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NHS 111 ‘increases ambulance use’

15 November 2013

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Non-emergency urgent care phone line NHS 111 increased ambulance use in its first year of operation, a detailed evaluation published in BMJ Open has found. 

Although NHS 111 was set up with the intention of relieving pressures on A&E, but during the first year of operation emergency ambulance incidents at the four pilot sites rose by just under 3%.

This would be equivalent to an extra 24 incidents per 1,000 triaged calls, each month. 

The authors suggest this would translate into an additional 14,500 call-outs for an ambulance service attending 500,000 incidents a year. 

An overall emergency and urgent care activity rose by between 5/15% per month at each site. 

But NHS England, claim Sheffield University’s results are “significantly out of date” and cannot be compared to the current NHS 111 service. 

The latest performance data shows that 93% of the population of England now have access to NHS 111. Calls are answered promptly and levels of satisfaction are high, NHS England claim. 

NHS England also state that the Sheffield study looked a very low volume of calls. Only 400,000 calls were offered to 111 for the first year of the study, whereas 111 is now being offered  around 600,000 calls a month.

A statement from NHS England said: “There is now no evidence that 111 is increasing A&E attendances – in fact attendances in areas with 111 for the most recent 12 months compared to 12 months earlier is down by 0.2%. 

“Ambulances dispatched from 111 transport the same proportion of patients to hospital as those dispatched by 999 – showing the service is appropriately sending ambulances. Evidence shows that the current NHS 111 service  is already becoming a powerful tool to redirect patients from A&E and 999 to less acute services.” 

But the researchers say their findings raise key questions, over the potential increase in volume of callers prompted by the planned closure of NHS Direct, and therefore the service’s sustainability, and whether NHS 111 is actually creating rather than curbing demand.

And they suggest: “It is probably unrealistic to expect any one service, such as NHS 111, to do everything, and real improvements may only be gained when a series of coordinated measures designed to increase efficiency across all services are implemented.”

NHS England is investing an additional £15 million to support NHS 111 through winter when it will be a key part of local, urgent and emergency care services.

The full study is available to view on the BMJ Open website.