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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.