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Rise in A&E attendances caused by NHS 111, emergency medicine leader claims

NHS 111 was responsible for almost the full increase in A&E attendances in the last year, the president of the College of Emergency Medicine has told MPs

Speaking at a House of Commons health committee hearing on A&E pressures this morning, Dr Clifford Mann said patients should not be blamed for attending A&E inappropriately when it was NHS 111 advising them to go there, or which had sent them an ambulance.

The meeting was held in response to reports that hospitals across the country have experienced severe A&E chaos in recent weeks, despite the Government injecting £700 million worth of winter funding to avoid the situation via better forward planning.

Dr Mann quoted figures showing there had been 450,000 extra A&E attendances in the past year, which could almost all be put down to NHS 111.

He said: ‘This may be an inappopriate point to point out but the reason that these people are attending our emergency departments is because we have told them to.

‘The NHS 111 figures are very interesting. Of the 450,000 extra attendances in the last year, 220,000 were advised by NHS 111 to come to the emergency department and for another 222,000, an ambulance was dispatched to them by NHS 111.

‘If you put those figures together you have more than 95% of the rise in type 1 attendances. So I don’t think we should blame people for going to the emergency department when we told them to go there. It’s absurd.’

The helpline was rolled out in April 2013, but has suffered a series of problems, including its main provider NHS Direct relinquishing its contracts after just over 12 months.

Commenting on the exchange, BMA chair Dr Mark Porter said: ‘We can only get to grips with pressure on A&Es if every part of the system – from our GP surgeries, to hospitals, to community care – is fully supported and working well, and this includes urgently addressing the shortage of A&E staff and GPs. We also need to ensure NHS 111 is improved to make it a doctor-and nurse-led service. This will help prevent patients being unnecessarily directed to A&E.’

He added that it is ‘simply not sustainable’ that investment in general practice ‘is declining while demand is on the rise and more care is moved into the community’.

Pulse reported that an LMC and an ambulance trust in the south west of England reported that NHS 111 telephone systems malfunctioned over the Christmas and New Year period.