Agenda item

The Committee considered a report of Leicester, Leicestershire and Rutland Clinical Commissioning Groups (LLR CCGs) regarding the NHS 111 First initiative which aimed to ensure that patients attended the appropriate NHS facility for their needs and did not attend the Accident and Emergency Department when there were other more appropriate venues for them to receive healthcare. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

The Committee welcomed to the meeting for this item Tamsin Hooton, Assistant Director of Urgent and Emergency Care, LLR CCGs.

Arising from discussions the following points were noted:

(i)          Members felt that the public needed greater clarity on what NHS 111 was for and when they should use it. Members emphasised the importance of clear communication to the public regarding which services they could use and when, particularly in relation to whether patients needed to make appointments before attending urgent care centres. It was suggested that flow charts could be used to demonstrate to the public how NHS 111 interlinked with the rest of the local health services.

(ii)         Consideration needed to be given to how the NHS communicated with people that resided in rural areas and whether print media or leaflet drops were the best method.

(iii)       Members raised concerns regarding the capacity of the NHS 111 service and whether it would be able to cope with additional demand caused by NHS 111 First publicity. In response reassurance was given that the scheme would not be promoted to the local population until the level of resilience was certain and a soft launch would take place over the coming weeks. Should the local NHS 111 service be overloaded with calls then the calls were automatically transferred to NHS call handlers elsewhere in the country.

(iv)       Concerns were raised by members that the NHS 111 call handlers had no clinical training and were merely following a checklist in order to refer patients for the appropriate advice and/or treatment. In response reassurance was given that as a result of national funding that had been received additional call handlers and clinicians were being recruited for the NHS 111 service and consideration was being given to the mix that was required. There were times when it was better for the call handler to send a patient straight to the Emergency Department rather than referring them to talk to a clinician on the phone.

(v)        After the initial call between a patient and the NHS 111 service had taken place, two further attempts would be made by NHS 111 to contact the patient and ensure their wellbeing. There was a risk that should the patient miss those two further calls they would lose contact with the NHS, however patients were advised to attend the Emergency Department if they were unable to access any other kind of support.

(vi)       Patients that lived near County borders would be referred to the nearest Emergency Department to where they resided even if it was in a different County, they would not automatically be referred to the Emergency Department in their own County. It was agreed that further details would be provided to members after the meeting regarding how the system chose which medical facilities to refer patients to.

(vii)      Members were interested to see more data on the numbers of patients attending the Emergency Department as opposed to calling NHS 111. They were also interested in seeing any data from the pilots which took place in Devon and London. The CCG agreed to find out what data could be shared with members.

(viii)    Given that patients were being advised to stay away from Leicester Royal Infirmary wherever possible a member questioned whether drugs could be accessed locally out of hours and whether there could be stock piles at community hospitals. The CCGs agreed to investigate this situation and report back to members.

RESOLVED:

That the update on NHS 111 First be noted.