111 online

Warning: this piece is vastly too long, as I’ve spent some years on this particular product.

The brief

111 online is a national digital service that performs a triage by asking a series of questions then displays recommended services to the user.

The online channel represents roughly 30% of all 111 service traffic, with 1 – 1.8 million users per month 1.

I joined the team in early 2018(!) as the online service was heading into a second public beta assessment with GDS.

The work

The initial contract turned into a long term commitment to help the product reach a stage of maturity where backlog issues become less about interaction design and more about how 111 acts as a connecting bridge between the user and services.

Personal highlights (in a very rough chronological order) include:

Finding pathways

One of the toughest challenges users face when using the digital (unassisted) service is selecting the right topic for their symptom. Over time we worked to improve the underlying search engine, then during 2022 moved to a “browse first” approach.

PICS: before, during, after

“Finding the right Pathway” post from March 2019

Service display

Improving the display of services to the user after triage, taking into account:

  • order of recommendation
  • type of service (physical, non-physical, referral)

PIC: before and after

Emergency prescriptions

Building a small “adjacent” service to allow users to refer to a pharmacist for an emergency supply of prescribed medicine. Imagine going on holiday somewhere and you’ve forgotten to pack your meds.

This strand of the service represents the 2nd highest usage overall.

PIC: start page

While I had the energy to do weeknotes, a lot of them were concerned with this piece of work

Making a referral simpler

Splitting up a long, js-heavy, referral form into a simpler “one thing per page” sequence.

PIC: dunno, before and after?

“Breaking things up” post from June 2019

GDS live service assessment

Taking the product into a GDS live service assessment was a big team effort.

/posts/2019/10/07/going-live/ https://www.gov.uk/service-standard-reports/nhs-111-online-live-assessment

Grappling with referrals and integration

A long piece of work looking at the possibilities of passing people along a primary care chain. From a triage into a primary care outcome into a primary care user-facing system.

This one was really interesting as it highlighted the technical ease with which this could be achieved, but the fundamentally opposing philosophical outlook of the respective systems from a clinical angle.



“Highlight” might be over-egging this one.

In early 2020 the pandemic hit and 111 online played a large part in the digital aspect of the COVID-19 response in England, essentially spending a certain length of time as the destination and hub (rightly or wrongly) for people’s varying needs — from clinical services to clerical things like isolation notes.

A somewhat garbled post from 3 months or so later kind of hits the tone for me.

New channels

Webchat pilot

Wider navigation problems

Guided entry

Tweaking clinical questioning

dental analgesia - deliberate reworkings of PWs


Unassisted vs assisted


Public beta and live GDS assessments

gradually getting traction for context difference - assisted vs unassisted etc

Find out traffic etc etc

Note - early 2023 this will be stale near instantly ~94% completion rate ~80% mobile usage now

What other KPIs


An imperfect service, but one that works. Maturity of interaction design.

links https://www.england.nhs.uk/2022/11/nhs-launches-nhs-111-online-campaign-ahead-of-winter/ Yup

  1. January 2023 stats