Publication - Research and analysis

Health - redesign of urgent care: evaluation - technical report

Published: 15 January 2025
From: Cabinet Secretary for Health and Social Care
Directorate: Chief Operating Officer, NHS Scotland Directorate
Topic: Health and social care
ISBN: 9781836911654

Technical report to support the redesign of urgent care evaluation main report.

6 Discontinued Caller Survey Comparison between variables

Interpretation of findings: column comparisons

When comparisons are made between percentage figures from two different questions, column proportion tests were conducted, with Bonferroni adjustments applied to significance values to account for multiple comparisons. These pairwise comparisons were conducted to identify statistically significant differences in the proportions of responses for X variable across categories of Y variable at a 95% confidence level.

In the table where such comparisons are made, each column has been assigned a letter. Within each row, each column is compared with each other column. For each significant pair, the letter of the category with the smaller column proportion appears in the category with the larger column proportion. The difference is significant at the 0.05 level.

In the example on the following page below, which demonstrates action taken after discontinuing a call, by whether health concern changed there are 15 pairs of comparisons within each row: A:B, A:C, A:D, A:E, A:F, B:C, B:D, B:E, B:F, C:D, C:E, C:F, D:E, D:F and E:F. Letters are shown to indicate statistical significance. If the second row is taken as an example (i.e., “Yes, {my/their} health condition worsened”), it was found that significantly more respondents called 999 ambulance service (B) when their health condition worsened compared to those:

Calling NHS 24 111 again (A)
Going to A&E or a Minor Injuries Unit (C)
Contacting a General Practice (D)
Contacting a pharmacist, another healthcare professional or another service (E); and
Looking on NHS inform or another website for information (F).

As a result, the letters, A, C, D, E and F (as they have the smaller proportions) have been placed in column B to indicate the statistically significant differences.

Change in health concern	Called NHS 24 111 again (n = 74) A	Called 999 Ambulance Service (n = 45) B	Went to an A&E or a Minor Injuries Unit (n = 107) C		Contacted a pharmacist, another healthcare professional or another service (n = 32) E	Looked on NHS Inform or another website for information (n = 30) F
Yes, {my/their} health concern improved	27.0%	17.8%	18.7%	32.7% C	15.6%	*
Yes, {my/their} health concern worsened	37.8% DF	66.7% ACDEF	32.7% F	18.4%	25.0%	*
No, {my/their} health concern did not change	35.1% B	15.6%	48.6% B	49.0% B	59.4% AB	66.7% AB

6.1: Column proportion comparisons

Table 1: Whether NHS 24 111 was contacted first or not, by time of contact
Service contacted first	In-hours^[12] (n = 96) (A)	Out-of-hours (n = 275) (B)
NHS 24 contacted first	76.0%	88.7% A
Other service(s) contacted before 111	24.0% B	11.3%

Table 2: Length of time before discontinuing the call, by time of contact
Length of time waiting before discontinuing call to NHS 24 111	In-hours (n = 93) (A)	Out-of-hours (n = 271) (B)
Less than 10 minutes	46.2% B	29.9%
Between 10 and 30 minutes	34.4%	38.4% A
More than 30 minutes	19.4%	31.7% A

Table 3: Action taken after discontinuing the call, by time of contact
Action taken after discontinuing call	In-hours (n = 96) (A)
Called NHS 24 111 again	15.6%	21.5% A
Called 999 Ambulance Service	14.6% B	10.9%
Went to A&E or to a Minor Injuries Unit	28.1%	28.0%
Contacted a General Practice	25.0% B	8.7%
Contacted a pharmacist, another healthcare professional or another service	*	10.2% A
Looked on NHS Inform or another website for information	*	9.1% A
Nothing – I did not contact any other service	8.3%	11.6% A

