ISRCTN ISRCTN51801112
DOI https://doi.org/10.1186/ISRCTN51801112
Secondary identifying numbers OL1EV_V103/19
Submission date
25/10/2019
Registration date
29/10/2019
Last edited
19/10/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

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

Study website

Contact information

Ms Janette Turner
Scientific

University of Sheffield
Regent Court
30 Regent Street
Sheffield
S1 4DA
United Kingdom

ORCiD logoORCID ID 0000-0003-3884-7875
Phone +44 (0)114 2220761
Email j.turner@sheffield.ac.uk

Study information

Study designObservational mixed methods study
Primary study designObservational
Secondary study designEcological study
Study setting(s)Other
Study typeOther
Scientific titleAn evaluation of the impact of online NHS11 on the NHS111 telephone service and potential effects on the urgent care system
Study acronymOL1EV
Study hypothesisTo 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(s)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
ConditionPeople seeking help for an urgent health problem
InterventionBefore 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 typeOther
Primary outcome measureMeasured 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 measures1. 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 study start date01/03/2019
Overall study end date30/06/2020

Eligibility

Participant type(s)Mixed
Age groupMixed
SexBoth
Target number of participantsSurvey 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 inclusion criteria1. 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 exclusion criteriaUser interviews:
1. Children under 16 years
2. Unable to provide consent
Recruitment start date01/08/2019
Recruitment end date31/03/2020

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centres

Yorkshire Ambulance Service NHS Trust
Springhill 2
Wakefield 41 industrial estate
Brindley Way
Wakefield
WF2 0XQ
United Kingdom
South Central Ambulance Service NHS Trust
7-8 Talisman Road
Bicester
OX26 6HR
United Kingdom
Hertfordshire Urgent Care Service
Ascots Lane
Welwyn Garden City
AL7 4HL
United Kingdom
Vocare
Cardinal Square West
10 Nottingham Road
Derby
DE1 3QT
United Kingdom
Derbyshire Health United Health Care
Johnson Building
Locomotive Way
Derby
DE24 8PU
United Kingdom

Sponsor information

University of Sheffield
University/education

Western Bank
Sheffield
S10 2TN
England
United Kingdom

Phone +44 (0)114 2221424
Email K.Pursall@sheffield.ac.uk
Website https://www.sheffield.ac.uk
ROR logo "ROR" https://ror.org/05krs5044

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date01/12/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThis 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 planThe 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.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 01/11/2021 18/10/2022 Yes No
Protocol (other) 07/03/2019 19/10/2022 No No
HRA research summary 28/06/2023 No No

Editorial Notes

19/10/2022: Protocol uploaded (not peer reviewed).
18/10/2022: Publication reference added.
28/10/2019: Trial's existence confirmed by funder and ethics committee.