Phone First: Northern Ireland health trusts told to 'pause' plans to cut service

Northern Ireland's health minister has instructed trusts which have not yet stood down their Phone First service to "pause any planned cessation" of the scheme.

The telephone triage system has already been scrapped by the Belfast Trust; it was to end within weeks in the Northern Trust and is under review in the Western Trust.

Phone First is aimed at reducing unnecessary visits to hospital emergency departments (EDs) by providing advice to patients on appropriate care options.

In a statement to BBC News NI, the Department of Health (DoH) said health trusts that have not yet stood the service down will be "liaising with their external providers for an extension".

The Northern Trust's line was due to close on 27 November, but its interim chief executive, Suzanne Pullins said on Thursday that they have been told to "pause the formal withdrawal to allow for reassessment".

Pullins announced the development as she appeared before Stormont's Health Committee to answer questions about the trust's savings plans.

NI emergency departments to trial phone triage

Lagan Valley ED introduces 'phone first' service

GP telephone first system 'here to stay'

Last month, committee members had expressed concern that Phone First was being cut just as hospital EDs prepared to deal with increased winter pressures.

Pullins acknowledged those concerns on Thursday, saying the decision to stand it down was in "no way a reflection of the service" which was "very valued".

But she explained that there were "no easy choices" given the scale of the financial savings the trust had been asked to find.

Phone First costs £500,000 to run and the trust has been asked to make £53.8m in savings for this year.

The DoH statement said that the Belfast Trust had redeployed its Phone First staff "to urgent care services to secure access to Urgent and Emergency Care".

It added that all trusts are focused on supporting EDs "to ensure optimal patient flow and access to the right care in the right place at the right time and from the right clinician to meet the patient needs".

Phone First was initially introduced during the pandemic in late 2020 to reduce the risk of Covid-19 spreading among patients in crowded hospital waiting rooms.

Under the system, patients call a dedicate line before travelling to hospital to check if they really need to go to an ED or if they could be treated elsewhere

Operating in a similar manner the NHS's non-emergency 111 medical helpline in England, Scotland and Wales, it was designed to be used in urgent but not life-threatening cases - the public is still advised to always call 999 immediately if someone's life is at risk.

It was trialled in Causeway Hospital before being gradually rolled out across all five hospital trust areas.

However, it was run by five separate teams who each had different hours and different contact numbers.

Before it closed its line at the end of September, the Belfast Trust estimated that move would save it approximately £500,000.

At last month's health committee meeting, senior staff from the Belfast Trust were questioned about their decision to cut the line as winter approached.

"It's frustrating, it's not something that we wanted to do... but we felt that it was the least worst option," said Claire Corry, Director of Finance at the Belfast Trust.

Her boss, Chief Executive Jennifer Welsh, explained the projected £800m shortfall in Northern Ireland's health budget meant all trusts had been instructed to find savings that "could be delivered without causing harm to service users".

Welsh explained Phone First was scrapped in Belfast in order to prioritise other services that "we think would generate more benefit for patients and staff".

She told Northern Ireland Assembly members at the 22 October meeting that there "wasn't a huge uptake in the service" and that it "wasn't having a huge impact".

However, Northern Ireland-wide statistics show a rising trend in usage over the past six years.

The Belfast Telegraph reported that calls reached their highest ever level in the same month that Belfast Trust closed its line.

Phone First Calls (October 2020 - September 2026)

There were 18,263 calls in September, 12,098 (66%) of which resulted in patients being referred on to EDs.

It was suggested to last month's committee that because two thirds of callers end up in EDs anyway, Phone First was less effective than some other services at reducing pressures.

But committee chair Philip McGuigan, of Sinn Féin, pointed out that Phone First may have helped to keep more than 6,000 callers out of ED in September alone.

During that meeting, McGuigan secured the support of the committee to write to the DoH to ask about the future of Phone First.

Before the minister announced the pause, BBC News NI had contacted all five trusts this week to ask about the future of their telephone triage services.

The Belfast Trust said its decision to stop its Phone First was taken "in the context of the very significant financial challenge" it and the wider health service was facing.

It added "other care options are still available" and pointed patients to its Choose the Right Care webpage in cases of urgent but non-life-threatening illness or injury.

The Western Trust said its Phone First service was being "assessed against current spend and affordability" as part of its savings plan.

"No decision has been made at this time and the service continues to operate as normal," its spokesperson added.

The South Eastern Trust said its Phone First service at both the Lagan Valley and Downe hospitals "will remain unchanged".

It added that Phone First is "not required" at the Ulster Hospital because its Urgent Care Centre directs patients "to the most appropriate service when they arrive".

A spokesman for the Southern Trust told BBC News NI it has no plans to withdraw Phone First.