THE HEALTH WATCHDOG has announced that it will explore the possibility of new telephone line to address the acute, non-urgent medical care needs of the public.

The Health Information and Quality Authority (HIQA) today published the terms of reference for a health technology assessment (HTA) of an alternative to the 112/999 national emergency phone line.

The aim of the HTA is to provide advice to the Health Minister and the HSE to support a decision on whether to provide an alternative telephone pathway.

HIQA will also assess the budget impact and organisations implications of an alternative national phone line.

An acute, non-urgent medical care need is where the investigation or intervention for an injury or illness could be safely deferred or managed in other areas of the healthcare system.

However, for people seeking healthcare it may be difficult to distinguish between medical care needs that require urgent medical attention, and those that are acute, but non-urgent.

The new phone line would involve patients with acute, non-urgent care needs calling a trained operator who would triage and redirect these patients to the appropriate healthcare services, particularly outside of normal GP hours.

HIQA said the introduction of an alternative phone line “has the potential to improve the appropriateness of ED presentation, potentially reducing unnecessary ED attendance”.

Currently, people with acute, non-urgent medical care issues can access healthcare through a number of services.

These include attending a GP during office hours or a GP out-of-hours services, a local injury unit or an emergency department, or calling 112/999 to access emergency ambulance services.

HIQA notes that when primary care services and local injury units cannot be readily accessed, people with acute, non-urgent care needs who are unable to wait either go to a hospital emergency department or call 112/999 for an emergency ambulance.

However, HIQA said this has “contributed to an increased burden on emergency services and departments”.

HIQA added that there may also be people who require care in the emergency department, but defer attending as they do not think this level of care is necessary, or because they expect long waiting times. 

A national phone service is intended to support the timely provision of care in the most appropriate setting, said HIQA.

HIQA’s Chief Scientist Dr Conor Teljeur noted that similar telephone advice and or triage healthcare services “with varying degrees of health service integration” have been implemented in several countries, including the UK, Denmark, Sweden, Australia, and Canada.

He added that it can be difficult to distinguish acute, non-urgent care needs from urgent conditions for someone requiring care.

Teljeur also remarked that there “may be overlap in terms of the symptoms experienced, and the perceived urgency for each person”.

“In many instances, there may be a number of services that could provide appropriate care rather than hospital emergency departments or an emergency ambulance,2 said Teljeur.

“An alternative telephone service would enable people to speak with a trained operator who would triage the caller and provide self-care advice or direct them to the appropriate healthcare services.”

He added that the HIQA assessment will look at the implications for service users and the healthcare system of introducing such an alternative phone line.

Meanwhile, the Irish Patients’ Association said that private health insurers have “successfully provided effective telephone nurses as part of their services for many years to almost 50% of the population.”

The IPA added that it “may be beneficial to consider outsourcing the alternative national phone line to these experienced private health insurance companies”.