The two Primary Care Trusts (PCT) make up one of the three areas trialing the NHS 111 service. County Durham and Darlington was the first to go live in August 2010 and NHS Luton will follow soon.

NHS Direct will triage incoming calls to 111 using NHS Pathways which enables a specially designed clinical assessment to be carried out by the person who answers the call. At the end of the assessment, there is an automatic search on an integrated directory of all the services around the patient to find which services are open in the right timeframe and have the right skills to help the individual.

Around 20% of callers may need to speak to another person for further advice – and they will be transferred over straightaway wherever possible. As the nurse will be using the same system there is no need to repeat the information.

East Midlands was experiencing year on year increases in 999 calls and accident and emergency attendances and estimated that 25% of calls to 999 were "neither serious nor immediately life threatening". It is hoped that the launch of 111 and the integration of NHS Pathways will allow call handlers to give patient options to suit their urgent healthcare needs more appropriately. However, if a patient requires an emergency blue light ambulance response this can be dispatched with no delay to the patient via NHS Pathways.

Early data from the Country Durham and Darlington pilot has shown a year on year DROP of 3.5% in A&E attendance since the introduction of the 111 service. This compares to a 1.5% growth in A&E attendance in the neighbouring PCT area.

All NHS organisations in East Midlands are committed to contributing to an electronic skills-based directory of services which for the first time will provide a comprehensive database to find what services are available, their location and their capacity and skill to deal with a patient’s urgent care need.

The NHS 111 number is intended to reduce confusion among patients about what number to call for urgent, non-emergency care when a 999 call is not necessary whilst reducing any unnecessary pressure on A&E and emergency services.

Up to now over 1.7 million calls have been triaged using NHS Pathways with no serious untoward incidents attributed to its use and was independently evaluated by three universities who concluded NHS Pathways as being 'safe and appropriate'

Jackie Shears, Head of NHS Pathways said: "This is great example of various NHS organisations in the East Midlands coming together and working as a team to provide a more integrated approach to urgent and emergency care.

"By working more closely together the East Midlands Ambulance Service, Primary Care Trusts, NHS Direct, NHS hospitals and independent urgent care providers can provide patients with a consistent and appropriate level of care to meet their needs."

The clinical assessment with NHS Pathways is governed by a unique committee, including representatives from all the Royal Colleges and the BMA. They decide on any enhancements to make it as effective as possible.