Introduction NHS 111 Wales is a free phone, nonemergency number that helps people get the right advice and treatment when needed. Clinicians, such as nurses and paramedics, work alongside health advisors to assess, advice and signpost patients.

For various reasons, Welsh Ambulance Services NHS Trust (WAST) had to rapidly replace its ageing call handling and clinical assessment systems. This early-stage innovation report describes the development of the newly created and implemented Call Prioritisation Streaming System (CPSS), now in use in NHS 111 Wales for call handling. It will outline the approach taken to creating, in partnership, CPSS from the existing intellectual property of WAST and describe some of its key benefits.

Methods The CPSS development process was adapted from various established processes. It included group preparation, engine preparation, protocol selection, alias creation, question topic, category, keyword creation, question rationale creation, full review, external peer-review process, engine testing and International Academies of Emergency Dispatch adoption and approval before implementation.

Conclusion This early-stage innovation report has outlined the creation of CPSS, which has already managed over 530 000 cases to date. The creation of such systems does not happen frequently, and the authors hope that in sharing this journey, learning might be adapted and taken into the creation of other systems or the evolution of existing protocols and systems.

Learning will occur immediately, with data from outcomes, user feedback, patient experience reports and feedback from wider system partners all being considered, and early evaluation will be undertaken.