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Most patients sent to A&E unnecessarily by NHS 111

Nearly three-quarters of patients sent to A&E by NHS 111 don't need to go there

Ingrid Torjesen

Tuesday, 01 December 2015

Nearly three-quarters of patients told to go to A&E after calling NHS 111 did not actually need to be sent there, a study* published in BMJ Open shows. 

Researchers at Cambridge University, led by Professor Martin Roland, set out to determine the effect of using experienced general practitioners to review the advice given by call handlers at the NHS 111 national telephone advice service.

GPs reviewed 1,474 cases where a patient had been directed to an A&E department by call handlers using triage software at the Cambridgeshire and Peterborough NHS 111 service and found that they would have sent just 400 cases (27.1%) to an A&E department.

Nearly three-quarters of patients would have been advised to do something else. Most cases (665 or 45.2%) would have been advised to attend a primary care out-of-hours centre or minor injury unit and 409 (27.8%) would have been advised to self-manage.

The researchers 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.” 

They added: “Telephone triage services need to consider whether using relatively unskilled call handlers supported by computer software is the most cost-effective way to handle requests for medical care.”

However, as only 6% of A&E attendances occur as a result of advice from NHS 111, the impact on the overall the A&E workload of restructuring NHS 111 would be “relatively small”.

* Anderson A, Roland M. Potential for advice from doctors to reduce the number of patients referred to emergency departments by NHS 111 call handlers: observational study. BMJ Open 2015;5:e009444 doi:10.1136/bmjopen-2015-009444

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