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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.

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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.

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  • 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

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

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

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  • 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?

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  • 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.

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  • 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!

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

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

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  • 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.
    Paul C

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