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NHS 111 booked slots to 'inevitably' be for only 'really unwell' Covid patients

The slots that practices have been asked to save for referrals from the Covid clinical assessment service (CCAS) will 'inevitably' be filled with only very sick coronavirus patients, NHS England has said.

In a webinar yesterday (Thursday), NHS England digital lead Dr Masood Nazir told GPs that ‘most’ of those appointment slots are currently unused.

However, he said this is set to change, and the service - which is part of the NHS 111 service - will be referring very sick Covid-19 patients.

It is unclear whether this is referring to face-to-face consultations, or only remote, but practices have been advised that they will need to set up 'hot areas' within their practice for Covid-19 patients.

Practices had been asked to keep appointment slots open for direct booking by NHS 111, which is triaging potential coronavirus patients through CCAS, but have been told there is no expectation this will require a face-to-face consultation.

Dr Nazir warned that practices have been asked to open up their appointment book in preparation for an 'inevitable' rush of patients with severe coronavirus symptoms.

Dr Nazir said: ’We’re all preparing in case the inevitable happens and there’s so much demand that actually we have no choice but all we see are really unwell Covid patients.

'At the moment that’s not the case. In many cases, most of the slots do not go used or nothing is booked in.' 

The requirement to keep slots open does not mean whole GP sessions should be 'blocked out', he added.

He also reiterated that patients should not be told that they will have a face-to-face appointment or advised to attend their practice.

Dr Nazir said: 'All that’s being done is for them to be transferred onto that list for the practice to pick up and then make contact with the patient either by telephone or video consultation - whatever is appropriate - assess them and then decide based on the local arrangement what the best next step is for that patient. That is all that should happen.'

Last week, NHS England announced temporary contractual changes stipulating that GP practices must free up one appointment per 500 patients every day for direct booking by NHS 111's CCAS.

The CCAS, which is staffed by clinicians, has been set up as an extension to NHS 111 during the Covid-19 outbreak to triage patients when the algorithm used by call handlers has been unable to determine whether or not they need hospital admission.

GPs have been asked to 'proactively manage' patients referred to them by the CCAS, and also to offer up their spare time to staff the telephone service.

The story was updated at 10:30am on 24 April 2020

Readers' comments (19)

  • Err....if they are REALLY UNWELL, shouldn't they be in hospital?

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  • Bugger; Jam GP beat me too it with the blindingly obvious comments.

    Said before and say it again they are on a different planet, why else would you bring up the Cancer DES in midst of pandemic?

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  • Unwell patients should be seen in hospital where they can have tests and supportive treatment. Only if and when this capacity is over-run should we look at how General Practice can be used as an emergency measure. This could involve hot hubs potentially.

    On an aside the CCAS is non existent as far as I can tell locally. All the 111 calls re Covid that I have had have been directly from call handler and not been forwarded to any clinician within 111.

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  • Lovely. The GPs have full PPEs?-No. GPs have oxygen to look after them?-Maybe for a short time.
    GPs have the vaccine and antiviral?-No.
    Pointless exercise-Yes. Infect the GP to spread it around-Yes.

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  • Why are the patients not being booked directly into the hot hubs..?.

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  • Dear NHS England,

    a period of silence on your part would be most welcome.

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  • Rogue1

    Quite right JAM
    Unfortunately that is the obvious answer, that is why NHS have missed it!

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  • Speaking as a practising (Locum) GP who has been trying for over a month to overcome all the bureaucracy and hurdles involved in "volunteering" to do extra duties ( i.e. answer NHS 111 Covid 19 CCAS calls from home,) and not enabled yet, the comment that GPs are being asked to give up their spare time to staff the service caused me a wry smile...!

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  • Why are the hot hubs that have been set up not on the DOS.
    By the time patients get seen there now they will have been through 4 rounds of triage.

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