111 Questions & Answers

Why are you introducing the NHS 111 service?

The NHS 111 service has been introduced as part of the wider revisions to the urgent care service to make it easier for the public to access the right services. The public has told us that there are times when they are unsure what to do or where to go for help, particularly when people have unexpected or urgent healthcare needs. This might be because the need arises when their GP practice is closed or because they are away from home.

The NHS 111 service makes it easier for the public to access healthcare services when they need medical help fast, but it’s not a life-threatening situation. NHS 111 will assess callers’ symptoms, give them the healthcare advice they need or direct them straightaway to the right local service. NHS 111 is available 24 hours a day, seven days a week and is free to call from landlines and mobile phones. NHS 111 can also help us take the pressure off the 999 emergency service and local A&E departments, which many people turn to if they don’t know where else to go for the urgent help they need.

How much will calls to NHS 111 cost?

Calls to the NHS 111 service are free to the caller from both landlines and mobile phones.

Will the NHS 111 service be available 24/7?

Yes, NHS 111 is available 24 hours a day, seven days a week, 365 days a year.

Where is the NHS 111 service currently available?

The NHS 111 service has full national coverage  The call centre for Cambridgeshire and Peterborough is located in Peterborough and calls are answered by local staff.

Does this mean that 111 is the one number for all health services?

111 is not intended to be the only number for access to all NHS healthcare services. The NHS 111 service is for when people need help fast, but it is not a life threatening 999 emergency and they don’t know who to call. For less urgent medical needs people should continue to contact their GP in the usual way and for immediate life threatening emergencies call 999.

999

Will NHS 111 deal with emergency calls?

The public should continue to call 999 for life threatening emergencies that require an immediate response. However, if a call to NHS 111 is assessed as being a medical emergency, the service will dispatch an ambulance directly, and provide first aid advice to the caller until the paramedics arrive, without the need to transfer the call, or for the caller to repeat information.

What happens if I don’t know whether it’s an emergency?

If someone calls NHS 111, and the clinical assessment identifies that they are facing a life threatening emergency, the NHS 111 service will dispatch an ambulance directly. The NHS 111 call adviser will provide first aid advice to the caller until the paramedics arrive, without the need for transferring the call, or for the caller to repeat information. It does not matter if you are unsure of whether something is urgent or an emergency; the NHS 111 service will direct you to the right service, first time, even if the right service is an ambulance response.

How many 999 calls are currently made for non-emergencies?

We know that more than 25% of calls made to 999 are Category C calls that are ‘neither serious nor immediately life threatening’. The NHS 111 service provides an alternative for these callers and will help to ensure that ambulance resources are directed to those who have a medical emergency and require an immediate response.

Operational / training

Who will answer NHS 111 calls?

Calls to NHS 111 are answered by fully trained NHS 111 call advisers, supported by experienced nurses and paramedics. They use a clinical assessment system to assess callers’ needs safely and effectively and direct them to the right NHS service.

What training will NHS 111 call advisers be given?

All NHS 111 call advisers and clinical advisors are required to complete a two week training programme (clinical staff attend a 3 week programme) in the class room with written examinations.  All staff attend an additional weeks training which is focussed on systems and procedures.  After training they are fully supervised for all shifts to ensure they are fully competent.  A percentage of all calls handled are audited on a monthly basis.  Six weeks after working on the live system the call  adviser and clinician attends an additional day’s training with an exam at the end.  At this point the call adviser and clinician is seen to be fully competent.  Call Advisers and clinicians attend regular review meetings and update training sessions.

Are the NHS 111 call advisers clinically trained?

All NHS 111 call advisers have received extensive training on the clinical assessment system that NHS 111 uses to assess callers’ symptoms and identify the right service to meet their needs. Part of this training involves specific education around anatomy, physiology and clinical features of injury and illness to enable them to provide a high quality assessment of symptoms. Every shift includes experienced nurses and paramedics who are also trained on the system and able to provide clinical support in the event of any difficulty.

Will the NHS 111 service be staffed by inexperienced call handlers, rather than nurses?

Calls to NHS 111 are answered by fully trained call advisers, supported by experienced nurses and paramedics. They use a clinical assessment system which enables them to assess callers’ needs safely and effectively and direct them to the right NHS service. NHS 111 call advisers undertake an equivalent level of training to 999 operators.

Using the clinical assessment system means a smaller proportion of calls need to be referred to a nurse or paramedic. This means the nurses/paramedics can focus on cases where their clinical skills are needed, rather than dealing with all incoming calls many of which will not require their expertise. However, should a patient be assessed as needing to speak to a clinician, they will be put straight through to a nurse/paramedic and not have to wait for a ‘call-back’.

Will people be diagnosed over the phone?

No, the NHS 111 call advisers will assess the caller’s symptoms using a clinical assessment system to determine the possible seriousness of their condition, and identify what service they need, and how quickly they need it (e.g. ambulance, A&E, urgent GP, or a range of other services).

How will NHS 111 call advisers’ performance be monitored?

The NHS 111 service uses a comprehensive programme of monitoring which ensures:

  • Detailed and comprehensive training and sign off to confirm complete competence before 111 advisers are able to take calls;
  • Clinical supervision on all shifts to provide support and identify issues immediately; and
  • Active audit of a percentage of calls taken by each 111 adviser and clinciian every month.

In addition, daily and weekly data identifies individual performance in key areas and allows immediate support to ensure all advisers provide a very high level of service at all times

Will social services be included?

In time the scope of the service could grow to become the single telephone access point for all urgent healthcare and social care services.

Can you provide examples of situations when someone could call 111?

The NHS 111 service is for when you need help fast, but it is not a 999 emergency and you are not sure which service you do need.  The call adviser will be able to recommend the best service for you (e.g. ambulance, A&E, urgent GP, or a range of other services).

Telephony

Why was 111 chosen as the number for the service?

We researched all the available three-digit numbers with the public and 111 was by far the most memorable and resonated most clearly with the public, not least, because it’s repeating three-digit echoes 999. The same research also found that 111 fits with the needs of blind or partially sighted users, and those with restricted mobility, who can often find phones difficult to use.

Ofcom consulted on the idea of this number being used for urgent health services and received over 200 responses. Overall 81% of respondents were in favour of the service and 68% were in favour of using 111 as the number.

Why not use the proposed EU wide number 116 117?

Our research showed that that the public were particularly keen on the idea of a three-digit number. A six-digit number is much more difficult to remember. However, anyone that calls 116 117 will be put through to the NHS 111 service.

Would it not be better to invest in improving existing telephone services or patient care?

The whole point of the NHS 111 service is to improve the public’s experience of NHS services by ensuring that people are put in touch with the right service, first time, to meet their individual healthcare needs. It will provide people with quick access to urgent healthcare services, via a free to call, easy to remember three-digit number, regardless of where they are, what time of day or day of the week it is, and whether they are at home, at work or away from their local area.