LAUSR

Objective To determine the feasibility and impact of having paediatric clinicians working in the Clinical Assessment Services (CAS) within NHS 111, a national telephone advice service. Design Observational study. Setting Six NHS 111 providers across England with CAS where volunteer paediatric clinicians (doctors and advanced nurse practitioners (ANPs)) worked between May and December 2020. A data reporting framework was used to compare the outcomes of calls taken by paediatric vs non-paediatric clinicians. Patients Under 16-year-olds prompting calls to NHS 111 over the study period. Main outcome measures The disposition (final outcome of calls) taken by paediatric versus non-paediatric clinicians, paediatric clinicians’ and patient experience. Results 70 paediatric clinicians (66 doctors and 4 ANPs) worked flexible shifts in six NHS 111 providers’ CAS over the study period: 2535 calls for under 16-year-olds were taken by paediatric clinicians and 137 008 by non-paediatric clinicians. Overall, disposition rates differed significantly between the calls taken by paediatric versus (vs) non-paediatric clinicians: 69% vs 43% were advised on self-care only, 13% vs 18% to attend emergency departments (EDs), 13% vs 29% to attend primary care, 1% vs 4% to receive an urgent ambulance call out and 4% vs 6% referred to another health service, respectively. When compared with recent (all age) national whole data sets, the feedback from calls taken by paediatricians noted a greater proportion of patients/carers reporting that their problem was fully resolved (92% vs 27%). Conclusions Introducing paediatric specialists into NHS 111 CAS is likely to increase self-care dispositions, and reduce onward referrals to primary care, ED and ambulances. Future work will evaluate the impact of a national paediatric clinical assessment service to which specific case types are streamed. A paper highlighting the impact of volunteer Paediatric clinicians working within 111 during the initial pandemic in 2020. It highlights lower refferal onwards rates & higher proportions of patients/carers reporting that their problem was fully resolved.