More patients being sent for emergency care via non-urgent 111 number

The NHS’s non-emergency line is sending a rising proportion of patients for emergency care, new analysis shows.
111 phone line

The NHS’s 111 non-emergency phone line is sending a rising number of patients for emergency care, new analysis shows.

Picture: Jim Varney

The proportion who call NHS 111 and are transferred to ambulances has ‘crept up’, according to a report from think tank the Nuffield Trust.

However, the report also found that the bulk of patients are directed to primary care, their GP or other community services.

The 111 service replaced the nurse-led NHS Direct at the end of 2013 and handles more than a million calls each month.

Large rise

The Nuffield Trust examined data from December 2013 to December 2016. The number of patients sent to the emergency department or having an ambulance dispatched rose from about 150,000 a month in 2013 to 200,000 in December 2016.

Researchers found the proportion of patients directed to emergency care has also risen, from about 18%-19% of patients to about 20%-22%.

The think tank estimates this equates to an increase of 20,000 more people a month.

High levels of variation were noted across the country, with some regions more likely than others to transfer callers to ambulatory care.

In north east England during 2016, 17% of callers were transferred to an ambulance compared with 8% in South Essex.

Wide variation

‘This is a high level of variation, and it is a problem for emergency services and patients if some areas are too eager or too reluctant to send an ambulance,’ said the report’s authors.

They also found a higher number of people sent to ambulance services instead of emergency departments.

The researchers said: ‘It does lend some plausibility to the suggestion that NHS 111 is too risk averse with people who have more urgent problems.’

Different view

Surveys conducted with people who have used the helpline, however, revealed it may have prevented millions from going to emergency departments or calling for an ambulance.

Around 45% of people polled said without the line they would have gone to their nearest emergency department or called for an ambulance, but, once they called 111, only about 20% were sent to these services.

‘Summed up across those years, it could have prevented as many as eight million people from presenting to emergency services,’ the report added.

Government response

An NHS England spokesperson said: ‘The latest monthly figures show NHS 111 answered over 1.35 million calls in December 2016 – 11% more than the previous December.

‘Of these, nearly 300,000 spoke to a clinical adviser, compared with 262,000 in December 2015. Typically, of the calls NHS 111 triaged, just 13% led to an ambulance being dispatched and just 8% were recommended to emergency departments.’

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