John McIvor’s pay deal included a publicly funded ‘golden goodbye’ of almost £300,000

The official responsible for the disastrous launch of the NHS out-of-hours hotline was paid almost £500,000 last year, the Daily Mail can reveal.

John McIvor’s pay deal – which was never published – included a publicly funded ‘golden goodbye’ of almost £300,000.

He earned the huge package while senior responsible officer of NHS England’s NHS 111 Implementation Group even though the launch of the out-of-hours service was condemned by doctors’ leaders as an ‘abject failure’.

Mr McIvor has been allowed to keep the pay-off even though Health Secretary Jeremy Hunt has pledged to clamp down on NHS fat cat salaries and cap redundancy pay.

He defended his record last night at 111 and said his total package equated to more than 30 years’ service and that the £300,000 related to a previous NHS role.

The revelation comes after the Daily Mail yesterday reported the ‘disgraceful’ £410,000 exit package given to David Flory, the NHS boss in charge of the watchdog which is meant to monitor hospitals’ performance. NHS England has launched an inquiry into the NHS 111 crisis exposed this week by the Mail.

Disturbing evidence shows the service is in meltdown, with only one nurse left to cover an area of 2.3million people. NHS 111 – which replaced NHS Direct and deals with urgent cases – has failed to meet targets every month so far this year and half a million patients have been unable to get through at all. One woman told of how she lost her one-year-old son William to blood poisoning after she was advised simply to give him Calpol by a 111 operator with no medical training.

As senior officer for 111, Mr McIvor was responsible for the implementation of the service, which was widely condemned as a ‘failure’ that put patients at risk. Despite his senior position, his package was not disclosed in NHS annual reports last year. But a Freedom of Information request by campaign group the TaxPayers’ Alliance found he was paid £479,222.67 for 2013-14 – the year in which 111 was rolled out.

Included in this was his salary for launching 111 and an ‘exit package’ of between £290,000 and £295,000. Before launching 111, Mr McIvor, 57, was chief executive of NHS Lincolnshire, for which he earned a salary of between £170,000 and £175,000.

He was made redundant but instead of leaving the NHS was given a position in April 2013 as national senior responsible officer for the NHS 111 Implementation Group. This appears to have been allowed as it was declared as a ‘short term extended employment with another NHS body’, rather than a new job.

After working for 111 for nine months, he then left in December 2013, claiming his salary and the redundancy package worth almost £300,000 from his previous job at NHS Lincolnshire. Instead of being announced publicly, the redundancy payout was disclosed only after months of campaigning by an MP. In the summer of 2013, the Department of Health announced that 44 very senior NHS managers were being made redundant, with their payments costing £12.2 million, but the managers were not named.

Mr McIvor’s payout was only made public a year and four months later, in a letter from Under Secretary of State for Health Dan Poulter to Stephen Barclay MP, who had asked about the payouts in a Parliamentary Question. It disclosed Mr McIvor’s redundancy payout but not his full remuneration for the year of £479,222 – which came to light only after the Freedom of Information Request by the TaxPayers’ Alliance.

The Mail has since established that Mr McIvor also claimed £3,887.49 in expenses that year. He now runs private firm px9 Ltd, which he owns with his wife Karen, 43.

While Mr McIvor was working for 111 in 2013, the service was widely criticised. Then chairman of the Royal College of General Practitioners Dr Clare Gerada said areas were ‘struggling to cope with insufficient numbers of “call centre” handlers’.

Earlier this week the Mail found that thousands of calls went unanswered and a child died following poor advice

At the British Medical Association local medical committees conference in May 2013, Manchester GP John Hughes described the implementation as an ‘omnishambles, a complete disaster’.

Two months later, Dr Chaand Nagpaul, chairman of the BMA’s General Practitioners Committee, told GP magazine Pulse: ‘The implementation and planning of 111 has been an abject failure.’ Dr Maureen Baker, chairman of the Royal College of GPs, said: ‘It is essential all NHS 111 centres are staffed appropriately.’

Tory MP Andrew Percy said: ‘These sorts of pay deals for NHS senior managers are a disgrace and an insult to patients.’ A Department of Health spokesman said: ‘We’ve already reduced the pay bill of NHS managers by £300million since 2010 but we’re going further by introducing tough measures to claw back redundancy payments, when highly-paid staff return to the same part of the public sector within a year.’

