This site is intended for health professionals only

NHS 111 ‘tells out-of-area registered patients to go to A&E’, warns GP

NHS 111 call centres are advising that patients registered under the Government’s flagship ‘GP choice’ scheme should go to A&E for urgent care, it has been claimed.

East London GP Dr George Farrelly phoned three different 111 services in London asking where such patients should be directed, in the instance they could not attend their registered surgery because they were too ill, and was told options included A&E or using a private GP service.

None had a list of alternative GP practices to attend, Dr Farrelly claimed.

Under NHS England plans for out-of-area registered patients, NHS 111 is the first port of call to direct them to urgent care cover services close to their home if they can’t get to their registered practice. The patient should then be referred to a local GP practice which has signed up to an enhanced service specifically designed to cover urgent care needs, including home visits, for patients registered away from home.

But Dr Farrelly said: ‘I contacted three separate NHS 111 London sites but none of them had a list of local GPs who had signed up for the out-of-area enhanced service. I was told that a patient not registered with a local GP would be advised to go to an urgent care centre or to A&E if they needed to see a doctor in hours.

‘One of the supervisors told me that if the patient was too ill and needed a visit they would have to use [a private GP service] and then bill the patient’s GP surgery for the cost. This did not seem likely, but it gives you the idea of the shambles we are in. This is an unsafe situation.’

As previously reported by Pulse, just 4% of London GP practices had signed up to the enhanced service at the time when the GP choice policy went live last month.

GPs have been able to register patients from outside their practice boundary area, without home visiting duties, since 5 January when the policy was implemented despite warnings from GPC that there was not sufficient urgent care cover in place. It had previously been delayed from October to January for that reason.

An NHS England spokesperson said: ‘With this change, there clearly need to be a service in place for such patients should they need to urgently see a GP at or close to home and when they cannot be expected to attend their registered practice. NHS England is responsible for putting these services in place, which will include home visits where clinically necessary, with its area teams working with local urgent care services including GPs and NHS 111 to set these up.’