Condition category
Not Applicable
Date applied
25/10/2019
Date assigned
29/10/2019
Last edited
28/10/2019
Prospective/Retrospective
Retrospectively registered
Overall trial status
Ongoing
Recruitment status
Recruiting

Plain English Summary

Background and study aims
The NHS 111 telephone service is being used increasingly by people who need help deciding which urgent care services to use when they need help quickly. Recently, an alternative online NHS 111 service has been introduced. This allows people to use either a website or an “app” to answer a series of questions about their health problem rather than the telephone. The online service can provide advice about what the patient needs to do next (for example self-care, see a pharmacist, make a GP appointment, go to an emergency department) or if needed link the person using the online service to a clinical advisor within the NHS111 telephone service for further assessment. It is hoped that this will help improve access to services, and help to reduce the impact of growing demand for the NHS 111 telephone services. This online service is now being offered across England. As it is relatively new it is not clear at the moment how effective this service is. The University of Sheffield will look at how well the new service is working in about eight sites and assess what impact the new online service has on the existing NHS 111 telephone service by measuring any changes in the number of calls and whether the new online service provides similar advice to the NHS 111 telephone service. They will also ask people who use both the NHS111 online and telephone services if they followed the advice they were given, if they found the service easy to use and how the new online service might affect how they use health services in the future. The researchers will also assess how the new online service affects the workload and the people who work at the NHS 111 telephone service and estimate the costs of the service.

Who can participate?
People who either call the NHS111 telephone service or use the NHS111 online service in five study areas

What does the study involve?
The number of calls to the 111 telephone service and contacts with the online service over a four-year period in the study areas are measured using routine national data to see if there has been a shift from the telephone service to the online service. The researchers also estimate what the likely future numbers of users for each service will be. In selected sites they look in more detail at what happens to people who use both the online and telephone services to see if there are differences. They also ask users about their experience of using the services and what they did after their contact using a survey and more detailed interviews with people who have used the service. A particular interest is the experiences of the people that use the online service and their views on whether it worked well or was difficult to navigate. Both the NHS111 telephone and online services already use a patient experience survey so this is used to ask some additional questions. The researchers also conduct more detailed interviews with users of the new NHS111 online service to ask in more detail about their experience.They also talk to staff to see if the introduction of the online 111 service has had any impact on their work and use the results of the statistical analysis and survey to assess whether the new service has had any effect on the costs of delivering the overall NHS111 service.

What are the possible benefits and risks of participating?
Patient views and experiences of the new service will help identify where it works well and whether any changes are needed to improve the advice provided to people who use it and make it more accessible and easy to use. Participating in the surveys or interviews is voluntary. It is possible that some people who agree to be interviewed may find recalling their health problem event upsetting. If this happens they will be able to withdraw at any time.

Where is the study run from?
The study is led by the Centre for Urgent and Emergency Care Research at the University of Sheffield. The five areas involved in the patient surveys and interviews are Yorkshire and Humber; Hampshire; South West London; Derbyshire and Bedfordshire & Luton.

When is the study starting and how long is it expected to run for?
March 2019 to June 2020

Who is funding the study?
National Institute of Health Research (UK)

Who is the main contact?
Janette Turner
j.turner@sheffield.ac.uk

Trial website

https://www.sheffield.ac.uk/scharr/sections/hsr/cure/projects/nhs111online

Contact information

Type

Scientific

Primary contact

Ms Janette Turner

ORCID ID

http://orcid.org/0000-0003-3884-7875

Contact details

University of Sheffield
Regent Court
30 Regent Street
Sheffield
S1 4DA
United Kingdom
+44 (0)114 2220761
j.turner@sheffield.ac.uk

Additional identifiers

EudraCT number

Nil known

ClinicalTrials.gov number

Nil known

Protocol/serial number

OL1EV_V103/19

Study information

Scientific title

An evaluation of the impact of online NHS11 on the NHS111 telephone service and potential effects on the urgent care system

Acronym

OL1EV

Study hypothesis

To assess if the introduction of the NHS111 online service has had an impact on reducing calls to the NHS111 telephone service and the national implications for the wider urgent care system

Ethics approval

Approved 24/07/2019, North West Haydock (Manchester HRA Centre, 3rd Floor Barlow House, 4 Minshull Street, M1 3DZ; Tel: +44 (0)202 104 8012; Email: nrescommittee.northwest-haydock@nhs.net), NRES ref: 19/NW/0361

Study design

Observational mixed methods study

Primary study design

Observational

Secondary study design

Ecological study

Trial setting

Other

Trial type

Other

Patient information sheet

Condition

People seeking help for an urgent health problem

Intervention

Before and after time series of NHS111 telephone activity 3 years before and 1 year after the introduction of an online NHS11 service in 9 areas. User/patient surveys and interviews for online and telephone NHS111 services in 5 case study sites. Qualitative interviews with service providers and stakeholders. Economic evaluation.

