Who provides the GP Out of Hours Service for Powys?

• Shropdoc provides the GP Out of Hours service for the majority of Powys. This will continue to be the case after the new 111 telephone number is implemented from 3 October 2018.
• Abertawe Bro Morgannwg University Health Board provides the GP Out of Hours service for the Ystradgynlais area. The 111 telephone number is already in place in the Ystradgynlais area.

What is 111 and why are you introducing it now?

• The 111 service will join up two services that are currently provided by different parts of the NHS in Wales – namely NHS Direct Wales and the GP out-of-hours service when your own surgery is closed.
• The introduction of a simple, free, memorable three-digit number has been planned in NHS Wales for a number of years. We know people sometimes find it hard to know which service to contact and when, so introducing a free-to-call number will make it easier not just to access urgent care but also health information and advice if you are not sure about what to do. It will also help ensure A&E departments and emergency ambulance service are used only for those patients who need them in a life-threatening emergency.

Why would I phone 111? What help can I get? Do I call this number instead of my GP or 999?

• 111 is available 24 hours a day and is there to provide advice if you are unsure which health service you need, or if you require general health advice or information.
• By linking NHS Direct Wales with GP out-of-hours, 111 Wales will be able to offer a range of health information, advice and urgent treatment when your condition or issue is urgent but not life-threatening.
• Remember, 999 should only ever be used when there is a life-threatening emergency. So if it is not an emergency, use 111.
• During the working week (8.00am-6.30pm, Monday to Friday), your own GP practice is available in the usual way and this will continue to be the main service that patients routinely use. There is no change in how and when you access your own GP during those hours.
• Outside of these hours including Bank Holidays, 111 Wales is your new way to get in touch with GPs and other health professionals who are available to respond to urgent issues for patients who can’t wait until their GP practice re-opens.

Who will I speak to? Will they know what they are talking about or will they just rely on computer software?

• If you call 111, you will initially speak to a trained call taker. All of their call takers undergo extensive training and education and they will ask you a series of short questions and take basic details (including your name, address, date of birth and so on) so that health care professionals such as doctors and nurses can focus on the clinical assessment.
• This will help 111 to prioritise the urgency of calls so that the sickest people get treated first.
• If 111 assess that you need to talk to your GP Out of Hours service they will transfer your details to Abertawe Bro Morgannwg University Health Board (Ystradgynlais area) or Shropdoc (rest of Powys) which are the local providers of GP Out of Hours services.

Will I get the help I need straight away or a call back/doctor’s appointment/ambulance?

• Depending on the urgency and severity of your call, you may speak to a health care professional, who could be a nurse, pharmacist or a doctor.
• Sometimes it may be necessary for you to speak to more than one person to get the right treatment but we will keep this to an absolute minimum so you get to speak with the right health care professional first time.
• If your need is urgent and requires you to see a GP out-of-hours, you will be asked to attend a primary care centre based at one of our hospital sites, as is the case currently. However, for the majority of conditions, our highly skilled nurses or pharmacists will be able to deal with many cases over the phone.
• Our call takers are trained to recognise when there is a threat to life; if you dial 111 but do need an ambulance, you will be put through to the emergency ambulance service.

Is the whole GP out-of-hours service transferring to NHS 111?

• No, only the call handling and initial clinical assessment formerly undertaken by the out-of-hours services will transfer to 111.
• Face-to-face appointments, GP telephone consultations and mobile visits will continue to be provided by the local out-of-hours provider - Shropdoc (in most of Powys) or Abertawe Bro Morgannwg University Health Board (in the Ystradgynlais area).

What will happen if I forget to call NHS 111 and I call the Shropdoc number instead?

• You do not need to worry about remembering the new number. If you call the current Shropdoc number, you will hear a message advising you who to call.

What will happen if I call my GP practice out of hours?

• If you call your GP practice outside normal opening hours, you will hear a message directing you to call the NHS 111 service. If you call within normal opening hours, you will be able to speak to practice receptionists as normal.

Will I be able to talk to someone in Welsh if I want to?

• Yes, the first message that you will hear when dialling 111 asks you to make a choice about whether you want to continue the call in English or in Welsh. The service employs a number of Welsh speakers, so you will usually be able to conduct the initial discussion in Welsh. There may be occasions where this is not possible, but we will always endeavour to meet your preference and with additional staff coming into the service we hope these occasions will be very rare.

What happens if I don’t speak English or Welsh?

