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NHS 111 Northumberland

NHS 111 ‘Call-First’ FAQs

You may have heard or seen in the news that NHS England is currently trialling a new ‘call-first’ approach, which encourages people to contact NHS 111 before going to A&E. To support this, 111 call handlers should be able to book people directly into appointments with alternative services or give people a pre-booked time to attend A&E to avoid overcrowding in departments.

Healthwatch England has produced this FAQ guide jointly with the Royal College of Emergency Medicine which outlines how the new approach should be working and common questions people may have surrounding it.

Emergency Departments (A&Es) are there for all and everyone in their time of need. They are the frontline care service we turn to when we’re experiencing a critical, life threatening health problem or have had a serious accident.

We want all patients to receive the best possible care in a safe and timely way, but too often people are kept waiting in their A&E. Many patients who go to A&E could be treated more appropriately, and often more quickly by another service within the NHS.

Which is why the NHS is asking patients to call 111 first. By calling 111 first patients can potentially avoid waiting unnecessarily in a hospital waiting room and find the service that is right for their needs.

Calling 111 first may also help to reduce pressure on parts of the health service that are overstretched by redirecting patients to services that are ready and available for them, helping make the NHS better for all.

The coronavirus pandemic has also made clear that we need to change the way we all access urgent and emergency care, to help reduce the risk of infection.
Here we outline what those changes are and answer some of the frequently asked questions about what these changes mean for patients.

NHS 111 Call-first Frequently Asked Questions

1. What is happening?
To ensure that patients get the right care as quickly as possible, save people long waits in A&E, and ensure emergency departments don’t get too crowded, patients are being asked to call NHS 111 first before going to their A&E – except in absolute emergencies. NHS 111 will advise patients on whether they could be better and more quickly served in a different care setting such as an Urgent Treatment Centre. Some areas are trialling booking appointments at A&E via 111 to help patients save time waiting if their issue is less urgent.

2. Why is this change being made now?
This is how we think emergency care should always be accessed, but it is really important that this becomes the norm now we are living with COVID-19. To support social distancing in A&E, we need to make sure A&Es really are for emergencies only, and sometimes patients waiting in A&E may be better served elsewhere, such as their General Practice. This means A&E departments are more crowded, putting patients at greater risk of COVID-19 and making it more difficult for staff to look after patients well. Social distancing in A&E may mean that some people have to wait outside or in their car until it is safe for them to come into the department.

To prevent this, the NHS wants to support as many people as possible to be seen quickly by other services that may be more appropriate for the needs of certain patients. This is why we’re asking patients to call NHS 111 before going to their Emergency Department.

3. What should I do if I have an emergency?
If you have an emergency, call 999 immediately or go straight to your Emergency Department (A&E). If you have a health issue that is not an emergency please contact your GP, call NHS 111 for advice or visit 111.nhs.uk. If you go to your A&E, you’ll be assessed on arrival but if the clinician thinks you should be seen elsewhere, you may be asked to phone NHS 111 and/or be directed to an alternative service.

4. Can you give me an example of an emergency and a non-emergency?
Emergencies include:
• loss of consciousness
• acute confused state and fits that are not stopping
• chest pain
• breathing difficulties
• severe bleeding that cannot be stopped
• severe allergic reactions
• severe burns or scalds
• stroke

If you think you are experiencing any of these it is vital you go straight to your Emergency Department or call 999.

Examples of non-emergencies would be earache or knee pain. While these may be uncomfortable you are unlikely to be in any danger and could be treated more appropriately somewhere other than you’re A&E. For these types of issues contact your GP, call NHS 111 or visit 111.nhs.uk. If your issue is urgent but not life-threatening – like a sprained ankle – calling 111 and getting a pre-booked appointment to attend A&E can save you a long and uncertain wait in the department, allowing you to wait in the comfort of your own home until the Emergency Department is ready to see you.

5. Will I ever be turned away from an A&E department?
No-one experiencing a medical emergency will ever be turned away – you will always be treated urgently if your condition is severe or potentially life-threatening.
If your condition is not life threatening or could be treated more appropriately or quickly elsewhere you may be asked to call 111 from the hospital. By asking those with less urgent issues to call NHS 111 first for assessment rather than going straight to their A&E, we aim to save patients time and get them the care most appropriate to their needs. You could be directed to a more appropriate service or one that can see you sooner. You may also be able to wait at home and avoid a long wait in a busy Emergency Department.

6. When I call 111, who am I speaking to and are they clinically trained?
NHS 111 services are managed slightly differently in each region, but most are run by ambulance services. You will speak to trained professionals who will either be or have direct access to healthcare clinicians, and who will be able to expertly assess the urgency of your condition or illness. They will direct you to the appropriate service, book you an appointment if needed, and/or tell you what to do next.

