Patients are told to call NHS 111 before going to A&E in NHS winter shake up

Patients are being urged to call 111 before attending accident and emergency departments to help regulate the number of people in hospital waiting areas.

Under the new scheme, those in need of care for a serious but non-life threatening condition will be able to book an appointment at their nearest A&E to avoid a long wait at hospital.

The 111 First programme is intended to schedule slots at A&E to help maintain social distancing in hospitals, or direct patients to other services such as a GP or pharmacist.

Currently being piloted in Plymouth and Cornwall, it is due to be extended to other parts of the country in the coming months.

The proposals will be brought in by NHS England in time for this winter to avoid the usual overcrowded scenes in A&E units, which could trigger major outbreaks of coronavirus. 

A spokesman for NHS England emphasised that those who did not book an appointment would not be turned away if they presented at A&E.

‘It reduces the crowding in A&E but still allows you to get the help you need,’ he said.

The spokesman said: ‘(NHS 111) staff can already book people who need it into face-to-face appointments with local clinicians or arrange home visits.

‘As the NHS now prepares for winter, we are further improving that offer with more clinicians and better links into local emergency departments.’

He added that those in need of urgent care would be given a slot within a matter of hours, while in serious cases 111 operators would send an ambulance to take a patient in immediately.

The service is due to launch a major public information campaign in the coming months informing the public where and how to access the care they need.

A pilot for a similar ‘phone-first’ triage system was launched at Cardiff and Vale University Health Board last month.

Walk-in patients and emergency admissions to hospitals in England fell dramatically in the first few months of lockdown.

Data published by NHS England shows 0.9 million A&E attendances were recorded in April 2020, down 57% from 2.1 million in April 2019.

Emergency admissions to A&E departments at hospitals in England also showed a sharp fall – down 39% from 535,226 in April 2019 to 326,581 in April 2020.

It was the lowest for any calendar month since current records began in August 2010.

Health officials became so concerned about the drop that many NHS foundation trusts urged people to attend if they needed urgent, non-Covid related care.

But experts are concerned that if the messaging is not handled correctly, the public – particularly the stoical elderly – could be deterred from seeking help in an emergency.

The King’s Fund think-tank urged NHS bosses to ensure the changes did not make it harder for patients to access care.

Speaking last month, Siva Anandaciva, from the King’s Fund, said: ‘No one wants to see a return to the days of overcrowded A&E departments, so looking at new ways of making the system work better and more efficiently for patients and staff is the right thing to do.’

But he added: ‘It is vital that there is compelling evidence from the pilots that these changes do not make it more difficult for some patients to access the care they require, at the time they need it.’

Professor Helen Stokes-Lampard, of the Academy of Medical Royal Colleges, which represents 23 colleges and faculties, added: ‘What’s essential is the way this is communicated to patients. We have to get the trust of the public.’