100% Live across London with NHS 111 Pathways NHS 111 Online roll out Healthy London Partnership Digital Transformation Team In March 2017, London's CCG’s were asked to adopt NHS 111 online access. HLP supported STP’s in this roll out to 100% live. NHS 111 Online was designed to reduce pressure on NHS 111 providers by shifting call demand online and providing citizens with an alternative medium to self serve, and access appropriate medical advice through the same decision support tool used by NHS 111 Health Advisors. In 2019/20 HLP will continue to work with local services, to support further uptake of the online 111 service. This will include exploring how 111 Online can be linked to primary care i.e. messaging into GP practices. Londoners will also be able to access 111 online through the new NHS App, which is being gradually rolled out across London and the UK, with planned completion July ‘19. What we did Scope of impact 100% Live across London with NHS 111 Pathways Bromley Bexley Greenwich Lewisham Southwark Lambeth Croydon Sutton Kingston Merton Wandsworth Richmond Havering Redbridge Barking & Dagenham Newham TH Hackney Waltham Forrest Enfield Barnet Haringey Camden Islington Central London WL H&F Brent Harrow Hillingdon Ealing Hounslow The HLP Digital IUC team supported the roll out of NHS 111 Online platform across each of London’s STP’s. HLP is now working with STP teams reviewing and tracking adoption to support greater channel shift from telephony services to Online services. This will support decreased pressure on IUC providers, particularly at peak times. 8% increase in triages (On average) each month for the past 9 Months between October 2018 and April 2019 9-10% Channel shift now supporting telephony services by providing an online triage Benefits Next Steps 1. Channel Shift: Continue to support increasing channel shift through advertising, engagement, and the London IVR Benefits to patients Being able to access triage services online that result in clinical advice or referrals into 111/IUC gives people more choice in accessing health care services in real time at a time that suits them. Patients are also provided with the option for a call-back or are put in an ITK queue. Benefits to staff NHS 111 online is one of several digital NHS services that are empowering people to manage their own health and care, mitigating the increased demand on telephony services. System-wide benefits Londoners have unique characteristics which are strengthened by online services – Non English speaking population and callers with mental health concerns have indicated a preference for 111 online services over telephony which reduces the ED disposition rate for this cohort of the population. 2. Online Emergency Repeat prescriptions: Supporting patient self serving when they run out of emergency drugs, through their local NUMSAS pharmacy To find out more, please contact: Contact Eileen Sutton @ eileensutton@nhs.net @healthyLDN

Frailty flagging @healthyLDN through NHS 111/IUC Healthy London Partnership Digital Transformation Team through NHS 111/IUC NHS 111/IUC in London have developed a first of type integration between our Patient Relationship Manager and a GP data source to relay a flag when a patient NHS Number has “Severe Frailty” marked within the GP record. This is directly supporting London’s vulnerable population and provides faster access to a clinician to provide more tailored care. Callers with frailty can often present with complex issues. Allowing a clinician to respond quickly with clinical information will improve the outcome for callers in crisis. How it works and what the impact has been Since launch in Dec ‘18: 45,000 frail callers successfully flagged to 111/IUC clinicians 35% of calls further supported by direct access to the GP record (MIG) 9.5% reduction in NEL Ambulance conveyances for patients over 75 since launch in December (Last 5 months against previous 5 months prior to go live) Benefits Next Steps Patients 111/IUC can unlock patient records and care plans and sharing with clinicians to ensure the 111 response is centred on patient’s needs. Staff System-wide Further developing a frailty pathway Service evaluation has also shown that the ability to share clinical information or records data reduces the urgency of management for the most vulnerable patients. In NEL so far this has reduced ambulance call out by 10% Patients who have been identified by their GP as having severe frailty and are calling 11 in crisis can now be fast-tracked to clinicians, Reducing call times and delays, and improving outcomes. Utilising learning from a detailed audit, to ensure that where available, GPs open flagged records. Remapping the Patient journey and informing more appropriate outcomes by reviewing the staffing and infrastructure that supports London's frail population, in order to further reduce ambulatory care conveyance. Pathway journey review – staffing supporting this: Call reviews and end to end patient journey review for all users have indicated a need for the following staff to support the frailty pathway:” Geriatrician GP Commissioning Lead GP Provider Lead Rapid Response nursing Lead “Simple decision support saves lives. As we move on we will get more complex inference rules. Every day you hear about delays in diagnoses or suboptimal treatment which could be addressed by algorithms operating on data previously captured. Plugging this into patients directly will make the biggest difference of all. There will be a delay between capability and action but that delay will gradually reduce when people start to expect it. Congratulations on running the first of these in London” Dr. David Stables CEO Endeavour Health / CO-Founder EMIS To find out more, please contact: Contact Eileen Sutton @ eileensutton@nhs.net @healthyLDN