Table 4: Action taken after discontinuing the call, by who the call was made for
Action taken after discontinuing call	I called 111 to get help for myself (n = 188) (A)	I called 111 to get help for a child (n = 89) (B)	I called 111 to get help for another adult (n = 110) (C)
Called NHS 24 111 again	23.4% C	21.3% C	11.8%
Called 999 Ambulance Service	9.6% B	5.6%	22.7% A B
Went to A&E or a Minor Injuries Unit	20.7%	39.3% A C	30.0% A
Contacted a General Practice	18.6% B C	6.7%	7.3%
Contacted a pharmacist, another healthcare professional or another service	9.0%	7.9%	8.2%
Looked on NHS Inform or another website for information	6.4%	11.2% A	8.2%
Nothing - I did not contact any other service	12.2% B	7.9%	11.8%

Table 5: Whether health concern changed by, action taken after discontinuing call
Change in health concern	Called NHS 24 111 again (n = 74) A	Called 999 Ambulance Service (n = 45) B	Went to an A&E or a Minor Injuries Unit (n = 107) C	Contacted a General Practice (n = 49) D	Contacted a pharmacist, another healthcare professional or another service (n = 32) E	Looked on NHS Inform or another website for information (n = 30) F
Yes, {my/their} health concern improved	27.0%	17.8%	18.7%	32.7% C	15.6%	*
Yes, {my/their} health concern worsened	37.8% DF	66.7% ACDEF	32.7% F	18.4%	25.0%	*
No, {my/their} health concern did not change	35.1% B	15.6%	48.6% B	49.0% B	59.4% AB	66.7% AB

Table 6: Action taken after discontinuing the call, by whether the respondent called any other service before NHS 24 111, or not.
Action taken after discontinuing call	Contacted NHS 24 111 first (n = 330) (A)	Contacted another service before NHS 24 111 (n = 57) (B)
Called NHS 24 111 again	19.4%	21.1% A
Called 999 Ambulance Service	12.4%	12.3%
Went to A&E or a Minor Injuries Unit	29.4% B	17.5%
Contacted a General Practice	12.4%	14.0% A
Contacted a pharmacist, another healthcare professional or another service	8.5%	8.8% A
Looked on NHS Inform or another website for information	7.9%	8.8% A
Nothing - I did not contact any other service	10.0%	17.5% A

Table 7: Action taken after discontinuing the 111 call, by overall rating of contact with urgent care service
Overall rating of urgent care experience	Called NHS 24 111 again (n = 76) A	Called 999 (n = 48) B	Went to an A&E or a Minor Injuries Unit N = 107) C	Contacted General Practice (n = 49) D	Contacted a pharmacist, another healthcare professional or another service (n = 43) E	Looked on NHS Inform or another website for information (n = 31) F	Nothing - I did not contact any other service (n = 43) G
Very poor or poor 0-3	11.8%	18.8%	13.1%	14.3%	*	19.4%	25.6%
Average (4-7)	44.7%	43.8%	62.6% A B	57.1%	69.7% A B	58.1%	58.1%
Good or very good (8-10)	43.4% C E F G	37.5% E G	24.3% E	28.6% E	*	22.6%	16.3%

Table 8: Overall rating of urgent care services, by time waited before discontinuing call.
Overall rating of urgent care experience	Less than 10 minutes (n = 133) (A)	10-30 minutes (n = 141) (B)	More than 30 minutes (n = 105) (C)
Very poor or poor (0-3)	10.5%	15.6% A	25.7% A B
Average (4-7)	49.6%	62.4% A	56.2% A
Good or very good (8-10)	39.8% B C	22.0%	18.1%

Table 9: Whether respondents would call NHS 24 111 to access urgent care if they had the same problem at the same time of day or night in the future, by time of contact
Calling NHS 24 111 again in future	In-hours (n = 91) (A)	Out-of-hours (n = 251) (B)
Yes, definitely	31.9%	43.4% A
Maybe	52.7% B	41.8%
No	15.4% B	14.7%

