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Response of NHS 111 to the COVID-19 pandemic


The national investigation

We have launched a national investigation into NHS 111’s response to callers reporting potential symptoms of COVID-19 during the pandemic.

NHS 111 is the 24/7 telephone and online service for people seeking advice and information about urgent medical problems. The NHS 111 telephone service adapted to the COVID-19 pandemic by introducing a COVID-19 National Response Service (CNRS).

The CNRS is a branch of the NHS 111 telephone service designed to assess patients, following an algorithm, reporting symptoms of coronavirus. The algorithm determines the appropriate management for the patient.

A key component of the CNRS was the COVID-19 Clinical Assessment Service (CCAS). When required the CCAS offered a remote clinical review to the assessment of patients reporting COVID-19 symptoms following their use of NHS 111.

CCAS was primarily formed of GPs returning to practice, sessional GPs and GP partners/salaried GPs with equipment and training offered to support high quality clinical triage.

Some patients calling NHS 111 with symptoms of coronavirus may have reached the core NHS 111 telephone service instead of the CNRS. In these cases, the call handler for the core NHS 111 telephone service would assess the patient, following the core pathway algorithm.

The national investigation will consider both the CNRS and the core 111 service’s response to patients reporting COVID-19 symptoms.

Reference event

The investigation was launched after HSIB became aware of a number of concerns presented to HSIB through its Citizens’ Partnership. Members of the Citizens’ Partnership work with HSIB to support the patient and public perspective in our healthcare safety investigations. The concerns included:

  • The NHS 111 telephone advice given did not fully respond to the severity of the reported symptoms.
  • Delays in answering/failing to return, telephone calls.

Investigation summary

The investigation will:

1) Understand the response of NHS 111 services to the COVID-19 pandemic.

2) Identify the systemic factors influencing the response to patients calling NHS 111 with COVID-19 related symptoms.