A joint report released today by a group of local Healthwatch in the South West, shows that although the NHS 111 service in Somerset and Devon is rated highly by the public, there are inconsistencies in the quality of the service.
111 is the NHS non-emergency number. When you call 111 you speak to a highly trained telephone adviser, supported by healthcare professionals (nurses or paramedics). They ask you a series of questions to assess your symptoms which allows them to direct you to the best medical care for your needs. NHS 111 is available 24 hours a day, 365 days a year, with calls free from landlines and mobile phones.
Devon Doctors is commissioned to provide an integrated urgent care service in the Devon and Somerset region, of which the NHS 111 phoneline and urgent out-of-hours care are key components.
From 5 October until 20 November 2020 local Healthwatch in Somerset, Devon, Plymouth and Torbay joined forces to promote a regional survey to ensure that people using the NHS 111 service had their say on the way it is delivered to them.
186 people from Somerset, Devon, Plymouth and Torbay completed the online survey, with the responses independently analysed by Healthwatch and detailed in their new survey report, available to read on the Healthwatch Somerset website.
Public feedback within the report shows that the accuracy and quality of the service people received was not consistent, despite many people rating their experience highly.
Key findings
40.86% (76) of people rated their experience of using the NHS 111 service as ‘very good’.
23.66% (44) of respondents waited longer than three hours for an arranged call-back.
A fifth, 20.43% (38), of commentators never received an arranged call-back.
Most people, 75.81% (141), said that their call was answered in a timely manner.
Improved training for call operators was the most common response to the question: ‘In your opinion how could the NHS 111 service be improved?’
Some people, 7.59% (12), reported that they had to call 999 or visit an emergency department due to inadequate responses from the NHS 111 teams.
7.53% of comments to the question ‘Is there anything else you would like to tell us?’ said that calling NHS 111 was quicker or better than access to their registered GP surgery.
It is evident throughout the feedback that the accuracy and quality of the service people received was not consistent.
Report recommendations
Reducing waiting times for arranged call-backs and inbound calls should be considered of high importance as current long waits may put patient’s safety at risk. Reviews of the assessment questions, staff training, and staffing levels may be required.
Improvements to call handling procedures and staff training surrounding these processes could be made, including training and guidance for difficult/emergency situations, flexibility of the diagnostic process for call operators, access to qualified medical support for call operators and staffing levels.
Ensure that training is consistent for all staff so that delivery of the assessment and conclusions of this are of the same standard for all patients.
Review the pre-recorded messages and frontline options for patients before they are connected to a call operator to reduce message length and increase patient options for faster diagnosis.
Improve procedures surrounding calls relating to patients with mental health problems to ensure they are handled with empathy and diverted to the correct support.
Consider the viability/benefits of a call-logging system that provides a point of reference so that if patients need to call-back, a record of their previous call is easy for the call operator to access and review.
Healthwatch in Somerset, Devon, Plymouth and Torbay will be inviting the Care Quality Commission (CQC) and Devon Doctors Ltd to work collaboratively with Healthwatch to implement changes highlighted in the report to improve services delivered to the community.
Martin Cordy, Interim Director of Contract Assurance at Devon Doctors Ltd, thanked Healthwatch for the report:
“Devon Doctors would like to thank Healthwatch for this report and the recommendations made in relation to the delivery of the 111 service. Devon Doctors supports the recommendations made within the report, however, many of these are unable to be implemented locally as it will require national changes in policy, process, and funding.
“We are working with Healthwatch to help the patient voice in relation to these issues be raised at a national level so that positive change can be made. The organisation is currently delivering a programme of service transformation to ensure that the quality of the service provided, including patient experience, enables us to deliver the best possible clinical care to patients within Devon and Somerset. The feedback from this report has helped shape elements of this plan to ensure that improvements are made in the areas concerning members of the public as well as those identified internally.
“Devon Doctors is pleased to confirm that it will be working in partnership with Healthwatch in the coming months to understand the public’s experience of urgent primary care services within Devon and Somerset and identify areas for future service transformation.”
The report findings will be presented to various organisations who have significant interest in the NHS 111 service, and a follow up engagement planned for approximately six months’ time.
Hannah Gray, Healthwatch Somerset Manager, commented:
“On behalf of Healthwatch Somerset and Healthwatch in Devon, Plymouth and Torbay I would like to thank everyone who took the time to contribute their views and experience by completing our survey. A special thanks also to the dedicated volunteers and all the sector organisations who helped to support the engagement activity despite the limitations of government restrictions.
“With essential services facing unprecedented challenges, it is really important that we, as the consumer champion for health and social care services, continue to listen to the community and share feedback with our stakeholders and key decision-makers on what is working well or not so well and what may need addressing. Your feedback from this report will be used to shape and improve the local NHS 111 service and really could make a positive difference.”