NHS 111

Background

NHS 111 aims to ensure patients with urgent medical needs access care in the right place at the right time, by providing health advice and directing patients to different NHS services over the phone. NHS England’s 2023 delivery plan for recovering urgent and emergency care services emphasises the importance of NHS 111 and commits to making better use of clinicians to direct patients to the most appropriate form of care. In this indicator, we assess response times to NHS 111 calls and the outcomes for callers. 

NHS 111 call answer times

The total number of calls made to NHS 111 has increased over time, from just over 1 million in January 2016 to 1.9 million in January 2024. The percentage of calls answered within 60 seconds has fallen over the same period, from 93% to 53%.

At the start of the coronavirus (Covid-19) pandemic, people were encouraged to call NHS 111 with concerns about symptoms of Covid-19. The number of calls increased dramatically to just under 3 million in March 2020, however only 1.4 million calls were answered. 1.1 million calls were abandoned after waiting at least 30 seconds, and only 30% of calls were answered within 60 seconds. In response to the surge in calls, an NHS 111 online service was launched and funding was announced to increase the number of call responders. The expansion of NHS 111 led to its integration within the NHS App, which holds over 30 million registered users.

In April 2021, some definitions were revised in the NHS 111 dataset, so ongoing data is not directly comparable with previous data. In the period between April 2021 and January 2023, there was an average of just under 1.9 million calls made each month.

In December 2022, all urgent and emergency care services (including ambulance transport and A&E) recorded some of the worst performances on record. NHS 111 performance hit a record low where only one in five of the 2.9 million calls (a record number) made in December 2022 were answered within 60 seconds. In the winter of 2023, due to rising cases of flu, the demand for urgent care increased by thousands of patients compared with the previous year. However, the measures put forward in the 2023 urgent and emergency care recovery plan and early winter planning have managed to offer support to one of the busiest winters. Service performance improved throughout 2023 and in January 2024, 62% of the 1.9 million calls were answered within 60 seconds. 

Abandoned NHS 111 calls

The number of calls answered by NHS 111 call handlers decreased between April 2021 and August 2022, from 1.7 million to 1.2 million, but subsequently increased back to 1.7 million in January 2024. The average proportion of calls answered each month between April 2021 and January 2024 was 80%. It is worth noting that even though 1.6 million calls were answered in December 2022, these constitute only 54% of total calls made to NHS 111 in that month.

Abandoned calls are those in which the caller hangs up at least 30 seconds after they have been queued to speak to an advisor. Between April 2021 and October 2021, the number of NHS 111 calls abandoned grew from 130,235 to 552,455. Over the next 12-month period (until October 2022), the number of calls abandoned fell to 242,918. Data for December 2022 shows a concerning increase from the usual average, with over 1 million calls abandoned, representing 41% of the total calls made to NHS 111 during the month. Four times as many calls were abandoned in December 2022 as in the previous or subsequent month. Since December 2022, the number of abandoned calls has decreased sharply, to 287,301 in January 2023. In January 2024, 187,440 calls were abandoned, representing 10.2% of all calls made. Abandoned calls represent an unquantifiable clinical need, as the caller’s condition hasn’t been established.

Although NHS England’s guidance published in August 2022 mandates that the proportion of calls abandoned should be less than or equal to 3%, the average proportion of calls abandoned every month following August 2022 has been four times the recommendation (13%).

Outcomes of NHS 111 calls 

NHS 111 call handlers give recommendations (technically termed as “dispositions”) to the caller based on what would be most appropriate for them to do next for their health needs. In January 2024, 678,986 callers were advised to contact/speak with primary care services. This made up 39.7% of all dispositions, making it the most common recommendation following an NHS 111 call. 16% of dispositions were to attend emergency services such as A&E, and upwards of one in ten (10.6%) required an ambulance that was dispatched to the caller. 12.1% of dispositions were to practice self-care. The least common disposition was to see a pharmacist; 8,092 people (representing 0.5% of total dispositions) were recommended that course of action. The distribution of recommendations in January 2024 is similar to that for January 2023.