NHS 111 increases demand on emergency services, study finds

NHS 111 increases ambulance call-outs and demand on A&E, a DH-commissioned study has found.

Ambulance: NHS 111 increases pressure on emergency services, study shows
Ambulance: NHS 111 increases pressure on emergency services, study shows

The first controlled study of the service, carried out by researchers at Sheffield University and published by BMJ Open, analysed 36 months of data on ambulance calls, A&E attendances and GP out-of-hours calls, covering the period up to and including first year of operation at four pilot sites and in three comparable sites.

Compared with the other three sites, researchers found no overall reduction in the number of emergency ambulance calls, attendances at emergency care or use of urgent care services at the four 111 pilot sites.

Ambulance incidents rose by nearly 3%, equivalent to an extra 24 incidents per 1,000 triaged calls, each month. This could translate into an additional 14,500 call-outs for an ambulance service attending 500,000 incidents a year.

Overall A&E activity rose 5-12% per month. The researchers said that a triage system operated by non-clinicians would inevitably err on the side of caution.

But NHS England said the study was ‘significantly out of date and is not directly comparable to the current 111 service’.

It said the study looked at a ‘very low’ volume of calls and there was no evidence that 111 increased A&E attendances.

‘In fact attendances in areas with 111 for the most recent 12 months compared to 12 months earlier is down by 0.2%. Ambulances dispatched from 111 transport the same proportion of patients to hospital as those dispatched by 999 – showing the service is appropriately sending ambulances,' NHS England said in a statement.

'A recent survey conducted by the NHS Confederation showed 79% of NHS Confederation members say that NHS 111 is not a big cause of A&E pressures.’

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