NHS 111 urgent care service

NHS 111 urgent care service Frequently Asked Questions (FAQs)

Contents Background 2 Operational 3 NHS Direct 5 999 5 101 6 Training 7 Service Impact 7 Telephony 8 Marketing 8 1

Background Why are you introducing the NHS 111 service? The new NHS 111 service is being 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 have 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 new NHS 111 service will make 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 assesses callers symptoms, gives them the healthcare advice they need or directs them straightaway to the right local service. NHS 111 is available 24 hours a day, seven days a week, 365 days a year and is free to call from landlines and mobile phones. NHS 111 can also help to 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. Is 111 the number for all NHS healthcare services? 111 is not intended to be the only number for access to NHS healthcare services. The NHS 111 service is for when people need help fast, but it is not a life-threatening 999 emergency. For less urgent health care needs, people should still contact their GP or local pharmacist in the usual way. Once the new service is rolled out nationally, there will be just three numbers for people to use when they need to contact the NHS for urgent care; 999 for life-threatening emergencies; their GP practice number; and 111. If a health professional provides a specific telephone number to call when someone is concerned about their health condition, people should continue to use this number. Is the introduction of the NHS 111 service just a cost cutting exercise? No, it is about giving patients a better service. We are introducing the NHS 111 service to improve the public s access to urgent healthcare services. However, we expect that the implementation of the NHS 111 service will also drive improvements in the way that urgent health care services are delivered and help to make them more effective and efficient. 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, 365 days a year. 2

When will NHS 111 roll-out nationally? The NHS 111 service for Milton Keynes and Northamptonshire will be launched in late March 2013 and will be operating across England by October 2013. Will social services be included? During the roll out phase, the NHS 111 service will primarily be for access to urgent healthcare, but callers with social care needs will be signposted to the right services to meet their needs. In time, the scope of the service will grow and could become the single telephone access point for all urgent healthcare and social care services. Operational Who is providing the NHS 111 service in this area? In Milton Keynes the service is provided by Harmoni and by Derbyshire Health United for Milton Keynes. Who will answer NHS 111 calls? Calls to NHS 111 are answered by fully trained NHS 111 health advisers, supported by Clinical Advisor who are experienced nurses and paramedics. They use a clinical assessment system called NHS Pathways to assess callers needs safely and effectively and direct them to the right NHS service. Calls to the NHS 111 service are answered by non-clinicians - is it safe? Just like 999 operators, NHS 111 call advisers are fully trained. They use a clinical assessment system which enables them to assess callers needs safely and effectively and direct them to the right NHS service. All advice provided is supported by experienced nurses and paramedics. Using the clinical assessment system means a smaller proportion of calls need to be referred to a clinician. This means that NHS 111 Clinical Advisors can focus on cases where their clinical skills are most needed, rather than dealing with calls that don't need their expertise. However, should a patient be assessed as needing to speak to a clinician, they will be put straight through to one. How will NHS 111 Health Advisors 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 active audit of a percentage of calls taken by each 111 adviser every month. In addition, daily and weekly data identifies individual performance in key areas and allows immediate support to ensure all Advisors provide a very high level of service at all times. 3

Will the NHS 111 service book appointments with GPs? No, The NHS 111 service will not be able to book GP appointments for patients. Health Advisors will advise patients to contact the practice directly. What clinical assessment system will NHS111 use? NHS 111 uses the NHS Pathways clinical assessment system. This is an NHS owned system that has been developed by a team of NHS doctors, nurses and IT specialists, as well as the Royal College of Psychiatrists, to provide a safe, consistent clinical assessment of a caller s symptoms and to identify the service that is best able to meet their needs. The system has been designed to assess calls about any symptom from life threatening to very minor and has been extensively tested, piloted and academically reviewed to confirm its effectiveness. Will people be diagnosed over the phone? No, the NHS 111 Health Advisors 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 (eg ambulance, A&E, urgent GP, or a range of other services). Is the service available to people with a hearing impairment or communication difficulties? Yes. People with communication difficulties or impaired hearing are able use the NHS 111 service via a text phone by calling 18001 111. Calls are connected to the Text Direct system and the text phone will display messages to tell the user what is happening. A Typetalk Relay Assistant will automatically join the call and they will speak the users typed conversation to the NHS 111 Health Advisor and will type back the Advisor s conversation, so that this can be read on the caller s text phone display (or computer). Is the service accessible to non-english speakers? Yes. The NHS 111 service uses a translation service so that it is accessible to people that do not speak English. An interpreting service will be available to callers within 90 seconds of having their call answered by the 111 service. Callers that do not speak English should state the name of the language they want to conduct the conversation in and the interpreting service will be used. Leaflets explaining how the NHS 111 service works are available in a number of different languages via www.nhs.uk/111. 4

