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About NHS Pathways

The pressures on ambulance services and Accident and Emergency (A&E) departments have been increasing and many of the patients that dial 999 for an ambulance or visit A&E could be treated more appropriately in primary care.

Until now urgent and emergency care has been fragmented and disconnected, as patients often don't know where they should go when they have an urgent care need that is not life threatening. This has led to inconsistencies in the responses and treatment patients receive for various reasons.

These include preventing cross referral, the need to re-triage at each step using different clinical assessment tools, patients being referred to services that do not have the skills they require or patients simply not knowing where and how they can access urgent care - as a result dialling 999.

How can NHS Pathways help?

NHS Pathways sets out to deliver a single clinical assessment tool that provides effective triage over the telephone in any setting taking calls from the public. This can include 999, NHS Direct, GP out-of-hours, NHS 111 and any other Single Point of Access (SPA) number in place.

This will ensure every patient accessing urgent and emergency care services is effectively triaged, reducing the need for them to repeat information and helping to make sure that they are directed to the right care, first time.

NHS Pathways was developed and is maintained by a group of NHS Clinicians with extensive experience of both urgent and emergency care provision, and also of clinical decision support tools. This includes GPs, nurses, paramedics and many more.

Clinical Safety has been a key part of the development process for NHS Pathways. Where possible, every clinical question and every piece of care advice is linked individually to at least three pieces of (preferably UK based) evidence and dated within the last five years.

NHS Pathways is under constant review and direction by the clinical community via the independent National Clinical Governance Group. This group is chaired by the Royal College of General Practitioners (RCGP) and is made up of representatives from those Royal Colleges with an interest in urgent and emergency care, College of Emergency Medicine (CEM), British Medical Association (BMA) and other organisations involved in the delivery of urgent and emergency care.

After extensive piloting with North East Ambulance Service, and full academic evaluation by the universities of Sheffield, Southampton and Swansea, NHS Pathways has been rolled out to four further ambulance trusts with most of the others having expressed an interest in using NHS Pathways as their primary clinical assessment tool for incoming 999 calls.

Read the full evaluation report

NHS Pathways was also awarded a ministerial licence in February 2009, becoming one of only three systems to be endorsed.

Ambulance trusts are not the only organisation where NHS Pathways can be used; multiple out–of-hours providers are also using the system. Additionally, all live NHS 111 sites have selected and use NHS Pathways to triage calls. This is contributing towards achieving the coalition government’s objective of creating a single number for urgent care.

The coalition government said in their manifesto:

"We will develop a 24/7 urgent care service in every area of England, including GP out-of-hours services, and ensure every patient can access a local GP. We will make care more accessible by introducing a single number for every kind of urgent care and by using technology to help people communicate with their doctors."

'The Coalition: Our Programme for Government' Page 25, 20th May 2010

See the deployment map showing the NHS Pathways story so far.

Find out more about How NHS Pathways works.

If you would like further information on NHS Pathways please contact the team or subscribe to the e-bulletin for news and developments