The NHS non-emergency helpline is sending an increasing number of people to emergency services, raising concerns about extra strain on A&E departments.

%image(14887012, type="article-full", alt="Prof John Appleby, from thinktank the Nuffield Trust, said: Its a concern that the proportion of callers sent to A&E and ambulances is growing all the time." Picture: DOMINIC LIPINSKI/PA IMAGES")

Figures from NHS England show the service covering Barking, Havering and Redbridge sent 54,507 people to A&E in the 2017-18 financial year, 23pc of all callers up from 19pc in 2014-15, the first year of full service for 111.

NHS 111 is a 24-hour helpline for patients who need medical help but do not need to call 999.

The service has become increasingly popular with Barking, Havering and Redbridge NHS 111 handling 232,878 calls in 2017-18, up from 202,567 in 2014-2015.

It referred 56pc of these to GP surgeries, pharmacies and dentist’s.

The service is commissioned by clinical commissioning groups (CCGs), which decide local health service spending.

The helplines are run by ambulance trusts, GP surgeries and private healthcare companies.

NHS 111 replaced NHS Direct, which employed nurses and other clinical staff, in 2014. Now, most calls are dealt with by staff with no clinical background working to a script, although around a fifth are referred to nurses or paramedics.

Prof John Appleby, Nuffield Trust chief economist and director of research, said in a report: “It’s a concern that the proportion of callers sent to A&E and ambulances is growing all the time; but surveys of callers appear to show that even higher numbers would have opted for these emergency services if they hadn’t been able to ring 111.”

“Different areas are sending varying numbers of callers to ambulances and A&E, and it would be worth NHS England or the Department of Health investigating this.”

But Shelagh Smith, interim chief operating officer, Barking, Havering and Redbridge University Hospitals NHS Trust said: “111 is an important service for our community to help signpost people to getting the right care, in the right place.

“We have, and will continue to promote 111 as a key part of the overall NHS service. It’s crucial that we continue to change the mindset and culture of people who might otherwise just come to our emergency departments, which we need to avoid.

“At the same time, it’s really important that 111 services have the right level of clinical expertise to advise people appropriately. As a partner in the broader health system, we know this is a top priority.”

Commenting on the national picture, an NHS England spokesman said: “This year more than 16 million people called NHS 111, the highest number ever and, despite this 30pc increase, just two in 10 patients were recommended to visit A&E or sent an ambulance.

“Currently, half of callers to NHS 111 get clinical advice and as this number continues to increase, even more people will be able to get the care they need over the phone rather than visiting a GP or A&E in person.”

Barking, Havering and Redbridge CCGs declined to comment.