NHS 111 implementation
in the South West
January 2012
What is NHS 111?
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A new national NHS telephone advice line and signposting
service
For patients with urgent health problems which require
assessment but are not so serious as to require 999
Free to call number 24/7 to respond to people’s healthcare needs
when:
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they need medical help fast, but do not believe it is a 999 emergency
they do not know who to call for medical help, for example they do
not have a GP to call or are away from home
they think they need to go to A&E or another NHS urgent care service
they require health information, signposting, or reassurance about
what to do next
There will be three options to call: 999 – 111 – or GP practice
during daytime
Why do we need it?
 Nationally:
 People are confused by what is available and too often use a
service which is not the best one to meet their needs
 Research in 2009:
– 38% were not sure of care options available for less serious
conditions outside GP hours
– 50% were more likely to use A&E on an evening/weekend to
access NHS help
– Variation in quality between different types of service and
different areas of the country
 In the South West:
 The Next Stage Review in 2008/9 found that people were
unclear about the options available to deal with an urgent care
need and did not know which number to call
 The Strategic Framework for Health in the South West
identified a need to streamline access to urgent care to help
route patients to the most appropriate service first time
The current picture
Government commitment 2010
‘The government will […] Develop a coherent 24/7 urgent care service
in every area of England that makes sense to patients when they have
to make choices about their care. This will incorporate GP out-of-hours
services and provide urgent medical care for people registered with a
GP elsewhere. We will make care more accessible by introducing,
informed by evaluation, a single telephone number for every kind of
urgent and social care and by using technology to help people
communicate with their clinicians.
White Paper Equity and excellence: Liberating the
NHS, July 2010
NHS 111 - national implementation
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NHS 111 is a national programme
Four national pilot sites set up in 2010:
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County Durham and Darlington (North East)
Nottingham City (East Midlands)
Lincolnshire (East of England)
Luton (East of England)
Department of Health & Secretary of State commitment to
implementation in all localities by April 2013
NHS 111 - aims
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The aim is to simplify access to the urgent care system
Specifically by:
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improving public access to urgent healthcare
helping people use the right service first time, including selfcare
providing management information on usage of services to
commissioners
enabling and supporting quality and productivity plans for
urgent care
NHS 111 - core principles
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The minimum requirements are set out in a national specification
NHS 111 service must be able, 24/7, to:
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dispatch an ambulance without delay
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complete a clinical assessment on the first call without the
need for call back
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refer calls to other providers without re-triage
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transfer clinical assessment information to other providers
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book appointments where appropriate
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signpost to another service, where outside the scope of 111
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conform to national quality and clinical governance standards
What will NHS 111 look like?
ACCESS
NHS 111 call advisers
Locally commissioned call handling
ANSWER
Clinical Assessment
Consistent assessment of clinical needs
ASSESSMENT
APPROPRIATE
CARE
Directory of local skills and services
Provided by each NHS organisation in a PCT area, including
opening hours, referral criteria, and real- time capacity
999
Midwife
A&E
MIU
Pharmacy
GP
in hrs
GP
OOH
NHS Direct
WiC
DN
Other services
Commissioner configuration in the South West
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20 shadow Clinical Commissioning Groups
Seven Primary Care Trust clusters:
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NHS Bath & North East Somerset and NHS Wiltshire
NHS Bristol, North Somerset, South Gloucestershire
NHS Somerset
NHS Gloucestershire and NHS Swindon
NHS Dorset and NHS Bournemouth & Poole
NHS Devon, Plymouth and Torbay
NHS Cornwall
Planning for NHS 111 in the South West
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NHS 111 services will be managed on a Primary Care Trust
cluster basis
Primary Care Trust clusters are working with Clinical
Commissioning Groups and providers to:
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specify the requirements for the local service
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develop a comprehensive Directory of Service which will
inform the choice of service people have when they call 111
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develop robust clinical governance arrangements
Co-ordinated procurement across the South West with locally
defined lots based on PCT cluster areas
Some facts and figures
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Current call volumes in South West:
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~750k 999 calls
~450k NHS Direct calls
~1.1m Out of Hours calls
Populations (5.3m for South West):
Primary Care Trust
Population
NHS Bristol North Somerset and South Gloucestershire
925,507
NHS Gloucestershire and Swindon
792,900
NHS Bath and North East Somerset and Wiltshire
643,030
NHS Devon, Plymouth and Torbay
1,138,100
NHS Bournemouth and Poole and Dorset
710,200
NHS Somerset
538,494
NHS Cornwall and Isles of Scilly
533,300
Timeline
 Advert published
September 2011
 Pre-Qualification Questionnaire
November 2011
 Invitation to Tender
January 2012
 Contract award
June 2012
 Mobilisation period
June 2012 – Jan 2013
 Phased implementation
Jan – March 2013