Written Statement - Evaluation of the 111 Pathfinder Service in Wales

The NHS’ strategic plan to introduce a national 111 service has been agreed and I have approved funding for 2018-19 and 2019-20. This follows the successful roll out of the pathfinder service in Abertawe Bro Morgannwg University Health Board and Carmarthenshire.

The 111 service offers a free easy to remember telephone number that allows people to be signposted to the right treatment in the right place by a multi professional team. The 111 service combines NHS Direct information and advice with ‘out of hours’ services. This model has emerged from the pathfinder programme, which will become part of a 24/7 model for access to primary care.

An evaluation undertaken by Public and Corporate Economic Consultants (PACEC) in conjunction with Sheffield University is now available and provides positive evidence about the roll out and impact of the 111 pathfinder within Abertawe Bro Morgannwg University Health Board. The evaluation of the 111 pathfinder is an important milestone in the roll out of the 111 service across Wales. The pathfinder was implemented to test the practicalities of establishing the combined service of NHS Direct Wales and the GP Out of Hours service. The evaluation report provides evidence about how the service has been perceived by both staff and patients, and analyses the performance data collected.

The key findings from the evaluation report include:

• The 111 pathfinder was successfully implemented in October 2016 and received over 71,000 calls in the first six months of operation, 94% of which were answered by call takers;
• Call priority: in the period under review 32,000 calls were triaged, of which 36% were urgent;
• Average triage time for priority one calls was 3 minutes compared to the 20 minute standard;
• There was a high level of service user satisfaction with 95% of survey respondents stating that they were satisfied or very satisfied with the whole 111 process;
• Key stakeholders involved in the development and the operation of the service are enthusiastic about the pathfinder and believe that greater benefits and efficiencies could be achieved with careful roll-out across Wales;
• The impact on GP Out of Hours is the provision of a more clinically-led model whereby patients have greater opportunity to access clinical telephone assessment and treatment (prescriptions etc.) in particular when the clinical hub is operating (evenings / weekends) without the need for a face to face appointment with GPs;
• Although it is difficult to be absolutely certain about the impact on ED attendance, in the first 6 months of the pathfinder, Abertawe Bro Morgannwg UHB saw a 1% decrease compared to the previous year. It is estimated the 111 pathfinder contributed to saving £218,000 through a reduction in Emergency Department attendances;
• During the period under review there was a reduction in ambulance conveyances to Emergency Departments. This change was seen largely in non-urgent (Green) conveyances, which reduced by just over 25%. Although this change cannot be wholly attributed to 111 it has contributed to a saving of £205,000 for ambulance conveyances.

The evaluation can be found at the following link:

https://www.ambulance.wales.nhs.uk/Default.aspx?pageId=315&lan=en

The NHS’ strategic plan for the 111 service in Wales has built on the evaluation of the pathfinder and are looking to extend the roll-out into other areas of Wales over the next 2-3 years.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.