Out of Hours

Since August 2019, the contact numbers for both the GP Out of Hours Service and NHS Wales Direct have changed to 111. 

A brand new non-emergency healthcare telephone number was launched yesterday in the Aneurin Bevan University Health Board area.

The new 111 phone number replaces the current NHS Direct Wales and GP Out of Hours service numbers. Patients can call 111 for health information and advice, as well as for urgent care such as GP Out of Hours.  

The easy-to-remember Freephone number will be available 24 hours a day to signpost patients to the most appropriate treatments for them, including the Out of Hours service if necessary. The service is clinically-led, with trained call handlers working together with clinicians such as GPs, Nurses, Advanced Nurse Practitioners and Pharmacists. 

For patients who are unsure whether or not their urgent health concern is an emergency, a trained call handler can determine this following a series of questions, and can arrange an ambulance if required. The service is designed to ensure patients get the right treatment, in the right place, at the right time, relieving pressure on our busy ambulances and Emergency Departments. 

Questions and Answers

Q. What is 111 and why are you introducing it now?

The 111 service will integrate two services that are currently provided by different parts of the NHS in Wales – namely NHS Direct Wales and the GP out-of-hours service when your own surgery is closed. The introduction of a simple, free, memorable three-digit number has been planned in NHS Wales for a number of years. We know people sometimes find it hard to know which service to contact and when, so introducing a free-to-call number will make it easier not just to access urgent care, but also health information and advice if you are not sure about what to do. It will also help ensure A&E departments and emergency ambulance services are used only for those patients who need them in a life-threatening emergency.

Q. Why would I phone 111? What help can I get? Do I call this number instead of my GP or 999?
During the working week (8.00am-6.30pm, Monday to Friday), your own GP practice is available in the usual way and this will continue to be the main service that patients routinely use. There is no change in how and when you access your own GP during those hours. Some people don’t realise that, outside of these hours and on Bank Holidays, there are always GPs and other health professionals available to respond to urgent issues for patients who can’t wait until their GP practice re-opens. By linking NHS Direct Wales with GP out-of-hours, 111 Wales will be able to offer a range of health information, advice and urgent treatment when your condition or issue is urgent but not life-threatening. Remember, 999 should only ever be used when there is a life-threatening emergency. So if it is not an emergency, use 111.

Q. Who will I speak to? Will they know what they are talking about or will they just rely on computer software?
If you call 111, you will initially speak to a trained call taker. All of our call takers undergo extensive training and education and they will ask you a series of short questions and take basic details (including your name, address, date of birth and so on) so that health care professionals such as doctors and nurses can focus on the clinical assessment. This will help us prioritise the urgency of calls so that the sickest people get treated first.

Q. Will I get the help I need straight away or a call back/doctor’s appointment/ambulance?
Depending on the urgency and severity of your call, you may speak to a health care professional, who could be a nurse, pharmacist or a doctor. Sometimes it may be necessary for you to speak to more than one person to get the right treatment but we will keep this to an absolute minimum so you get to speak with the right health care professional first time. If your need is urgent and requires you to see a GP out-of-hours, you will be asked to attend a primary care centre based at our hospital sites, as is the case currently. However, for the majority of conditions, our highly skilled nurses or pharmacists will be able to deal with many cases. Our call takers are trained to recognise when there is a threat to life; if you dial 111 but do need an ambulance, you will be put through to the emergency ambulance service.

Q. What are the benefits to patients and what are the benefits to the NHS?
The main benefit to patients is that for the first time, you will have access to a range of services by dialing a single free-to-call number that will make it easier for you to get the right service. This supports the wider campaign encouraging patients to ‘Choose Well’ and helps to keep our emergency departments (EDs, or also known as A&E) and 999 service for those who really need them. The other benefit is that sometimes patients think EDs are the only place available, especially at night or weekends. Ringing 111 will help to signpost patients to the right place.

Q. I live in the Aneurin Bevan University Health Board area, but every time I try and ring the 111 number from my mobile, I’m being told that the service isn’t available in my area. Why is that?
If the ‘Wi-Fi Calling’ feature is enabled on your mobile phone, it could be interfering with your location when trying to ring the 111 service. You will need to turn off Wi-Fi Calling before dialing, to ensure that we can determine your correct location. To turn off Wi-Fi Calling, you’ll need to change the settings in your phone. The process is slightly different for each phone, so please contact your service provider for help on how to do this.

