NURSES at helpline NHS 24 believed managers would not listen if they raised concerns about a beleaguered new computer system.

New board papers confirm staff felt inadequately prepared to use the new technology - but were uncomfortable about speaking out.

The latest reports also show that frontline workers, who handle calls from patients with urgent medical problems around the clock, did not practice an entire phone call using the new system before it went live.

And that line managers "also did not have confidence" in the telecommunications package which was launched in November, only to be withdrawn twice because the delays it caused risked patient safety.

The technology, which was supposed to ensure patients ringing for advice were dealt with more efficiently, is still not in place well over a year after it should have been implemented and the whole project is about £50m over budget.

Trade unions at NHS 24 consulted with staff in the wake of the failed launches to try and find out what went wrong. Last week the findings prompted the new chief executive Angiolina Foster to issue an email to all staff promising to develop a culture where "every member of staff can confidently speak up knowing they will be listened to with attention and respect".

Graham Revie, lead steward at NHS 24 for the Royal College of Nursing and staff side chair, said: "The members when we went out said they felt unable to raise concerns with NHS 24 openly and they felt even if they did, nothing would be done. The trade unions now have brought this through the staff governance committee to the attention of the board."

Asked why staff felt they would not be heard, Mr Revie said: "I think the culture within the organisation was driving towards implementing this (technology) successfully and the staff are part of that culture."

NHS 24 is now aiming to relaunch the telecommunications system, called the Future Programme, in mid-June.

Staff have asked for assurances that the technology it is able to cope with the number of patients who ring in at the busiest times.

The latest board papers show that changes are being made to the system in the wake of the failed launches - among them revisions to the risk assessments staff follow when deciding what advice to give patient callers.

Training staff in a way which better reflects the reality of their jobs is also being planned before the Future Programme goes live again.

Concern has been raised that technical changes were made before the previous launch, but not communicated in a way that would allow them to be included in staff training.

Staff also told union representatives that when the system was running in November team leaders and managers "appeared not to have had sufficient knowledge of the system to assist with the performance and operational issues". This "led to confusion and added to their lack of confidence with the system".

A list of issues highlighted by NHS 24's staff governance committee include concern about "staff engagement and culture" and the need to address "management structures-relationships-communication".

Reference is made to "allegations of 'unacceptable' behaviour."

A spokeswoman for NHS 24 said: "NHS 24 learned a huge amount from the system being live for 10 days in November 2015. Following the rollback a very detailed lessons learned exercise was undertaken and we gathered a significant amount of feedback from staff about their experience. Since then we have been working with teams across the organisation to develop a comprehensive staff readiness and engagement programme to ensure staff are confident and ready to operate the new system when it goes live in summer 2016. NHS 24 is absolutely committed to supporting our highly skilled staff in the use of the new system."