NHS 111

NHS 111 is free to the caller and accessible 24/7, 365 days a year.

I work for the Trust’s NHS 111 service – the non-emergency number when you urgently need medical help or advice but it’s not a life-threatening situation.

This service is provided round-the-clock by over 500 staff from our two clinical co-ordination centres in Bicester, Oxfordshire, and Otterbourne, Hampshire. As well as providing the NHS 111 service for the four counties in the South Central region, we also provide it for people calling from Bedfordshire and Luton.

Last year we took over 1.25 million calls from members of the public and as we’re based in the same centres as the Trust’s 999 service, we can seamlessly transfer calls to 999 when am ambulance is required.

NHS 111 calls received in 2015/16

The NHS 111 service is provided using NHS Pathways trained call handlers and professional clinicians (nurses/ paramedics). The Trust is justifiably proud of meeting the NHS 111 service contract key performance indicators (KPIs) on most occasions: 95% of calls are answered within 60 seconds; call abandonment rate is well below the 5% target; and transfer to 999 has been reduced and remains consistently lower than the national average for all NHS 111 services.

Regular surveys undertaken over the past year confirm that patients are generally satisfied with the NHS111 service that SCAS provides.

We have undertaken a number of innovative developments and pilot projects to further develop and enhance our high quality non- emergency service and improve the patient experience.

When to use NHS 111

You should use the NHS 111 service if you urgently need medical help or advice but it’s not a life-threatening situation.

Call NHS 111 if:

  • you need medical help fast but it’s not a 999 emergency
  • you think you need to go to A&E or need another NHS urgent care service
  • you don’t know who to call or you don’t have a GP to call
  • you need health information or reassurance about what to do next

For less urgent health needs, contact your GP or local pharmacist in the usual way.

If a health professional has given you a specific phone number to call when you are concerned about your condition, continue to use that number.

For immediate, life-threatening emergencies, continue to call 999.

How does NHS 111 work?

The NHS 111 service is staffed by a team of fully trained advisers, supported by experienced nurses and paramedics. They will ask you questions to assess your symptoms, then give you the healthcare advice you need or direct you straightaway to the local service that can help you best. That could be A&E, an out-of-hours doctor, an urgent care centre or a walk-in centre, a community nurse, an emergency dentist or a late-opening chemist.

Where possible, the NHS 111 team will book you an appointment or transfer you directly to the people you need to speak to.

If NHS 111 advisers think you need an ambulance, they will immediately arrange for one to be sent to you.

Calls to NHS 111 are recorded. All calls and the records created are maintained securely, and will only be shared with others directly involved with your care.

Our control rooms have 999 call handlers and dispatchers as well as call handlers for the new NHS 111 service.

Co-locating the two services together enables closer working of the two teams and helps to ensure a consistent professional response to the public from both operations.

South Central Ambulance Service is providing the NHS 111 service to the residents of Oxfordshire, Berkshire, Hampshire and Buckinghamshire. The call handlers use the NHS Pathways assessment tool, a standard set of questions to establish what service the caller may need.
.
Within the Clinical Co-ordination Centre (CCC) we also have a Clinical Support Desk (CSD), staffed by trained nurses and if a call is identified as other than life threatening or serious, it may be transferred to the nurses to provide further assessment and an appropriate care option.

NHS 111 Compliments
  • ‘We were all very impressed and humbled by the exemplary level of care available to the people of Oxfordshire. Please carry on the fantastic work’
  • ‘I had occasion to use the NHS 111 service last night and I should like to say how impressed I was by the service I received. I got through immediately and was dealt with by a very pleasant, patience and helpful gentleman. I know that the service has come under fire in recent weeks so I thought it important to give praise when it’s due. Excellent service all round. Thank you all and well done the NHS’
  • ‘I just received a call from a lady, who called our service on Sunday 16th June and received first class service. She was very impressed and wanted to pass on her thanks’
  • ‘Just taken a call from a gentleman and at the end of his call asked if I would pass on his praise for the NHS 111 service, he has used it twice including today and found the call takers to be very courteous and helpful and has received a very good service.’
  • ‘We have just received a call from a lady who phoned in on 25th May. She wanted to compliment the service having read all the bad press over the past couple of weeks. She said that the call handler she spoke to was very polite and helpful and offered her an out of hours appointment within the disposition time.’
  • ‘Can you pass on our thanks to all the Treble One, EOC and Ops staff who got a response car and ambulance so quickly to our daughter, please?’
  • I’m writing to say how impressed with the service I received when I phoned NHS 111 when my husband was taken ill at 4am recently. The lovely lady on the phone told me exactly what to do and before I came off the phone an ambulance was outside our home. She made me feel calm and I can say how impressed with the service I was’.
  • ‘It was a pleasure to see and meet the people who front this for us and the dedication to do it correctly’.
NHS 111 Stories

Jo-Anne Rowney

Jo-Anne Rowney had been feeling short of breath and was off work. However, on waking up one morning she felt noticeably worse, finding it hard to breathe and virtually unable to talk. Having called NHS 111, she was advised to get to hospital but with her housemates all having left for work earlier, Jo-Anne was unable to get there. Whilst explaining this with great difficulty, the 111 operator realised Jo-Anne was having an asthma attack and starting to panic, and, as a result, immediately despatched an ambulance to her.

