Paediatric NHS 111 Clinical Assessment Services pilot: an observational study

Area of Science:

• Healthcare Services Research
• Paediatric Medicine
• Digital Health

Background:

• NHS 111 provides national telephone advice, with Clinical Assessment Services (CAS) managing urgent care needs.
• Integrating specialist clinicians into telephone services is a potential strategy to optimize patient care and resource allocation.

Purpose of the Study:

• To assess the feasibility and impact of paediatric clinicians working within NHS 111 CAS.
• To compare call outcomes and patient experiences between paediatric and non-paediatric clinicians.

Main Methods:

• An observational study involving six NHS 111 providers across England.
• Paediatric clinicians (doctors and advanced nurse practitioners) volunteered in CAS between May and December 2020.
• A data reporting framework compared dispositions and patient-reported outcomes for calls concerning under 16-year-olds.

Main Results:

• 70 paediatric clinicians handled 2535 calls, compared to 137,008 calls by non-paediatric clinicians.
• Paediatric clinicians significantly increased self-care advice (69% vs 43%) and reduced referrals to emergency departments (13% vs 18%) and primary care (13% vs 29%).
• Patients/carers reported higher problem resolution (92% vs 27%) with paediatric clinician calls.

Conclusions:

• Introducing paediatric specialists into NHS 111 CAS appears feasible and beneficial.
• This integration can enhance self-care dispositions and decrease unnecessary referrals to higher care settings.
• Future research should explore a national paediatric clinical assessment service for streamlined care.