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
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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.