• Andrew Anderson and Martin Roland.
• Cambridgeshire and Peterborough Clinical Commissioning Group, Locton House, Cambridge, UK.
• BMJ Open. 2015 Nov 27; 5 (11): e009444.

ObjectiveTo determine the effect of using experienced general practitioners (GPs) to review the advice given by call handlers in NHS 111, a national service giving telephone advice to people seeking medical care.DesignObservational study following the introduction of GPs to review call handlers' decisions which had been made using decision support software.SettingNHS 111 call centre covering Cambridgeshire and Peterborough.InterventionWhen a call handler using standard NHS 111 decision support software would have advised the caller to attend the hospital accident and emergency (A&E) department, the decision was reviewed by an experienced GP.Main Outcome MeasuresPercentage of calls where an outcome other than A&E attendance was recommended by the GP.ResultsOf 1474 cases reviewed, the GP recommended A&E attendance in 400 cases (27.1%). In the remainder of cases, the GP recommended attendance at a primary care out-of-hours centre or minor injury unit in 665 cases (45.2%) and self-management or some alternative strategy in 409 (27.8%).ConclusionsFewer callers to NHS 111 would be sent to emergency departments if the decision was reviewed by an experienced GP. Telephone triage services need to consider whether using relatively unskilled call handlers supported by computer software is the most cost-effective way to handle requests for medical care.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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