Debate contribution: Healthcare: Integrated 111 Service

Debate contribution by Ms Claire Sugden on 18 May 2026.

MLA

Ms Claire Sugden

Party at the time

Independent

Date

18 May 2026

Type

Debate contribution

Business

Opposition Business

Heading

Healthcare: Integrated 111 Service

Assembly identifier

Official Report component 5548802

Read the official Assembly record

Text

I support the motion — at least, the principle of exploring what is being suggested. I suspect that many people across Northern Ireland are surprised that we do not already have a fully integrated 111 service, given that it has become such a recognised and understood part of healthcare elsewhere in the UK. It is simple; it is memorable; and it gives people clear access to the health service at a time when many people genuinely do not know where to turn. Despite the wait times and numbers that we see, most people do not want to go to A&E. Nobody wants to sit for six, eight, 12 hours or longer in an overcrowded emergency department with other sick people unless they absolutely have no option. Like many across Northern Ireland, I have, unfortunately, spent long hours in the A&E over the past year, whether on my own behalf or that of family members. I remember waiting for over 17 hours on one visit. As a relatively young and robust person, I could manage that. It was unpleasant, exhausting and frustrating, but I could cope.

What stayed with me far longer, however, was what I saw when I looked around the waiting room. I heard distressed children screaming into the night. I saw older people visibly weeping in pain. I watched vulnerable people become increasingly uncomfortable sitting in chairs for hour after hour because there were no beds and because the staff did not have the space available to deal with the sheer volume of people coming through the doors. The truth is that many of those people did not want to be there either. They were there because there was nowhere else for them to go. They had been directed there by their GP, an out-of-hours service, a pharmacist or another healthcare professional because the support that they needed was not available in a community setting. More often than not, people attend emergency departments not because they want to but because every other part of the system has effectively funnelled them there. Increasingly, we are seeing older people present at A&E: people who have fallen; people whose conditions have worsened because their issues were not tackled upstream; and people who could perhaps have been supported at home, in the community, through social care, through early intervention or through better local access to diagnostics and treatment before things reached a crisis point. That is why I support the principle behind having an integrated 111 service. At present, we have Phone First. That service has its value, and figures show that almost half those who used Phone First and urgent care services in 2024-25 avoided a referral to the emergency department. That tells us something important, which is that when they are given an accessible route into the system, many people safely avoid an unnecessary trip to A&E. Phone First is, however, fragmented and inconsistent. Hours vary across trusts, access varies across trusts and public awareness varies across trusts. It has a really long phone number. I could not even begin to imagine how to start dialling it without googling it, whereas everybody knows 999. Everybody can remember 111, and that is the number that would be used. Northern Ireland does not need to be the outlier here. If it comes down to simpler and better communication, I definitely think that it is something that the Minister and the Department need to explore. It is one of the more inclusive tools that we could introduce into healthcare. We often talk about digital exclusion, particularly among older people, but we would not be asking someone to navigate a complicated website or app. Rather, it is a straightforward telephone service, with a number that is easy to remember. If anything, we should really be thinking about how older people — the people who will access the service most — will be able to use it. It will not represent a transformation, however, if the services behind it do not have the capacity to respond. As I said, many of us have had experiences of ending up in A&E simply because there was nowhere else for a relatively straightforward test or assessment to be carried out. I do not mind sharing with Members that I had to attend A&E to get an ECG done. It took minutes to perform, but I waited for hours for those few minutes. The diagnostic process was not readily available elsewhere — in my GP surgery, for example — so the emergency department became the default destination for me. Often, people who attend A&E do not believe that something catastrophic is happening. Rather, they are attending because they need reassurance, monitoring or basic diagnostics to rule out something serious. If we genuinely want to reduce pressure on our emergency departments, that has to be part of the wider conversation as well. It cannot be enough just to put those diagnostic tools in our GP surgeries. We also have to fund our GPs. We have to give them the confidence to know that it is not just another add-on, separate from their GP contract. I support the motion. I support a clearer, more coherent front door into our healthcare, and I support helping people access the right care at the right time in the right place. Alongside that, however, we need the courage to deal with the wider failures in the system that continue to push people towards A&E departments, because, too often, that is the only door that is open to them.

923 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 15:37 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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