Article co-created by Dr Karen Wallace, Director of Clinical Partnerships & Innovation at Maximus and Sarah‑Jane Graham, NHS 111 and IUC Adviser to Maximus UK.
The NHS 10-Year Plan, released in July 2025, set out an ambitious vision for transforming our healthcare system to ensure it is “Fit for the Future”. At the heart of the plan are three key priorities: moving care from hospitals to community settings, preventing illness rather than just treating it, and realising the transformative potential of digital technology.
NHS 111 will play a pivotal role in delivering this vision, particularly in delivering care closer to home. As the ‘front door’ for the Urgent and Emergency Care (UEC) system, NHS 111 handles nearly 20 million calls annually, providing advice or directing patients to appropriate services. This position makes NHS 111 a critical enabler of the Plan when guiding patients towards safe, effective alternatives to hospital-based care within their local Place or Neighbourhood.
Significant strides have been made in developing Integrated Care Systems (ICS). Yet further work is needed to strengthen integration, streamline processes, and enable informed, collaborative decision-making amongst ICS providers that supports the Plan. To succeed, there are three opportunities for NHS 111 providers:
- Strengthening NHS 111’s connectivity across the ICS
- Empowering NHS 111 providers to directly refer into safe, connected community care pathways
- Improving data sharing amongst Health and Social Care providers to enable informed, timely decisions and personalised care
Making local care visible and accessible service directories
Connectivity across the NHS health and social care system remains a barrier to delivering genuinely integrated care. A critical foundation within Urgent and Emergency Care (UEC) is visibility of local services through the NHS Directory of Services (DoS). This directory underpins NHS 111’s ability to identify what services exist locally and guide patients towards the right care, in the right place, first time.
When accurate and up to date, DoS helps reduce delays and misdirection by improving NHS 111’s visibility of appropriate, localised community pathways.
As community services such as Integrated Neighbourhood Teams, Virtual Wards and Urgent Community Response teams continue to develop and more localised care routes emerge, the role of the DoS becomes even more critical. The success of these services relies heavily on timely and accurate updates from Integrated Care Boards (ICBs) and ICS providers regarding new services, pathways, and evolving provision. Without this consistent flow of accurate information, these services may be less visible or harder for NHS 111 to access effectively, limiting their ability to connect patients to the right care.
However, embedding pathways into the DoS is only part of the solution. True integration goes beyond adding information; it requires providers to collaborate and integrate systems to transform isolated pathways into a connected ecosystem that delivers seamless care across ICS boundaries. While the DoS improves visibility, access still depends on referral capability, operational readiness and local integration. This is why NHS 111 providers must collaborate closely with community services to ensure the referrals received are seamless and appropriate, taking learning supported by regular audits, and effective feedback loops to drive continuous improvement and best practice across the ICS. This ensures that NHS 111 colleagues can confidently select the “top of the DoS” option which delivers the most appropriate, prioritised care pathway, helping meet patient needs as close to home as possible.
Empowering NHS 111 teams to deliver the right care, first time
While DoS determines where care should be delivered, NHS 111 providers rely on Clinical Decision Support Systems (CDSS) to determine what care is needed and how urgent it is. Cautious by design, CDSS guides NHS 111 Health Advisors (HAs) and Clinical Advisors (CAs) through structured assessment to ensure decisions are consistent and safe.
When combined with data access, information sharing and stronger connectivity with local services, clinical judgement is strengthened – supporting more personalised, context aware urgent care. This enables appropriate community care to be delivered safely closer to home, reducing avoidable hospital attendance and ambulance dispatch.
Training NHS 111 HAs in enhanced assessment probing techniques is essential to patient safety, accurate triage and directing callers to the most appropriate level of care. Combined with learning from successful referrals, improvement opportunities identified through regular audits, and feedback from patients and ICS providers, NHS 111 providers will have the ability to continuously improve training, skills and tools for NHS 111 colleagues whilst enabling ICBs and ICS providers to collaboratively refine localised clinical pathways to meet patient demand.
Collectively, these actions help optimise patient outcomes and strengthen technical system interfaces and interoperability. This will build stronger clinical decision-making, increase referrals into community pathways, inform future commissioning requirements and deliver on the ‘Care Closer to Home’ strategic priority while reinforcing the NHS commitment to personalised care.
Enabling informed NHS 111 clinical decisions through better information
Informed decision-making depends on access to accurate, timely information to respond to urgent care needs safely. When NHS 111 and Integrated Urgent Care (IUC) clinicians have access to relevant patient records, medical history, and care plans, they can make safer, more confident decisions about whether a patient can be supported at home.
Progress has grown, but technical fragmentation and inconsistent information sharing still block effective collaboration across Primary Care, Secondary Care, Community Care, Social Care, and Voluntary, Community and Social Enterprise (VCSE) providers. Consistent, standardised access to patient information enables informed, personalised clinical decision-making across NHS 111 and Integrated Urgent Care services. Access to medical history, test results and medications allows clinicians to tailor advice and care pathways to the individual.
Whilst we wait for the NHS App single patient record to arrive in 2028, we must make better use of existing solutions. This includes wider use of GP Connect, consistent adoption of shared care records, and standardised data sharing agreements are essential. Better information sharing strengthens clinical judgement, reduces unnecessary hospital referrals, and builds trust in community pathways, helping the NHS 10-Year Plan deliver on its promise of care closer to home. It’s not about more data; it’s about making every piece of relevant clinical intelligence available when decisions matter most.
Building the foundations for connected care
The foundations exist: community services are expanding, NHS 111 handles millions of patient contacts annually, and the 10-Year Plan sets the direction. However, what requires further focus and sustained commitment from all ICB and ICS providers is the continued evolution of the connective infrastructure. This includes the systems, information flows, and collaborative practices that turn isolated innovations into truly integrated pathways.
Three enablers underpin this transformation: visibility, confidence and informed decision-making. Together, they empower NHS 111 to guide patients towards receiving care closer to home, reducing unnecessary hospital visits and easing pressure on urgent care services.
As the ‘front door’ for UEC, NHS 111 can play a powerful role in delivering care closer to home but only through ICS collaboration, technology investment, and NHS 111 providers and ICS providers making a firm commitment to adopting innovative approaches and continuous improvement strategies. With these steps, NHS 111 can help realise a modern, sustainable patient-focused NHS fit for the future.
At Maximus, we help make this vision a reality. We work with partners to link services, technology, and community support into seamless, person-centred pathways. Our 24/7 contact centres manage millions of interactions, supported by AI-enabled triage and clinical oversight from over 1,800 professionals. With over 20 years’ experience, regulatory readiness – including CQC registration – and real-world AI integration, we help commissioners turn strategic ambitions into operational reality. Together, we build connected systems that deliver care where patients need it most.
Learn more about our Integrated Urgent Care services.