Table 10: Whether respondents would call NHS 24 111 to access urgent care if they had the same problem at the same time of day or night in the future, by whether they called for themselves, a child or another adult.
Calling NHS 24 111 again in future	Called 111 to get help for myself (n = 170) (A)	Called 111 to get help for a child (n = 85) (B)	Called 111 to get help for another adult (n = 101) (C)
Yes, definitely	41.8% C	45.9% C	33.7%
Maybe	45.9% B	37.6%	46.5% B
No	12.4%	16.5%	19.8% A

Table 11: Overall rating of contact with urgent care services, by who the call was made for
Overall rating of urgent care experience	Called 111 to get help for myself (n = 188) (A)	Called 111 to get help for a child (n = 89) (B)	Called 111 to get help for another adult (n = 110) (C)
Very poor or Poor (rating 0-3)	16.5% B	11.2%	20.9% B
Average (rating 4-7)	54.8%	62.9% A C	51.8%
Good or Very good (rating 8-10)	28.7%	25.8%	27.3%

Table 12: Time waited before taking further action, by action taken after discontinuing call
Time waited before taking further action	Called NHS 24 111 again (n = 71) A	Called 999 Ambulance Service (n = 48) B	Went to an A&E or a Minor Injuries Unit (n = 106) C	Contacted a General Practice (n = 47) D	Contacted a pharmacist, another healthcare professional or another service (n = 32) E	Looked on NHS Inform or another website for information (n =31) F
Less than 30 minutes	53.5%	60.4%	46.2%	55.3%	53.1%	83.9% A B C D E
Between 30 minutes and 2 hours	28.2% D	20.8%	34.9% D F	10.6%	18.8%	*
Between 2 and 4 hours	*	*	13.2%	12.8%	*	*
More than 4 hours	*	*	5.7%	21.3% A B C	* A B C	*

6.2: Crosstabulations

Table 13: Reason for discontinuing call, by length of time waited before discontinuing the call.
Reason for discontinuing call	Less than 10 minutes (n = 160)	Between 10 and 30 minutes (n = 204)	More than 30 minutes (n = 130)
It was taking too long for my call to be answered (n = 207)	23%	43%	65%
The recorded message advised me that my call would not be answered quickly (n = 90)	23%	17%	15%
The recorded message advised me to contact my General Practice (n = 47)	18%	*	*
The recorded message advised me to access the NHS Inform online service (n = 42)	8%	12%	4%
I did not understand what the recorded message was saying (n = 19)	7%	*	*
I felt frustrated by the recorded message / phone menu (n = 40)	8%	9%	6%
I decided to contact a different health service- (n = 28)	7%	5%	5%
I no longer needed help, advice, or treatment (n = 21)	8%	*	*

Table 14: Action taken after discontinuing call, by reason for contacting service
Action taken after discontinuing call	I thought this was the most suitable service for the health concern (n = 130)	I thought I would get help more quickly from this service (n = 115)	I did not know what other health service to contact (n = 46)	{my/Their} condition changed (improved or worsened) (n = 50)
I called NHS 24 111 again (n = 76)	51.3%	18.4%	11.8%	18.4%
I called 999 Ambulance service (n = 47)	*	44.7%	*	25.5%
I went to an A&E or a Minor Injuries Unit (n = 107)	45.8%	33.6%	7.5%	13.1%
I contacted a General Practice (n = 47)	29.8%	38.3%	*	*
I contacted a pharmacist, another healthcare professional or another service (n = 33)	*	48.5%	*	*
I looked on NHS Inform or another website for information (n = 31)	*	32.3%	32.3%	*

Table 15: Reported time taken to get to A&E / MIU (Answered by those who attended and A&E or MIU after discontinuing their NHS 24 call).
Service attended (A&E or Minor Injuries Unit)
I went to an Accident and Emergency (A&E) Department (n = 77)	27.3%	45.5%	19.5%	*	*
I went to a Minor Injuries Unit (n = 30)	26.7%	56.7%	16.7%	*	*

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Information

6 Discontinued Caller Survey Comparison between variables

Interpretation of findings: column comparisons

6.1: Column proportion comparisons

6.2: Crosstabulations

Contact

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