NHS Pathways

NHS Pathways evolved following reports by the National Audit Office (NAO) into the inconsistency of 'hear and treat' statistics across the ambulance services of the United Kingdom. In June 2011 it was approved by the NAO "as a way to make substantial savings and improve efficiency in ambulance services."^[8] Its development was intended to coincide with – and be integrated into – the growth of the new non-emergency healthcare system NHS 111.^[9] By October 2011, the Department of Health announced plans to extend NHS 111 – and Pathways – across the UK by 2013 to replace NHS Direct.^[10] Its role in emergency medicience received media coverage from the BBC that focused on the hope that it would reduce unnecessary ambulance dispatches as an improvement on the existing AMPDS or criteria-based dispatch systems. The North East Ambulance Service, already using NHS Pathways, declared that it reduced such call outs by 2,000 per month.^[11] Using an attached capacity management system (CMS) NHS Pathways can analyse the medical services local to each caller, and thus direct the patient to nearby minor injury units or doctor's surgeries depending on the presenting condition. The NHS launched Pathways with the example of an adult female with an arm laceration who – upon being triaged by NHS Pathways via NHS 111 – was directed to a minor injuries unit one mile from her home that was identified by the CMS function of NHS Pathways as being suitable. In theory, any patient with any medical condition can contact any telephone-based medical care provider (999, NHS 111, out-of-hours GP) and be directed to any care pathway, be it ambulance, doctor, nurse, or emergency department, using one system.^[12] In June 2020 it was reported that NHS Pathways had made more than 300,000 referrals since its launch and that its algorithms had been updated to reflect the need for patients with COVID-19 symptoms to be referred to the NHS 111 Covid Clinical Assessment Service. This in turn also ensured that patients with non-COVID-19 symptoms, where clinically appropriate, could be referred the Community Pharmacist Consultation Service (CPCS).^[13] In August 2020, it emerged that NHS111 online experienced record usage with more than 30 million users visiting NHS111 online between 26 February and 11 August 2020, due to the Covid pandemic. Its newly introduced dashboard, based on the volume of triages going through NHS Pathways, proved itself as a valuable indicator for getting early warnings about potential local outbreaks. NHS111 online became a reliable and trusted source of NHS and government guidance on the pandemic, also connecting the public to additional digital services related to coronavirus, such as the issue of isolation notes or sending text messages to support patients who were managing their illness at home.^[14] In October 2021, having dealt with almost 20,000 suspected cardiac arrest patients, it emerged that NHS Pathways was well equipped to identify cardiac arrests and escalating priority of ambulance response, as well as instructing and supporting members of the public in administering CPR successfully, considerably increasing the patient's chance of survival.^[15]

• "NHS Pathways - Integrating Urgent and Emergency Care" (Press release). National Health Service Clinical Directorate. 10 May 2011. Retrieved 6 June 2013.