News

03.12.2020

NHS 111 First Stakeholder update

Enhanced NHS 111 Service Stakeholder Update 

December 2020

Following months of work from clinicians and staff across the system, we’re pleased to confirm that from today patients are being offered timeslots by 111 into Emergency Departments (ED) at University Hospitals North Midlands and University Hospitals Derby and Burton. 

Neighbouring hospitals in the Black Country, Birmingham, Derbyshire, Shropshire and Cheshire have also introduced timeslots in EDs.

This is a national ambition for all trusts to offer the enhanced NHS 111 service to enable 111 to directly book patients into time slots for Emergency Departments, when clinically appropriate.   

By triaging a greater number of patients through 111 first we can reduce unnecessary attendances at EDs and help keep staff and patients safe in waiting rooms – maintaining social distancing during the COVID-19 pandemic. Importantly, our priority is to help people get to the right service for their needs.    

We want to reassure people that nobody who attends an ED without having contacted NHS 111 beforehand will be turned away without support. Patients who do go to EDs will be offered advice and support, including advice on other services that may be able to see them quicker than waiting in the ED.  

Please remember that for all life threatening emergencies people need to dial 999.

Why is this important?

Our Emergency Departments (EDs) have been seeing increased demand over the past few weeks with the number of positive COVID-19 cases continue to rise within our region.   

This need has always been present but has been brought into focus during the coronavirus pandemic, which now moving to the endemic phase is a catalyst for such change to occur more quickly.

 What will happen?

As happens now, all patients with a timeslot will be met by the triage team who will assess their needs and give further instructions. A timeslot is different to an appointment, and patients may still have a smaller wait, as the EDs will also have to prioritise critical cases that come in through ambulance or walk-in.  

By phoning 111 first and receiving a timeslot patients will hopefully see the following benefits:

  • We can advise the patient on the best time to attend, thereby avoiding peak times and reducing their wait
  • Clinicians at the ED will have the details of the clinical assessment undertaken by NHS 111 so know what to expect when the patient attends their timeslot.

What happens if I don’t have a timeslot?

For patients who go to ED, and have not gone through 111, they will be assessed by the triage team. If they need ED they will be asked to wait and will be seen according to clinical need. If ED is not the best place for their care, they will be encouraged to consider other services including the minor injury units/GP triage within hospitals. This already happens at the moment and we recognise that there is no one size fits all approach, every case is dealt with individually. Over time, we hope to encourage more people to phone 111 first.

What is happening in Same Day Emergency Care?

Same Day Emergency Care covers a range of day case hospital clinics, where a patient does not need to be admitted. This could include Deep Vein Thrombosis (DVT) assessment and certain surgery pathways. Patients who phone 111 can now also be booked into some clinics directly, bypassing the EDs altogether. For example, a patient experiencing DVT symptoms will be given a timeslot direct into the DVT clinic. At the moment, they would be signposted to wait in ED, triaged and then sent onto the clinic to potentially have a further wait. By offering a timeslot, the patient will go straight into the relevant clinic, reducing waiting times and unnecessary steps in the patient’s journey.

Before being offered a timeslot, patients will be assessed first by the call handler at 111 and then by the clinicians at 111. This ensures we get the patient to the right place, first time. The clinicians at 111 will then be transferring the patient’s information through to the receiving clinic, so they know the background to the case.

We have trialled timeslots into some Same Day Emergency Care clinics since Mid-November and have already seen positive results for patients. The clinical teams continue to work together to monitor the timeslots both for EDs and Same Day Emergency Care and we hope to explore other services that could benefit from this approach.   

Next steps

 There will be a phased approach to communications, targeted to reach people who could have accessed alternative services to EDs if they had phoned NHS 111. A national communications campaign is due to launch today/this week and we will promote how people can use NHS 111 to access advice and to be signposted to the right place for their needs.

We will continue to listen to the views of local patient groups to inform our approach to the enhanced service. So far, feedback has been positive and the ability to receive an ED and Same Day Emergency Care timeslot has been generally welcomed. 

The programme team is now exploring other services that would benefit from timeslots, including walk in centres and minor injury units. We will keep you updated as this work progresses.

For any further information on NHS111 First please contact twb.comms@nhs.net. If you would welcome a meeting to discuss this further, please let us know.

 

 

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