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Contact usEvaluation of NHS 111 #MentalHealth in London
Mental ill-health is an increasingly urgent concern and priority in the UK. The NHS Long Term Plan sets out a vision for robust 24/7 all age access to mental health crisis services, with the access point being NHS 111. NHS 111 #MentalHealth (#MH) aimed to offer a pathway with consistent, seamless, and timely access to mental health care and support.
In London, the NHS 111 #MH service is delivered by five London NHS mental health trust providers, each covering distinct geographical areas and populations. London’s transformation of the 3-digit NHS 111 number aimed to go live by April 2024.
This evaluation was delivered in partnership by the Health Innovation Network (HIN) South London and UCLPartners (UCLP) on behalf of NHS England. The HIN and UCLP are embedded within and understand London’s health and care system. The evaluation approach and methodology were co-developed with programme partners, including commissioners, clinical colleagues, and experts by experience. It focused on the initial 11 months of implementation from April 2024 to February 2025.
Key findings
Rapid implementation
All services were launched and operating 24/7 by the hard launch deadline of April 2024. Some providers offered limited hours from as early as November 2023.
Delivery model variation
Providers shared common principles in their service design, triage processes, and workforce composition. However, they diverged in their integration with local crisis telephone services and maturity of their digital infrastructure. Not all minimum viable product expectations were met.
Call volumes remain below expectations
The service received a total of 74,020 calls between April 2024 and February 2025, achieving only 51% of the expected call volume target. The NHS 111 physical health service continued to receive mental health related calls during this period (38,622 calls), forming 34% of mental health related calls across both services.
System positioning
Although positioned as a crisis service, 45% of calls were classified as advice, consultation, or information. Most providers have aligned it with their existing crisis telephone services to streamline operations. However, inconsistent naming, scope, and integration led to system confusion.
A promising shift in referral patterns
There were fewer primary and emergency care referrals, when compared to mental health related calls to NHS 111 physical health prior to the hard launch of NHS 111 #MH. Emergency care referrals reduced by 1.5% and primary care referrals reduced by 24%.
Staff experience
Staff demonstrated resilience and adaptability. However, their experience was challenged by complex governance, recruitment difficulties, and telephony and electronic patient records system issues.
Evaluation of workforce resourcing, skill mix, and service quality is incomplete
The absence of defined standards, limited data, and constraints in the evaluation design prevented further analysis. However, findings highlight opportunities to improve quality through standardisation, the development of nationally accredited training pathways, and investment in data-driven service planning.
Service user feedback was limited by small sample sizes
60% of respondents said they would use the service again and praised staff for their kindness and compassion. Some felt the service lacked personalisation and primarily served as a signposting function.
Cost savings were driven by ambulance and primary care referral reductions
- This is based on the economic analysis of referral pathways compared to pre-implementation, conducted for one out of five providers.
Recommendations
Looking ahead, there is a clear opportunity to strengthen NHS 111 #MH by reassessing its role in the wider mental health system. The evaluation presents a set of 15 detailed recommendations across the following five core themes:
Strategic review and service co-design
Evolve from a minimum viable product into a clearly defined, effective, and user-centred component of London’s mental health system.
Governance and system leadership
Establish clear accountability, streamline oversight structures, promote system-wide learning to reduce duplication, and support continuous improvement.
Workforce development and support
Develop a standardised and accredited training pathway, continue to review the workforce model and skill mix, and ensure staff wellbeing remains a priority.
Technology and infrastructure
Strengthen the digital foundations of the service to improve efficiency and ensure joined up care.
Data and evaluation
Improve and standardise data collection, and invest in a full economic analysis to assess the relative benefits and costs of the service.
These steps will be essential to ensure NHS 111 #MH evolves into a well-rounded service that delivers consistent, high quality, and patient-centered mental health care across London.
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