NHS 111 could boost GP demand and undermine out-of-hours

NHS 111 could cause a surge of demand in primary care and undermine existing out-of-hours providers, an NHS Alliance report has warned.

Urgent care: NHS 111 threat to out-of-hours services
Urgent care: NHS 111 threat to out-of-hours services

The NHS Alliance report, Getting to grips with integrated 24/7 emergency and urgent care, warned that demand in general practice could surge ‘as a result of publicity’ about the new emergency number.

NHS 111 could also ‘highlight access issues in general practice and stimulate the wider use of interventions such as telephone consultations', the report said.

The NHS Alliance report discussed the findings of two workshops set up to discuss integrated 24/7 emergency and urgent care – one in East Kent and the other in the north west of England.

The workshops found that clinicians and providers were concerned that NHS 111 would have a negative impact on existing out-of-hours providers.

A switch from out-of-hours providers receiving calls, to NHS 111 taking the call first and then passing it on for clinical assessment, would ‘inevitably' change the focus of out-of-hours services, the report said.

‘Out-of-hours providers were concerned that there was insufficient evidence for them to predict the impact on local services and therefore little capacity for planning. The final report of the pilot site evaluation by Sheffield University is therefore keenly anticipated,’ it said.

Another key issue raised during the workshops was whether NHS 111 should be able to book directly into GP out-of-hours services.

One participant said: ‘If we shift stuff into the out-of-hours period because that’s where people have landed after their 111 call there will be a significant impact. You only have to have a small increase in calls to out-of-hours services to see a big effect downstream.'

The report also raised concerns about the disengagement of GPs in out-of-hours care.

It said: ‘There was also concern expressed that many GPs have abrogated responsibility for out-of-hours care entirely to out-of-hours services and this diminished their understanding of and engagement in the wider urgent care system.’

However the report did highlight potential benefits of NHS 111. It said that the ‘introduction of NHS 111 will bring a new level of data to urgent care services’.

‘This will enable service providers and commissioners not only to identify gaps but also to plan services and develop risk stratification. Ideally, urgent care services want to track patients through their urgent care journey.’

A DH spokesman said the Sheffield University report on NHS 111 was due to be published 'shortly'.

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