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Independents' Day

Two areas set to pilot call-before-you-walk A&E model

NHS England will pilot a system of having patients call NHS 111 before attending A&E in Portsmouth and London.

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

Speaking at a House of Commons Health and Social Care Committee hearing earlier this week, NHS England chief executive Simon Stevens said this comes as 'we are seeing now a significant rebound in the number of A&E attendances and emergency admissions' following a signficant decline during the peak of the Covid-19 outbreak.

NHS England's national medical director Stephen Powis, who is leading the project, stressed the importance of ensuring A&Es do not become overcrowded.

He said: 'That has always been important to us and of course it's even more important now that we have Covid in the background.'

And he added: 'We are piloting various forms of that "call first" in London, in Portsmouth, in other areas too, because we want to make sure that we get the model right. 

'We want to move, as we did before Covid, increasingly to a 111-first model which ensures that we do everything we can to give appropriate advice to signpost people to the most appropriate place for treatment.'

But NHS England stressed that the new system would not mean patients would be completely blocked from turning up at A&E directly.

NHS England chief operating officer Amanda Pritchard said: 'However, it's worth saying that we're not at the moment envisaging that the 111-first model would be the only way you get to A&E.' 

In 2017, the press offices at the Department of Health and NHS England vehemently denied talks were ongoing about similar pilots.

NHS England even went as far as to say the story was ‘false’, although they were forced to apologise 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 last week that he would like to see a model where NHS 111 triages patients before attending A&E.

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 (8)

  • Hospitals have had their debts written off

    They are on block contracts, but they are 75% closed

    GPs have dropped income, no Covid money

    And now hospitals are going reject even the Emergencies...

    Great...

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  • Vinci Ho

    Well, this is well cooked politically . The fact is , we had an A/E consultant asking the question during daily update session about when GPs would return to ‘normal‘ seeing patients face to face . NHSE was absorbing the pressure and prepared this ‘solution’ . Patients will be shuffled around .

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  • But open the pubs. And A+E gets ransacked by hooligans and bottled heads. It's a shambles. The public will soon urinate on A+Es door, then clap and fall over. The Government need to get back on that disgraceful podium and tell the public exactly what they're doing, planning and enlist some civic duty. Waiting lists, rejected referrals...it goes on and on. And the ombudsmen is open to complaints again, so they can 'learn' and put your face in the gutter. Duty of candour and whistle-blowing...delusional more like.

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  • This will be the end of GPs is deprived areas.

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  • Not great but it might be necessary in this climate.

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  • Start charging £25 to attend. I was in A+E before Covid with piece of metal stuck in my cornea that I couldn’t remove myself. Waited four and a half hours and watched the insignificantly unwell file in and out. Free at point of use will always be abused.

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  • Water always takes the route of least resistance. 111 will tell 70% of people that they have to be seen by their GP within two hours, and call ambulances for everyone else. We will be expected to take on all the unfunded urgent care as well as everything else. We are not an urgent care service.
    I thnk we need to set reasonable limits on what the government can expect of us. If that means it takes a month to see your GP because of decades of under-investment and workload dump, that needs to be their problem and not ours.
    Want to be seen in A&E? Exaggerate your symptoms. Patients will soon realise this.

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  • you are assuming there will be any GPs left for the urgent ooh care services to see them. just pointing out this may be a consideration you need to think about.

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