East Sussex Health Overview and Scrutiny Committee (HOSC) newsletter

HOSC hears plans for new NHS 111 service

From next year residents of East Sussex will be able to receive enhanced over the phone advice from GPs and other clinical staff when they call 111, HOSC has learned.

Under the new NHS 111 service, which goes live on 1 April 2020, members of the public will, if necessary, be passed from a 111 call-handler to a qualified clinician working in the new Clinical Assessment Service (CAS). The clinician will be able to either offer treatment and advice over the phone, or book them into an appointment at an Urgent Treatment Centre (UTC) or a GP practice.

Responding to questions from HOSC about whether sufficient staff could be recruited to the service by 1 April, Colin Simmons, 111 Programme Director, explained that the providers of the new service, South East Coast Ambulance Service NHS Foundation Trust (SECAmb) and Integrated Care 24 Ltd (IC24), already run between them both existing 111 services and an out of hour GP service, which includes over-the-phone clinical assessments. They are currently in the process of understanding the gap between their current workforce and the number of staff they will need to run the new service.

Asked by HOSC whether there was a risk the CAS could take clinical staff, including GPs, from other areas of the health service, Mr Simmons said the providers are developing ways to recruit staff in innovative ways that are attractive to prospective staff but that do not take them from other services. He said this may include a contract that allows existing GPs to work for the CAS remotely in their own office, rather than physically from a CAS call-centre, whilst still continuing with their traditional GP role. Mr Simmons said that GPs had shown interest in this proposal.

Asked whether the new service will have access to a patient’s details, Colin Simmons said clinicians in the CAS will have access to a patient’s summary care record, subject to permission from the patient, that is produced by their GP practice. 111 call handlers, on the other hand, would only be able to see basic details such as their name and date of birth.

Charles Adler, Paramedic and Integrated Urgent Care Manager, said access to a patient’s summary care record will enable clinicians based in the CAS to better diagnose a patient over the phone.

The Committee asked whether there are concerns that patients will not properly articulate their symptoms over the phone to the clinicians working in the CAS.

Colin Simmons said that it is recognised that it is not always possible to diagnose everything over the phone, so call handlers and CAS clinicians will signpost to face-to-face services, such as UTCs or out of hours services, as necessary. FaceTime and other video calling services will also be developed over time and will aid in remote diagnosis of patients.

The Committee asked how the service would be advertised.

Colin Simmons said there would be a campaign in the new year for 111 and the other new urgent care services, such as UTCs. There was also a separate plan for engaging with seldom heard groups and a plan for ensuring the service is compliant with British Sign Language requirements, as well as having interpreters in place for people for whom English is not their first language.

The Committee requested a future update on the 111 service after it goes live in April.

You can read the full discussion in the minute of the 26 September meeting.