NHS 111 Online study
Research type
Research Study
Full title
Ethnographic study of patient pathways and workforce implications of NHS 111 Online
IRAS ID
272729
Contact name
Catherine Pope
Contact email
Sponsor organisation
University of Oxford /Clinical Trials and Research Governance
Duration of Study in the UK
1 years, 0 months, 13 days
Research summary
Research Summary
The NHS provides a telephone service to help people who need advice or care when their general practice (GP) is shut, this is called NHS 111. An online (Web-based) version of NHS 111 which allows patients to get medical help or advice using their smartphone or a computer has been introduced across England. We plan to evaluate this service.
Demand for GP and emergency care services is increasing and sometimes people don't use the most appropriate services for the health problems they have. Providing NHS 111 Online could help people to use the right services, and may provide advice that helps them do more self-care. However some research suggests that online systems can increase demand for other health services, and we know that not everyone finds online services easy to use.
Because NHS 111 Online is being rolled out across England we cannot do an experiment to test how it works, so we will do detailed research (called case studies) in 8 settings. We will ask people (using interviews and surveys), and observe what patients and staff do, to understand the online service. We want to look at the care pathways people follow after they use the online service as well as the work and workforce arrangements for NHS 111 Online. We will visit 8 settings and talk to staff and managers about the work. We will use surveys to ask patients and potential patients about how easy the online system is to use and what they think about the system. We will also interview staff and managers from a similar system used in Australia to see how our service compares with theirs.
Summary of Results
NHS 111 services help people who need health advice or care by phone (using the 111 number and online (using the Web on a smartphone or a computer). Demand for GP and emergency care services keeps increasing and there are concerns that sometimes people do not use the right services for the health problems they have. NHS 111 can direct people to services and give advice that helps them do more self-care.
Previous research suggests that not everyone finds online services easy to use. There is a worry that NHS 111 services may increase work for other health services. Our research used interviews and surveys to find out about the NHS 111 online service.
We interviewed 80 people working in or with NHS services to find out about their experiences of NHS 111 online. There was low awareness of NHS 111 online partly because there are so many other computer technologies and different services available. Interviewees often mixed up NHS 111 online with the 111 telephone service. People are confused about where to get help. Interviewees also said that NHS 111 creates ‘extra work’ especially for emergency departments (A&E). We interviewed 41 staff and stakeholders linked with a similar system used in Australia, called Healthdirect: they had similar concerns.
Our survey found that people who had used NHS 111 online were younger and had higher levels of education. People who had used NHS 111 online also had higher eHealth literacy (they were more able to access and understand online health services). But they were also sicker, they reported having more long-term conditions and they used more health services.
Our research suggests that we need to reduce confusion about what NHS 111 online does, get rid of unnecessary extra work, and see whether it really improves access to care for everyone.
REC name
London - Stanmore Research Ethics Committee
REC reference
20/LO/0294
Date of REC Opinion
10 Feb 2020
REC opinion
Favourable Opinion