7. My NHS 111 always sends me to A&E. Why can’t I save myself the delay and just go straight there?
In 2018, only one in ten callers to 111 was advised to visit A&E. NHS 111 can often provide health advice over the phone, or book you an appointment at an alternative service that is available. This will save you time. If you are told to go to an A&E, you will be booked in and staff at the hospital will be expecting your arrival.

8. Will I receive an appointment more quickly if I have a more urgent health need?
Yes, patients are always assessed and prioritised based on the urgency of their need.

9. If I call 111 and they say I need care from a non-emergency service, will they be able to make an appointment for me?
This varies by location, but one aim of the call-first approach is to ensure it happens more. If 111 can’t make you an appointment at an alternative service immediately, they will direct you to the best service to meet your needs.

10. What if I can’t contact NHS 111?
91% of calls to NHS 111 are answered within 60 seconds. You can also use NHS 111 online. If you have an emergency, you should call 999 or go straight to your Emergency Department. If you do not have the means to contact 111, go to your Emergency Department  and they will have facilities for you to do this. You can also contact your GP.

11. If 111 directs me to a non-urgent service, but the service tells me to go to A&E, will I be seen more quickly?
If a health professional believes that your condition has become or is becoming urgent, then you may be directed to your A&E, where you will be prioritised according to your condition. However, it will depend on the circumstances and the urgency of your medical need.

12. If I turn up at A&E and I haven’t called 111, will I need to wait longer?
Depending on your condition, you may be asked to call NHS 111 on arrival. They will assess whether you could be more appropriately treated elsewhere – and potentially more quickly. You may be given an appointment time at your GP or A&E. This will save you waiting unnecessarily. If you are directed elsewhere and choose to wait for treatment at you’re A&E, you may end up waiting longer. However, if you are seriously ill or injured you will of course be seen as quickly as possible.

13. What happens if I turn up to A&E and they tell me to call 111, but 111 then tell me to go to A&E?
This shouldn’t happen but in the unlikely event that it does you will be further assessed at your A&E and treated in a timeframe appropriate to your needs.

14. Do I need to call NHS 111 if I arrived at an A&E in an ambulance?
No, the triage and assessment by a paramedic provides a higher level of care than you would get by phoning NHS 111. If you are brought to the hospital by an ambulance, this means that the ambulance staff thinks you need further help. A&Es have always prioritised the treatment of patients who arrive by ambulance, as these people are sicker.

15. If I call 111 and they give me an appointed time to attend the A&E what will happen if I can’t get there on time?
Please do try to stick to your appointment time. Being late has a knock-on effect on the treatment of other patients, and your own care – Emergency Departments are very busy places and you may have to wait longer as a result of being late. However, what happens if you are late will depend on the severity of your condition, local policies and how busy the A&E is.

16. How far ahead of my pre-booked appointment will I need to turn up?
It is important to turn up on time as being late has a knock-on effect but arriving early does not mean you will be seen before your allotted time. We would advise checking in no more than 15 minutes before your appointment.

17. What happens if someone gets a booked appointment for A&E but doesn’t show up? Will someone check that they’re ok?
We expect all departments that book-in patients to have systems in place to assess whether a follow up is necessary. It is particularly important that vulnerable patients or those at risk of abuse who miss appointments are checked up on.

18. Will anyone else other than 111 be able to book me into A&E (e.g. GP practice etc)?
No, but your GP may tell you to go to your A&E if your needs warrant it.

19. What if I go to A&E and am advised to go to a different service but I still want to wait there and be seen?
You will be seen but you might to have to wait longer. You may find that you will be seen quicker by going to the other service.

20. What if my condition changes while I’m waiting at home?
This depends on the change in your condition; if you become seriously ill, call an ambulance, otherwise call NHS 111 again.

21. How do I cancel an appointment made by 111?
If you no longer need your appointment, please call NHS 111 to cancel it. Someone else may be able to use your timeslot.

22. If I’m told not to go to A&E, where else might I be directed to?
This will vary locally depending on what is available. You may be directed to a pharmacist, your GP, A&E or given advice on how best to self-care if your call advisor thinks you are safe to do so. You may also be directed to an Urgent Treatment Centre. These are facilities you can go to if  you need urgent medical attention, but it’s not a life-threatening situation. If you are unsure about what service is right for you, call NHS 111.

23. I have a complicated ongoing medical problem that is looked after by the hospital. When I get ill, I normally go straight to the A&E and they call the specialist to come and see me. Should I carry on doing this?
It might be better for you to try and contact the specialists that look after you before you come to the Emergency Department. Some patients with complicated medical problems need to be looked after in places other than the Emergency Department, particularly if they are vulnerable to infections. Obviously, if you are extremely ill, you should call an ambulance.

