Royal College of Paediatrics and Child Health president Prof Neena Modi said the system was unfair on call handlers who are  not medically trained. She said even clinicians would find it hard to assess small children by a phone call. NHS England acknowledged the importance of thorough training but said the royal colleges helped produce the protocols. A report last month by NHS England described how NHS 111 missed chances to save 12-month old William Mead from Cornwall, who died in 2014 from blood poisoning following a chest infection after staff failed to recognize the seriousness of his condition. NHS England has said call handlers for the 111 service should be trained on how to recognise a complex call and when to call in clinical advice earlier.

But the NHS report concluded that if a medic had taken the final phone call, instead of NHS 111 adviser using a computer system they probably would have realised the child's cries meant he needed urgent medical attention.

The RCPCH president said 111 had been brought in at huge cost without proper evaluation of whether it was a safe service. She said patients were better cared for when they could contact a family doctor.