thing.”

“I would certainly recommend this job to other people. It’s a good experience which helps you enhance your conversation skills – it’s hard when somebody is distressed and you don’t even see them, they don’t see you, don’t know them and you’re trying to calm them down. As a clinician, you just learn new things every single day,” she adds.

Blanka shares her proudest moment before signing off. “Recently I went to visit one of the patients in a different capacity and his mother asked if I worked in 111 over the weekend to which I replied yes. She told me she had to call 111 a couple of days ago, and they were marvellous to her. So, when you get a feedback like that, it’s wonderful. There have been quite a few instances like that, and all the positive feedback is just so uplifting – I’m a part of that achievement,” she says proudly.