title: Potential for advice from doctors to reduce the number of patients referred to emergency departments by NHS 111 call handlers: observational study.
abstract: OBJECTIVE
  To determine the effect of using experienced general practitioners (GPs) to review the advice given by call handlers in NHS 111, a national service giving telephone advice to people seeking medical care.
  
  
  METHODS
  Observational study following the introduction of GPs to review call handlers' decisions which had been made using decision support software.
  
  
  METHODS
  NHS 111 call centre covering Cambridgeshire and Peterborough.
  
  
  METHODS
  When a call handler using standard NHS 111 decision support software would have advised the caller to attend the hospital accident and emergency (A&E) department, the decision was reviewed by an experienced GP.
  
  
  METHODS
  Percentage of calls where an outcome other than A&E attendance was recommended by the GP.
  
  
  RESULTS
  Of 1474 cases reviewed, the GP recommended A&E attendance in 400 cases (27.1%). In the remainder of cases, the GP recommended attendance at a primary care out-of-hours centre or minor injury unit in 665 cases (45.2%) and self-management or some alternative strategy in 409 (27.8%).
  
  
  CONCLUSIONS
  Fewer callers to NHS 111 would be sent to emergency departments if the decision was reviewed by an experienced GP. Telephone triage services need to consider whether using relatively unskilled call handlers supported by computer software is the most cost-effective way to handle requests for medical care.
authors.affiliation: Cambridgeshire and Peterborough Clinical Commissioning Group, Locton House, Cambridge, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Anderson
authors.affiliation: University of Cambridge, Cambridge, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D002648:Child; D004636:Emergency Service, Hospital; D006801:Humans; D008875:Middle Aged; D010820:Physicians; D011320:Primary Health Care; D012017:Referral and Consultation; D012648:Self Care; D013222:State Medicine; D013689:Telephone; D014218:Triage
keywords: General practice; Out of hours care; Triage