NHS 111 NHS 111 An Overview June 2015

Jessica Perkins NHS 111 Communications & Engagement West Midlands Core to our values Use the insights to develop and improve outcomes – try to guarentee that no community is disadvantaged and high quality care is available to all

Introduction – purpose of PATIENT ENGAGEMENT To understand what the public and patients want from the NHS 111 service now and in the future. To understand how different patient groups want to access the service moving forward, and what would work best for them. Part of our commitment to patient engagement and participation is to understand what the public and patients want from the NHS 111 service now and in the future. Want to understand how different patient groups want to access the service moving forward, and what would work best for them.

What is NHS 111? Do you all know what NHS 111 is and when it should be used?

What is NHS 111? 111 is the NHS non-emergency number. It’s fast, easy and free It is available 24 hours a day, 365 days a year. Call 111 and speak to a highly trained advisor, supported by healthcare professionals.  They will ask you a series of questions to assess your symptoms and immediately direct you to the best medical care for you. NHS 111 replaced NHS Direct which closed down on 31 March 2014 What is NHS 111? 111 is the NHS non-emergency number. It’s fast, easy and free It is available 24 hours a day, 365 days a year. Call 111 and speak to a highly trained advisor, supported by healthcare professionals.  They will ask you a series of questions to assess your symptoms and immediately direct you to the best medical care for you. Replacing NHS Direct Before NHS 111, we had a national call centre service called NHS Direct. There was a Government decision to move to NHS 111 and create a dedicated service for people to contact when they had urgent but non-life threatening health concerns. NHS Direct was seen as a stand alone service, rather than part of the wider health system. Queries were rarely resolved at the initial contact with the patient. NHS Direct relied heavily on calling patients back, which often took too long. The original 0845 number was switched off in Feb 2014 and NHS Direct was closed on 31st March 2014.

What is Urgent and emergency care? The NHS provides urgent and emergency care Ring 999 for life threatening emergencies Ring 111 for urgent help and advice e.g. upset stomach and being sick constantly, child complaining of earache which is worsening Just wanted to explain some the detail – 999 / 111 – urgent v emergency – these are all subjective and one person’s urgent is another person’s emergency – this isn’t for us to define today,

How do you access non- emergency healthcare? How do you access non- emergency healthcare? – TAKE NOTES local pharmacy for healthcare advice? Online symptom checker?

How does it work? When you call 111 you will be assessed by fully trained advisers who are supported by experienced nurses and paramedics. They will ask you questions to assess your symptoms and give you the healthcare advice you need or direct you straightaway to the local service that can help you best. If the NHS 111 team think you need an ambulance, they will request one immediately. How does it work? When you call 111 you will be assessed by fully trained advisers who are supported by experienced nurses and paramedics. They will ask you questions to assess your symptoms and give you the healthcare advice you need or direct you straightaway to the local service that can help you best. If the NHS 111 team think you need an ambulance, they will request one immediately.

What happens when you call nhs 111 When you call 111 you will be assessed, given advice and directed straightaway to the local service that can help you best. That could be an out of hours doctor, walk-in centre or urgent care centre, community nurse, emergency dentist or late opening chemist. You are assessed by fully trained advisors who are supported by experienced nurses and paramedics. They use a clinical assessment system to assess a caller’s needs safely and effectively and direct them to the right NHS service. The clinical assessment system has been developed by a team of NHS doctors, nurses and IT specialists which has been extensively tested, piloted and academically reviewed to confirm it’s effectiveness. When using the clinical assessment system means a smaller proportion of calls need to be referred to a nurse or paramedic. This means that NHS 111 nurses and paramedics 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 nurse or paramedic, they will be put straight through to one. If the NHS 111 team think you need an ambulance, they will send one immediately.

NHS 111 West Midlands Watch video… https://www.youtube.com/watch?v=Kgx2yUyZIJw

When have you had to call NHS 111? Share your experience Has anyone in the room used NHS 111?

NHS 111 When should you call it? You need medical help fast, but it’s not a 999 emergency You don’t know who to call for medical help or you don’t have a GP to call You think you need to go to A&E or another NHS urgent care service; or You require health information or reassurance about what to do next When should you call it? You need medical help fast, but it’s not a 999 emergency You don’t know who to call for medical help or you don’t have a GP to call You think you need to go to A&E or another NHS urgent care service; or You require health information or reassurance about what to do next

If you have used NHS 111, what was your experience like If you have used NHS 111, what was your experience like? Share your feedback… How can the service be improved? What did you like about the service? TAKE NOTES Benefits Reduces anxiety for patients Able to pick up symptoms and illness through a call Reduction of calls to 999 and A&E attendance – 111 is a good filter Some patients prefer not to burden emergency services so it is good to have 111 as an option for advice and help

