You said   

You want to talk to a GP or a medically trained advisor and you want to do it quickly.  

“Have a doctor to talk to without long waits. The person on the phone could not assess the urgency of the condition. As a result, I decided to go to A&E where I received urgent treatment straight away"

We did

NHS 111 will incorporate a Clinical Assessment Service (CAS) with a multi-disciplinary team made up of appropriate clinicians and clinical navigators leading to an increase in medical consultations completed within the NHS 111 service.
The Clinical Assessment Service will provide safe, rapid, enhanced telephone clinical triage and advice to resolve a health problem or provide the appropriate onward referral.

You said

You want confidence that when you phone, the person you speak to will know of the possible services available to help you and can tell you how to access them or even make an appointment for you.

“The person on the phone did not seem to have any local knowledge of where I could go”.

We did

The service will have access to a resource called the Directory of Services which will provide up to date and well maintained information about clinical and other service options for patients. In many cases it will be possible for the service to make you an appointment but if this is not the case or you need to speak to somebody immediately, the service will be able to transfer you, during opening hours, directly to the service you require.

Your said

You want fewer questions at the beginning of the call before you are helped.

“I had something in my eye - no need to ask me a raft of questions about whether I had breathing difficulties or concussion”.

We did

The new model will include the use of Interactive Voice Recognition (IVR) to immediately filter calls to the correct treatment options e.g. dental, pharmaceutical, etc., and have the ability to exit the current lengthy questioning process much earlier in the call.  The assessment will be quick and not involve unnecessary questions.

You said

You want to be able to trust that the service will respond quickly and appropriately for all levels of need.

We did

The Integrated Care Service has a number of core principles fundamental to the delivery of care. Some of these are detailed below:

  • In an emergency an ambulance will be dispatched for you without delay;
  • Your call will be transferred to a clinician so that you can talk to an experienced clinician should this be necessary;
  • Information about your clinical assessment can be electronically transferred to another service if needed;
  • An appointment can be made with the Out-Of-Hours provider when required;
  • The Clinical Assessment Service will be able to host conference calls to allow specialists to join a call;
  • Call backs will take place within safe timescales;
  • The IUC service will have accurate up-to-date information about local ‘locations of care’ and pharmacies including knowing opening times and services offered;
  • Support will be provided to patientsi where English is not the first language;
  • Support will be provided to patients with a hearing impediment, sensory impairment, physical disability, communication difficulty and mental health issues;
  • Any prescription required will be sent directly to a convenient pharmacy;
  • If further care or advice is needed patients will be referred electronically, or signposted to, another service that has the appropriate skills and resources to meet their needs.

You said

You want the NHS 111 service to know if you have called previously and to also be able to access your patient record.
“Need saved records urgently as I have medical alerts and always have to explain this to 111”.
“This service needs to be commissioned so that it works for End of Life Care patients. There needs to be clarity about how it works with existing hospice services”
“We rang 111 three times . . . Every time we rang we had to start from scratch telling the whole story, and going through irrelevant questions which had been answered less than 24 hours beforehand”.

We did

It is a primary aim of the procurement that the service will be able to remotely view patient records (history/medication etc)
The service will link into The National Repeat Caller Service which exists to make sure that the health professionals taking calls can access the clinical records of any recent contacts made via NHS 111 by or on behalf of patients.

You said

You want respect and inclusion for carers.
“The service is good but there are barriers for carers. When I have called about my elderly mother we go through hoops each time about them needing to speak to the patient. As my mother's advocate/carer, this causes some frustration. On top of which mum is hard of hearing so she ends up handing the phone back to me and getting upset”.

We did

There have been instances when people have called NHS 111 regarding others who do not know about their call - sometimes mischievously. Because of this the NHS 111 health adviser will always ask to speak to the patient directly in order to avoid misunderstandings and conflict with the Data Protection Act. It is possible for patients to ask their GP to create a ‘Special Patient Note’ providing NHS 111 with the power to speak to a named carer.

You said

You want assurance that your GP will know what has happened to you when you called NHS 111.

We did

As part of the current and this new service, your GP will always be sent an electronic Post Event Message to a patient’s registered GP surgery by 08:00 the next working day.

You said

You want provision for people who have sensory impairments.

We did

Innovations to ensure people with sensory impairments can easily access the service are under development including Skype/Facetime and remote consultation.
You can currently access the NHS 111 service online via NHS Choices at https://www.nhs.uk/NHSEngland/
AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx
where you can access Typetalk or Textphone. There are plans to launch an NHS 111 Online platform incorporated into the Integrated Urgent Care Service when the new service goes live.

You said

You want pharmaceutical and medication advice.

We did

The Clinical Assessment Service will employ/have access to pharmacists who will be able to advise and manage pharmacy and medication queries. It will be possible for these pharmacists to arrange for prescriptions to be available at a local pharmacy should this be necessary.

You said

You want access to mental health services.

We did

The Integrated Urgent Care Service will have access to mental health staff. When you call NHS 111 with a mental health problem you will be directed to a mental health professional that can talk to you and direct you to an appropriate mental health service if necessary. It is anticipated that the service will, in time, be able to transfer you to an appropriate mental health service directly.

You said

You want access to dental services.

We did

People needing help with dental complaints will be able to talk to a dental nurse for advice about what to do. The dental nurse will have access to booking facilities for local dental services if the dental need is urgent.

You said

You want to receive care Out-of-Hours in places that are convenient for you to reach.

We did

Face to face consultations during evenings and weekends can be made for you directly by the Integrated Urgent Care Service.
We asked you during our consultation in June 2017 whether you were happy with the locations for Out-of-Hours appointments and you overwhelmingly said that you were.

You said

You have a condition for which you are receiving on-going care and want to see your own GP.

We did

If you are calling within the working hours of your local GP practice, and it is considered crucial that you see your own GP for continuity of care, then the Integrated Urgent Care Service will be able to access GP practice appointments to make a direct booking for you.

You said

You would welcome the introduction of an App and/or Online facility to access the service.

We did

The new service includes an NHS 111 Online facility which is intended to Go Live at the same time as the new contract; this is anticipated to be April 2019.