Factcheck: NHS 111 isn't referring triple the number of patients to GPs and A&Es

"Referrals from NHS 111 to A&E increased from just under 400,000 calls in 2013 to over a million in 2014. Similarly, referrals to GPs went up from just under 3 million to 8 million between 2013 and 2014." — BBC News, 4 February 2014

News that the NHS 111 phoneline has been sending triple the number of patients to GPs and to A&E might seem to offer an explanation to recent pressures on the NHS. But it's not true.

The story is based on a press release from the British Medical Association (BMA). The time periods referred to in the release were incorrect, and this
meant the size of the increase was overstated. The BMA have said the error was caused by misleading labelling in the original data published by NHS England. They've also issued a second press release which no longer contains the error.

The correct figures show the number of people directed to GPs and A&E doubled rather than tripled, but even this comparison might be misleading without the full context. The number of calls handled also doubled in the same time period—in part because the 111 service was in the process of being rolled out at the time.

The error

Data published by NHS England on 111 calls includes a table labelled 'YTDdata'. YTD usually stands for 'year to date'. So you could be excused for thinking YTD data for October 2013 would give you information on calls from January to October that year.

But that's not the case. The table actually covered all callers since the service began its pilot in August 2010, right the way up to October 2013. Those calls resulted in about 3 million people being directed to a GP surgery.

These calls were then compared to the equivalent figure for October 2014, which came to 8 million. A jump from 3 million one year to 8 million the next would be almost a tripling when you account for some rounding up and down.

But remember - the 3 million callers up to October 2013 were already counted in the 8 million who called between August 2010 and October 2014.

So the jump was more like 3 million (over a three year period) to 5 million over a one year period.

We've told the BMA we believe they should issue a correction and pass that to the newspapers and other outlets that printed these incorrect figures. They've told us they'd be happy to do so if it's demonstrated that their figures were seriously wrong. We're pursuing this.

As 111 was rolled out across England it referred more people

It's perhaps unsurprising that there was a big jump in referrals from January-October 2013 and the same period in 2014. The 111 phone service was scheduled to replace NHS Direct by April 2013 but problems meant it wasn't fully rolled out until the end of that year.

So the increase takes in three months when the service wasn't supposed to be operating fully (from January to April 2013) and compares it to a period in 2014 when it was.

Over 9 million calls were answered in the January-October 2014 period. Of these, around half ended in the patient being directed to a GP surgery or other primary or community service* and 600,000 to A&E.

That's a doubling of the number of calls (up 106%), of referrals to GPs (up 109%) and A&Es (up 114%) compared to the same period of 2013.

So the comparison doesn't suggest that there was a big jump in the rate of referral from 111, just that it handled more people than before in roughly the same way.

*these figures don't include those referred to a pharmacy or dentist.