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Phone First redirecting more patients to right services


The ‘Phone First’ service, currently being trialled across the Western, Southern and Northern HSC Trusts’ areas, is having a significant impact in redirecting patients away from busy Emergency Departments to other more appropriate services, new data has highlighted.

For urgent care treatment that is not life threatening, patients including children, are asked to Phone First before attending Emergency Departments (EDs) at Causeway, Antrim Area, Daisy Hill, Craigavon Area, Altnagelvin and the South West Acute Hospitals.

Patients are also asked to ‘Phone First’ before attending the Minor Injuries Units in South Tyrone, Mid Ulster Hospitals and the Urgent Care and Treatment Unit in Omagh.

For all emergencies that are life threatening always call 999 immediately. This can include: stroke, heart attack, loss of consciousness, breathing difficulties, severe bleeding or major trauma.

Early data has indicated significant changes in ED attendances, however, further work will be required to understand the trends against the backdrop of the pandemic.

Examples include:

There were 3391 walk in ED attendances in Antrim Area Hospital from 1 December 2020 to 31 January 2021 compared to 8076 for the same period the year before – this shows a reduction of 58% for those patients who were triaged for level 3, 4 and 5 conditions (5 being less serious)

There were 4924 walk in ED attendances in Craigavon Area Hospital from 1st December to 31st January 2021 compared to 7248 for the same period last year. A reduction of 32% for those patients who were triaged for level 3, 4 and 5 conditions.

Head of General Medical Services at the Health and Social Care Board, Dr Margaret O’Brien welcomed the initial results of the Phone First trials so far.

She said: “The pandemic has created unprecedented challenges across health and social care, highlighting the importance of working together to improve access to our services and prioritise those who need them most.

“It is very encouraging to see that the Phone First service, introduced gradually last Autumn across some Trusts, has helped reduce pressures on our EDs especially during the third surge of the pandemic whilst at the same time enabling many patients to be redirected to other urgent care services, avoiding lengthy waits in ED waiting rooms and reducing the risk of transmission of Covid-19 infection.

“The key aim of Phone first is to keep EDs for emergencies only and early feedback has indicated a substantial reduction in the number of patients being triaged and treated for minor illness or injuries in our EDs.

Dr O’Brien concluded: “Given the clear evidence and success of the Phone First service trials we now envisage rolling the service out across all EDs and Urgent Care services in Northern Ireland in the spring.”

The introduction of the Phone First service is one of 10 key recommendations highlighted in the No More Silos Action Plan published by the Minister for Health in 2020 following a review of urgent and emergency care services in NI.

A regional No More Silos Network and 5 Local Implementation Groups have been established and are currently developing plans for each of the recommendations, including establishing Urgent Care Centres which will be based at current Emergency Department sites to help reduce patients visits to EDs.  The centres will be managed by medical and nursing staff. In addition, a range of new rapid access and pathways to help patients avoid hospital referrals and get quicker access to the most appropriate care are being developed to include; Mental Health, Dermatology and Gynaecology services.

For more information and a list of Frequently Asked Questions visit: https://hscboard.hscni.net/urgent-emergency-care

How to contact the Phone First service:

Southern Area

Northern Area

Western Area

Phone First Data

Northern Trust Phone First Data from 1 December 2020 to 31 January 2021:-

Southern Trust Phone First Data from 1st December 2020 – 11th January 2021:-

Western Trust Phone First Data from 25th January – 21st February 2021:-

ED Triage

People who arrive in ED are triaged under a scheme called Manchester Triage – it classifies the magnitude of the presentation of patients from 1 to 5.  For those who are very ill and needing resuscitation they would be categorised as level 1 and very minor illness/injuries would be classified as level 5.

Phone first aims to keep EDs for emergencies only so we expect to see a drop in patients being triaged in ED for categories 3, 4 and 5.

Further information

No More Silos Action Plan – https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-no-more-silos.pdf