Abstract

Background
Thousands of 999 calls are made to ambulance services in England that could be resolved more appropriately by other healthcare providers. We aimed to investigate the understanding, use and experiences of older people accessing traditional emergency (999) and the new alternative NHS111 services.
Methods
Four semi-structured interviews and three focus groups were carried out with older people (aged 65 years and over), typically recruited from Age UK groups. We recruited participants of different sex, geographical location and use of 999 ambulance and/or NHS111 services. A topic guide explored the participants’ understanding, use and experience of both services. Framework analysis was carried out and a phenomenological approach adopted to emerge the decision-making processes individuals’ used in choosing to contact urgent (NHS 111) or emergency care (999).
Results
Participants reported confusion about the NHS111 service. Whilst all participants understood the purpose of the 999 emergency ambulance service, those who used NHS111 were often not clear of what the service was meant to provide. Participants were often dissatisfied with the NHS111 response because it did not meet their expectations of providing useful advice, reassurance or more frequently, to facilitate access to a doctor. Participants notably tended to consider NHS111 as an out-of-hours service that they should use when their GP surgery was closed.
Implications
Developing a greater understanding of how older people decide to contact services would support future policy and practice implementation. Research should further explore people’s decision-making when selecting 999 or NHS111.