Turner, J. orcid.org/0000-0003-3884-7875, O'Cathain, A., Knowles, E. et al. (1 more author)
(2013)
Impact of the urgent care telephone service NHS 111 pilot sites: a controlled before and after study.
BMJ Open, 3.
e003451.
ISSN 2044-6055
Abstract
Objectives To measure the impact of the urgent care telephone service NHS 111 on the emergency and urgent care system.
Design Controlled before and after study using routine data.
Setting Four pilot sites and three control sites covering a total population of 3.6 million in England, UK.
Participants and data Routine data on 36 months of use of emergency ambulance service calls and incidents, emergency department attendances, urgent care contacts (general practice (GP) out of hours, walk in and urgent care centres) and calls to the telephone triage service NHS direct.
Intervention NHS 111, a new 24 h 7 day a week telephone service for non-emergency health problems, operated by trained non-clinical call handlers with clinical support from nurse advisors, using NHS Pathways software to triage calls to different services and home care.
Main outcomes Changes in use of emergency and urgent care services.
Results NHS 111 triaged 277 163 calls in the first year of operation for a population of 1.8 million. There was no change overall in emergency ambulance calls, emergency department attendances or urgent care use. There was a 19.3% reduction in calls to NHS Direct (95% CI −24.6% to −14.0%) and a 2.9% increase in emergency ambulance incidents (95% CI 1.0% to 4.8%). There was an increase in activity overall in the emergency and urgent care system in each site ranging 4.7–12%/month and this remained when assuming that NHS 111 will eventually take all NHS Direct and GP out of hours calls.
Conclusions In its first year of operation in four pilot sites NHS 111 did not deliver the expected system benefits of reducing calls to the 999 ambulance service or shifting patients to urgent rather than emergency care. There is potential that this type of service increases overall demand for urgent care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2013. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 04 Apr 2017 14:56 |
Last Modified: | 04 Apr 2017 14:56 |
Published Version: | http://dx.doi.org/10.1136/bmjopen-2013-003451 |
Status: | Published |
Publisher: | BMJ Publishing Group: Open Access |
Refereed: | Yes |
Identification Number: | 10.1136/bmjopen-2013-003451 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:114531 |