The 111 firm made Shirley wait six hours Shirley Pooley died just two days after becoming sick on Boxing Day 2010 Despite her husband's calls to 111, no help arrived until he dialled 999 "I got the impression Shirley had fallen completely off the radar," he says. By Frances Hardy Tragic: Mother-of-two Shirely Pooley died of pneumonia aged just 51 three days after this picture was taken on Christmas Day 2010 The photo shows a smiling Shirley Pooley, her face radiating health and happiness. Taken on Christmas Day 2010, there is no clue that less than three days later she would be dead from pneumonia, aged just 51. The fact that her untimely death left behind a loving husband, Gary, and their two teenage children, Megan, then 19, and Gareth, 14, is tragedy enough. The thought that she could still be alive today had she not been failed by a shambolic out-of-hours doctor service adds another layer of anger and regret to her grieving family's terrible loss. As Gary, 57, explains, his wife's medical history was a complicated one. Shirley suffered from asthma and the incurable auto-immune condition Lupus, which is caused by problems with the body's natural defence system against illness and infection. It manifested itself in symptoms such as fatigue, joint swelling and skin rashes. With the help of medication, Shirley managed her health problems well most of the time, but after a happy family Christmas at home in Needham Market, Suffolk, she fell extremely ill with a cold on Boxing Day. "Her breathing wasn't good and she felt lethargic," says Gary. But Shirley was a no-fuss type. She always thought that, compared to others, her problems were minuscule. However, by lunchtime the next day Shirley had developed gastric problems and was so weak she had to be lifted onto the lavatory. Concerned by his wife's deteriorating condition, Gary telephoned the family's GP surgery shortly after 2.30pm. Had the GPs - who knew Shirley well - been on call, they would have been aware of her underlying health problems and of her need for prompt attention. Instead, Gary's call was redirected to an out-of-hours helpline managed by Harmoni, Britain's largest urgent care provider. It was 3.35pm when a doctor rang him back. "He was clearly foreign and I struggled to understand him," recalls Gary. He offered us an appointment at an out-of-hours surgery, but I explained that my wife was too ill to be moved; that she was struggling to breathe. "Alarm bells should have been ringing, but the doctor just said: "We'll get someone to you when we can." He was no more specific than that. More than six hours after Gary's first conversation with a Harmoni operator, a doctor had still not arrived. Ringing again, Gary was fobbed off with excuses. I had told the doctor earlier that she appeared to be struggling to breathe, but when I called back it seemed as if I was starting from scratch. By now, Shirley was rapidly deteriorating. "Her lips had gone blue and her speech was slurred and incoherent," says Gary. Aware that his wife could wait no longer, he called 999. A first responder arrived almost immediately, and the ambulance just minutes later. "The paramedics were brilliant," recalls Gary. They put an oxygen mask straight on her and I held her hand as they rushed her into resuscitation. He stalls, momentarily choked by the recollection. His daughter Megan, now aged 21, continues quietly: "It was the worst nightmare you can possibly imagine. It wasn't my Mum there at all. Grief: Shirley's husband Gary, centre, with their two children, Megan, now 21, and Gareth, now 17, who were with her during her rapid deterioration which began with a cold on Boxing Day Despite medics" best attempts to save her, Shirley suffered two cardiac arrests. Her death certificate records she died of pneumonia at Ipswich Hospital, shortly after 4am on December 28. "She was so very ill and I could not bear to see her suffering," says Gary, and again he weeps. "I said: "You have to let her go." " Megan adds: "I have so much admiration for Dad. He did his very best. Megan is now an undergraduate at Anglia Ruskin College in Cambridge, while Gareth, 17, hopes to join the Navy or the police. His parents, both dedicated to public service, set him an admirable example. Shirley, a police officer for 17 years before health problems forced her to retire, had been a schools liaison officer. "She knew everyone," smiles Megan. Everyone respected her - even the little terrors in the schools she visited. At her funeral, there was a sea of people paying their respects. Gary and Shirley with their children on their wedding day in 2007: Shirley, a police officer for 17 years before health problems forced her to retire, had been a well-like and respected schools liaison officer Shirley's health problems had not constrained her. She still played netball and was an avid supporter of Ipswich Town FC. She and Gary, a retired police traffic officer who now works as a civilian driving instructor for Suffolk Constabulary, were planning their retirement when her life was so cruelly snatched away. The caravan they had bought to go touring in now stands idle on the drive of the home that was once the hub of a happy family life. What do you miss about Shirley? I ask, and Gary reflects for a second. "Everything," he says, simply. She was our linchpin. She held us all together. An inquest into Shirley's death this April heard about irregularities in the way Harmoni dealt with her case. Gary's conversation with the doctor was not recorded, although his other conversations with call centre operators were. He recalls telling the doctor that Shirley was "struggling to breathe" but the doctor's notes from the call referred to her having "no difficulty breathing." Gary believes this discrepancy, and problems with Harmoni's internal communications, led to his wife's case being wrongly downgraded from urgent to routine. 'She was our linchpin': Shirley pictured in 2003 with Megan, then 11, and Gareth, then six. An inquest into Shirley¿s death this April heard about irregularities in the way Harmoni dealt with her case Suffolk Coroner Dr Peter Dean recorded a narrative verdict that Mrs Pooley died from lobial pneumonia - a treatable infection - to which her pre-existing Lupus contributed. He said: "There were significant delays in providing medical assistance for a variety of reasons but whether these adversely affected the outcome could not be established on the evidence." A spokesman for Harmoni simply offered the same impersonal response their press office appears to issue in such instances: "We would like to express our deepest sympathy to those families who lose a loved one in any circumstances. The coroner concluded it was not possible to know whether the outcome would have been different if Mrs Pooley had been seen earlier. The evidence heard at the inquest demonstrated that the service has appropriate policies and procedures to recruit clinicians and audit their performance. Gary, meanwhile, is left with a legacy of grief and regret. "I will always ask myself: "Had the doctor come, would the outcome have been different?" We'll never know the answer - but we do know she would at least have had a fighting chance. ■ Have you had a problem with out-of-hours care?