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Urgent care

NHS 111 pharmacists in Wales close 80% of calls with no onward referral

Speaking at the first pharmacy Celtic Conference, Alexandra Gibbins from NHS 111 in Wales attributed the service’s success to routing the right calls to the right healthcare professionals. 

Around eight in ten calls to NHS 111 in Wales that are picked up by pharmacists are closed without the need for onward referral, the programme’s national lead has said.

Speaking at the first pharmacy Celtic Conference in Edinburgh on 26 March 2019, Alexandra Gibbins, professional lead for NHS 111 pharmacists in Wales, said the NHS 111 model in Wales “is different” to the model in England and Scotland.

She explained that pharmacists in Wales operate at the back end of the NHS 111 system, receiving calls that have already been triaged by both call handlers and nurses, who use the NHS Pathfinders algorithm at the front end.

“That is different to 111 in Scotland and England where [clinicians] sit at the front end and work off algorithms,” said Gibbins. “[At NHS 111 in Wales, the pharmacists] don’t work off algorithms. It’s autonomous clinical decisions. They pick up a call and assess the call. It’s a telephone consultation.”

She added that calls are “already prioritised” when they are picked up by pharmacists working in the 111 call centre.

As a result, Gibbins told The Pharmaceutical Journal that pharmacists working in the Welsh southwest NHS 111 hub, which includes Abertawe Bro Morgannwg University Health Board and Hywel Dda Health Board, “are safely completing and closing 80%” of the calls they pick up. 

“That’s without intervention from anyone else.”

Gibbins added that the high closure rate “is because we’re selecting the right calls … we’re routing the right calls to the right professionals and that’s why they’re able to deal with that high level [of calls]”. 

“I also think it’s testament to the training and support that we give the pharmacists to enable them to deal with those calls,” she added.

While Gibbins was not able to provide exact figures for the pharmacist closure rate in the Welsh southeast NHS 111 hub, which includes Powys Teaching Health Board, she said the figures are likely “near enough the same”.

This comes after NHS England said that half of the cases dealt with by pharmacists in the Digital Minor Illness Referral Service were closed without the need for onward referral.

Wales began rolling out the NHS 111 model in October 2016 in Abertawe Bro Morgannwg University Health Board, with a full rollout expected in 2021.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206354

Readers' comments (1)

  • It is not just pharmacists working at Welsh 111 services that work in this way. Pharmacists working at 111 provided by the North West Ambulance Service also carry out telephone triage and make autonomous clinical decisions following triage. We do not use algorithms. We close 75% of our calls without onward referral.
    Julia Whettam. Senior Pharmacist NWAS

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