Mr McIvor said: ‘The Daily Mail stories on NHS 111 are about current performance. When I took on responsibility for NHS 111 in 2013 its performance continually improved after the failure of some providers at its initial launch. When I left the NHS it was meeting virtually all of its performance targets.’

He said his salary for 2013/14 was ‘nowhere near’ the figure for his total pay package for the year of £479,222.67, adding: ‘I received no “exit payment”. Any pension I received was earned over my 33 years in the NHS, not simply in 2013/14.’

Whistleblower number two reveals chaos at NHS hotline: Worker tells of how there were 'never enough staff' to help at centre covering the South West

Whistleblower Grace Quick has claimed there were 'never enough staff' working the 111 service

A second whistleblower from the NHS out-of-hours hotline has bravely waived her anonymity to reveal how it is frequently in chaos.

Grace Quick, who worked for 111 until earlier this year, said the service ‘made her really angry’ for patients.

She claimed there were ‘never enough staff’ and it was frequently ‘impossible’ to get hold of a nurse for help.

On Tuesday the Daily Mail revealed how 111 is in meltdown in many parts of the country. Shocking evidence revealed that there was sometimes just one nurse on duty to cover 2.3million people in the East Midlands.

NHS bosses insisted that 111 was providing a ‘prompt and safe’ service in most areas and suggested the problems identified by a whistleblower in the Midlands were a ‘regional’ issue.

But now Miss Quick – who worked in a call centre more than 200 miles away which covered Devon, Cornwall, Somerset and Dorset – says the problems are ‘exactly the same’ in her region.

She revealed how:

■ Managers would tell staff to ‘get off the phone as quickly as possible’ to meet targets;

■ Sometimes more than 200 callers would be waiting to be answered;

■ Ambulances would be sent out for people with colds, bruises and even nosebleeds – instead of the patients who really needed help;

■ She was reprimanded for spending too much time on the phone to a mentally ill patient who was ‘clearly distressed’;

■ Staff were not given breaks and were told not to take more than 15 seconds between calls;

■ Five months after she stopped working for the service, she is still receiving ‘daily’ texts from ‘desperate’ managers ‘begging’ for more staff to come in.

Miss Quick worked in a 111 call centre in St Leonards, Dorset, from last October until the end of May.

She said that after reading the Mail’s investigation she too wanted to speak out because ‘pretty much all of the problems’ were also occurring in her area.

Five months after leaving, she said: ‘I still get daily texts – sometimes twice a day – with them begging for staff. They are desperate – there are never enough people.

‘On the weekend, when it was busy, it was like a hell hole. You are just taking call after call after call and there’s no let-up whatsoever.’

She said weekends and bank holidays were the most understaffed times – and that, as in Derbyshire, the service was regularly short of nurses. Although there were always at least two nurses or paramedics on duty, she said it was frequently impossible to get hold of them because they were overwhelmed.

‘You’d go in and sometimes there would be 100 calls waiting,’ she said. ‘At Christmas it would be more than 200 people waiting, you’d have about 150 waiting on a bank holiday – and however many calls you pick up the numbers just don’t go down.’

Because staff at 111 are not medical professionals, they rely on a computer system called ‘pathways’ to make decisions about patient care. But Miss Quick said she became increasingly concerned about its reliability.

She claimed it would often send out ambulances for ‘stupid, petty things’ instead of people who really needed help. ‘I must have sent out ambulances so many times for silly reasons,’ she said.