Jo-Anne recalls what happened next:

“It seemed like virtually no time at all until a paramedic arrived. He kept me calm, explained what had happened and what he was going to do. He took my stats and again explained clearly what they meant. He reassured me and nebulised me, staying with me until I felt better and making sure I had a doctor’s appointment booked for later that day.”

The new NHS 111 service for residents of Berkshire, Buckinghamshire, Hampshire and Oxfordshire is provided by SCAS. The two control rooms which provide the 24-7 service for NHS 111 calls are the same as those where SCAS receives 999 calls. As a result, and as evident in Jo-Anne’s case, it ensures that whatever number you call, if the trained operator recognises a medical emergency an ambulance or paramedic can be despatched in the same way as if you had called 999.

For Jo-Anne, a significant factor she remembers was how calm her paramedic was able to make her feel and she was impressed with how he didn’t just treat her symptoms of panic and the asthma attack itself, but explained what was going on constantly and advised her what she should do next.

“I definitely felt better once he left and whilst I’m fine now, I am more careful to make sure I use my inhaler”, says Jo-Anne. “My experience reminded me how careful I have to be with my asthma but more importantly it made me appreciate the work the ambulance service does. Everyone I interacted with that day was very helpful, very caring and very professional.”

Mary Purnell

Usually when something unexpected happens and you, a friend or family member, are in pain it can be a ‘default’ to head to the local A&E. Luckily in this instance when it struck Mary Purnell’s family at 1am, she had the presence of mind to remember to call NHS 111.

Mary lives with her daughter and her daughter’s boyfriend Dan and it was at 1am in early January when Dan work up in excruciating knee pain. It had happened once before a few months earlier and that time, the severe spasm had been equally painful but soon eased. This time, however, it was different.

“It was probably more painful this time and was lasting much longer”, says Mary. “It was time to get some help. There was no way Dan could be transported to A&E so I immediately suggested my daughter call NHS 111. I was aware of the NHS 111 service through my work and it seemed to me to be the best thing to do.”

The NHS 111 service is designed for anyone who needs urgent medical help that is not a 999 (i.e. life-threatening) emergency. Mary’s daughter made the initial call and then passed the phone on to Dan to explain exactly what was happening to him. The call handler soon realised that due to Dan’s incredible pain and immobility, it was not going to be possible for him or a family member to get him to a medical centre and so a paramedic was despatched.

Mary picks up the story.

“I told Dan to prepare for a long wait – thinking that just like an A&E department, there would more urgent cases ahead of him. But the paramedic arrived in 15 minutes! He gave Dan some gas and air, established a really good rapport with him in difficult circumstances and stayed with him until the seizure began to ease. He explained exactly what he was doing at every stage and made sure Dan knew it was important to make an urgent GP appointment to start investigating what was making the knee seize up.”

In many ways, Mary feels dialling NHS 111 was a better decision than going to the local A&E.

“If we had turned up at A&E”, she says, “we could have waited there for two, three maybe even four hours. After all, they are there to treat life-threatening emergencies first and everything else – however painful it might seem – comes second.”

Mary found using NHS 111 easy, with a professional and knowledgeable person on the other end of the line who treated Dan as an individual and was able to get urgent, necessary help to him without him having to leave home.

“The thing that I’ll take away from this”, says Mary, “is that NHS 111 is a gateway into ALL the NHS services and takes away the decision from the patient as to what, if any, is the best service to choose. We couldn’t have asked for a better, more professional and straightforward service. I would recommend NHS 111 to anyone and have done so since!”

Stephen

When her partner Stephen began displaying some asthma like symptoms after having had a cold all week, Vickie didn’t think too much of it. After all, she thought, Stephen has had some undiagnosed respiratory problems for a few years and the asthma symptoms he was experiencing over the weekend were similar to ones that had come and gone in the past.

By Sunday evening however, Stephen was beginning to struggle with his breathing, finding it hard to talk and was virtually unable to walk from one room of their home to another.

