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To what extent do callers follow the advice given by a non-emergency medical helpline (NHS 111): A retrospective cohort study

Nakubulwa, Mable Angela; Greenfield, Geva; Pizzo, Elena; Magusin, Andreas; Maconochie, Ian; Blair, Mitch; Bell, Derek; ... Woodcock, Thomas; + view all (2022) To what extent do callers follow the advice given by a non-emergency medical helpline (NHS 111): A retrospective cohort study. PloS One , 17 (4) , Article e0267052. 10.1371/journal.pone.0267052. Green open access

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Abstract

National Health Service (NHS) 111 helpline was set up to improve access to urgent care in England, efficiency and cost-effectiveness of first-contact health services. Following trusted, authoritative advice is crucial for improved clinical outcomes. We examine patient and call-related characteristics associated with compliance with advice given in NHS 111 calls. The importance of health interactions that are not face-to-face has recently been highlighted by COVID-19 pandemic. In this retrospective cohort study, NHS 111 call records were linked to urgent and emergency care services data. We analysed data of 3,864,362 calls made between October 2013 and September 2017 relating to 1,964,726 callers across London. A multiple logistic regression was used to investigate associations between compliance with advice given and patient and call characteristics. Caller’s action is ‘compliant with advice given if first subsequent service interaction following contact with NHS 111 is consistent with advice given. We found that most calls were made by women (58%), adults aged 30–59 years (33%) and people in the white ethnic category (36%). The most common advice was for caller to contact their General Practitioner (GP) or other local services (18.2%) with varying times scales. Overall, callers followed advice given in 49% of calls. Compliance with triage advice was more likely in calls for children aged <16 years, women, those from Asian/Asian British ethnicity, and calls made out of hours. The highest compliance was among callers advised to self-care without the need to contact any other healthcare service. This is one of the largest studies to describe pathway adherence following telephone advice and associated clinical and demographic features. These results could inform attempts to improve caller compliance with advice given by NHS 111, and as the NHS moves to more hybrid way of working, the lessons from this study are key to the development of remote healthcare services going forward.

Type: Article
Title: To what extent do callers follow the advice given by a non-emergency medical helpline (NHS 111): A retrospective cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0267052
Publisher version: https://doi.org/10.1371/journal.pone.0267052
Language: English
Additional information: © 2022 Nakubulwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10147300
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