ArticlePloS one2021
Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013-2017.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Triage and Diagnostic Accuracy of Online Symptom Checkers: Systematic Review.Journal of medical Internet research · 2023Pooled it
- Outcomes of a state-wide virtual emergency department in Victoria, Australia: a linked data analysis of emergency department utilisation and hospital use.The Lancet regional health. Western Pacific · 2026Article
- The Use of Triage in Primary Care in the UK: An Integrative Review and Narrative Synthesis.Journal of advanced nursing · 2026Review
- Winter all year round in urgent and emergency care: a large retrospective analysis of routinely collected NHS data across England, 2021-2022.BMC health services research · 2026Observational
- Clinical advisors at NHS 111 improve accuracy for paediatric patients and their advice is more reliably followed: a retrospective observational cohort study.Archives of disease in childhood · 2026Observational
- Emergency department attendance by callers to NHS111 who end the call prior to triage: A time-to-event-analysis.PloS one · 2026Article
- Evaluation of the performance of telephone triage service.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Safety and accuracy of digitally supported primary and secondary urgent care telephone triage in England: an observational study using routine data.BMC medical informatics and decision making · 2025Observational
- An analysis of NHS 111 demand for primary care services: A retrospective cohort study.PloS one · 2024Article
- Correction: Patient compliance with NHS 111 advice: Analysis of adult call and ED attendance data 2013-2017.PloS one · 2024Article
- Modelling NHS England 111 demand for primary care services: a discrete event simulation.BMJ open · 2023Article
- Clinician-led secondary triage in England's urgent care delivery: a cross-sectional study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Factors associated with longer wait times, admission and reattendances in older patients attending emergency departments: an analysis of linked healthcare data.Emergency medicine journal : EMJ · 2023Observational
- Use of urgent, emergency and acute care by mental health service users: A record-level cohort study.PloS one · 2023Article
- Creating a Real-World Linked Research Platform for Analyzing the Urgent and Emergency Care System.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
- Online Symptom Checkers: Recommendations for a Vignette-Based Clinical Evaluation Standard.Journal of medical Internet research · 2022Article
- Observational
- Safety of Triage Self-assessment Using a Symptom Assessment App for Walk-in Patients in the Emergency Care Setting: Observational Prospective Cross-sectional Study.JMIR mHealth and uHealth · 2022Observational
- To what extent do callers follow the advice given by a non-emergency medical helpline (NHS 111): A retrospective cohort study.PloS one · 2022Article
- Non-urgent emergency department attendances in children: a retrospective observational analysis.Emergency medicine journal : EMJ · 2022Observational
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The NHS 111 telephone advice and triage service is a vital part of the management of urgent and emergency care (UEC) services in England. Demand for NHS 111 advice has increased since its introduction in 2013, and the service is of particular importance in light of the current pandemic and resulting increased demand for emergency care. Currently, little is known about the effectiveness of NHS 111 in terms of the appropriateness of the advice given, or about the compliance of patients with that advice. We aimed to address this issue by analysing a large linked routine dataset of all NHS 111 calls (n = 3,631,069) and subsequent emergency department (ED) attendances made in the Yorkshire & Humber region from March 2013-March 2017. We found that many patients do not comply with advice, with 11% (n = 289,748) of patients attending ED when they are advised to self-care or seek primary care. We also found that a considerable number of these patients are further classed as urgent (88%, n = 255,931) and a substantial minority (37%, 106,207) are subsequently admitted to hospital. Further, many patients who are sent an ambulance or told to attend ED are classed as non-urgent upon attending ED (9%, n = 42,372). This research suggests that the level at which NHS 111 is currently triaging results in many hundreds of thousands of mis-triaged cases annually. Additionally, patients frequently do not comply with the advice they receive. This has implications for understanding the accuracy and efficiency of triaging systems.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.