Delivering enhanced safety, productivity and experience: early results from a frequent caller management system

Patients are increasingly resorting to emergency or acute services provided by the NHS (NHS England, 2013). At best, this is defended as a culture of misguided or ill-informed patients inappropriately using easily accessible services. At worst the behaviour can be described as a widespread abuse of a perceived free NHS (Kennedy and Ardagh, 2004). This phenomenon, however, is not simplistic either in cause or resolution. Understanding the behaviours, expectations and attitudes of the public when faced with a health crisis is essential to understanding why patients continue to access inappropriate services for their needs (NHS England, 2013).

Frequent callers to 999 often do so without malice and have legitimate healthcare needs; they are often vulnerable and have complexities to their individual healthcare requirements (Phillips et al, 2006). Calling 999 often results in a disproportionate response from the NHS, causing cost inefficiencies, poor patient outcome and a failure to deliver the appropriate health care for their needs (Snooks et al, 2004). It is also anticipated that by reducing acute admissions to hospital the NHS could improve patient outcome (Naylor et al, 2013) and productivity (Poteliakhoff and Thompson, 2011). Ambulance services are transforming into the gate-keepers of NHS acute services, by encouraging patients towards the most appropriate healthcare provider for their needs. As demands on the 999 system increase, it is vitally important that the NHS attempts to understand and tackle the issue of patients frequently accessing 999 for health care.