This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

NHS England aiming to roll out ‘111-first’ A&E model nationally by winter

All NHS 111 services are set to triage A&E patients before winter, NHS England has confirmed.

The call-before-you-walk system, which requires patients to call NHS 111 before attending A&E services, is currently being piloted in London and Portsmouth, as well as in Cornwall.

Previously, NHS England's national medical director Stephen Powis, who is leading the project, said that he wants to move ‘increasingly to a 111-first model’.

But now NHS England has confirmed to Pulse that its ambition is for all NHS 111 services in England to roll out the model by this winter.

A spokesperson also confirmed that there are plans to expand pilots to Newcastle in the meantime.

NHS England has stressed that the new system will not completely block patients from turning up at A&E directly.

Meanwhile, a hospital in Wales is also looking to introduce a ‘phone first’ triage system for those needing urgent care at its emergency unit from the end of July

Dr Katja Empson, consultant in the Emergency Unit at Cardiff and Vale University Health Board said the system was being introduced following a review of how to continue providing services ‘while co-existing with Covid-19’.

She stressed that the new system ‘will not replace 999 calls’ for life-threatening emergencies such as a suspected heart attack or stroke and that ‘this process will not change’.

The news comes three years after Pulse reported that NHS England and the Government had been in talks about such pilots - although they denied this.

However, NHS England was forced to apologise for calling the story ‘false’ when Pulse published a recording of the NHS England source.

Health secretary Jeremy Hunt was said to be involved in the talks at the time, and he finally admitted in a comment piece for the HSJ earlier this month that he would like to see the model rolled out.

Reacting to the suggestion of patients requiring a referral to A&Es at the time, GP urgent care leaders said the idea needed 'a lot of thinking through' and warned it would 'inevitably' put more pressure on GP out-of-hours services.

Pulse voluntary donation scheme

Since the outbreak of this pandemic, Pulse has strived to support you, whether it be through our resources page, our ‘Clinical Crises’ series, holding policymakers to account with exclusives such as practices being supplied with faulty masks, or GPs being told to stop routine services in the hardest hit areas.

However, good journalism cannot be done on the cheap and, like the whole publishing industry, we have been affected by the economic slowdown. We also strongly believe the content we produce should remain free as we feel it is essential for you. Because of this, we have set up a voluntary donation scheme. There is no compulsion whatsoever to donate. But if you feel we are helping you, and you would like to support us, anything you can spare would be greatly appreciated. Read more here.

Donate here

Readers' comments (22)

  • An alcohol and drug test before A+E may also curtail the burdensome winter crowd. Maybe that frail disabled patient on the trolley or one with a GI bleed might tell that self-entitled patient to go home and sleep 'it' off.

    Unsuitable or offensive? Report this comment

  • National Hopeless Service

    Great idea provided eye stuff gets referred to an optician, foot stuff to a chiropodist
    , nursing stuff to the district nurses etc etc. I fear GPs will be the default for any non acute dross especially if 111 maintains access to our appointment systems

    Unsuitable or offensive? Report this comment

  • You must see a not emergency service GP within 2 hours, as the emergency service A+E department may see you within 4hours?

    Unsuitable or offensive? Report this comment

  • good idea, except for the bit about NHS 111 who have a track record of dispatching ambulances to all sorts of triv

    Unsuitable or offensive? Report this comment

  • The most important question is : if the gp call list is full and the a/e call triage says see GP who will be sued and prosecuted for manslaughter?

    Unsuitable or offensive? Report this comment

  • A terrible unsafe idea. Unimaginably worse if the GP has to call A&E to make a referral and seek permission from the SpR/consultant to send in a patient.

    Unsuitable or offensive? Report this comment

  • One detect another triumphant idea to make the NHS 'worldbeating".and increase the collateral damage from the current pandemic even further to climb up the world league!

    Unsuitable or offensive? Report this comment

  • Remember what the PCN network DES has us signed up to regarding OOH responsibility

    Unsuitable or offensive? Report this comment

  • This will shift patients towards GP, and we have no room left.
    Should have started by expanding GP numbers.

    Unsuitable or offensive? Report this comment

  • Dear All,
    Don't worry the great unwashed will soon smell the rat and outwit the boffins at Skipton House. They'll get an Uber and just turn up.
    Regards
    Paul C

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say