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Patients to be encouraged to pre-book A&E appointments by December



NHS England wants patients to book into a slot via NHS 111 before attending A&E this winter, but will not stop patients from turning up without calling ahead.

All A&E providers across England are to implement a ‘minimum specification’ of the ‘NHS 111 first’ model by December 2020, NHS England said.

In its latest board papers, NHS England revealed details of its plans for ‘transforming access’ to urgent and emergency care services through the model – which would see 111 services triage patients before they attend A&E. 

The papers said: ‘Early mover systems – one in each region – will be the first to trial some of these innovations. An early, formal evaluation of the impact on services within the early mover geographies has been commissioned for September. 

‘The ambition [is] then that all systems will have implemented a minimum specification of the model by the first December 2020.’

The papers reiterated that patients will still be able to choose to attend A&E without going through the ‘111 first’ service, but said the model is ‘proving popular in trials’.

They said: ‘The central premise of NHS 111 First is that the offer to patients must be an improvement on the status quo, enhancing patient experience and quality of care.’

NHS England said it is increasing the ‘capacity, productivity and utility’ of existing 111 services through:

  • Investment in clinical capacity within local Clinical Assessment Services. 
  • Investment in NHS 111 call handling capacity. 
  • Improved profiling of all local services on the national Directory of Service. 
  • Establishing NHS 111 to ED referral processes. 
  • Development of processes and IT to stream low acuity patients to alternative non-ED settings. 
  • Local patient communications and engagement. 

NHS England is also looking at ‘development’ of the national Covid clinical assessment service (CCAS), the papers said.

Meanwhile, NHS England added that it will launch a campaign to encourage use of the model and create a ‘new social norm’.

It said: ‘We are now developing a campaign to encourage people to use 111 First, before they walk into an ED. 

‘This pairs developments in the NHS 111 service, such as booking into an ED time slot, which will be available across the country from December, with a national, regional and local communication push through public and stakeholder messaging.’

The campaign, which will feed into the annual ‘winter pressures’ campaign, is planned to go live in December, NHS England said.

It added: ‘This year Covid-19 could significantly worsen winter pressures and the ability of the NHS to safely manage demand.’

Earlier this month, plans for pilots of the 111-first model were first revealed – three years after Pulse reported that NHS England and the Government had been in talks about such pilots.

NHS England confirmed to Pulse two weeks ago that the pilots were set to expand, with the ambition that all NHS 111 services in England would roll out the model by this winter.

Meanwhile, the Welsh Government has said it wants to roll out a call-before-you-walk A&E model across the country, following pilots.

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