Q. Will I be able to talk to someone in Welsh if I want to?
Yes, the first message that you will hear when dialing 111 asks you to make a choice about whether you want to continue the call in English or in Welsh. NHS 111 employs a number of Welsh speakers, so you will usually be able to conduct the initial discussion in Welsh. There may be occasions where this is not possible, but we will always endeavour to meet your preference, and with additional staff coming into the service, we hope these occasions will be very rare.

Q. I live outside of Wales but I may need to contact the service on behalf of a relative who lives in the ABUHB area. What do I do?
If you ring 111 from outside of Wales, you will be routed to your local 111 service, which will be unable to transfer your call to a 111 Wales centre. In these circumstances, please ring your relative’s GP Practice and follow the instructions on the answerphone message.

Q. I live in the ABUHB area but work in Cardiff. What happens if I wanted to ring 111 whilst at work?
As the 111 service isn’t yet available in the Cwm Taf/ Cardiff & Vale Health Board areas, you should ring your GP, which will provide you with an alternative number to call (if it was outside the Monday to Friday, 8:00-18:30 window).

Q. What happens if I don’t speak English or Welsh?
If you don’t speak English, we will still be able to help you. We use a service called ‘Language Line’ and this enables us to have a three-way phone call with an interpreter so that we can still provide the help that you need.

Q. What happens if I am deaf?
The InterpreterNow service, which is available 7 days a week, between 8am and midnight, is available for deaf (and hearing) British Sign Language [BSL] users to communicate with hearing people via an online BSL interpreter. InterpreterNow can be accessed using a computer, or via the InterpreterNow app on your smartphone or tablet. Once you have contacted the InterpreterNow service, the interpreter will contact us by telephone and relay your conversation with a member of our team e.g. a Nurse Advisor or a Health Information Adviser, depending on what the problem is. You will be asked a series of questions to assess your needs, and then will be provided with the appropriate healthcare advice or directed to the local service that can help you best.

Q. Where is the money for this coming from?
Welsh Government has funded the implementation and set-up costs for the first few 111 pilot sites in Wales. Each Health Board in Wales is now directly contributing to the implementation costs of 111 and further roll-outs across Wales, but overall this represents a direct increase in funding to 111, NHS Direct and out-of-hours services for Welsh patients.

Q. Is there a website available?
The current NHS Direct Wales website at www.nhsdirect.wales.nhs.uk is available. This provides information on local services, as well as comprehensive information on health issues. There are also ‘symptom checkers’ on a range of common health problems.

Q. Where is the call centre based? Why are we ringing a 111 call centre rather than the local out of hours services where they understand the local community and local services?
111 Wales has call centres in Cwmbran, Swansea, Bangor and Haverfordwest. Each of these have access to a directory of local services and will be able to give you the same level of care and advice. NHS 111 Wales is also ensuring ongoing training and development for staff to familiarise themselves with each area that forms part of the NHS 111 service, and they already have experience of doing this in a number of Health Board areas. The out of hours services will continue to provide local care when needed.

Q. Who runs the 111 phone line?
NHS 111 in Wales is run by the Welsh Ambulance Service NHS Trust.

Q. I have heard that 111 leads to an increase in the number of referrals to ambulance services. Is this the case?
NHS 111 Wales already has significant experience of providing 111 services in Swansea, Bridgend, Neath Port Talbot, Carmarthenshire, Powys, Pembrokeshire and Ceredigion, and this has not led to an increased demand on ambulance services.

Q. What do local GPs think of the changeover? Do they support it?
Local GPs have been actively involved in designing the service and quite a few have worked directly within the Clinical Support Hub. We maintain close links with primary care teams and to date there have been no concerns raised by GPs about the 111 Wales service.

Q. Who do I complain to if I have a concern about 111 and my out of hours care?
If you have a concern about the service received from 111, please contact the Welsh Ambulance Services NHS Trust Putting Things Right team at www.was-tr.wales.nhs.uk/Default.aspx?pageId=20
or by calling 0300 321 321 1.

If you have a concern about the service received from Aneurin Bevan University Health Board GP Out of Hours Service, please contact the Aneurin Bevan University Health Board Putting Things Right Team at www.wales.nhs.uk/sitesplus/866/page/87012 or by calling 01495 745656.

The Community Health Council (CHC) exists to represent and protect public interests in NHS services by monitoring the quality of care, seeking redress where appropriate and acting as a source of information for local people. They are available to advise and provide assistance to anyone with a suggestion or concern about the health service.