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Jackie Heardman Local DoS Lead
NHS Pathways
111 Directory of
Services
CCG Directory of Services (DoS)
• The DoS consists of a collection of
services, split into service types, listed
under a commissioning organisation
• Each service is profiled to include: • Demographic Info – contact details,
opening hours, call handler instructions etc
• Timeframe (Dispositions)
• Clinical Content (Symptom Groups /
Symptom Discriminators)
• Service Restrictions eg age / gender /
registered patient population
• Generally there are two main clinical
updates per year (Spring/Autumn)
111 Triage Process Telephone
Triage
Symptom Discriminator
(level of care required)
Disposition (timeframe)
Symptom Group (Presenting Problem)
Age Postcode Gender
CCG Ranking
Service Search
Outcome (returns nearest 2 of
each service type)
Service
Capacity
Services returned which match the triaged Symptom Group, Symptom Discriminator and Disposition
Opening Hours
! If no services
meet the criteria
2 nearest EDs will return
DoS Example Ranking Strategy
Highest (Pharmacy / Community)
High
(GP/OOH/WIC /MIU/UCC)
Normal
Low
(ED)
Lowest
(Council)
Pharmacy
Ranking by
CCG
Services 48
Ranking 1
Services 44
Ranking 1
Services 82
Ranking 1
Services 40
Ranking 1
Services 41
Ranking 1
Services 48
Ranking 1
Services 112
Ranking 1
Services 106
Ranking 1
Services 42
Ranking 1
Services 39
Ranking 1
Services 40
Ranking 1
Services 25
Ranking 1
Services 49
Ranking 1
Services 31
Ranking 1
Services 39
Ranking 1
Services 121
Ranking 1
Services 52
Ranking 1
Services 53
Ranking 1
Services 61
Ranking 1
Services 53
Ranking 1
Services 45
Ranking 1
Services 38
Ranking 1
Services 30
Ranking 1
Services 41
Ranking 1
Services 67
Ranking 1
Services 57
Ranking 1
Services 63
Ranking 1
Services 39
Ranking 1
Services 53
Ranking 1
Services 25
Ranking 1
Services 58
Ranking 1
Services 85
Ranking 1
Grand Total - Active
Services1727
NHS West Lancashire
CCG
NHS Wigan Borough
CCG
NHS Wirral CCG
Pharmacy Service/Ranking by CCG
NHS Stockport CCG
NHS Tameside And
Glossop CCG
NHS Trafford CCG
NHS Warrington CCG
NHS West Cheshire
CCG
NHS Salford CCG
NHS South and Vale
Royal CCG
NHS South
Manchester CCG
NHS South Sefton CCG
NHS Southport and
Formby CCG
NHS St Helens CCG
NHS Heywood
Middleton and
Rochdale CCG
NHS Knowsley CCG
NHS Lancashire North
CCG
NHS Liverpool CCG
NHS North
Manchester CCG
NHS Oldham CCG
NHS Cumbria CCG
NHS East Lancashire
CCG
NHS Eastern Cheshire
CCG
NHS Fylde and Wyre
CCG
NHS Greater Preston
CCG
NHS Halton CCG
NHS Blackburn with
Darwen CCG
NHS Blackpool CCG
NHS Bolton CCG
NHS Bury CCG
NHS Central
Manchester CCG
NHS Chorley and
South Ribble CCG
Services 48
Ranking 1
Services 44
Ranking 1
Services 82
Ranking 1
Services 40
Ranking 1
Services 41
Ranking 1
Services 48
Ranking 1
Services 112
Ranking 1
Services 106
Ranking 1
Services 42
Ranking 1
Services 39
Ranking 1
Services 40
Ranking 1
Services 25
Ranking 1
Services 49
Ranking 1
Services 31
Ranking 1
Services 39
Ranking 1
Services 121
Ranking 1
Services 52
Ranking 1
Services 53
Ranking 1
Services 61
Ranking 1
Services 53
Ranking 1
Services 45
Ranking 1
Services 38
Ranking 1
Services 30
Ranking 1
Services 41
Ranking 1
Services 67
Ranking 1
Services 57
Ranking 1
Services 63
Ranking 1
Services 39
Ranking 1
Services 53
Ranking 1
Services 25
Ranking 1
Services 58
Ranking 1
Services 85
Ranking 1
Grand Total - Active
Services1727
NHS West Lancashire
CCG
NHS Wigan Borough
CCG
NHS Wirral CCG
Pharmacy Service/Ranking by CCG
NHS Stockport CCG
NHS Tameside And
Glossop CCG
NHS Trafford CCG
NHS Warrington CCG
NHS West Cheshire
CCG
NHS Salford CCG
NHS South and Vale
Royal CCG
NHS South
Manchester CCG
NHS South Sefton CCG
NHS Southport and
Formby CCG
NHS St Helens CCG
NHS Heywood
Middleton and
Rochdale CCG
NHS Knowsley CCG
NHS Lancashire North
CCG
NHS Liverpool CCG
NHS North
Manchester CCG
NHS Oldham CCG
NHS Cumbria CCG
NHS East Lancashire
CCG
NHS Eastern Cheshire
CCG
NHS Fylde and Wyre
CCG
NHS Greater Preston
CCG
NHS Halton CCG
NHS Blackburn with
Darwen CCG
NHS Blackpool CCG
NHS Bolton CCG
NHS Bury CCG
NHS Central
Manchester CCG
NHS Chorley and
South Ribble CCG
Ranking Strategy in
Action Patient calls 111
Primary CareIn Hours
(08.00-18.30)GP Practice
Primary CareMIU WIC UCC
Primary CareOOH
(18.30-08.00)
Telephone Triage
Primary Care Services eg Pharmacy, Dental, Optom,
Community Services
ED(24/7/365)
NW Pharmacy
Services
Symptom Groups / Symptom Discriminators
orgname
Pharmacy-
Boots UK
Blackpool
Pharmacy-
Lloyds
Bloomfield
Rd Blackpool
Pharmacy-
Sainsburys
Pharmacy
Blackpool
Pharmacy-
Bispham
Pharmacy
Blackpool
Pharmacy-
Tesco
Pharmacy
Blackpool
8.0
Pharmacy
Starter
Template
v1.10
orgtype Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist
symptom groups symptom discriminator
acne, spots and pimples - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
allergic reaction - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
athlete's foot - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
bites or stings, insect or spider - PC minor injury TRUE TRUE TRUE TRUE TRUE
ear discharge or ear wax - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
earache - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
eye, painful - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
eye, painful -