NHS Direct Will NHS 111 replace NHS Direct? The NHS 111 service, being introduced as part of the overall improvements to the urgent care system, will provide an easier to use, integrated 24/7 service enabling the public to access the right service, first time. When NHS 111 is rolled out nationally, it will replace the NHS Direct 0845 4647 telephone number. Until then, NHS Direct will continue to provide its current service. Once NHS Direct is no longer live, any patients calling the 0845 4647 NHS Direct number will be asked to hang-up and re-dial the 111 number. How is NHS 111 different to NHS Direct? NHS 111 is a free to call service, available through the easy to remember three-digit 111 number. It will provide a more comprehensive service by delivering clinical assessments of callers needs at the first point of contact, and ensuring that they are directed straightaway to the service that is best able to meet these needs, taking into account their location, the time of day at which they call and the capacity of local services. It will also enable us to offer the public an improved telephone experience, by referring people directly to the appropriate service and eliminating, as far as possible, the need for call backs. What will happen to NHS Direct staff when NHS 111 has been rolled out? We are working with commissioners to ensure that where NHS Direct is not the chosen provider of the NHS 111 service, the majority of NHS Direct frontline staff - including nurses and health advisors - will be able to move to the appointed service provider. 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 be able to transfer the call to the ambulance service dispatcher who will then dispatch an ambulance. All information given to the NHS 111 Health Advisor will be forwarded to the Ambulance dispatcher so that patient does not need to repeat information. What happens if a caller does not 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 be able to transfer the caller to the ambulance dispatcher. The NHS 111 Advisor 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 a person is unsure of whether something is urgent or an emergency; the NHS 111 service will direct them to the right service, first time, even if the right service is an ambulance response. 5

How many calls to 999 are currently made for non-emergencies? More than 25% of calls made to 999 are Category C calls ( neither serious nor immediately life threatening ). The NHS 111 service provides an alternative for these callers whilst ensuring that ambulance resources are directed to those who have a medical emergency and require an immediate response. 101 Why are you introducing two similar numbers? The NHS and the police service are introducing 111 and 101 respectively to improve the public s access to their non-emergency services. The public should call 111 when they urgently need medical help or advice but it's not a life-threatening situation. Calls to 111 will be answered by trained advisers, supported by experienced nurses, who will immediately ask questions to assess the person s symptoms, give the required healthcare advice and direct them to the right local service as quickly as possible. The public should call 101 when they need to contact the police, but do not require an immediate emergency response. Calls to 101 will be answered by police call handlers in the control room of the local police force - the call handlers can connect callers to their local team or station or despatch officers to deal with the issue. Won t the public be confused by having similar three-digit numbers? The 111 and 101 numbers provide access to two very different and distinct services - the NHS and the police. Each number will be branded and promoted very differently to help people understand the difference between the two. Why wasn t one three-digit number used to access both non-emergency police and NHS services? The 111 and 101 three-digit numbers have been developed a number of years apart. The Home Office originally piloted the 101 number in 2006, whereas the 111 number was first introduced in 2010. The two numbers are being implemented separately and intentionally provide access two very different and distinct services. What happens if a member of the public calls the wrong number when they need a non-emergency service? Health Advisors can advise callers on the service that is best suited to their needs. Callers will be advised to hang up and re-dial the appropriate number. 6

Training What training will NHS 111 advisers be given? All NHS 111 Advisors using the NHS Pathways clinical assessment system to answer calls undertake a 60 hour training programme. This includes a pre-course learning pack that provides an introduction to the system and key areas of anatomy, physiology and medical terminology, classroom tuition and written and practical assessments which require a 70% pass mark. Advisors are given two attempts to pass the assessments, and if they fail on the second attempt, they are not given a permanent role with the NHS 111 service and are unable to take patient calls. Additionally, all Advisors receive a minimum of four weeks of supervised use on the live system followed by another assessment. This includes a clinical audit of calls taken and direct feedback to the individual. This is in addition to any training provided by the organisation on use of telephony, call control and local processes and procedures for call referral under different circumstances, such as child protection, vulnerable adults, frequent callers or patients with special notes. Are the NHS 111 Health Advisors clinically trained? All NHS 111 Health Advisors have received extensive training on the clinical assessment system used by NHS 111 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 clinicians to provide clinical support in the event of any difficulty. Some calls will be passed to a clinician to deal with complex issues or where the assessment concludes that the patient needs clinical guidance on managing their symptoms at home. Service impact Will more callers be directed to face to face urgent care services rather self care? This is difficult to predict as there have been mixed results from the pilot areas. These have shown that whilst services in one area are affected, those in other areas aren t. The Pathways clinical assessment system is constantly being assessed and developed in order to ensure the patient s safety and that they are directed to the most appropriate care service straight away. 7

Telephony Why was 111 chosen as the number for the service? Research showed that of all the available three-digit numbers, 111 was resonated most clearly with the public, not least, because it s repeating three-digits echoes 999. The same research showed that 111 fits the needs of blind or partially sighted users, and those with restricted mobility, who often find phones difficult to use. 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. How many calls will there be? We estimate that when the NHS 111 service is rolled out across England, it will receive between 14 and 30 million calls per year. This is based on existing usage of services such as NHS Direct and out of hours services. The pilot phase will enable us to find out just how many people will use the NHS 111 service. Marketing How are you making the public aware of the new service? Once the service is live, we will be running marketing campaigns across Milton Keynes and Northamptonshire to build public awareness and understanding of the new NHS 111 service. Our campaign will utilise social media, online and offline advertising as well as public events and press releases. Where can people find information about the new NHS 111 service? Information about the new NHS 111 service is available at: www.nhs.uk/111 www.miltonkeynes-northamptonshire.nhs.uk/nhs111 8