Northumbria Healthcare logo

Non-essential hospital visits suspended

From Northumbria Healthcare NHS Foundation Trust:
Due to the rise in cases of coronavirus in the community, non-essential visiting is to be suspended in hospitals across Northumberland and North Tyneside, with effect from midnight, Thursday 17 September 2020.
Northumbria Healthcare NHS Foundation Trust has taken this difficult, however important, decision to protect its patients and staff.Until further notice, visiting will only be permitted in the following circumstances and PPE must be worn:

  • For patients who are receiving end-of-life care or are terminally ill and in the late stages of their illness
  • For birthing partners in maternity units
  • For parents or legal guardians in the children’s unit
  • For long-stay patients and those with dementia or where best interest decisions or exceptional clinical/social matters are being discussed, at the discretion of the nurse in charge

Women can bring their birthing partners when attending 12 or 20-week scan appointments.

This move comes as tougher restrictions are announced for the seven local authority areas in the North East, including Northumberland and North Tyneside.

iPads will continue to be available on wards to facilitate ‘virtual’ visiting and friends and relatives will be able to stay connected to loved ones by ringing the trust’s patient line on 0191 293 4306, available Monday to Friday 9am to 5pm or sharing pictures/photos via In addition, patients can make unlimited phone calls to UK landlines and mobiles free of charge via bedside units.

Anyone attending an outpatient or diagnostic appointment or for a minor injury, urgent care or in an emergency at hospitals in Northumberland and North Tyneside is asked to do so alone, unless they need to be accompanied by a carer, to reduce footfall. People attending hospital sites are being reminded to wash their hands at the basins when entering and leaving, wear a face covering and maintain social distancing.

Marion Dickson, executive director of nursing, midwifery and allied health professionals at Northumbria Healthcare, said:

“In light of the increased numbers of cases of coronavirus across Northumberland and North Tyneside, we simply must take action now to protect our patients, staff and local communities.

“Suspending non-essential visiting is a difficult decision to make however, given the current situation in our communities, it is the right one if we are to reduce the spread of coronavirus in our hospitals and take care of our most vulnerable patients.

“As nurses, we know the positive impact seeing and hearing from loved ones can have on a patient and we would urge families to make use of the methods we have in place to facilitate virtual visiting and staying connected.

“We had tremendous support from our communities when we had these visiting restrictions in place previously and we would appeal to them again for their co-operation at this difficult time.”

The trust is also reminding people to:

  • Follow advice on https://www.nhs.uk/conditions/coronavirus-covid-19/if they have symptoms and not to attend A&E or hospital sites for a Covid-19 test.
  • Keep your distance and follow rules on social distancing – please stay apart 2 metres from others where possible. If it isn’t – one metre with mitigations such as a face covering.
  • Do not mix with people from outside your household or support bubble
  • Wear a face covering – especially in enclosed public spaces when social distancing can be difficult or when you are in contact with people you would not normally meet. This includes when you are using public transport, car sharing and using taxis. Please remember to wear a face covering if you are attending health care settings such as a hospital, clinic, GP surgery or pharmacist.
  • Keep those hands extra clean – wash hands for 20 seconds and often. Use soap and water to wash your hands or use hand sanitiser. It is especially important to do this when you
    • get home or into work
    • blow your nose or sneeze
    • eat or handle food or drinks

The main symptoms of coronavirus are:

  • a high temperature
  • a new, continuous cough
  • a loss of, or change to, your sense of smell or taste

If you have symptoms, you are advised to get a test and stay at home. For more information visit www.gov.uk/coronavirus

 

Our Quarterly Report for January to March 2020

This report outlines the feedback we collected from people in Northumberland between January and March 2020.

How we received feedback this quarter:

  • Telephone calls, emails and social media (65%)
  • Postal Surveys and Feedback forms (5%)
  • Talking to people at local engagement events (15%)
  • Through a meeting (5%)
  • Through a third party (10%)

Areas of Focus

We are open to all feedback about health and social care services. Responses to our Annual Survey helped us to identify three specific areas of focus which we prioritised in 2019/20:

  1. General Practitioner Services (GP Services)
  2. Mental Health Services, including dementia care
  3. Access to Services

Between January and March 2020, we received 20 pieces of feedback through talking to people at local engagement events, telephone calls, emails, our website, surveys and feedback forms and other sources. Alongside this, we signposted 20 people to services, 16 of which have already been counted in the aforementioned feedback. Altogether we had 24 different recordable interactions this quarter.

This report explores who we are hearing from across the county, presenting a summary of general respondent demographic information. Demographic information shared includes location, gender, age, and whether the respondent is sharing their own health and social care experience or speaking on behalf of a friend or relative.

We also look at the general sentiment of comments, with specific reference to the service type (e.g. primary care, secondary care, mental health, social care), as well as whether the feedback relates specifically to quality of care or access to services. Service category, for instance whether the comment refers to a GP surgery or

 Read the report for January to March 2020