How the 111 service works
1) A Comprehensive directory of services
All NHS organisations in Nottingham have agreed to contribute to an electronic skills-based directory of services which, for the first time, will provide a comprehensive database which can be searched to find what services are available, their location, with capacity and skills to deal with a patient’s urgent care need.
During the 12 month testing stage, the 111 service will concentrate on urgent healthcare needs but the electronic directory will include details of those urgent social care services that people may need to be signposted to from 111.
2) Standardised clinical assessment system
At the moment our main healthcare telephone call handlers in the East Midlands – East Midlands Ambulance Service and NHS Direct – use different computerised triage systems to assess callers’ needs. This means that callers are not assessed in the same way and if they do need to be transferred between different organisations they often have to be re-assessed, meaning that callers have to repeat information or make another call.
As part of the pathfinder programme for Nottingham City, NHS Direct has agreed to put in place a standardised clinical assessment system called NHS Pathways for people who dial 111, linked to the electronic directory of services. It is anticipated that this system will also be adopted by the East Midlands Ambulance Service in 2011, and by also by NHS Direct under its current 0845 46 47 telephone number. This will mean that in the future when someone dials 999, NHS Direct or the new 111 number, a clinical assessment will be undertaken using the same system, with both organisations being able to access the same directory of services. As the caller’s health needs are assessed, their answers will determine what particular clinical skill will be required to address their need. At the end of the assessment, a unique combination of codes identifies the clinical skills required, and the time frame within which they must be provided to the patient. The call handler then has immediate access to the electronic directory of services to find which local services are available to meet this need and can make an appropriate referral or provide the right advice to the caller. This provides added patient choice and also provides the commissioners of health services with a record of which services are needed and when. Over time this will mean that commissioners will be able to identify if we have the right services available at the right times, any gaps in services required or any unnecessary duplication.
3) Single call to access urgent care – 111
In Nottingham City, calls to the new 111 phone number will be handled initially by staff at NHS Direct who will use the standardised clinical assessment system and the electronic directory of services described above. Its staff will go through a rigorous training programme on these new systems before the service goes live to the public.
Calls to the 111 service will be free to the caller whether they call from a landline or a mobile phone.
If someone calls 111 but they are assessed as needing an emergency ambulance response the NHS Direct call-handler will be able to transfer information straight to East Midlands Ambulance Service who will be able to dispatch an ambulance as quickly as if the caller had dialled 999 in the first place.