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Feature Technology in Healthcare

The apps attempting to transfer NHS 111 online

BMJ 2018; 360 doi: (Published 15 January 2018) Cite this as: BMJ 2018;360:k156
  1. Stephen Armstrong, freelance journalist, London, UK
  1. stephen.armstrong{at}

Four regional pilots are spearheading NHS England’s plans to move 30% of callers to apps and websites—are they effective and safe, asks Stephen Armstrong

A symptom checker chatbot app aimed at triaging primary care patients in north west London hit the headlines at the end of 2017, when it emerged that patients planned to game the system in order to secure appointments more quickly.1

The story about the app, and its controversial producer Babylon Health (see box), caused confusion by suggesting that it was the same app being trialled as an alternative to the NHS 111 telemedicine number, also made by Babylon and being tested in north London.

The controversy therefore somewhat obscured the drive to put developing NHS 111–including digital access—at the heart of attempts to reduce the growth in demand on hospital emergency departments. This includes NHS England regional pilots—launched in January 2017—of four NHS 111 apps, just one of which (in North Central London) was through Babylon.

The diverter

NHS England estimates that between 1.5 and three million people who attend emergency departments each year “could have their needs addressed in other parts of the urgent care system.”2 NHS 111 is the diverter. The number of people calling NHS 111 who receive clinical assessment during the call will increase by a third by March3 so that only patients who genuinely need to attend emergency departments or use the ambulance service are advised to do so.

At the same time, according to NHS England’s plan,2 the next two years should see the NHS roll out enhanced triage across urgent care services, urgent treatment centres, care homes, and ambulance services. General practice out-of-hours and NHS 111 services will increasingly be combined, and by 2019, NHS 111 will be able to book people into urgent face-to-face appointments.4 …

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