A study of urgent and emergency referrals from NHS Direct within England

Cook, Erica Jane; Randhawa, Gurch; Guppy, Andrew; Large, Shirley

doi:10.1136/bmjopen-2014-007533

Cited by 11 publications

(15 citation statements)

References 17 publications

(19 reference statements)

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“…11,12 Furthermore, GPs more often triaged older patients to faceto-face contacts, which could be related to higher frequency of comorbidity and higher likelihood of a severe acute health problem. [13][14][15] Moreover, a problem persisting for 12-24 hours could indicate a (sub) acute problem that needs relatively quick treatment, indicating a need for consultation in particular during weekends when own GP is unavailable.…”

Section: Discussionmentioning

confidence: 99%

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

et al. 2016

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“…The Public Health England (PHE) Real-time Syndromic Surveillance Team established a telehealth syndromic surveillance system in 2001 to monitor calls to the National Health Service (NHS) Direct telephone helpline (NHS Direct) [9]. During 2013 NHS Direct was replaced in England by a new service, NHS 111 [10]; PHE subsequently developed a new national syndromic surveillance telehealth system based upon the daily calls received by NHS 111 [11].…”

Section: Introductionmentioning

confidence: 99%

The burden of seasonal respiratory infections on a national telehealth service in England

et al. 2017

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Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged <5 and 5-14 years, and adults over 65 years were modelled separately as were time lags of up to 4 weeks between calls and laboratory specimen dates. Associations with respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for 'cold/flu', whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

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“…Routine data from 21 Dutch cooperatives showed higher OOHS use in neighbourhoods with more non-Western immigrants33 while national data from Norway showed that migrant groups had lower emergency primary care contact rates overall although rates were higher for specific migrant groups 39. In England, TTA data found that, following contact with NHS Direct, white British or Bangladeshi children were most likely to be referred to urgent care services including OOHS while children of Indian and ‘other white’ ethnicity were least likely to be referred 40…”

Section: Resultsmentioning

confidence: 99%

What do we know about demand, use and outcomes in primary care out-of-hours services? A systematic scoping review of international literature

et al. 2020

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ObjectiveTo synthesise international evidence for demand, use and outcomes of primary care out-of-hours health services (OOHS).DesignSystematic scoping review.Data sourcesCINAHL; Medline; PsyARTICLES; PsycINFO; SocINDEX; and Embase from 1995 to 2019.Study selectionEnglish language studies in UK or similar international settings, focused on services in or directly impacting primary care.Results105 studies included: 54% from mainland Europe/Republic of Ireland; 37% from UK. Most focused on general practitioner-led out-of-hours cooperatives. Evidence for increasing patient demand over time was weak due to data heterogeneity, infrequent reporting of population denominators and little adjustment for population sociodemographics. There was consistent evidence of higher OOHS use in the evening compared with overnight, at weekends and by certain groups (children aged <5, adults aged >65, women, those from socioeconomically deprived areas, with chronic diseases or mental health problems). Contact with OOHS was driven by problems perceived as urgent by patients. Respiratory, musculoskeletal, skin and abdominal symptoms were the most common reasons for contact in adults; fever and gastrointestinal symptoms were the most common in the under-5s. Frequent users of daytime services were also frequent OOHS users; difficulty accessing daytime services was also associated with OOHS use. There is some evidence to suggest that OOHS colocated in emergency departments (ED) can reduce demand in EDs.ConclusionsPolicy changes have impacted on OOHS over the past two decades. While there are generalisable lessons, a lack of comparable data makes it difficult to judge how demand has changed over time. Agreement on collection of OOHS data would allow robust comparisons within and across countries and across new models of care. Future developments in OOHS should also pay more attention to the relationship with daytime primary care and other services.PROSPERO registration numberCRD42015029741.

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A study of urgent and emergency referrals from NHS Direct within England

Cited by 11 publications

References 17 publications

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

The burden of seasonal respiratory infections on a national telehealth service in England

What do we know about demand, use and outcomes in primary care out-of-hours services? A systematic scoping review of international literature

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