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The waiting game

GPs advised to contact CCAS-referred patients within 30 minutes

GPs should contact or assess Covid-19 patients referred to them via NHS 111 within 30 minutes, NHS England has advised.

It has previously said GPs must free up one appointment per 500 patients each day to accept direct referrals from NHS 111’s Covid central assessment centre (CCAS).  

But, during a live webinar on Thursday evening, NHS England's digital lead Dr Masood Nazir said GPs could 'start with a smaller number', if the appointments are not filled up.

However, he also reiterated that should the pandemic take a turn for the worse, GPs may have to set aside all appointments for referrals from CCAS.

And, although NHS England previously clarified that patients booked in by CCAS will not be given a time slot and are not expected to 'turn up' at practices, Dr Nazir said that GPs may decide they need to see the patient face to face.

He said: ‘The patients aren’t given a slot time but they are advised that you will make contact with them fairly quickly. We would advise and are making a recommendation that you try to keep an eye on the list and make contact with the patient or make a decision about what to do with that patient within 30 minutes.’ 

Asked by GPs if this was a 'requirement', Dr Nazir said: ‘All we’re asking is that some contact is made with the patients in a timely manner, so they’re aware that they’ve not been forgotten.’

Practices ‘ideally’ need to hold open the minimum number of appointments of one per 500 patients, Dr Nazir added.

But he said: ‘We’re happy for you to start with a smaller number, but if that smaller number gets full we’d encourage you to keep an eye on it and increase that to make sure you do get to the minimum of one in 500.’

According to Dr Nazir, 'the experience so far of practices' which have enabled direct booking via GP Connect is that they 'may get a few appointments'.

But he added: 'If the crisis gets worse, then I think all of us will be affected and the appointments may go up or we may have to stop looking at doing routine work and just focus on this.'

The new requirement for appointments to keep open for NHS 111 direct booking includes the previously contractually required one in 3,000. These appointments should be booked into the same session, making them ‘much easier’ to manage for practices, Dr Nazir said.

And he said it was up to GPs how they consulted the referred patients, whether via video, telephone or face to face 'based on your assessment'.

At the end of last month, NHS England said the slots practices have been asked to save will 'inevitably' be filled with only very sick coronavirus patients and asked GPs to prepare for a 'rush' of these patients.

Readers' comments (27)

  • Does this mean if it hasn't been used within 30 mins of the allocated time we can take it back for our own use?

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  • Crisis? Hardly a need for lots of appointments - hospitals also half full and GP has returned to normal....Normal that is taking longer to do....since I manage patients in a manner I determine I will ring patients back WHEN I decide

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  • I think this is very useful advice. If those patients are contacted within 30 minutes, I can give them the special 30 minute treatment window antibiotics which treat coronavirus. Later than 30 minutes, well, very different.

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  • and we want to trust their managerial skills because????

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  • We are the government and we know what is going on in every nook and cranny of the country.

    We have the luxury of more time to deal with everything that is going on the the lives of everyone of your patients than you do.

    ..or we are deluded...

    ..Perhaps if they trusted 'public servants and professionals' as much as they trust 'deloitte' 'randox' 'capita' 'circle' et al...

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  • Utter nonsense. Does this 'digital lead' work in the real world. ICUs are busy but the rest of the hospital system is not. I admitted 2 patients yesterday directly to assessment unit - 1 surgical and 1 covid +ve with ?dvt/pe.

    As I have said in previous posts- if patients unwell, and I would normally send for assessment, then hospital assessment is appropriate. ie. if these CCAS patients are so sick they need call within 30mins (which OOH service rarely manages anyway) then they should have been directed to a secondary care assessment. We should only get the milder patients who may need some review over the next few days to ensure not deteriorating or who have some other non-covid symptoms that require assessment.

    Only in a state of emergency with secondary care overwhelmed should we be 'stepping outside of our usual limits' to help manage the crisis. Locally this is not happening. We have half full hospitals and ICU departments with capacity.

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  • More control freakery from NHSD leadership, who clearly exist in a parallel universe where we all have enormous spare capacity and resources.

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  • Dear All,
    We do not run an emergency response service.
    Regards
    Paul C

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  • As a CCAS doctor, the patients that I have referred to their GP have all had symptoms likely to be due to other conditions eg bacterial chest infection, asthma exacerbation, young baby with new rash. They have already waited up to six hours to be reviewed by one of the clinicians who are all current or recently retired GPs and have no access to the patient's medical records. Personally I think these patients should be being reviewed by their own GPs during practice hours.
    It's an imperfect system - the patient's I have spoken to are often just wanting to get reassurance because they haven't been able to speak to anyone from their own practice...

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  • Vanessa Pliny - How come you did not have to phone these patients within thirty minutes rather than 'up to six hours ' ?!

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