Major A&E shake-up plans to be rolled out in coming weeks

Pilots for a new urgent care model requiring walk-in patients to book slots in emergency departments are expected to be rolled out in at least one site in every health system in the coming weeks, HSJ has learned.

The move comes amid concerns from trust managers who warned some 111 providers’ systems were too “risk averse” and were sending too many patients who could have been treated in other care settings to hospitals.

Local managers believe NHS 111 not directing enough people to alternative services was a cause of a major incident at Gloucestershire Hospitals Foundation Trust’s emergency services earlier this month, HSJ understands. And trust leaders in other parts of the country are understood to have similar concerns.

Trials of 111 First have already been publicly confirmed at Portsmouth Hospitals Trust, Royal Cornwall Trust, Newcastle Hospitals FT and Blackpool Hospitals FT. HSJ also understands five London sites, one for each integrated care system in the capital, are also running trials.

These “early adopter” trusts have been given autonomy to trial different models for “111 First”. Most EDs at these sites still treat “walk-in patients” as normal. But in Portsmouth, patients with minor injuries who turn up at ED without calling ahead have, on three different days, been instead told to call 111 following assessments.

NHS England said further trials will take place in the Midlands and East of England, but the specific trusts undertaking these trials have not been decided yet.

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Source: HSJ, 2 September 2020