NHS 111 as it is today NHS 111 is available across the whole of England, making it easier for the public to access urgent healthcare services when they need help fast Around a million people a month use NHS 111 and are satisfied with the service NHS 111 services are positioned across the country, provided by your local Clinical Commissioning Groups who hold the budget for local healthcare provision NHS 111 intends to direct people to the right local service, first time, or gives health advice that is best able to meet a persons needs It is important to provide patients with urgent and emergency care services, allowing access to the right care An online directory (or catalogue) of services that is linked to NHS 111 helps with this 111 today… NHS 111 is available across the whole of England, making it easier for the public to access urgent healthcare services when they need help fast Around a million people a month use NHS 111 and are satisfied with the service NHS 111 services are positioned across the country, provided by your local Clinical Commissioning Groups who hold the budget for local healthcare provision NHS 111 intends to direct people to the right local service, first time, or gives health advice that is best able to meet a persons needs It is important to provide patients with urgent and emergency care services, allowing access to the right care An online directory (or catalogue) of services that is linked to NHS 111 helps with this

What do you think are the drawbacks/limitations of phone access to healthcare? What are the drawbacks/limitations of phone access to healthcare? Suggestions…. The time is takes to go through the call Phone triage Waiting for a call back – if you are anxious and unwell, wait time can be stressful because you want an immediate response Number of questions you are asked when you call 111 Call handler came across as unsympathetic Young people or elderly people may feel nervous calling – phone acts as a barrier – some people will not comfortable with a call Palliative care – a call may trigger a 999 response when it is not needed

Possible Developments A major strand of future work is to catch up with the opportunities offered by digital technology, such as online, smartphone applications, email, text. Provide an online version of NHS 111 Direct booking to more services Improve access when a telephone service is not appropriate Text message or email sent to caller confirming information given over the phone Reduce amount of information asked next time you use the service What is your vision for the future and development of 111 service? Suggestions: Online assessment, live chat, phone app – especially for younger people Would not use web in urgent situation Develop symptom checker Skype, facetime – this may appeal to younger people. If rolling out this type of solution it needs to a clinician not call handler Patient records – would help if there was some information about LTCs and medication Text confirmation of call outcome would be useful What is your vision for the future and development of 111 service?

NHS 111 Project avatar Access to the NHS 111 service has traditionally been made by callers phoning into the service. To support multi-channel access into the NHS 111 service new ways of interacting with the service need to be considered.   The following high-level objectives have been identified: Ability to access the service from a mobile device Ability to access clinical decision support mediated by a virtual nurse Ability to make a referral into a NHS 111 service Ability for a NHS 111 Health Advisor to access the referral and perform a call-back, update the case and perform a PDS trace Ability for a NHS 111 Clinical Advisor to access to access the referral and perform a call-back, update the case and perform a PDS trace and onward refer Project avatar Access to the NHS 111 service has traditionally been made by callers phoning into the service. To support multi-channel access into the NHS 111 service new ways of interacting with the service need to be considered.   The following high-level objectives have been identified: Ability to access the service from a mobile device Ability to access clinical decision support mediated by a virtual nurse Ability to make a referral into a NHS 111 service Ability for a NHS 111 Health Advisor to access the referral and perform a call-back, update the case and perform a PDS trace Ability for a NHS 111 Clinical Advisor to access to access the referral and perform a call-back, update the case and perform a PDS trace and onward refer

What is NHS 111 Project avatar? A mobile phone application is currently being developed which will engage in natural conversation with patients A virtual nurse avatar will assist patients in assessing their medical conditions and deliver appropriate health education Testing A key focus within the development of this work is understanding the patient view of the digital technique, enabling patients to test the platform and to feedback their views and opinions. This feedback would then be incorporated within the development of the software. What is NHS 111 Project avatar? A mobile phone application is currently being developed which will engage in natural conversation with patients A virtual nurse avatar will assist patients in assessing their medical conditions and deliver appropriate health education Testing A key focus within the development of this work is understanding the patient view of the digital technique, enabling patients to test the platform and to feedback their views and opinions. This feedback would then be incorporated within the development of the software.

Would you like to be part of the Virtual patient Network? We are continually striving to develop a service that meets the needs of our diverse population, and we can only do this by checking back with patients. As such, we’d like to continue the conversation with you! On-going involvement will not require face to face meetings, but contact over the phone, or over email, to ask questions about specific ideas for the service. We consider this to be a ‘Virtual Network’ that acts as a ‘test-bed’ for innovation and service development. If you would like to be part of the Virtual Network please register your interest by sending your contact details to: engagement.westmidlands111@nhs.net Would you like to be part of the Virtual patient Network? We are continually striving to develop a service that meets the needs of our diverse population, and we can only do this by checking back with patients.  As such, we’d like to continue the conversation with you!  On-going involvement will not require face to face meetings, but contact over the phone, or over email, to ask questions about specific ideas for the service.  We consider this to be a ‘Virtual Network’ that acts as a ‘test-bed’ for innovation and service development.  If you would like to be part of the Virtual Network please register your interest by sending your contact details to: engagement.westmidlands111@nhs.net