Questions have been raised over the efficacy of the NHS's non-emergency phone-line service after operators failed to spot that a baby was suffering from sepsis.
Twelve-month-old William Mead, from Penryn, who died on 14 December 2014, might have lived if NHS 111 staff had been better trained, says a new report.
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A coroner's inquest six months after William's death found he had been killed by septicaemia blood poisoning caused by a long-running chest infection that could have been treated and saved.
William's mother Melissa said doctors had told her "not to worry" and that staff on the 111 helpline assured her it was "nothing serious" before he died.
The report concluded that if a medic had taken her phone call, rather than a 111 operator, they would probably have identified William's cries "as a child in distress" and his life could have been saved.
It also listed the missed chances to save William's life, saying:
- His GP did not record all of the relevant information in his notes;
- William's symptoms had not been recognised by doctors as something serious;
- The advice given to William's parents about what to do if his condition worsened over the weekend was inadequate;
- The Meads' out-of-hours GP service did not have access to William's records;
- The pathway tool used by NHS 111 call-handlers was too crude to spot the "red-flag" signs of sepsis.
Lindsay Scott, the director of nursing for NHS England in the south-west, apologised to the Meads and said local staff at NHS 111 had been given extra training.
Melissa Mead said she hoped other parents would be spared her ordeal.
"We are glad the report has shown up there were failures and missed opportunities. We hope from the recommendations made this never happens again," she said.
"We fought the hardest battle to get answers, knowing we had already lost William."
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