NHS 111

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NHS 111 is a free-to-call single non-emergency number medical helpline operating in England and Scotland. The service is part of each country's National Health Service and has replaced the telephone triage and advice services provided by NHS Direct, NHS24 and local GP out-of-hours services. The transition was completed in England during February 2014[1] with Scotland following during April 2014.[2]

The service is available 24 hours a day, every day of the year and is intended for 'urgent but not life-threatening' health issues[3] and complements the long-established 999 emergency telephone number for more serious matters, although 111 operators are able to dispatch ambulances when appropriate using the NHS Pathways triage system.[4][5]

NHS Direct Wales continues to operate via 0845 4647, but it is intended the 111 service will be offered from some point in 2015.[6]

Origins and development[edit]

During 2007, the Department of Health's Our NHS, Our Future report identified confusion surrounding access to certain NHS services in England and suggested the introduction of a national, three-digit number for out-of-hours healthcare services could help simplify the situation. Arrangements to identify and secure a suitable non-emergency number for England began in July 2009,[7] with the number 111 allocated by telecommunications regulator Ofcom in December of that year.[8] The health services of Northern Ireland, Scotland and Wales will be able to introduce their own similar services using the same number if they choose to do so.

In late August 2010, the Conservative-Liberal Democrat coalition government proposed that 111 could replace the existing NHS Direct (084546 47) telephone helpline in England.[9][10] This suggestion proved controversial as it was seen by some critics as a "cut-price" replacement, due to likely replacement of NHS Direct with NHS 111 telephone advisors lacking professional training in healthcare. Although then-Health Secretary Andrew Lansley denied plans to close NHS Direct in England, explaining that existing staff would provide the new service and that merely the phone number would change.,[9][11][12] it was announced in October 2013 that NHS Direct would be closed down in 2014.[13]

The first trial, in County Durham and Darlington, started on 23 August 2010, with Nottingham starting on 18 November 2010, Lincolnshire on 22 November 2010, and Luton on 3 December 2010.

Management of the service[edit]

In England, the service is accountable at a Clinical Commissioning Group level but was originally commissioned on a regional basis, with a number of service providers. The largest provider at launch was NHS Direct, who provided services to approximately 1/3 of the UK population and were the previous provider of the national advice service, with other providers including regional ambulance trusts, and out-of-hours GP providers. The lack of clarity as to accountability was criticised in a Deloitte report into the service launch failure by NHS Direct. As of December 2013 all NHS Direct contracts are being services by "stability partner" organisations such as ambulance trusts or GP co-operative organisations. In Scotland, a single national service is provided by NHS 24.

European number[edit]

The NHS 111 service will also be available via the harmonised European number for medical advice 116 117 under reciprocal agreements made with fellow European countries to simplify and improve public access to recognised 'Harmonised Services of Social Value'.[14][15][16]

Failure of service on initial launch[edit]

NHS 111 was launched in a limited number of regions in March 2013 ahead of a planned national launch in April 2013. This initial launch was widely reported to be a failure.[17][18] Prior to the launch the British Medical Association had sufficient concern to write to the Secretary of State for Health requesting that the launch be postponed.[19] On its introduction, the service was unable to cope with demand; technical failures and inadequate staffing levels led to severe delays in response (up to 5 hours), resulting in high levels of use of alternative services such as ambulances and emergency departments.[20][21] Dr Laurence Buckman, chair of the British Medical Association's General Practitioners' Committee, described the launch of the service as "a disaster in the making", and recommended delaying the full launch for safety reasons.[21][22] The public sector trade union UNISON also recommended delaying the full launch.[23] The problems led to the planned launch date being abandoned in South West England, London and Midlands (England).[24][25][26] In Worcestershire, the service was suspended one month after its launch in order to prevent patient safety being compromised.[27]

NHS Direct which won several large tenders subsequently withdrew from the service. It was announced in October 2013 that NHS Direct would be closed down in 2014.[13]


