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 1.8 million in January 2023. The percentage of calls answered within 60 seconds has fallen over the same period, from 93% to 59%.
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 launchedand funding was announced to increase the number of call responders.
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 November 2022, there was an average of just under 1.8 million calls made each month. The percentage of calls answered within 60 seconds decreased from 73% in April 2021 to 44% in November 2022.
Rising cases of flu, concerns about Group A Streptococcus infections, and staff absence due to sickness contributed to the heightened demand for urgent care at the peak of winter in 2022. 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. Service performance improved in January 2023, with 59% of the 1.8 million calls 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 slightly to 1.5 million in January 2023. 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. The average proportion of calls answered each month between April 2021 and January 2023 was 77%.
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. 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 six times the recommendation (18%).
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 2023, 621,123 callers were advised to contact/speak with primary care services. This comprised 46% of all dispositions, making it the most common recommendation following an NHS 111 call. 18% of dispositions were to attend emergency services such as A&E, and upwards of one in ten (11%) required an ambulance that was dispatched to the caller. 15% of dispositions were to practice self-care. The least common disposition was to see a pharmacist; 5,682 people (representing 0.4% of total dispositions) were recommended that course of action.
About this data
Integrated Urgent Care Aggregate Data Collection (IUC ADC)
The IUC ADC has been published since April 2021. The number of calls answered includes only calls answered by a professional, excluding recorded messages and use of an interactive voice response message resulting in a call back. The time before the call is answered is taken from the moment the call is placed in a queue, or after any interactive message designed to steer a call to the most appropriate respondent. To be counted as answered, the call must have been picked up by a human.
For more information, see the IUC ADC Specification 2022-23.
NHS 111 Minimum Data Set
Prior to April 2021, data on NHS 111 was published in the NHS 111 Minimum Data Set. The number of calls answered in 60 seconds is measured as the number of calls answered within 60 seconds of being queued for an advisor. The percentage of calls with clinical input is the percentage of triaged calls which were answered by, or transferred to, a clinician or a clinical advisor using a Clinical Decision Support System. For more information, see the Weekly NHS 111 collection specification.