Call-before-you-walk: Acutely ill patients being diverted from A&E departments, GPs warn

Acutely ill patients requiring emergency care are being diverted to their GP via the new NHS 111 First call-before-you-walk A&E triage system, Pulse has learned.

GPs have reported receiving inappropriate NHS 111 referrals including:

• an acutely dizzy elderly patient who was later confirmed to have had a posterior circulation stroke; 
• a patient with acute coronary syndrome; and
• a patient with acute UTI symptoms.

Meanwhile, GPs are also warning that patients are using the triage system as a way of ‘jumping the queue’ because the route is likely to get them an appointment quicker than calling their practice.

From this month, patients in England are being asked to call 111 before attending A&Es – with 111 triaging them to the most appropriate service, including GP practices.

Scottish patients are also being asked to phone ahead of attending A&E; while pilots are ongoing in Northern Ireland; and Wales is in the process of rolling out a ‘contact first’ model following summer pilots.

The BMA has said the influx of inappropriate referrals by NHS 111 is likely being ‘compounded’ by the new 111 First system, which is ‘contributing to the immense pressures currently facing primary care’.

GPs have raised concerns about several cases in which patients should not have been sent to them by 111 because they required more urgent care.

One GP, who asked not to be named, told Pulse: "I had a patient with UTI symptoms – a temperature of 39°C, a heart rate of 140, nausea and abdomen/loin pain. They were told: speak to your GP."

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Source: Pulse, 21 December 2020