Derbyshire Central Navigation Hub is the first Clinical Assessment Service in England to accept 111 Online Primary Care Validations
The DHU project, aimed at reducing the number of unnecessary trips for patients to A&E, Urgent Treatment Centres and Urgent Care Centres in Derbyshire, has proven to be a success during an initial pilot.
The new service started in October 2024 for patients who have used 111 Online between 8am and 4pm and received advice to speak to a GP within one or two hours. Previously patients would need to contact their own GP practice and often there would be no available appointments within this short window. DHU’s new service now gives patients the option to speak to a clinician within DHU’s Central Navigation Hub (CNH). Patients are then called back within one or two hours.
The intention is to improve access to urgent care assessment and prevent waits that may result in the patient otherwise visiting A&E or Urgent Treatment Centre unnecessarily.
"Direct patients to the right place more quickly..."
Dr Saurabh Johri is Regional Clinical Director for UEC and Primary Care at DHU, he said: “It means that more patients are assessed by a clinician within one or two hours, reducing the pressure on busy GP practices whilst ensuring these patients get the expert care and advice that they need more quickly.
“Through remodelling we have freed up the resources to run this service without additional cost to our commissioners, including GPs, advanced practitioners and other health professionals who can speak to the patient and understand more about their condition. We can then direct patients to the right place more quickly. Sometimes, due to the nature of their condition, patients will be directed to A&E, some do need a GP appointment whilst others can be given advice to self-treat at home.
“It is another way that we are able to ensure the patient gets the right treatment at the right place by the right person, which is what we need to help make the NHS and the wider health system run as efficiently as possible.”
In the last three months we’ve seen 74.6% in March, 83.8% in April and 75.9% in May of 111 Online primary care referrals to the CNH managed without a GP appointment. All of these patients received more appropriate care from a different part of the system that was better equipped to treat that patient.
"Respond to demand and patient need..."
Gemma Payne-Wright is DHU’s Service and Pathways Co-Ordinator, she added: “It means that these services become more accessible to those who really need them. It’s such a flexible service because the clinicians these patients speak to work remotely, which means we can quickly adapt the service to respond to demand and patient need.
“DHU was the first organisation in England to deliver this service. From October 2024 we piloted it in Derbyshire and over the winter period ran the same service in Leicestershire with similar results. Patients who are referred to us don’t have to queue or wait on the phone and get the right care much faster. From our perspective, it’s about helping to alleviate pressure on the system, and it’s working.”