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Abstract
Aims The NHS 111 was introduced to increase efficiency in directing service-users to appropriate urgent-care-services and reduce strain on accident and emergency departments. Patient experience is widely recognised as a key indicator of health care quality, thus it is essential to investigate service-user experiences to understand how they can be improved. Since parents and children are amongst the highest users of urgent-care-services, this study aimed to investigate experiences of parents using NHS 111 on behalf of their child in addition to assessing what factors may influence their decision to follow advice and explore whether the most appropriate care pathway was followed.
Methods A Patient Reported Experience Measure (PREM) was developed and tested with parents who recently called NHS 111 on behalf of their child under 16 years for one of four conditions: fever; constipation; diarrhoea/vomiting; or breathlessness. The PREM was piloted employing a telephone survey methodology with parents who called NHS 111 in North West London between March–June 2015. 1000 surveys were completed in a four-week fieldwork period.
Results Data revealed positive experiences of the service overall with most parents stating they got what they needed and would use the service again. However, almost a quarter of parents didn’t fully have confidence and trust in the first call handler which may have impacted their decision to follow the advice given (see Figure 1).
Countering this, parents who were given a thorough explanation of why the advice was appropriate reported having more confidence and trust in the call handler (see Figure 2).
Proportion of parents who followed the advice, by level of confidence trust (n=960)
Respondents’ confidence and trust in first person they spoke to, by whether they were clearly told the advice or action taken by NHS 111 was the right thing to do (n=974)
An “experience of the call” composite score revealed associations between a positive experience of the call and (i) parents feeling advice/action was right, and (ii) following the advice. This indicates that being listened to, being involved in decisions, and having confidence could impact parents’ decision to follow the advice and thus the effectiveness of the service.
Conclusion The PREM proved a useful tool to understand parents experiences of using NHS 111 as well as providing evidence that their overall experience of the call could influence decisions to follow advice and ultimately access the most appropriate care pathway for their child’s needs.