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NHS 111 to roll out across Wales ‘over the next three years’

NHS 111 is set to roll out across Wales, combining the existing NHS Direct and GP out-of-hours call handling services.

The country-wide launch will take place over the course of the next three years.

It follows a pilot in two regions – Abertawe Bro Morgannwg Health Board and Carmarthenshire – which showed a 95% satisfaction rate, the Welsh Government said.

An evaluation of the trial schemes, carried out by the University of Sheffield, also reported a 1% drop in A&E attendance in one region and a 29% reduction in the number of non-urgent patients taken to hospital by ambulance – although the figures cannot be solely attributed to 111.

In England, the replacement of NHS Direct with NHS 111 led to a vast reduction in medically trained call handlers and increased referrals to GPs and A&E – a situation which NHS England has since began to overturn.

But the Welsh Government said the Welsh model differs from other UK models by having a greater proportion of clinical staff within it from the start.

However, concerns have been raised by staff that the algorithms used in the system were too risk averse, creating additional pressure on the GP out-of-hours system.

The evaluation authors recommended a structured review of the triage systems to avoid too many patients being sent through GP out of hours when they could self-manage or make an in-hours appointment.

Health secretary Vaughan Gething said the roll out would happen over the next three years.

He said: ‘I’m very encouraged to see evaluation which suggests a link between 111 and a decrease in ambulance conveyance.

‘It is also clear from feedback that this service has been valuable in supporting patients and helping the NHS to treat patients with urgent care needs more effectively.’

He added that emergency departments had been under pressure particularly this winter and NHS 111 would help patients find the right place for their needs.

Dr Charlotte Jones, chair of BMA Wales’ GP committee, said: ‘111 should ultimately result in a more streamlined service for patients and health care professionals. The design of the service makes perfect sense, but unfortunately, we are aware of several emerging issues regarding workforce sustainability, quality of triage and prioritisation of calls that need to be quickly addressed in order to make the service safe, sustainable, and effective for patients and staff alike.

‘We will discuss these issues directly with the 111 programme leads and Welsh Government in order to find solutions to improve the service.’