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Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017

The NHS 111 telephone advice and triage service is a vital part of the management of urgent and emergency care (UEC) services in England. Demand for NHS 111 advice has increased since its introduction in 2013, and the service is of particular importance in light of the current pandemic and resulting...

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Autores principales: Lewis, Jen, Stone, Tony, Simpson, Rebecca, Jacques, Richard, O’Keeffe, Colin, Croft, Susan, Mason, Suzanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109810/
https://www.ncbi.nlm.nih.gov/pubmed/33970946
http://dx.doi.org/10.1371/journal.pone.0251362
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author Lewis, Jen
Stone, Tony
Simpson, Rebecca
Jacques, Richard
O’Keeffe, Colin
Croft, Susan
Mason, Suzanne
author_facet Lewis, Jen
Stone, Tony
Simpson, Rebecca
Jacques, Richard
O’Keeffe, Colin
Croft, Susan
Mason, Suzanne
author_sort Lewis, Jen
collection PubMed
description The NHS 111 telephone advice and triage service is a vital part of the management of urgent and emergency care (UEC) services in England. Demand for NHS 111 advice has increased since its introduction in 2013, and the service is of particular importance in light of the current pandemic and resulting increased demand for emergency care. Currently, little is known about the effectiveness of NHS 111 in terms of the appropriateness of the advice given, or about the compliance of patients with that advice. We aimed to address this issue by analysing a large linked routine dataset of all NHS 111 calls (n = 3,631,069) and subsequent emergency department (ED) attendances made in the Yorkshire & Humber region from March 2013-March 2017. We found that many patients do not comply with advice, with 11% (n = 289,748) of patients attending ED when they are advised to self-care or seek primary care. We also found that a considerable number of these patients are further classed as urgent (88%, n = 255,931) and a substantial minority (37%, 106,207) are subsequently admitted to hospital. Further, many patients who are sent an ambulance or told to attend ED are classed as non-urgent upon attending ED (9%, n = 42,372). This research suggests that the level at which NHS 111 is currently triaging results in many hundreds of thousands of mis-triaged cases annually. Additionally, patients frequently do not comply with the advice they receive. This has implications for understanding the accuracy and efficiency of triaging systems.
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spelling pubmed-81098102021-05-21 Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017 Lewis, Jen Stone, Tony Simpson, Rebecca Jacques, Richard O’Keeffe, Colin Croft, Susan Mason, Suzanne PLoS One Research Article The NHS 111 telephone advice and triage service is a vital part of the management of urgent and emergency care (UEC) services in England. Demand for NHS 111 advice has increased since its introduction in 2013, and the service is of particular importance in light of the current pandemic and resulting increased demand for emergency care. Currently, little is known about the effectiveness of NHS 111 in terms of the appropriateness of the advice given, or about the compliance of patients with that advice. We aimed to address this issue by analysing a large linked routine dataset of all NHS 111 calls (n = 3,631,069) and subsequent emergency department (ED) attendances made in the Yorkshire & Humber region from March 2013-March 2017. We found that many patients do not comply with advice, with 11% (n = 289,748) of patients attending ED when they are advised to self-care or seek primary care. We also found that a considerable number of these patients are further classed as urgent (88%, n = 255,931) and a substantial minority (37%, 106,207) are subsequently admitted to hospital. Further, many patients who are sent an ambulance or told to attend ED are classed as non-urgent upon attending ED (9%, n = 42,372). This research suggests that the level at which NHS 111 is currently triaging results in many hundreds of thousands of mis-triaged cases annually. Additionally, patients frequently do not comply with the advice they receive. This has implications for understanding the accuracy and efficiency of triaging systems. Public Library of Science 2021-05-10 /pmc/articles/PMC8109810/ /pubmed/33970946 http://dx.doi.org/10.1371/journal.pone.0251362 Text en © 2021 Lewis et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lewis, Jen
Stone, Tony
Simpson, Rebecca
Jacques, Richard
O’Keeffe, Colin
Croft, Susan
Mason, Suzanne
Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title_full Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title_fullStr Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title_full_unstemmed Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title_short Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013–2017
title_sort patient compliance with nhs 111 advice: analysis of adult call and ed attendance data 2013–2017
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109810/
https://www.ncbi.nlm.nih.gov/pubmed/33970946
http://dx.doi.org/10.1371/journal.pone.0251362
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