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GPs buried under trusts' workload dump

GPs offered cash to open up appointment booking to NHS 111 call handlers

Exclusive GPs are being offered 70p per patient to open up their appointments for ‘direct booking’ by NHS 111 call handlers as part of a major pilot of new urgent care models.

The north-east England scheme will allow patients to be remotely allocated a GP appointment by the urgent care hotline, should they require one, in a bid to improve patient outcomes and boost access to GP appointments.

But local leaders have warned that the funding is likely to run out, leaving practices with no way to control their workload.

The pilot is being led by the North East Urgent and Emergency Care Network (NEUECN), one of eight urgent and emergency care ‘vanguards’ announced last year that are piloting new ways of configuring urgent care.

A spokesperson said that the scheme would ‘provide simpler and more secure access for patients who would otherwise be directed to GPs through less secure routes’.

A ‘range of payment levels were discussed, and the final amount of 70p per registered patient was set in line with the funding available to the project’, the spokesperson added.

The payments will be made via CCGs but NEUECN will be working with GP leaders and practices across its patch to handle concerns. 

But Dr George Rae, chief executive officer of Newcastle and North Tyneside LMC, told Pulse he had concerns over the scheme.

He said: ’[I]t looks like the funding is a one-off with the input from NHS 111 continuing for four to five years.

‘That’s something I know is causing concern in the LMC and [our local GP] federation… [That GPs will be asked to continue to do this] without any funding in the future.’

Dr Rae added: ’At the end of the day it’s up to the partnerships to decide what they’re going to do. I would, personally, have very significant reservations about that at this point in time.’

The North-East urgent care vanguard covers a population of 2.7m patients across Northumberland, Newcastle, Sunderland and County Durham and is trialling methods including reviewing how ’urgent care should be empowered to make direct referrals to primary care’.

NHS 111 problems go on and on

phone, telephone, nhs 111, phone call, call centre - online

phone, telephone, nhs 111, phone call, call centre - online

Source: shutterstock

NHS 111 has been a persistent thorn in GPs’ sides since it launched – with disastrous consequences – in 2013.

The system replaced nurses with lay call handlers who follow a series of pre-programmed questions to triage patients and recommend a disposition. GPC chair Dr Chaand Nagpaul has criticised the scheme for ‘disproportionately’ recommending patients go to their GP adding unnecessarily to practice workload.

Last year, as part of an NHS England bid to mitigate winter pressures, NHS 111 providers were told to recruit GPs to give advice to call handlers at peak times and boost the input from clinically trained professionals.

And health secretary Jeremy Hunt has previously proposed the opposite, suggesting at a national conference that lay call handlers should be able to access patient records and ‘use more of their judgement.

Last summer NHS England put a temporary halt on the procurement of new NHS 111 contracts while it deliberated plans to link the service with GP out-of-hours.

 

Readers' comments (42)

  • NHS England /Dept of Health worry me more and more .A series of stupid suggestions flow from them on a regular basis. The 3 111 pilots showed 3 things 1)didnt save money2) more referrals to ambulance services 3)couldnt measure the one thing it needed to ie patient outcome.The "triaging " -isnt triaging -it creates a disposition ie needs 999 or call or 2hr visit etc -the training to do this most difficult job is nowhere enough,and the responsibilities and risks are huge.
    There is no way any sensible government would even suggest this
    I despair of the woeful ideas that are coming out of this department.I have been a doctor for 40years and never seen such crass running of the nhs
    The health select committee seriously need to look at how their colleagues are running the nhs

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  • Sunderland seems to be the only area which took a very sensible and pragmatic approach to this scheme.Getting the best of both worlds.

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  • You must be joking!

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  • My staff and our doctors are perfectly well placed to decide whether these patients need to be seen by a GP. It will create a monumental increase In workload in a system that is already saturated. Crash the system for 70p a patient. I think not!

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  • No doubt there will be a huge waste of valuable appointments given the absurd algorithms and inadequately trained 111 staff. An appointment with a GP will become the easy coverall for problems not clearly allocatable elsewhere.

    I assume that no Practice has a surfeit of appointments so it really has to be financially worth while going for. Given the cost of a locum (if you can find one) to do a surgery of 16 to 20 patients it should be quite easy to work out how inadequate the remuneration is. Furthermore once established as part of the system how easy will it be to stop when funding evaporates.
    Another pathetic idea when the only solution is more Gps and adequate funding of General practice on the first place.

    Who of they employ to think up these ideas!

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  • Vinci Ho

    The fundamental issue here is 'quality of triaging' which is something Agent Hunt did not f***ing understand refused to understand . Because if one held an argument the triaging was good, it was perhaps logical to allow a direct access to GP's appointments.

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  • 111 booking my appointments?!
    ha-ha-ha
    No, can't do.

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  • the best triage is done by the usual GP. If GP were properly funded we would not need 111 or any other silly scheme.

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  • This is absolutely daft. If a practice is stupid enough to enter into this they deserve all they get.

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  • In other news, a local practice near me has ditched GP phone consulting, reduced locum booking and advised receptionists to 'signpost' excess patients to WIC.

    £20/patient might be enough to manage our current demand, not 70 pence! That is an insult.

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