NHS 111 NWAS was approached by NHS England in June this year with a proposal to deliver the 111 service for the North West region due to the decision of NHS Direct to withdraw from the NHS 111 contract. NWAS agreed to this request and, on 29 October 2013, took over responsibility for the North West NHS 111 service. It is expected that the service will be retendered in 2015. NWAS NHS 111 service operates from a call centre at Middlebrook in Bolton, with smaller call centres in Carlisle and Manchester. NWAS has a core team of 120 staff, who have transferred from NHS Direct, supported by a further 80 staff provided by our agency partner, Conduit Global Ltd. The North West service handles all direct dialled 111 calls arising in Cumbria, Lancashire, Greater Manchester, Merseyside and Cheshire as well as GP out of hours calls arising from GP surgeries in East Lancashire, Blackburn with Darwen, Warrington and Salford. The normal daily activity for week days is approximately 1,600 calls and at weekends rises to 2600 each day. The pattern of demand is for particularly busy periods in the early evening and week end mornings. Some callers focus on calls for surgery or pharmacy opening hours and general health advice. These are dealt with without a formal triage and make up about 10 per cent of all calls. The remaining 90 per cent are answered by an NHS Pathways trained call handler. The patients' presenting condition is assessed for priority symptoms, and if high risk symptoms are described the patient may be sent an emergency ambulance or have an assessment from one of our clinicians. Around 11 per cent of triaged calls are sent an emergency ambulance response. Of these, about 45 per cent are Red 2 and 45 per cent are Green 2 responses. The remainder are made up from Red 1 and Green 3 and 4 responses. A further eight per cent of patients are advised to attend Emergency Departments themselves. About 30 per cent of calls are transferred to a senior NHS111 clinician for further clinical advice. We aim to 'warm transfer' 98 per cent of patients from the call handler to the clinician to ensure a seamless experience. In total, 66 per cent of triaged callers are directed into primary care, 11 per cent get an emergency ambulance response, eight per cent are advised to go to an Emergency Department and the remainder receive a range of self-care advice and community referrals. Over the next few months, the Trust will be actively engaging with stakeholders to showcase the work of 111 and ensure it is viewed as an efficient provider of health advice to the public. The Trust will continue to work closely with the commissioners who will closely monitor the performance of the service.