Intervention type

Other

Phase

Drug names

Primary outcome measure

Measured using routine national data:
1. Change in number of contacts with the NHS111 telephone service: time series analysis of trends 3 years before and 1 year after the introduction of NHS111 online
2. Cost consequences: cost estimates of NHS111 online service, combined cost of NHS111 online and telephone services and urgent care system cost changes, measured 1 year after the introduction of NHS111 online

Secondary outcome measures

1. Usability, acceptability and compliance with advice provided by NHS111 online, assessed using the NHS Digital NHS 111 online patient survey and telephone interviews within 2 weeks of contact
2. Usability, acceptability and compliance with advice provided by NHS111 telephone service, assessed using the postal/telephone NHS111 patient experience survey within 2 weeks of contact
3. Changes to service provision and workforce effects, assessed using NHS staff and stakeholder interviews at least 1 year after implementation of online service

Overall trial start date

01/03/2019

Overall trial end date

30/06/2020

Reason abandoned (if study stopped)

Eligibility

Participant inclusion criteria

1. Individual members of the public who log in to the NHS111 online service or call the NHS111 telephone service
2. Staff and other stakeholders involved in delivery or commissioning of NHS111 services

Participant type

Mixed

Age group

Mixed

Gender

Both

Target number of participants

Survey and interviews with users/patients - 1) 800 respondents NHS111 online survey, 2) 800 respondents NHS111 telephone survey, 3) 40 interviews with NHS111 online usersy

Participant exclusion criteria

User interviews:
1. Children under 16 years
2. Unable to provide consent

Recruitment start date

01/08/2019

Recruitment end date

31/03/2020

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Yorkshire Ambulance Service NHS Trust
Springhill 2 Wakefield 41 industrial estate Brindley Way
Wakefield
WF2 0XQ
United Kingdom

Trial participating centre

South Central Ambulance Service NHS Trust
7-8 Talisman Road
Bicester
OX26 6HR
United Kingdom

Trial participating centre

Hertfordshire Urgent Care Service
Ascots Lane
Welwyn Garden City
AL7 4HL
United Kingdom

Trial participating centre

Vocare
Cardinal Square West 10 Nottingham Road
Derby
DE1 3QT
United Kingdom

Trial participating centre

Derbyshire Health United Health Care
Johnson Building Locomotive Way
Derby
DE24 8PU
United Kingdom

Sponsor information

Organisation

University of Sheffield

Sponsor details

Western Bank
Sheffield
S10 2TN
United Kingdom
+44 (0)114 2221424
K.Pursall@sheffield.ac.uk

Sponsor type

University/education

Website

https://www.sheffield.ac.uk

Funders

Funder type

Government

Funder name

National Institute for Health Research

Alternative name(s)

NIHR

Funding Body Type

government organisation

Funding Body Subtype

National government

Location

United Kingdom

Results and Publications

Publication and dissemination plan

This research is funded by NIHR and a full report will be published in the NIHR Journals Library. Papers will also be submitted to peer review journals for different work packages (e.g time series analysis, user survey analysis). Concise summaries will be provided for the NHS (providers, commissioners, policy) and lay audiences. Summaries will be disseminated via professional stakeholder groups across the NHS. Briefings will be prepared for NHS England and NHS Digital. Public involvement co-applicants will advise on suitable dissemination strategies for the wider population.

IPD sharing statement
The data the researchers are using will be provided by NHS Digital from information assets they hold and cannot be shared under the terms of the data-sharing agreement. Individuals can apply for the same datasets using the NHS Digital Data Access Request Service.

Intention to publish date

01/12/2020

Participant level data

Not expected to be available

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

28/10/2019: Trial's existence confirmed by funder and ethics committee.