  1. ^ http://www.healthcare-today.co.uk/news/february-will-see-the-last-nhs-111-sites-go-live/24920/
  2. ^ http://www.nhs24.com/111
  3. ^ [1][dead link]
  4. ^ "NHS Direct delivering NHS 111 in East Midlands and East of England". NHS Direct. December 2010. 
  5. ^ "NHS Pathways". NHS Connecting for Health. Retrieved 2013-06-05. 
  6. ^ "No NHS 111 line before April 2015, says Mark Drakeford". BBC News. 2013-11-20. 
  7. ^ "Ofcom | A Three-digit Number for Non-Emergency Healthcare Services". Stakeholders.ofcom.org.uk. 2009-08-20. Retrieved 2013-05-01. 
  8. ^ "Ofcom | New 111 non-emergency healthcare phone number confirmed". Media.ofcom.org.uk. 2009-12-18. Retrieved 2013-05-01. 
  9. ^ a b "NHS Direct launches". NHS Direct. 28 August 2010. 
  10. ^ "Government confirms plan to scrap NHS Direct helpline". BBC News. 29 August 2010. 
  11. ^ "UNISON Health Care - Our NHS Our Future". Unison.org.uk. Retrieved 2013-05-01. 
  12. ^ Bob Roberts (2010-09-10). "NHS Direct to continue after ConDem 'climbdown' - Mirror Online". Mirror.co.uk. Retrieved 2013-05-01. 
  13. ^ a b "NHS Direct to close down next year". BBC News. 24 October 2013. Retrieved 10 November 2013. 
  14. ^ "Ofcom | Harmonised European numbers for harmonised services of social value (116XXX numbers)". Stakeholders.ofcom.org.uk. Retrieved 2013-05-01. 
  15. ^ http://helplines.community.officelive.com/111consultation.aspx
  16. ^ http://www.theregister.co.uk/2009/07/09/nhs_111
  17. ^ "Patients failed by helpline disaster". This is Bath. 2013-03-01. Retrieved 2013-05-01. 
  18. ^ "Launch of new NHS call centre in Lancashire branded a 'disaster' (From Lancashire Telegraph)". Lancashiretelegraph.co.uk. 2013-03-26. Retrieved 2013-05-01. 
  19. ^ "BMA â€" GPs urge delay to phoneline implementation". Bma.org.uk. 2012-02-25. Retrieved 2013-05-01. 
  20. ^ Liz Hull (2013-03-24). "New NHS phoneline 'will put lives at risk': Doctors' warning after 111 number goes into meltdown | Mail Online". London: Dailymail.co.uk. Retrieved 2013-05-01. 
  21. ^ a b Sophie Goodchild, Health and Social Affairs Correspondent (2013-03-22). "Lives are being risked by five-hour delays on NHS helpline, say GPs - London - News - London Evening Standard". Standard.co.uk. Retrieved 2013-05-01. 
  22. ^ "Contract changes and 'chaotic' reform put patients at risk, warns GPC". GPonline.com. 2013-03-22. Retrieved 2013-05-01. 
  23. ^ "Union says it warned NHS bosses about dangers of 111 service (From This Is Wiltshire)". Thisiswiltshire.co.uk. 2013-02-28. Retrieved 2013-05-01. 
  24. ^ "Out-of-hours GP helpline launch called off after trial causes chaos". This is Somerset. 2013-03-23. Retrieved 2013-05-01. 
  25. ^ "BBC News - Shropshire non-emergency medical advice calls diverted". Bbc.co.uk. 2013-03-25. Retrieved 2013-05-01. 
  26. ^ "E-Health Insider :: NHS 111 in 'total meltdown'". Ehi.co.uk. Retrieved 2013-05-01. 
  27. ^ "BBC News - Worcestershire withdraws NHS 111 advice line". Bbc.co.uk. 2013-04-25. Retrieved 2013-05-01. 

External links[edit]