NHS 111 Stakeholder Briefing NHS 111 can be designed locally to - PowerPoint PPT Presentation

NHS 111 Stakeholder Briefing “ NHS 111 can be designed locally to reach far beyond the initial vision ” NHS 111 Lessons learnt and shared understanding, NHS 111 Programme, Version 1.2, September 2011 Contact: Programme Manager: Dr Kathryn MacDermott, Assistant Director Strategy & QIPP Communications & Engagement Project Lead: Alex Louis

A reminder…what is NHS 111? • A new 24/7 telephone service which aims to make it easier for people to access local health services when they urgently need medical help or advice but it's not a life-threatening situation (i.e. not a 999 emergency)

The strategic context • Coalition government commitment to introduce a three digit number to access non-urgent care nationwide by 2013. “ We will develop a coherent 24/7 urgent care service in every area in England that makes sense to patients when they have to make choices about their care. This will incorporate GP out of hour ’ s 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. ” • Consultation for a three-digit number carried out in 2009 showed clear evidence of support from patient representative groups and clinicians. • Early pilots introduced in 2010. • London pilots due 2012

What are the benefits of NHS 111? • Introduction of a consistent clinical • Information on the capacity of, and assessment tool and referral demand for, urgent care provision management. available via Directory of Services (DoS) reporting, allowing commissioners to • Reduction in attendances at A&E and an respond more intelligently to local increase in patients being directed and needs/demands. conveyed to the most appropriate care • Improved clinical governance of all setting for their needs. general practice and community services • Activity shifted to more clinically through caller outcome information. appropriate, lower cost care settings. • Signposting of access to NHS dentistry in • Reduction in ambulance ‘999’ activations hours as well as Out of Hours (OOH). and conveyances to A&E. • Improved end of life care services through • Reduction in unscheduled admissions by coordination of individual patient care. directing patients to home-based • An increased percentage of patients nursing/care services. achieving preferred place of death.

Support for a three digit number • DoH started work in 2008 scoping a single number to access NHS urgent healthcare services • Included public research which showed overwhelming support for a ‘ 999 style ’ memorable number • Public support for introduction of 111 very high; 88% of people interviewed said likely to use the new service • Public support matched with extensive support from British Medical Association, Royal College of General Practitioners & Royal College of Physicians • Provider organisations including LAS, NHS Direct and out of hours providers are positively engaged in 111 pilot • All SHAs support the introduction of single number to access urgent healthcare services.

NHS 111 : more than a number • Provides a definitive clinical assessment at the first point of contact, without the need to call patients back. • The service will direct people to the right NHS service, first time, without the need for them to be re-triaged. • It will be able to transfer clinical assessment data to other providers and book appointments for patients when locally agreed and appropriate. • It works alongside the London Ambulance Service (LAS) and will be able to despatch an ambulance without delay and without the need for the patient to repeat any information.

Unplanned care • Review use of urgent care centres Key deliverables: • Review use of walk in centres • Develop and implement unscheduled care strategy • Implement 111 • Reduce the level of unscheduled secondary care activity • Reduce inappropriate A&E attendances Key outcomes: • Reduce A&E conversion rates • Increase the volume of activity undertaken in primary and community based services and local settings (at home/hospices) • Reduction in readmissions

London 111 Operating Model ACCESS NHS 111 call advisers ANSWER Locally commissioned call handling NHS Pathways ASSESSMENT Consistent assessment of clinical needs Directory of local skills and services (CMS) Provided by each NHS organisation in a PCT area, including opening hours, referral criteria, and real- time capacity GP GP 999 A&E MIU WiC DN in hrs OOH APPROPRIATE CARE Rapid response Palliative care Midwife Pharmacy nursing services, hospices Integration with End of Life Register

The future of Urgent and Emergency Care

NHS 111 national pilots so far • NHS 111 launched in Aug 2010 in County Durham & Darlington, and December 2010 in Nottingham City, Lincolnshire and Luton in total, over quarter million calls received. • System impact data released monthly by the Department of Health reviewing the impact of NHS 111 services on A&E, UCC, Primary Care, ambulance services and NHS Direct. – Durham and Darlington data compared with the same period from the previous year shows that A&E attendances decreased by 1%, in comparison to a 9% increase in A&E attendances for the same time period in the control site. This is equal to a net 10% reduction – OOH, WiC and UCC contacts have increased by 4% per cent compared to control site where contacts increased by 19% over the same time period. This is equal to a net reduction of 15%. – 45% drop in NHSD 0845 calls • Majority of calls receive a primary care disposition this includes pharmacy, community nursing, out of hours as well as in-hours primary care dispositions.

London roll-out process • The Secretary of State set a deadline of April 2013 for NHS 111 service to be available across England. • DH requested firm 111 roll-out plans from SHAs be submitted in September 2011 plans needed to include the financial case. • To ensure universal coverage by 2013 DH have said that where plans do not exist, commissioners be expected to engage with NHS Direct as an ‘ opt-in ’ to work in partnership with ambulance and local GP out of hours providers to provide 111 services on an interim basis until a formal procurement process takes place. • All London clusters have now submitted plans that ensure NHS 111 service coverage through pilots by January 2013. London CCGs must endorse local plans. • London is planning formal procurement of NHS 111 post pilots from 2014 – with the early pilots intended a high quality, efficient 111 service integrated with primary and community urgent care systems.

Geographic view of London pilot plan to meet coverage by April 2013 Jan 2013 Oct 12- July 2012 June 12-Jan Jan 2013 2013 July 2012 Aug-Nov 2012 March 2012