• If you don’t speak English, we will still be able to help you. We use a service called ‘Language Line’ and this enables us to have a three-way phone call with an interpreter so that we can still provide the help that you need.Q. What happens if I am deaf?
• If you are deaf and use Type Talk, you will still be able to use the service in Wales. The number is 18001 111. In addition, 111 Wales is currently working with the British Deaf Association (BDA) in Wales to pilot an interpreter service to improve services for deaf service users including thinking about how to maximise new technology. A further update will be available in the autumn once the pilot has been evaluated.

Is there a website available?

• The NHS Direct Wales website at www.nhsdirect.wales.nhs.uk provides information on local services, as well as comprehensive information on health issues. There are also ‘symptom checkers’ on a range of common health problems.

 I live on the border between England and Wales. Which service should I contact?

• If you live in Wales near the border with England, and you ring 111, you may be asked to select the service you wish to contact: Wales or England. Choose NHS 111 Wales and they will ensure you receive the health information and advice you are seeking. If you live in Wales and you are registered with a GP in England there may be circumstances in which NHS 111 Wales refers you to a service in England if this is the right service for you.
• If you live in England near the border with Wales, and you ring 111, you may be asked to select the service you wish to contact: England or Wales. Choose NHS 111 England and they will ensure you receive the health information and advice you are seeking. If you live in England and you are registered with a GP in Wales there may be circumstances in which NHS 111 England refers you to a service in Wales if this is the right service for you.

Who runs the 111 phone line?

• NHS 111 in Wales is run by the Welsh Ambulance Services NHS Trust.
• NHS 111 may refer you to the GP Out of Hours Services if you need GP medical advice that cannot wait until your GP is next open. The GP Out of Hour Service is provided by Shropdoc for the majority of Powys, and by Abertawe Bro Morgannwg University Health Board for the Ystradgynlais area.

I have heard that 111 leads to increase in the number of referrals to ambulance services. Is this the case?

• NHS 111 Wales already has significant experience of providing 111 services in Swansea, Bridgend, Neath Port Talbot and Carmarthenshire and this has not led to an increased demand on ambulance services.

Where is the call centre based?

• The NHS 111 Call Centres for Wales are currently based in Swansea, Cwmbran and Bangor. In support of the roll out of NHS 111 in Powys, a comprehensive database of local services – a Directory Of Services – has been developed to ensure people are directed to the most appropriate service. NHS 111 Wales is also ensuring ongoing training and development for staff to familiarise themselves with each area that forms part of the NHS 111 service. They already have experience of doing this for Swansea, Neath Port Talbot, Bridgend, Carmarthenshire and Ystradgynlais.

Who do I complain to if I have a concern about 111 and my out of hours care?

• If you have a concern about the service received from 111 please contact the Welsh Ambulance Services NHS Trust Putting Things Right team at http://www.was-tr.wales.nhs.uk/Default.aspx?pageId=20 or by calling 0300 321 321 1
• If you have a concern about the service received from the Shropdoc GP Out of Hours Services please contact the Shropdoc Patient Advice and Liaison Service at https://shropdoc.org.uk/patient-services/patient-feedback or by calling 01743 454900
• If you have a concern about the service received from Abertawe Bro Morgannwg University Health Board GP Out of Hours Service (in the Ystradgynlais area) please contact the Abertawe Bro Morgannwg University Health Board Putting Things Right Team at www.wales.nhs.uk/sitesplus/863/page/59105 or by calling 01639 683363
• If you live in Powys and you are not sure who to raise your concerns with about 111 and GP Out of Hours Services, please contact the Powys Teaching Health Board Putting Things Right team at powysthb.wales.nhs.uk/complaints or on 01874 712697.
• The Community Health Council (CHC) exists to represent and protect public interests in NHS services by monitoring the quality of care, seeking redress where appropriate and acting as a source of information for local people. They are available to advise and provide assistance to anyone with a suggestion or concern about the health service.

Your local CHC can be contacted as follows:

Powys Community Health Council (South Powys residents)
1st Floor, Neuadd Brycheiniog, Cambrian Way, Brecon, Powys LD3 7HR
Tel: 01874 624206
Email: enquiries.powyschc@waleschc.org.uk

Powys Community Health Council (North Powys residents)
Ladywell House, Newtown, Powys SY16 1JB
Tel 01686 627632
Email: enquiries.powyschc@waleschc.org.uk