77.8% of NHS 111 calls NOT advised to go to Emergency Department

Research published on BMJ Journals showed the above percentage from analysis of 16.6million calls to 111 in 2015-2017.

Avoidable attendance

During the recent outbreak, NHS 111 services have been inundated with calls from worried members of the public.

As a result, the NHS upgraded its service as our previous article this week discussed

In previous years, calling to 111 services where the patient did not require emergency treatment was commonplace.

However, according to the study, this did not prevent many patients from attending ED regardless of advice given.

The objectives of the study were to ‘measure the frequency of patients making avoidable emergency department attendances after contact with NHS 111.’

Additionally, the study sought to examine how reliable it would be to predict these attendances.

The idea to the creation of the 111 service is of course to reduce the number of ED attendances.

The study was conducted over all locations within England.


“Of 16 563 946 calls to 111, 12 894 561 (77.8%) were not advised to go to ED (they were advised to either attend primary care, attend another non-ED healthcare service or to self-care).”

“Of the calls where the patient was not advised to go to the ED, 691 783 (5.4%) resulted in the patient making an avoidable ED attendance within 24 hours.”

“Among other factors, calls were less likely to result in these attendances when they received clinical input but were more likely when the patient was female or aged 0–4 years.”

The cost of the avoidable attendances was said to be around £2.1million per month.

The study also tested whether attendances can be predicted based on the nature of the phone called made to 111.

It would appear from the study that more patients decided to attend ED when not being assessed by a doctor or nurse over the phone.

Statistics suggest that only 38.37% are transferred to a doctor or nurse during their call.

Previously, the Cabinet Minister for Children’s Services has criticised the service saying:

“It’s not good and it needs investment, it’s a national issue. People need to be answered with information.”

With Carol Prowse, Lay Member for Commissioning concerned that the service is ‘getting worse’ and could be pushing people onto the ‘overburdened A & E’