This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

GPs go forth

NHS 111 boosts clinical input 'to reduce pressure on GP practices'

NHS England has increased the number of NHS 111 calls that receive clinical input, in an effort to ease pressure on GP practices.

In April, 50.2% of NHS 111 callers spoke to a clinician, exceeding NHS England’s latest target to have half of calls receive clinical input.

Last year, NHS England chief executive Simon Stevens said one in three callers would speak to a clinician by the end of 2017.

GP leaders said the increased clinical input ‘is a positive step’ but added that clinicians with access to patient records should be able to ‘intervene when necessary’.

NHS 111 has long faced criticism for a lack of clinical input, with the BMA initially saying that colds and sore thumbs were being referred to primary care, while an NHS England report concluded in 2014 that NHS Pathways, the system used by NHS 111 operators, was not sensitive enough to identify sepsis.

But NHS England said the increased clinical input will ease pressure on primary care by avoiding onward referrals to GP practices.

An NHS England spokesperson said: ‘Performance targets set out in the Next Steps document, called for 50% of NHS 111 callers to be able to speak to a clinician by Spring 2018 and this was achieved in April.

‘More cases are now being completed on the phone by a range of experienced clinicians avoiding potential onward referral to GP practices, therefore easing pressure on primary care as well as other frontline A&E and ambulance services.’

The Next Steps on the Five Year Forward View document initially set a goal to ‘enhance NHS 111 by increasing from 22% to 30%+ the proportion of 111 calls receiving clinical assessment by March 2018’.

NHS England clarified to Pulse that the target was revised up, after the document was originally published, from 30% to 50% by Spring 2018.

The new target was laid out in another document of 15 ‘key performance indicators’ for integrated urgent care services, including a target ‘50% of calls [to] receive clinical input’. 

Dr Mark Sanford-Wood, BMA GP committee deputy chair, said: ‘Greater clinical input from the outset of these calls is a positive step, as it can provide more accurate diagnosis and avoid unnecessary trips to hospital, which impacts both doctors and patients. After all, diagnosis is so much more than a tick-box exercise.

‘However, it is important that local clinicians with knowledge of the patient and access to their records are, when appropriate, able to offer their input and intervene when necessary.’

This comes after an NHS director said last year that four in five NHS 111 referrals to practices could be avoided if the calls are first taken by a GP.

Readers' comments (8)

  • We’re all saved!

    Unsuitable or offensive? Report this comment

  • 111 does improve GP, they send everything straight to A&E and most of those via a 999 call. Chest pain, headache. Paper cut, sneezing. All managed in the same 111 way.

    Unsuitable or offensive? Report this comment

  • I don't quite get why they are not all handled by clinicians.

    Unsuitable or offensive? Report this comment

  • It will not solve the problem. They will still be sending patients either to us or A+E.

    Unsuitable or offensive? Report this comment

  • Ultimately they need to be able to:
    1 - See the notes in full.
    2 - Prescribe if appropriate. (Via EPS)

    Unsuitable or offensive? Report this comment

  • AlanAlmond

    How about they do something about the utter crap they send to the GP every time they have contact with anyone. Nothing more that a meaningingless list/pro forma of emergency red flag symptoms the patient DIDNT present with - for the sole benefit of a legal team should they ever need to review the notes to sue somebody many years later. Time wasting, impenetrable and wouldn’t be permitted in any other safety critical organisation (e.g. the airline lindustry)

    Unsuitable or offensive? Report this comment

  • Because NHS 111 is a part of a politically driven agenda which was hailed as a success in my area of practice where it was trialled despite universal misgivings by clinicians, no-one has actually looked for evidence as to its effectiveness, especially cost-effectiveness. To describe it as a disaster is being unkind to disasters. It's algorithms are so risk averse that all and everything is directed to somewhere else in the health service, the most notable being the ambulance service. I have lost count of the number of patients who have told me that a 999 ambulance has been dispatched to them even when they have protested that it is unnecessary.
    The irony in our area is that NHS 111 is run by the local ambulance service. (Conflict of interest anyone?)

    And it is not as though it is a cheap service. In 2008 every call to its predecessor NHS Direct cost the taxpayer £25 and it is unlikely that those costs will be less 10 years later. Just think what General Practice could do with that sort of investment.

    Unsuitable or offensive? Report this comment

  • I bet patients who ring or assume that they are speaking to a clinician. This then leads to poor public view of clinicians.
    I agree with Obi. Why isn’t a clinician involved in all calls?
    Waste of money.

    Unsuitable or offensive? Report this comment

Have your say