MY GRANDSON COULD HAVE DIED: CASE STUDY Robert Pauley believes his grandson would have died if he had not ignored the advice of a 111 call operator. The 71-year-old, from Gosport in Hampshire, dialled the service last summer when his grandson, Noah, suffered a life-threatening reaction to a wasp sting. ‘When I called 111, I was kept on the phone responding to needless questions for 30 to 40 minutes,’ he said. ‘During this time he went into anaphylactic shock. ‘The person on the phone was going through a questionnaire and kept toing and froing, speaking to their adviser. ‘This was just far too long to be kept on the phone – emergency situation or not. When I realised that no advice was coming I politely hung up and rang 999 and thank goodness I did. ‘Thankfully, I realised from my limited experience that this was serious.’ The grandfather of five, who often babysits the children, said: ‘Thankfully, the ambulance turned up within a few minutes and my grandson was rushed to hospital. The doctor said if I had waited any longer he would have died.’ The retired radio engineer added: ‘111 does not work. I think the whole system should be dismantled and handled by each individual NHS trust. Now I avoid 111 like the plague’. A spokesman for South Central Ambulance Service NHS Foundation Trust said: ‘If Mr Pauley has not raised any of his concerns previously with the trust we would welcome him to do so in order that we can investigate them fully and respond directly to him. ‘He can do so by contacting our patient experience team on 0300 123 9280.’ Advertisement

‘One example is nose bleeds. You have to ask if the bleeding would fill more than two mugs.’ On other occasions, patients whom she felt needed more urgent help were made to wait. She claimed one patient with severe asthma was not allocated an ambulance – even though he was struggling to breathe. ‘On the system it just said they needed to see a doctor within two hours,’ she said.

‘I could hear that this person was struggling to breathe and I couldn’t get hold of anyone. I was running around like a headless chicken because I suffer from asthma myself and I know that when you’re in that state you need help.

‘You don’t want to sit around waiting for two hours for a phone call. In the end I did manage to get him seen more urgently - but it goes to show the ambulances are not always sent out for things that are really important.’ Miss Quick added that the service had ‘wasted money’ buying expensive ‘paramedic-style’ uniforms for all staff – despite the fact they were working within a call centre and were not clinically trained. She added: ‘If I was out in public I’d tend not to wear it because I’d worry that someone’s going to keel over and someone’s going to say: “there’s a paramedic”.’

She claimed that for the population of Cornwall, Dorset, Devon and Somerset – around 2.4 million people – there were sometimes just two nurses or other clinical professionals on duty. However, there were usually around four.

One of her biggest concerns was the way 111 dealt with the mentally ill.

Miss Quick said there was ‘no effective system’ to deal with people with mental health problems. And because of the pressure to deal with calls quickly, she was told not to spend too long talking to callers. On one occasion she claims she was told to ‘get off the phone’ when she was spending longer than usual speaking to a man who was distressed.

The Government scrapped the NHS direct service and introduced the 111 number for less urgent cases

‘There was no effective system for mental health,’ she said. ‘We always had to cut mental health patients short.’

Miss Quick claimed that she had to take harrowing calls – including from a person who said they were on a dual carriageway about to kill themselves.

But despite asking for training on how to deal with such calls, she says she was told none was available.

And even after a distressing and complex call, managers would demand staff were back answering the phones immediately. ‘You have 15 seconds between each call to type up notes and then go into the next one,’ she said.

‘I found that quite hard. Having someone on the phone that’s saying they’re going to jump in front of a car, and then to then go on to another call and act completely normal – it’s difficult.’

Miss Quick, 20, is now working as a shop assistant in Ferndown, Dorset.

Andrew Bridgen, Tory MP for North West Leicestershire, last night demanded fresh answers from Mr Hunt.

In the light of the Mail’s revelations, he added: ‘This is systemic – it is systemic failure, nationally across 111.’

The South Western Ambulance Service (SWAS) has run the 111 number in Cornwall, Devon, Dorset and Somerset since the previous provider, NHS Direct, pulled out in 2013.

When it withdrew, NHS Direct complained that the funding was insufficient to run a safe service. Worryingly, SWAS has also now announced it is pulling out, because the ‘operating model’ for 111 is ‘not financially sustainable’.

But even though it has admitted it cannot run the service effectively, it will continue to operate 111 until March.

SWAS denied Miss Quick’s allegations and said high quality care was its ‘top priority’.

A spokesman denied that staff were told to keep calls short to meet targets, although they acknowledged that staff were told to allow only a brief time between calls – saying this was to ‘minimise waiting times for callers.’

The spokesman said clinicians were available ‘in each of our control rooms on every shift and that the service provided ‘a wide range of courses and training opportunities’. However the service was ‘strengthening its processes’ for dealing with mentally ill patients.

The spokesman conceded that Miss Quick should not be receiving the texts.