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How we’re supporting Urgent & Emergency Care services this winter

By Amanda Neylon. 8 September 2017. 

In the NHS, we faced a very challenging winter in 2016/17. Some patients waited unacceptably long times in A&E departments for admission to hospital, others spent long periods in hospital when they were clinically ready for discharge. So huge efforts are being made to improve services for this winter.

At NHS Digital, we have a key role alongside our local and national colleagues to play in enabling the wider system changes that are aimed to reduce the pressure on A&E, through providing existing and new digital services.

We have a Five Year Forward View strategy for the NHS in England which sets out our technology commitment for urgent and emergency care.

Some of the things that we know are important include enabling every A&E, Urgent Treatment Centre and ePrescribing pharmacy access to extended patient data either through the Summary Care Record or local care record sharing services. Plus access to primary care records, mental health crisis and end of life plan information. Clinicians being able to access quality, relevant personal information, particularly mental health and end of life care, during the 111 triages, mean that they are able to triage more effectively and thus reduce the impact on Urgent & Emergency Care.

111 teams being able to book patients directly, which reduces the likelihood of patients ignoring the advice and going direct to A&E. For winter 2017, we are working to have in place systems for booking appointments from 111 services into Urgent Treatment Centres and GP out of hours practices, and from Urgent Treatment Centres into GP out of hours practices.

We’ve also started working with suppliers to seamlessly route electronic prescriptions from NHS 111 and GP out of hours to pharmacies via the Electronic Prescription Service (EPS). Patients being able to pick up their prescriptions direct from their local pharmacy after speaking to a 111 clinician, will help to reduce pressures on the Urgent & Emergency Care system and the number of interactions for patients.

NHS 111 Online provides a service for those patients accessing urgent care services, who prefer to engage digitally, and helps to manage increasing demand on 111 telephony services. Four different NHS 111 Online products are currently being piloted in Leeds (NHS Pathways), Suffolk (Expert 24), North London (Babylon) and the West Midlands (Sensely) – two apps and two responsive web based tools. NHS 111 Online is free to use for the public and it helps to direct the patient to the right point of care first time. Over the next few months, we will be rolling out these NHS 111 online digital services to our priority areas to connect patients to Integrated Urgent Care services via NHS 111.

We continue to provide NHS Pathways, a clinical tool used for assessing, triaging and directing telephone calls from the public to urgent and emergency care services such as 999, GP out-of-hours and NHS 111, based on the symptoms they report when they call. It has an integrated directory of services, which identifies appropriate services for the patient’s care if an ambulance is not required. NHS Pathways handles more than 14 million calls made to the NHS per year and is used to support local 111 and 999 services.

In addition for this winter, we’ve got an Intelligent Data Tool in the form of performance management and commissioner dashboards to provide data on 111 and 999 services using NHS Pathways in a simple, easy to read and analyse format.

We’re also trying to make changes to the Directory of Services (DoS), which provides information on services that a patient can be referred in to. These will improve usability and the accuracy of search returns, such as the way service results are ranked.

We’re working closely with the Urgent & Emergency Care and regional NHS teams across the country and are here to help NHS staff as we approach the winter. If you’d like to get in touch regarding our work and programmes, please contact us on 0300-303-5678 or

Last edited: 11 September 2018 10:12 am