THE parents of an autistic teenager who died after failings by NHS 111 say they were horrified to learn coroners had already warned about similar shortcomings.

Hannah Royle, from Horsham, suffered a cardiac arrest as she was driven to hospital after a 111 algorithm failed to notice she was seriously ill.

Last year, a coroner said the 16-year-old’s death had exposed a risk people were being misled about the capability of the system and its staff members.

According to the BBC, concerns had been raised about the call centre triage software in 2019 after three children died.

The NHS said it had learnt lessons from each case, but had not established a link between the deaths.

Hannah had a cardiac arrest as she was driven to East Surrey Hospital by her parents. She had suffered a twisted stomach, but call handlers believed she had gastroenteritis.

A coroner said NHS 111 staff failed to consider her "disabilities and inability to verbalise" when using the triage software.

Known as NHS Pathways, the algorithm relies on answers being given over the phone to a set series of questions. The system guides call handlers, who are not medically qualified, to direct patients to other parts of the NHS for further assessment and treatment.

In 2019, three coroners issued reports "to prevent future deaths" after serious abdominal illnesses in children were missed by NHS 111.

In all cases, coroners raised concerns about the ability of children to understand call handlers' questions or articulate their symptoms.

Hannah's father Jeff Royle said: "It's horrific. The sole intention of the reports is to prevent deaths, and they have not prevented further deaths."

Mr Royle said he was haunted by the failings that led to his daughter's death.

"It's nothing less than sheer agony," he added. "I haven't got over it, it's like it happened yesterday."

Three warnings in 2019:

Two-year-old Myla Deviren died after a twisted intestine went undetected. After her death, a coroner said the system should be reviewed because children cannot "articulate their symptoms in a way that lends itself to prescribed pathway questions and answers".

Sebastian Hibberd, six, died of a blocked bowel. A coroner investigating his death warned NHS Pathways "did not allow a meaningful assessment of pain in a child". The coroner said "the ability of a child to communicate such pain should be reviewed".

Alexander Davidson, 17, died after complications from a blocked pancreas. A coroner warned he had "struggled to comprehend some of the medical terminology" call handlers used. The coroner told the NHS to consider "how young and/or vulnerable patients can be assisted to provide accurate information about their symptoms".

An NHS spokesman said: "Each case has been thoroughly investigated and appropriate action has been taken in line with the coroners' findings."

It said that NHS 111 handles 20 million calls per year and "the guidelines used by staff are regularly reviewed with oversight from the independent National Clinical Governance Group, chaired by the Royal College of General Practitioners".

It said all four deaths, which had different causes and varying contributing factors, had been reviewed individually, and no link had been established between them.