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A series of interlinked algorithms (pathways) its own challenges. Our IT function already had
link clinical questions and care advice. These, in plans to manage a potential call centre closure
turn, lead to accurate and timely diagnosis. Call or some other emergency – hence it had 100-plus
handlers are presented with a series of questions. encrypted laptops on standby. As we moved staff
Based on the answers, the right clinical response to remote working, these laptops were rapidly
with a specific level of care and time frame, can be deployed.
reached. Questions are in a clinical hierarchy, so
life-threatening questions are asked first, moving As the number of COVID-19 positive cases
on to questions about less-urgent symptoms. increased, it was inevitable members of our team
would contract the virus. Despite implementing
ARLY in the pandemic, all non-essential tasks various COVID-19 safety measures with Public
were halted. The COVID-19 National Response Health England, a cluster of positive cases at one of
EService began taking 111 calls from around our call centres sparked immediate action.
the nation to ease pressure on local call centres. If, for any reason, a call centre comes off-line,
Updates to the Pathways algorithm, previously
revised every few months, soon appeared with The PM:
increasing regularity. The algorithm was rapidly regular briefs
developed to reflect increasing knowledge of
COVID-19. Throughout this time, the “day job”
of receiving calls on a multitude of conditions
continued, but with many face-to-face services
suspended.
Before the pandemic, the licence for managing
a 111 service dictated staff must be based in call
centres. This became more and more problematic.
We needed to find more space as we recruited staff
and socially distanced our teams. activity is re-routed across the national network.
In this case, arrangements were made with NHS
The generosity of local organisations to give up England to close our call centre for 24 hours for
office space for training was overwhelming. But deep cleaning.
finding additional call centre accommodation
would take time: leases needed to be signed, Time was allocated at the local COVID-19 testing
telecoms arranged, working hubs created from centre for everyone to be tested. Within six hours,
scratch. test appointments were organised for all staff,
trainers, contractors and visitors who had come
While this work continued, there was a sea-change. to the call centre in the preceding weeks. This, in
Pathways approved remote working; staff could turn, prompted tests on staff at each of our other
(temporarily) work from home. This presented centres. Some used existing testing stations while
others called in the army to undertake swabbing
and ensure results were returned within 24 hours,
allowing work to continue.
At the time of writing, the first wave of this
pandemic has slowed. Call volumes were returning
to pre-pandemic levels. Social distancing and all
the processes put in place to keep call centres and
staff safe remained in place: temperature checks at
entry points, cleaning down equipment, screened
cubicles, increased testing and risk assessments.
We have learned a lot from the first wave and our
800,000 calls to 111 dealt with dedicated team is diligently preparing for whatever
any subsequent wave may throw at us.
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