THE term ‘tragic’ is much overused but Adrian Kibbler believes that a case that is truly worthy of that billing will send a chill through Ludlow and south Shropshire.

WILLIAM Mead was a 12-month-old baby who lived in Cornwall.

He had been generally unwell for a few weeks and there had been a number of visits to the doctors. When his parents became concerned about him at home they called 111 and went through the list of questions with the call handler.

The reassurance came that there was nothing serious to worry about. William’s mum checked on him regularly and on one of these visits her first reaction was that he was unusually cold – he was dead.

It seems that we do almost everything over the telephone or on line these days ranging from banking to completing our tax return, booking visits from gas engineers – the list is endless.

This now includes out-of-hours medical calls and many GP surgeries are increasingly offering telephone consultations.

While frustrating, most of the time this works okay but 111 involves an increased level of risk because the people taking the call are not always medically trained so the diagnosis and action required is generated by a computer algorithm.

Add into the pot the fact that the person providing the information is likely to be worried and under stress and it is hardly surprising that tragedies like little William Mead happen.

The particular relevance to Ludlow and south Shropshire is that the Clinical Commissioning Group is considering tendering out the Shropdoc out-of-hours service where out-of-hours medical calls are handled by doctors.

Let it be said that, whatever service is provided, as long as human beings are involved mistakes will be made. All of us, doctors, nurses, airline pilots, solicitors, shop assistants and, yes, even journalists make mistakes.

Even a face-to-face consultation with a doctor is no guarantee because in the case of little William, he had been seen previously by doctors and a report into the tragedy shows that a chest infection was not picked up.

This is not to say that those who made mistakes or those who make them in the future are bad at their jobs. Illness does not always progress in a straight line and some conditions can be difficult to diagnose.

Little William died from sepsis which happens when the body’s immune system goes into overdrive. It can be difficult to diagnose and the symptoms can be complex.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published a report in November 2015, saying sepsis kills more people than breast, bowel and prostate cancer combined in the UK and suggesting that there are 200,000 cases a year and up to 60,000 deaths which, they add, could be an underestimation. Health Secretary Jeremy Hunt has suggested that 12,000 of these could be avoided.

One indicator of sepsis is low blood pressure and a high heart rate – a test that cannot be undertaken down a telephone line, irrespective of whether a doctor or untrained call handler is on the other end.

So there is no substitute for a face-to-face consultation but where a telephone call has to do then, please, let us have a trained medical person on the end of the line.