Concern as a quarter of NHS 111 calls end at A&E

By Dominic Robertson | Shrewsbury | Health | Published:

A quarter of all calls to NHS 111 across the region end up with an ambulance call out or a trip to A&E.

The number of people sent to hospital after calling the number has risen 18 per cent in five years. Today concern was raised about pressures being placed on A&E units in the region

The latest NHS England figures show the West Midlands call centre, which covers Shropshire, sent 23,089 people to A&E in March 2019 – 25 per cent of all callers.

This is up significantly from March 2014, when 11,802 patients were referred to A&E. That was in the first year of full service for NHS 111.

NHS 111 is a 24-hour helpline for patients who need medical help but do not need to call 999. The service took the place of NHS Direct and some GP out-of-hours services in 2014.

Most calls are dealt with by staff with no clinical background working to a set script, although around a fifth of callers are referred to nurses or paramedics.

Shropshire’s A&E departments, at Royal Shrewsbury Hospital and Princess Royal Hospital Telford, have both been under considerable pressure in recent months.

In January it was revealed that the trust which manages the hospitals, Shrewsbury & Telford Hospital NHS Trust, had the second worst performance in the country against the four hour waiting time target.



The Nuffield Trust, an independent health think tank, conducted an analysis of the 111 service in 2017 and warned then of the increasing proportion of people being sent to A&E.

John Appleby, chief economist and director of research for the Nuffield Trust, added: “It’s a concern for the NHS that the proportion of callers sent to A&E and ambulances is growing all the time. However, surveys of callers appear to show that even higher numbers would have opted for these emergency services if they hadn’t been able to ring 111.”

Its report said health professionals have been critical of the decision to scrap the NHS Direct Service and replace it with 111.

The new figures show the West Midlands helpline handled 91,372 calls in March 2019. It referred 58 per cent of these to primary care, such as GP surgeries, pharmacies and dentists. About two per cent of them were advised to rest at home.


The service is commissioned by local clinical commissioning groups, which make spending decisions for health services, and the helplines are run by ambulance trusts, GP surgeries and healthcare companies.

Nationally, there is significant variation in the number of A&E referrals by each service.

Gloucestershire NHS 111 sent 27 per cent of all callers to A&E in March 2019, while Hertfordshire sent just 13 per cent.


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