BUSINESS IMPROVEMENT


Nick Chapman, NHS Direct chief executive, discusses the need to provide reliable health information to give patients more choice.


N


HS 111 will be an innovative addition to the urgent care landscape and will


significantly change the way in which peo- ple access healthcare. At NHS Direct, we are using our 12 years’ experience in pro- viding patients with healthcare advice by phone and the internet to contribute to the NHS 111 pilots and to inform the national roll-out.


NHS 111 is a new service being introduced to make it easier to access local NHS health- care. People in Luton, County Durham and Darlington, Lincolnshire, Nottingham City, the Isle of Wight, parts of Derbyshire and Lancashire (excluding West Lancashire) are now calling 111 when they need medi- cal help fast, but it isn’t a 999 emergency. NHS Direct is involved in all of these cur- rent pilots, leading on a number of them and providing a health information service to the others.


Remote and virtual healthcare is an in- creasingly important part of the NHS. By providing advice and information over the phone and on the internet, patients get what they need, when they want it, from wherever they are. Giving self-care advice


CASE STUDY - Delivering NHS 111 in the North West


The NHS 111 pilot in the North West currently covers Lancashire (excluding West Lancashire) and will cover Cumbria in the near future. NHS Direct is working as part of a consortium to deliver this pilot which includes out-of-hours service Fylde Coast Medical Ser- vices (FCMS) and the North West Ambulance Service NHS Trust (NWAS). The pilot is overseen by the North West Strategic Health Authority (SHA). When the pilot is completely rolled out it will cover a population of 1.8m people.


This is the first pilot where all the organisations involved play an equal part in delivering the service. The pilot demonstrates


Above:


Getting good health advice to patients by phone or online can help them look after themselves.


when appropriate means they can look af- ter themselves. Steering them to the right setting at the right time means they get to the care they need first time. Providing re- liable and easy-to-find health information gives patients more control and choice over their health.


At the same time a multi-channel


how working together and clinical engagement can provide robust clinical governance, high levels of resilience and a service that is fully integrated into the exist- ing urgent care system. It also demonstrates how the patients’ needs can be met quickly in a single call.


The North West SHA approached NHS Direct, FCMS and


the


NWAS to work together to deliver the NHS 111 pilot. The North West SHA saw the combination of national resilience from NHS Direct, and regional knowledge and insight from FCMS and NWAS as the perfect combination to deliver a local, integrated NHS 111 service.


Each organisation plays a part in 22 | national health executive Jan/Feb 12


service, that makes best use of internet and phone alongside more traditional face-to-face channels, can help the NHS manage growing demand within existing budgets by reducing avoidable demand on GP surgeries, A&E departments and ambulances. Helping to manage the pressures on stretched primary and secondary healthcare means that these


the front-end delivery of the NHS 111 pilot service. Both FCMS and NHS Direct provide the call han- dling in the areas they covered out-of-hours prior to NHS 111. The NWAS will start taking calls in the pilot from February 2012, and all new activity coming from the public directly dialling 111 will be shared between the three organi- sations. Having three providers working together allows greater flexibility around forecasting and demand management.


Calls can be handled by one, two or all three providers simultane- ously if demand requires and the service can quickly and effective- ly respond to peaks and troughs. The telephony system has been designed so that if there is ad- ditional demand on one provider,


patients queuing for any longer than 40 seconds are redirected to another provider to answer with- out any delay.


In this North West pilot nurses from NHS Direct provide clinical support to call handlers. They can also undertake further as- sessments of patients with more complex symptoms or where a patient needs additional reas- surance. In these circumstances calls can be transferred to a nurse immediately and their data sent across electronically.


This means that the nurse is able to view the initial assessment that has already taken place so the patient doesn’t need to repeat the information they have already provided.


© Paul Swansen


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