The death of a two-year-old girl who had a twisted bowel has led a coroner to call for changes in NHS non-emergency and out-of-hours services.
Myla Deviren's symptoms in 2015 were not "appreciated" by two 111 operators and an out-of-hours nurse, coroner Rosamund Rhodes-Kemp said.
Ms Rhodes-Kemp called for "robust systems" to prevent sick children going without life-saving treatment.
The 111 provider said it had made a number of changes since Myla's death.
Myla, of Peterborough, was found unresponsive and was taken to Peterborough City Hospital, but was pronounced dead on 27 August.
In a prevention of future deaths report Ms Rhodes-Kemp, assistant coroner for Cambridgeshire, said after Myla became unwell her mother rang 111.
During the call the health assistant "did not appreciate the significance of key symptoms", Ms Rhodes-Kemp said.
Myla's mother was passed to a clinical adviser, whom Ms Rhodes-Kemp said "ignored her instincts" to call an ambulance after hearing the little girl had blue lips and breathlessness.
The call was then passed to an out-of-hours nurse who "decided that this was a case of gastroenteritis early in the call and did not appreciate the description of a child with worsening signs".
The coroner said: "It is probable that with earlier transfer to hospital by ambulance and with appropriate treatment [Myla] would have survived."
Ms Rhodes-Kemp said that further steps in the 111 and out-of-hours services should be taken, including mandatory annual training for all call staff and having a "suitably-qualified" paediatric specialist clinician available.
She added the "default position and precautionary advice should be – if in doubt call an ambulance".
The chief executive of Cambridgeshire Community Services (CCS), which ran the out-of-hours service at the time of Myla's death, &quRead More – Source