Patients in Staffordshire and Stoke-on-Trent are benefiting from a new service which aims to reduce overcrowding and risk of transmitting Covid-19 in hospital emergency departments.
The enhanced NHS 111 First service was launched in December 2020 and offers a booked time slot in emergency departments and walk-in centre to patients with an urgent – but not serious or life-threatening – illness or injury.
The national NHS 111 First programme was introduced to improve outcomes and patient experience in healthcare settings during Covid-19 and provide a long-term model of access to urgent and emergency care services.
In Staffordshire and Stoke-on-Trent approximately 70% of emergency department attendances at University Hospitals of North Midlands NHS Trust (UHNM)are self-presenting, walk-in patients, and the majority occur during the day and early evening, which has implications for managing social distancing in waiting rooms.
Patients who are thinking about going to an emergency department are now asked to contact NHS 111 first instead of walking in. The service will, where appropriate book them a time slot for attendance at either the emergency department at Royal Stoke University Hospital or County Hospital, Stafford or may book them direct into specialist clinic bypassing the need to attend the emergency department altogether.
Alternatively 111 may offer a timed slot to attend the walk-in centre at Haywood Hospital, Burslem or redirect to a more appropriate local service, which could be an urgent treatment centre, GP practice or pharmacy. People who need emergency care should still call 999.
Dr Zia Din, Consultant Physician in Acute Internal Medicine at UHNM, said: “The need for this kind of service has existed for some time, but Covid-19 has really accelerated the need to get it done.
“Simply speaking, the risk of infection means we need to ensure as few people at any one time are waiting in the Emergency Department. Opening up access to time slots, for the 111 service, in our Same Day Emergency Care services, means patients can be directed straight to the best place required to deliver the care they need, preventing them from unnecessary waiting in the Emergency Department. For example, we can treat many of the common conditions including headaches, deep vein thrombosis, cellulitis or diabetes.
“Patients who do not require hospital care can be directed to another appropriate service within the community, such as an Urgent Treatment Centre (UTC) or walk in centre where waits are generally shorter. Booked time slots also mean that we can even out demand throughout the day, cutting the number of people who are waiting at any one time and helping to control the risk of overcrowding and ensure social distancing is maintained.
“Our Emergency Departments will, of course, always deal with life threatening conditions first. They are the emergencies we are here for.”
Dr Steve Fawcett, Medical Director for Staffordshire and Stoke-on-Trent CCGs said: “This enhancement to NHS 111 is nationally mandated and we’ve already seen a successful response to the service at both the Royal Stoke and County Hospitals as well as the Haywood Hospital Walk-in-Centre.
“We are asking people to think differently about how they use our A&E and Emergency Departments, but this has the potential to help them run more efficiently, get people seen in the correct place with less wait, and all-importantly, make our hospitals as Covid safe as it is possible to be.
“The NHS 111 service has come a long way since it was first available. Satisfaction rates are very high* and most calls are answered within 60 seconds.
“More resources have been invested to make NHS111 happen. We have always said we need 111 to become as familiar as 999 and we are seeing that happen.”
Wendy Colclough, who manages Haywood Hospital walk-in centre, said: "Ringing NHS111 before coming down to the walk-in centre will help you beat the queues as you'll receive a time to attend. It will also help ensure you get to the right service first time. There has been some change in services because of Covid-19 and NHS 111 will be able to offer advice about the best place to go."
Dr Jim Heptinstall, Medical Director for Totally plc’s Urgent Care Division, the provider of Vocare services, said: “NHS 111 is the best way for patients to get the right care in the quickest way possible.
“Emergency Departments are often under significant pressure and unnecessary attendances can be avoided by contacting 111 instead to speak to one of our trained clinical advisors, who will help get patients to the best place for their healthcare needs. In our 111 call centres we have recently introduced a national platform which means when people locally dial 111 even if it is very busy, they will usually be able to speak to someone quickly.
“A&E is still available for all emergencies, but 111 are the experts in urgent care and are here to help, so visit 111.nhs.uk or give us a call if you need medical advice or assistance.”
Patients who walk into A&E will still but seen but may have to wait longer. Those with medical emergencies should still dial 999.