Thank you, Presiding Officer. I am pleased to have this opportunity to update Members on the NHS 111 pathfinder service in Wales. This is testing the practicalities of implementing a new and integrated service to help meet people’s urgent care needs.

The Welsh 111 service brings together NHS Direct Wales and GP out-of-hours call handling and triaging into a single service. It provides many opportunities to simplify access to services for patients, whilst supporting the delivery of primary care plans for Wales. The service supports patients in making the right choices about care, in the right place, at the right time.

The new 111 service provides health advice and urgent care support through a free-to-call telephone service. This directs patients to the most clinically appropriate service for their needs. This should allow patients to be treated closer to home, whereas, too often in the past, this would have been in an emergency department, which is not always the right place for their care.

The Welsh 111 model was launched in Abertawe Bro Morgannwg University Local Health Board in October last year, and extended to Carmarthenshire in May 2017, this year. We’ve already received positive feedback from local clinicians, operational staff and, more importantly, the public who have made use of the service.

The 111 service in Wales differs from other UK models. We have a far greater proportion of clinical staff within our service than significant areas of England, for example. The 111 pathfinders in ABM and Carmarthenshire demonstrate that the service can support the assessment, direction and management of patients more effectively, using a range of healthcare professionals in a clinical support hub. That hub utilises the skills of experienced GPs, nurses and pharmacists, working within a clinical contact centre, and the hub is operational during the peak periods of out-of-hours demand. The GP within the hub has both a direct clinical role in dealing with complex calls, and crucially they also act as a supervisor, overseeing and managing queues. They also act as a resource for the wider unscheduled care system, for example, paramedics and nursing homes have a direct line in to 111 and there have been tangible benefits.

Between 4 October last year, when we launched the service, and 30 April this year the service within ABM has dealt with more than 73,000 calls. Access to the service since launch has been good and the feedback from patients, particularly via social media, has been positive. I am also pleased to say that locally within ABM and Carmarthenshire the in-hours GP services and emergency department staff have been positive about the service, and importantly there are no significant patient safety issues.

We’ve commissioned a formal evaluation from the Public and Corporate Economic Consultants unit in association with the University of Sheffield, and that report is expected in late July. That report, together with the valuable information gleaned by those delivering the 111 pathfinder, will help us to identify issues that need to be resolved prior to any final decision being made about the pace and timing of an all-Wales roll-out. When we launched the pathfinder in Wales we wanted to build on the good practices and initiatives that were already taking place, whilst learning lessons from similar services in England and Scotland. We want to ensure that we have a clinically safe and robust service in Wales. Adopting the pathfinder approach with some caution will ensure that lessons from the evaluation can be incorporated, and take on board advice from clinicians and patients. These can then be built into the design of our permanent model.

I recognise that there is more still to do if we are to implement a national service to support the people of Wales using prudent healthcare principles. I have therefore asked the 111 programme board to provide me with a robust plan by autumn this year for taking the service forward. I expect that plan to set out options for how the 111 service could operate post pathfinder as a national service to support patients and the NHS to treat patients with urgent care needs more effectively.

I want this plan to outline the future strategic role of the 111 service and its role at the heart of our unscheduled care system here in Wales. I’ll therefore consider a number of issues, including: the potential role of the 111 service as a single point of access for non-emergency health services, and the potential to integrate other healthcare inquiries into 111 in the longer term; agreeing how expanding the range of specialists employed within the clinical support hub could better support patients with complex and specific conditions, for example, paediatric diabetes and mental health; to quantify the resources required to deliver the service on both an interim and a longer term basis; the opportunities and economies of scale and other benefits that may be presented by the co-location of 111 clinical support hubs with the Welsh Ambulance Services NHS Trust’s clinical contact centres; the potential to expand the opening times for the hub to provide greater resilience and support to other areas of the NHS; and the development of a nationally agreed and managed directory of services, along with an IT digital platform allowing Skype calls for transforming the way that patients and professionals interact.

In conclusion, though, I am very pleased with the progress that has been made to date, which I have seen for myself on a visit earlier this year, and I want to acknowledge the hard work of the 111 team centrally, but in particular the clinicians and operational staff who are making this work and making it a successful pilot to date. The 111 pathfinder service has been a success so far. Lessons are already being learnt and considered as plans are developed for the future roll-out. A number of big decisions do, though, still need to be made, but I have made it clear that this is about doing it right, not necessarily doing it quickly. I believe that 111 will provide us with significant opportunities to enable patients to receive the most appropriate service for their care needs, at the right time and in the right place.