NHS 111: User-centred design to ease urgent care pressure

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Covid-19 created a perfect storm for urgent care. Overcrowded waiting rooms became infection risks, and already-stretched services were pushed to breaking point. NHS systems across the South West needed to act fast - redesigning access to care to reduce pressure and keep people safe.

Healthier Together worked with Healthia to test and refine a new model: encouraging people to call NHS 111 before walking into urgent care. The aim? Divert unnecessary footfall, improve safety, and match people to the right care, first time.

The project won a Global Award for Excellence at the Quirks Healthcare Awards - competing with work from GlaxoSmithKline, Nutricia, Unanimous AI and others.
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What we did

We worked as one blended team - researchers, service designers, NHS staff and frontline clinicians - to prototype and test how 111 could work as a first port of call for urgent care.

• We designed realistic storyboards and scenarios to simulate new user journeys
• We explored people’s reactions, expectations and likely behaviours at each step
• We tested responses to campaign messages for posters, leaflets and social media
• We co-designed solutions with clinical, operational and reception staff
• We used rapid cycles of insight, prioritisation and iteration to keep momentum

Healthia’s approach focused on real-world behaviour and emotional drivers - not abstract user journeys.
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What we found

Urgent care access wasn’t just a logistical problem. It was a behavioural one.

• People didn’t know when or why to call 111
• Many assumed 111 was a “call centre” - not a route to local care
• There were low levels of trust and awareness, especially in underserved communities
• The system felt impersonal, complex and hard to navigate - especially under stress
• Frontline staff wanted change, but needed support to deliver it
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What changed

The insight we generated fed into strategic, operational and cultural change:

• 70% reduction in ED footfall after calling 111
  A pilot scheme introduced clinical triage into 111 calls, replacing algorithms with real people. Patients were better supported, and unnecessary A&E visits dropped.
• Business case for community navigators
  Our findings fed into a proposal for local NHS representatives to help people access care - building trust, understanding and uptake at a grassroots level.
• Investment in user-centred design
  The project inspired investment in regional user experience capability - embedding UCD practice across the South West and supporting long-term cultural change.
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“This project has enabled us to bring the voice of patients and service users to life. The findings have been taken on board at all levels of the organisation and have shaped how we approach communications, messaging, and future plans for the service.”
- Alex Ward-Booth, Head of Insight & Engagement, BNSSG CCG ICS