Staff operating NHS 111 calls are leaving in significant numbers, a union has warned.
Heavy workloads, chronic staff shortages and abuse from callers have been listed as reasons for their departures from the service.
Unison revealed figures from six ambulance services in England and Wales, showing almost half of their workforce left their jobs in the three years leading up to April 2024.
The study also highlighted a severe impact on well-being, with 300,000 days lost to ill health across these six organisations during the same period.
In the year to April 2024, the service for Yorkshire had the highest staff turnover (76 per cent), followed by South East Coast (62 per cent) and South Central (44 per cent), said Unison.
The report also includes a survey of more than 200 staff, who said the volume of calls, staff shortages and aggressive and abusive callers were the worst challenges they faced in the job.

Unison’s 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.”
Unison said it received relevant data from six NHS ambulance trusts: London, North West, South East Coast, South Central, Wales and Yorkshire.
Meanwhile, England's resident doctors are to strike for six days next month, the British Medical Association (BMA) has announced, escalating their ongoing row over jobs and pay.
This latest industrial action will commence at 7am on 7 April, immediately following the Easter bank holiday weekend.
The walkout is scheduled to conclude at 6.59am on 13 April.
“We have been negotiating in good faith for weeks to try and end the simultaneous pay and jobs crises for resident doctors,” BMA Resident Doctors Committee chair Jack Fletcher said.
“Frustratingly, we had been making good progress right up until the point, in the last two weeks, when the government began to shift the goalposts. As talks progressed, it became clear that the money proposed for pay increases was now going to be spread over three years.
“This is combined with today’s pay review body (DDRB) recommendation of a 3.5 per cent uplift, pointing to yet more years in which our pay, at best, barely treads water.
“We have made abundantly clear throughout this dispute that our aim is pay restoration, and any deal that did not move us substantially in that direction was not going to fly.”
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