Phone 111 instead of going to casualty
PATIENTS will be told to call 111 before attending Accident & Emergency departments under controversial reforms of the NHS.
Pilot schemes are being launched urging patients who do not require an ambulance to book appointments to go to casualty. NHS chiefs say the aim is to reduce crowding at A&E and direct people to the “most appropriate” place.
Those considering going to A&E will be asked to phone 111 or navigate the service’s website. Those considered in need of treatment will be given a time to attend, while the remainder will be directed to the best place for care.
However, medics fear the reforms could create deadly obstacles for those in need of urgent care, following the reports of deaths among those who went untreated during lockdown.
Figures show fatalities caused by high blood pressure rose by a third among the under-65s in the two months ending on July 10.
Similar trends were seen in deaths caused by cardiac arrhythmias, while deaths from diabetes rose by a quarter in this group. The number of deaths and hospital admissions for coronavirus, meanwhile, have fallen to record lows.
Trials of “111 First” are already under way in Portsmouth, Cornwall. Newcastle, Blackpool and parts of London will follow shortly. NHS chiefs plan pilot schemes in every region before a full roll-out by December.
However, Dr Chris Moulton, former vice president of the Royal College of Emergency Medicine and an A&E consultant at Bolton NHS Foundation trust, said: “The last thing you want in an emergency is to have to make a phone call. We need to get back to faceto-face medicine and open access for patients immediately.”
Health chiefs said those who needed an ambulance would not be diverted and insisted patients who turned up to A&E without an appointment would not be turned away.
But the Health Service Journal reported that on at least three occasions in the Portsmouth pilot, patients with minor injuries who went to hospital unannounced were told to call 111, after being assessed. Portsmouth University Hospitals Trust insisted no patient would be turned away from A&E.
ONS figures show rising numbers of deaths for a number of conditions, especially heart problems. Charities said patients had paid “a heavy toll” for restricted access to the NHS during lockdown, and warned steps taken to limit face-to-face care during Covid must not become “the new normal”.
Statistics covering the period to July 10 showed 1,129 deaths linked to high blood pressure among under-65s when around 843 would have been expected. There were also 323 deaths caused by arrhythmias, compared with a five-year average of 242.
Rachel Power, chief executive of the Patients Association, said any changes in access to A&E required careful handling. “We’re supportive of initiatives to help direct patients to the right care,” she said. “If that means they can call 111, get an appointment and be seen on the same day without waiting hours in A&E, that will be an improvement.
“We would not support creating new barriers to patients getting care.”
Last month, a study of 50,000 patients found deaths from the most common
‘If they can call 111, get an appointment and be seen on the same day, that will be an improvement’
type of heart attack rose nearly 40 per cent during lockdown. It prompted warnings that the Government’s “Stay Home” message may have deterred patients in medical crisis from seeking help. The numbers attending A&E fell 50 per cent at some points during the pandemic.
Prof Stephen Powis, NHS medical director, said the “111 first” model would help ensure A&E departments did not get crowded. He told MPS the move also aimed to ensure people received the most suitable care.
Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said A&E appointments would also help prevent overcrowding at a time the NHS was attempting to maintain social distancing.
An NHS spokesman said: “GPS, nurses, paramedics and others working in the NHS 111 phone and online service have already played a key role in helping millions get the right care and advice safely over the last six months.”
He added: “We will be launching a major public information campaign to ensure people know how they can get the care they need in the safest way possible.”