PC extended ophthalmic assessment and management
capability, minor condition (PEARS) TRUE
eye, red or irritable -
PC extended ophthalmic assessment and management
capability, minor condition (PEARS) TRUE
eye, sticky or watery -
PC extended ophthalmic assessment and management
capability, minor condition (PEARS) TRUE
eye, visual loss or disturbance -
PC extended ophthalmic assessment and management
capability, minor condition (PEARS) TRUE
eyelid problems -
PC extended ophthalmic assessment and management
capability, minor condition (PEARS) TRUE
failed contraception - PC Failed Contraception over 72 hours TRUE TRUE
failed contraception - PC failed contraception TRUE TRUE TRUE
failed contraception - PC full Primary Care assessment and prescribing capability TRUE TRUE TRUE
failed contraception - PC sexually transmitted infection TRUE TRUE
hair loss - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
head lice - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
health and social information - PC failed contraception TRUE TRUE TRUE TRUE TRUE TRUE
health and social information - PC medication enquiry TRUE
health and social information - PC pharmacy, location information TRUE TRUE TRUE TRUE TRUE TRUE
hearing problems or blocked ear - PC assessment and management capability, minor condition TRUE
itch - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
limb, cold or colour change - PC assessment and management capability, minor condition TRUE
mouth ulcers - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
nasal congestion - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
nhs pathways in house clinician - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUEpain and/or frequency passing urine - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
rectal pain, swelling, lump or itch - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
repeat prescription - PC repeat prescription, routine TRUE TRUE TRUE TRUE TRUE TRUE
repeat prescription - PC repeat prescription, urgent TRUE TRUE TRUE TRUE TRUE TRUE
scabies - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
sexual problems or concerns - PC contraception issue TRUE TRUE
tattoos, birthmarks or moles - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
toe pain or swelling - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
vaginal discharge - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
vaginal itch or soreness - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
wrist, hand or finger pain or swelling - PC assessment and management capability, minor condition TRUE TRUE TRUE TRUE TRUE TRUE
Symptom Discriminators Explained….
SDs mainly fall into 3 categories AMB, ED, PC
Primary Care SDs
• SD Full Primary Care assessment and prescribing capability
This means a practitioner with the capability to perform a full clinical assessment of Primary
Care conditions within the SG. The practitioner should be able to prescribe for and manage
the conditions and arrange investigations, admission or referral for specialist opinion if
required.
• SD Full mental health assessment and prescribing capability
This means a practitioner with the capability to perform a full clinical assessment of mental
health problems within the SG. The practitioner should be able to prescribe for and manage
conditions and arrange admission if required.
• SD Full dental assessment and prescribing capability
This means the capability to perform a full clinical assessment of dental conditions within the
SG. The practitioner should be able to prescribe for and manage dental conditions relating to
the SG and to arrange investigations, admission or referral for specialist opinion if required.
• SD Full obstetric assessment and management capability
This means a Registered Midwife or Medical Practitioner who can provide assessment and
advice for pregnancy-related problems within the Symptom Group and arrange investigation
and admission if required.
• SD Assessment and management capability, minor condition
This means a healthcare professional, e.g. an optician or pharmacist, with the capability to
clinically assess and manage specific conditions within the SG that are unlikely to require
prescription medication, further investigation or onward referral.
Dispositions
(response timeframe)
orgname
Pharmacy-
Boots UK
Blackpool
Pharmacy-
Lloyds
Bloomfield
Rd Blackpool
Pharmacy-
Sainsburys
Pharmacy
Blackpool
Pharmacy-
Bispham
Pharmacy
Blackpool
Pharmacy-
Tesco
Pharmacy
Blackpool
8.0
Pharmacy
Starter
Template
v1.10
orgtype Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist
dispositions
DX28: Contact Pharmacist within 12
hours TRUE TRUE TRUE TRUE TRUE TRUE
DX45: Service Location Information TRUE TRUE TRUE TRUE TRUE TRUE
DX79: Failed Contraception TRUE TRUE TRUE TRUE TRUE
DX82: Medication Enquiry TRUE TRUE TRUE TRUE TRUE TRUE
DX46: Refer to Health information
within 24 hours TRUE TRUE TRUE TRUE TRUE
DX97: Emergency Contraception
within 2 hours TRUE TRUE TRUE TRUE TRUE TRUE
DX98: Emergency Contraception
within 12 hours TRUE TRUE TRUE TRUE TRUE TRUE
Team Contact Details
Jackie Heardman
111 Team
Manager
(01253 951684
Sam Ibbotson Project Support Manager
( 01253 951437
Lauren Guest
Project Support Manager
(01253 951249
Karen Bambrook
Project Support Manager
(01253 951314
Any Questions?
