Impact of NHS 111 Online on the NHS 111 telephone service and urgent care system: a mixed-methods study

Background: The NHS emergency and urgent care system is under pressure as demand for services increases each year. NHS 111 is a telephone triage service designed to provide advice and signposting to appropriate services for people with urgent health-care problems. A new service, NHS 111 Online, has...

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Bibliographic Details
Published in:Health services and delivery research 2021-11, Vol.9 (21), p.1-148
Main Authors: Turner, Janette, Knowles, Emma, Simpson, Rebecca, Sampson, Fiona, Dixon, Simon, Long, Jaqui, Bell-Gorrod, Helen, Jacques, Richard, Coster, Joanne, Yang, Hui, Nicholl, Jon, Bath, Peter, Fall, Daniel, Stone, Tony
Format: Article
Language:English
Subjects:
health care
nhs 111
service evaluation
triage
urgent care
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Summary:Background: The NHS emergency and urgent care system is under pressure as demand for services increases each year. NHS 111 is a telephone triage service designed to provide advice and signposting to appropriate services for people with urgent health-care problems. A new service, NHS 111 Online, has been introduced across England as a digital alternative that can be accessed using a website or a smartphone application. The effects and usefulness of this service are unknown. Objectives: To explore the impact of NHS 111 Online on the related telephone service and urgent care system activity and the experiences of people who use those services. Design and methods: A mixed-methods design of five related work packages comprising an evidence review; a quantitative before-and-after time series analysis of changes in call activity (18/38 sites); a descriptive comparison of telephone and online services with qualitative survey (telephone, n = 795; online, n = 3728) and interview (32 participants) studies of service users; a qualitative interview study (16 participants) of staff; and a cost–consequences analysis. Results: The online service had little impact on the number of triaged calls to the NHS 111 telephone service. For every 1000 online contacts, triaged telephone calls increased by 1.3% (1.013, 95% confidence interval 0.996 to 1.029; p = 0.127). Recommendations to attend emergency and urgent care services increased between 6.7% and 4.2%. NHS 111 Online users were less satisfied than users of the telephone service (50% vs. 71%; p 
ISSN:2050-4349
2050-4357
DOI:10.3310/hsdr09210