People considering going to A&E will be asked to call NHS 111 first in pilot scheme

Laura Donnelly
Sir Simon Stevens said this process could ensure pressure is relieved on A&E departments - Stefan Rousseau/PA
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The NHS is to pilot a "call first" model for Accident and Emergency which could be rolled out across the country, health chiefs have said. 

Sir Simon Stevens said research suggested that, in the vast majority of cases, the process could ensure that patients with minor conditions were diverted for treatment elsewhere, relieving pressures on A&E departments.

Pilots of the "call first" model will begin in Portsmouth this week and in every region of the country within months, officials said. People considering going to A&E will be asked to call 111 and either be given a time-slot to attend or advised on the best place to go for treatment. 

The number of patients attending casualty departments fell by around half  during the pandemic, and A&E medics have warned that their units can now only cope with about half as many cases as they did previously if they are to run safely, because crowding risks virus spread. 

Sir Simon said a review of the type of cases which did not show up at A&E departments in April found that "by a ratio of about 14 to one, they were for the most part, more minor conditions that could be treated, either on a booked basis or at an urgent treatment centre, or in general practice".

The NHS medical director, Professor Stephen Powis, said the health service would move "increasingly to a 111-first model". Officials said those turning up at A&E would not be sent away, but that the model would attempt to reduce queues in emergency departments

Last month, the Royal College of Emergency Medicine (RCEM ) called for the introduction of booked appointments for A&E, which health chiefs have now endorsed. 

The RCEM president, Dr Katherine Henderson, said it would cause "enormous harm" to patients if Britain returned to crowded casualty units with "elastic walls". Instead, she said patients should be given a "contact point", such as the NHS 111 line, to book a slot in an emergency department, be seen directly by a specialist or diverted to the care they need. 

This week, A&E doctors said changes to the layouts of A&E departments to segregate patients and ensure social distancing meant they could cope with about half as many patients as they used to. 

It came as they raised fears that casualty units could end up overwhelmed  if drinkers overdo their celebrations when pubs reopen on July 4. A memo from NHS officials to hospital trusts has warned them to plan for "peaks in activity similar to that of New Year's Eve".