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30.11.15

NHS 111 sends more patients than necessary to A&E, study suggests

Nearly three-quarters of patients told to visit an emergency department after calling NHS 111 did not actually need to be sent there, a new study suggests. 

For a short-term observational study, GPs in the Cambridgeshire and Peterborough NHS 111 service reviewed 1,474 cases where a patient had been directed to an A&E department. 

Researchers at Cambridge University found that if a GP had checked call handlers’ decisions to send patients to the emergency department, nearly three-quarters of patients would have been advised to do something else – most commonly to attend a GP out-of-hours centre for a face-to-face consultation with a GP or a nurse. 

The study, published in the BMJ Open Journal, revealed that of the 1,474 cases reviewed, GPs would have sent the patient to an A&E department in 400 cases (27.1%). 

However, most cases (589 or 40%) would have been sent to an out-of-hours clinic run by GPs; others would have been advised self-care or some alternative management in 409 (27.8%) cases; and GPs would only have sent people to a Minor Illness and Injury Unit in 76 (5.2%) cases. 

The report authors said: “The criticisms that NHS 111 sends more patients than necessary to A&E departments therefore appears correct, though we were not able in this study to assess the appropriateness of decisions made by either the GPs or the call handlers. 

“Since, nationally, only 6% of A&E attendances occur as a result of advice from NHS 111, the ability to reduce overall A&E workload by restructuring NHS 111 is relatively small.” 

The researchers have suggested that the study should be replicated in other NHS 111 call centres in England. 

An NHS England spokesperson said: “NHS 111 is delivering a high-quality service in the face of high demand. Only around 8% of calls to NHS 111 result in advice to attend A&E.” 

Recently, NHS England announced that NHS 111 and general practice Out of Hours services have been brought together under a new 24/7 urgent clinical service set to offer advice and treatment to patients. 

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