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.
The NHS 10‑Year Health Plan sets a clear direction: shift care from hospitals to neighbourhood and community settings, accelerate digital transformation, and pivot from treating sickness to preventing ill health. Delivering this ambition depends on reaching people earlier, resolving need more effectively, and using every interaction within our Health and Social Care system to add value.
As one of the most widely used access points into the health system, NHS 111 can turn this ambition into reality. It can shift from a reactive gateway to a proactive driver of prevention, early intervention, and population health improvement.
Turning scale into meaningful impact
Every NHS 111 interaction provides a valuable opportunity to add wider benefit. By applying the Making Every Contact Count (MECC) principles, each touchpoint can go beyond resolving the immediate reason for contact by identifying unmet needs.
Applying MECC can also support better care by gathering and sharing data with Integrated Care Systems (ICS) to influence local pathways and Neighbourhood priorities, and by empowering patients and carers to self‑manage their health and wellbeing where appropriate. This focus on supporting prevention will drive better patient and system outcomes and deliver much needed future proofed sustainability.
By providing clear, trusted information and condition‑specific guidance, NHS 111 helps people recognise warning signs and manage symptoms with confidence. It also helps them understand when escalation is genuinely needed and where in the Health or Social Care system to seek support. Over time, repeated interactions using an open, proactive approach builds trust and shift behaviours, reducing unnecessary referrals and improving patient flow across Urgent and Emergency Care (UEC) pathways.
Expanding clinical capability and resolving need earlier
Within NHS 111 services and Integrated Urgent Care (IUC) models, providers can deliver enhanced, holistic clinical consultations with the ethos of ‘no decision in isolation.’ Clinical Advisors and multidisciplinary Clinical Assessment Service (CAS) colleagues can assess, advise and, where appropriate, ‘consult and complete’ the episode of care at first contact. NHS 111 providers should also adopt a ‘community‑first’ approach to reduce hand‑offs to acute services and ease system pressures. This approach improves patient safety, increases use of locally developed care pathways, and reduces avoidable Emergency Department attendance and ambulance dispatch.
Better access to shared records and relevant medical history strengthens clinical decision‑making. This enables safer, more personalised assessments that reduces duplication. Delivering this relies on workforce confidence, capacity, and sustainability. As digital tools and clinical decision support mature, investment in skills and clinical trust will become essential. This will help build a resilient, dynamic NHS 111 workforce able to intervene earlier within a preventative, digitally‑enabled system.
Proactive support for people with long‑term conditions
This evolution is vital for people with long-term health conditions, where early intervention can prevent deterioration. With 26 to 28 million people in the UK living with at least one long-term condition, and more than 13 million managing multiple conditions, there is a growing need for approaches that identify risk earlier and support people before deterioration occurs.
NHS 111 and IUC providers, working alongside community services such as Virtual Wards and Urgent Community Response Teams, could play a key role in enabling telehealth and remote monitoring. This includes using digital wearables to track personalised health thresholds such as blood pressure, oxygen saturation, respiratory rate, weight changes, peak flow, and glucose levels. When readings fall outside expected ranges, NHS 111 and IUC providers could act as an early point of identification and coordination – providing timely advice, virtual assessment, medication review, or referral. By intervening earlier, this approach helps people stay well at home, reduces deterioration and prevents unnecessary urgent care, improving outcomes for those with long-term conditions.
Using insight to target prevention
Beyond individual care, NHS 111 generates real-time intelligence on presenting need, unmet demand, trends, and emerging pressure. At scale, this insight drives a targeted population health management approach at Place and Neighbourhood level, aligning with Integrated Care System (ICS) priorities and strengthens the Core20PLUS5 approach to tackling health inequalities.
By identifying patterns in deprived communities and among high-risk groups, and combining this with wider determinants such as smoking, obesity and socioeconomic factors, NHS 111 providers can help target and implement prevention interventions.
Crucially, providers can link insight to downstream outcomes. This shows how early identification and intervention can prevent deterioration, reduce escalation, access the right care, in the right place, first time, and enhance outcomes for people most affected by inequality. This positions NHS 111 as an active contributor to prevention at system level, rather than a reactive access point.
Designing prevention that works for communities
Effective prevention relies on trust, relevance, and accessibility – factors that must be designed in, not assumed. NHS 111 providers play a key role in tailoring support to meet their population’s diverse needs. This includes considering language, culture, faith, and levels of digital confidence within underserved communities.
Digital provision or access alone is not enough. NHS 111 providers have the opportunity to work with communities to build digital confidence and health literacy. They can offer familiarisation with NHS 111 online and the NHS App through community outreach, collaboration with Voluntary, Community and Social Enterprise (VCSE) partners, and by using NHS England marketing materials to raise awareness. By supporting people to understand and use digital routes while maintaining accessible telephone channels, we can ensure digital transformation remains inclusive and does not widen inequalities.
Equally important is access to trusted, local support. By partnering with local organisations, community champions and local help hubs, NHS 111 can provide signposting to hyper localised services. These services can address wider determinants of health such as social isolation, housing, financial insecurity and employment, strengthening engagement and uptake among those most at risk of avoidable deterioration.
Enabling prevention at scale
The NHS vision for prevention and community‑based care will not be realised without MECC, and NHS 111 is uniquely placed to lead this shift. With its scale, reach and trusted role, NHS 111 can move from a reactive gateway to a proactive engine for early intervention, personalised support, and population‑level improvement.
NHS 111 can reduce avoidable escalation, improve flow and help address inequalities by combining proactive prevention with enhanced clinical capability. This capability is strengthened through direct access to community pathways, real‑time visibility of local services and improved data sharing across Integrated Care Systems. This is not just about answering calls. It is about shaping a smarter, more preventative system where better information and stronger connections across services help clinicians use insights to add value to every interaction.
The opportunity is clear: NHS 111 can be the frontline of prevention, turning strategic ambition into measurable impact for patients, communities and the wider NHS.
How Maximus is driving prevention through clinical and digital excellence
Delivering prevention at scale and improving access to care demands more than ambition. It requires clinical strength, digital innovation, workforce expertise, and deep community connections. Trusted by government, businesses, and charities, we work alongside partners to deliver flexible, scalable services that support vulnerable people and create resilient systems – moving from strategy to impact together.
We treat digital as an enabler by combining high‑quality telephone access with advanced digital channels, AI‑supported decision tools and an omnichannel service approach. The aim is to create inclusive pathways that build confidence for users and teams, with technology augmenting people rather than replacing them.
We design with communities, not just for them. By blending local engagement with data‑driven insight, we shape solutions that are locally relevant, culturally competent, and accessible. Our experience working with local and combined authorities and voluntary sector partners helps ensure designs are place‑based and scalable.
Delivery starts with confidence. Our governance frameworks, CQC readiness, compliance expertise and agile workforce solutions create stability, while connected platforms and coordinated operations bring services, technology, and communities together in unified, person‑focused journeys.
The outcome is connected systems that route people to the right support and improve experience and efficiency. At Maximus, we embed inclusivity and trust throughout design and delivery – creating systems that are connected, equitable and genuinely patient‑centred.
