DH publishes early lessons from NHS 111

The Department of Health has published some lessons learned from the early implementation of NHS 111.

A first interim report from the evaluation of the new service's pilot sites has highlighted a series of issues uncovered by a rapid review in October last year.

The review, which is being carried out by the Medical Care Research Unit at Sheffield University, reported that stakeholders found delivering the NHS 111 service much more complex, difficult and time consuming than expected.

It said there had been “significant technical issues” around the licensing, adaptation and integration of the different IT and telephony systems that needed to be linked.

It also highlighted the need to make sure that the NHS 111 service was integrated into the urgent care system.

A key issue that emerged from the review was the difficulty of developing a Directory of Services that call handlers could use to refer callers on to other NHS services.

The report said an accurate DoS was “crucial” for NHS 111 credibility and stakeholder and public confidence.

The report added: “For example before advising a NHS 111 caller to ring the district nurse, the call-handler needs to be confident that the district nurse is the right service and that the NHS 111 referral will be accepted as appropriate by the district nurse.”

The researchers said the DoS needed to be robust, with clear management and governance procedures, and that populating the DoS would be an on-going and time-consuming process if it was to be kept up-to-date and fit for purpose.

Figures published by the DH this week showed that the NHS 111 service is currently referring almost 60% of its calls on to other services.

The review also recommended that the capacity of the NHS Pathways decision support system will need to be increased if it is to be used for a national roll-out. 

It further said national and local marketing strategies would need to be aligned to provide consistent and explicit messages about the purpose of NHS 111.

The Sheffield University team helped the DH conduct its rapid review, which involved a series of focus groups in three of the four NHS 111 pilot sites plus interviews with NHS Direct and members of the NHs 111 national team.

A further interim report is due to be published in the autumn, providing a more detailed analysis of NHS 111's use and impact on the urgent care system.

The further interim report will also include the results of its first user surveys carried out in February and March this year. A final evaluation report is due to be published in spring 2012.