Exploring The Role Of NHS 111 In Urgent Care

Dr Foster - Associate Medical Director, NHS 111 and Urgent Care Services

Michela Littlewood - Head of Quality Assurance, NHS 111 Yorkshire Ambulance Service NHS Trust

Objectives

• Overview of NHS 111/ Yorkshire & Humber

• How NHS 111 integrates with urgent care

• The NHS 111 challenges/ Addressing The Challenges

• How you can help

NHS 111 in Yorkshire & Humber

• 13 GPOOHs services/ 23 CCGs/ 15 SRGs

• Managed by Yorkshire Ambulance Service

• Partnership with Local Care Direct (LCD) who provide urgent care in West Yorkshire

• Largest NHS 111 provider with 11% of population

• Approx 26,000 calls per week which can rise to anything up to 40,000 per week during the winter months

• 63% of calls taken when GPs surgeries are closed ie evenings, weekends and bank holidays

• Around 276 call handlers

• Total of 51 clinical advisors – dental nurses, nurses and paramedics

Integrated Urgent care Commissioning Standards (v15)

How NHS 111 integrates with urgent care

• Use of the Directory of Service (DOS)

• CCG meetings/ local clinical Governance meetings

• End to end reviews with clinical commissioners/ quality leads

• NHS England National 111 Clinical Governance Group

• System Resilience Groups (SRGs)

• National Ambulance Service Association (ASA)

The NHS 111 challenges

• Increasing call volumes

• Shortage of clinicians

• Attrition rates for non clinical staff

• Access to social care outcomes

• Dramatic peaks in call volumes at certain times

• Vanguard development

Addressing The Challenges

• National evidence supports early clinical intervention of 999 referrals from NHS 111

• National pilots/ locally Y&H– Senior Clinical floor walking staff to support early

clinical intervention

– Pharmacists

– Specialist Palliative Care Nurses

– Dental nurses

– Clinical Advisors Homeworking

How you can help

• Consider NHS 111 in service redesigns• Ensure you know the CCG Lead• Consider services that can take direct referrals form

NHS 111 ie Mental Health• The DOS can help both publicise your service &

ensure quick referrals for patients• Be clear with what service offer ie WICs/ MIUs/ EDs• Importance Joint working between 111 & 999

services• Watch for Vanguards

Any Questions?