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Abstract
Background Although one objective of NHS 111 is to ease the strain on urgent and emergency care services, studies suggest the telephone triage service may be contributing to increased demand. Moreover, while parents and caregivers generally find NHS 111 satisfactory, concerns exist about its integration with the healthcare system and the appropriateness of advice. This study aimed to analyse the advice provided in NHS 111 calls, the duration between the call and ED attendance, and the outcomes of such attendances made by children and young people (C&YP).
Methods A retrospective cohort study was carried out of C&YP (≤17) attending an ED in the Yorkshire and Humber region of the UK following contact with NHS 111 between 1 April 2016 and 31 March 2017. This linked-data study examined NHS 111 calls and ED outcomes. Lognormal mixture distributions were fit to compare the time taken to attend ED following calls. Logistic mixed effects regression models were used to identify predictors of low-acuity NHS 111-related ED attendances.
Results Our study of 348 401 NHS 111 calls found they were primarily concerning children aged 0–4 years. Overall, 13.1% of calls were followed by an ED attendance, with a median arrival time of 51 minutes. Of the 34 664 calls advising ED attendance 41% complied, arriving with a median of 38 minutes—27% of which defined as low-acuity. Although most calls advising primary care were not followed by an ED attendance (93%), those seen in an ED generally attended later (median 102 minutes) with 23% defined as low-acuity. Younger age (<1) was a statistically significant predictor of low-acuity ED attendance following all call dispositions apart from home care.
Conclusion More tailored options for unscheduled healthcare may be needed for younger children. Both early low-acuity attendance and late high-acuity attendance following contact with NHS 111 could act as useful entry points for clinical audits of the telephone triage service.
- emergency departments
- pediatrics
- statistics
- models, statistical
- data interpretation, statistical
Data availability statement
Data may be obtained from a third party and are not publicly available. Researchers can request data extracts from the CUREd research database to be used in research studies focusing on urgent and emergency care within the UK. Researchers will need to go through an application process to obtain data and if successful, will only be supplied with data that does not contain patient identifiers.
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Data availability statement
Data may be obtained from a third party and are not publicly available. Researchers can request data extracts from the CUREd research database to be used in research studies focusing on urgent and emergency care within the UK. Researchers will need to go through an application process to obtain data and if successful, will only be supplied with data that does not contain patient identifiers.
Footnotes
Handling editor Liza Keating
X @gdj043
Contributors AK, CB and KH conceived the study. AK designed the analysis which was conducted as part of AK’s PhD research and supervised by CB, KH, GDJ and RS. AK conducted and reported all analyses. CB, KH, GDJ and RS reviewed and all interpreted the findings. AK drafted the original manuscript with support from CB, KH, GDJ and RS. All authors reviewed the final manuscript. CB acts as guarantor for this work and attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding This research was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Yorkshire and Humber (funder reference: NIHR200166), at the University of Sheffield and supported by the National Institute for Health and Care Research Applied Research Collaboration South West Peninsula.
Disclaimer This report is independent research supported by the National Institute for Health and Care Research Applied Research Collaboration South West Peninsula. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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