“We both tried to remain calm”, remembers Vickie. “We thought that with a good night’s sleep and some rest, he’d be fine again in the morning. Stephen had used an inhaler in the past which we couldn’t find, but as he has not been diagnosed with asthma he does not have a repeat prescription and so late on a Sunday evening we thought there was nothing to do but wait and see how he was the following morning.”

Reluctant to call 999 with what they thought wasn’t an emergency, Vickie and Stephen agreed to call NHS 111 around midnight as Stephen was really becoming quite unwell.

Vickie explains what happened next:

“The person I spoke to was very calm and after answering a few questions, he said he was sending an ambulance out to us right away. Within a few minutes Paul and Zoey from SCAS were here and it became clear we should perhaps have called 999 hours before!”

Paul and Zoey began treating Stephen, explaining at every stage what was going on, and reassured Vickie that she had done exactly the right thing to get in touch with the ambulance service. Despite the couple being reluctant to call 999 because they felt there were more urgent cases that might need an ambulance, Paul and Zoey explained that the system was able to differentiate between incidents that required one and those that didn’t, so if in doubt, call.

“We are really grateful to have such fantastic people working for our local ambulance service”, concludes Vickie. “Paul and Zoey were really friendly and helpful – even telling Stephen exactly how to go about getting an emergency appointment at our local GP the following day for necessary medicines and tests. I’m just really sorry I completely forgot to offer them a cup of tea for their troubles!”

Sophie Kayani

Sophie Kayani from Bourne End, Bucks, had used the NHS 111 service on a number of occasions for her children so when she awoke suddenly in excruciating pain having simply rolled over in bed early one morning last December, that was the number her husband Kass called straight away.

“I have an ongoing knee condition”, explains Sophie, “that causes my meniscus cartilage to lock – which basically means my knee joint completely locks and is very painful. Whilst on previous occasions I was able to ‘pop’ the joint back fairly quickly, on this particular morning I couldn’t and the pain was far worse than it had ever been before.”

Having got through to SCAS’ NHS 111 call centre, husband Kass was taken through the standard pathway questions and had to answer on behalf of Sophie who was, by her own admission with the intensity of the pain, ‘completely out of it’. This in itself was a major concern for Kass as he knew Sophie had a very high pain threshold and her reaction was completely out of character.

“I think Kass was very relieved when he was told that an ambulance had been despatched”, remembers Sophie, “and the call handler had obviously briefed Maria and Alex well – the paramedics who arrived – as they had the gas and air ready as soon as they came in. And I certainly needed it!”

The paramedics explained that they would try and manipulate Sophie’s knee in order to ‘unlock’ it but were unable to do so. Having given Sophie as high a dose of the painkiller, co-codomol, as they were allowed, they gave her the bad news that they were left with little alternative than to prepare her for a trip to her local hospital as it wasn’t getting any better and Sophie was still in extreme pain.

“Obviously being in such extreme discomfort”, says Sophie, “Alex and Maria decided to get a line in and I was then also given a small dose of morphine as nothing else seemed to be working up to that point and this, they explained, was necessary in order to transport me downstairs, into the ambulance and off to hospital.”

Whilst waiting for the morphine to take effect, Alex and Maria prepared the equipment they would need to get Sophie off her bed and downstairs. With that ready, they then began manoeuvring her very carefully into position.

“This involved lifting the affected leg straight up”, remembers Sophie, “and just as they did that – ‘pop’ – it went back in! At last the pain – which was far worse than childbirth believe me – subsided and a trip to A&E was thankfully avoided.

Having given her morphine, Alex and Maria knew that they couldn’t simply walk away and on to the next job. They needed to ensure that Sophie was fine to be left and having got her out of bed and walking, albeit very slowly, to and from the bathroom, the next stage was to get her ‘discharged’ by an out-of-hours GP.

“In order to do that they had to go back through the NHS 111 call centre themselves to get the out-of-hours GP on the phone who could then discharge me remotely from their care. All-in-all, from the time they arrived they were probably with Kass and I for around two to three hours”, says Sophie. “I can’t thank them enough – they were absolutely excellent – as was the person my husband spoke to on the NHS 111 phone line. Whilst I was in extreme pain, we knew it wasn’t life-threatening which is why we chose to call NHS 111 not 999. And obviously the call handler was able to understand the seriousness of my condition and despatched Alex and Maria anyway to help.”

Sophie is now waiting for a further scan on her knee and a follow-up appointment with her knee consultant.

I would recommend NHS 111! They were amazing when I was unwell. It's all about the right place at the right time, and they sorted that!

@LadyLoveliness

NHS 111 call handlers

Clinical coordination centres

Watch Karen talk about her experience when calling the NHS 111 service

NHS Direct

NHS Direct closed on March 31 2014. For outstanding issues or questions, please click here and use the appropriate contact point given.