NHS England will extend the trial of direct booking of GP appointments by NHS 111 call handlers, as a component of proposals to roll this out universally and the BMA’s GP board has consented to an expansion of the pilot in 2018/19, even though participation will be optional.
However, NHS Employers stated the lessons learned will inform next year’s contract negotiations.
It comes as Pulse announced in December that Clinical Commissioning Groups (CCGs)s have been told to reserve 5 percent of GP appointments for direct booking by NHS 111, increasing to 30 percent of appointments by April 2019.
At the time, GPs stated the system would not work except if it was agreed in the contract and a pilot project has been operating in the North East of England since 2016, with participating practices offered a one-off payment of 70 pence per patient.
Outlining the details of the newly arranged settlement agreements, NHS Employers announced that NHS England intends that direct booking by the 111 clinical assessment service (CAS) into practice systems should be rolled out universally as soon as possible.
It announced the General Practitioners Committee (GPC) also notes that potential benefits and implications of direct booking into practice systems for patients and practices will be demonstrated as this work progresses.
Over the ensuing year, NHS England and GPC will pull together to promote further use of 111 direct booking where agreed with practices, to thoroughly estimate benefits and discuss any matters about its process of putting a decision or plan into effect and possible outcomes.
Lessons received, and the solutions reached, will inform a discussion in the 2019/20 contract agreements but the British Medical Association GP committee chair Dr Richard Vautrey played down the implications.
He told Pulse: ‘This is simply looking at the evidence this year of the experience of those using NHS 111 direct booking into GP appointments.
‘That’s particularly the case for extended GP access sites and there’s a pilot taking place in the North East.’
But why confuse things more and does anybody want this?
The dilemma is that we have some patients with particularly complicated needs who simply have to be seen for their many unsorted issues and identified in print for their GP to follow up on and that just won’t get sorted until the coroner has to be called in because they have died because some nincompoop from NHS 111 and who has barely been given enough instruction and reads off a prompt sheet and has announced to the patient that they’re not an emergency.
We whine about the receptionists at our doctor’s surgery, but at least they know how the method operates better than some NHS 111 person at the end of the telephone and at least has some discretion when it comes to their patients and knows which ones have to be seen quickly or at least followed up promptly.
Good luck to NHS 111, it’s a struggling and rubbish service, it’s a lunatic system and affects public safety and confidence but of course, you can see where this is heading, the government wants the system so inadequate that it disintegrates on its own.
Then the people themselves will demand the system to be improved and will be ready to finance part of their health care, in which case the government will recommend full privatisation for health care and this is actually what the government wants.
It will happen, gradually but most definitely and it will take several fatalities with it. Politicians will not shoot themselves in the foot by telling the public they must provide directly for their health care, so be ready for a surprisingly rocky spin in the next few years.
NHS Direct is a farce, ignorant and incompetent and a pretty quick process or set of rules they use for you. They ask, do you feel ill, well if you felt okay you wouldn’t be phoning them! If you say yes, then they say, see your GP.
Do you think you need to see your GP, then see your GP inside 12 hours, well you didn’t need to phone NHS 111 for that. Do you not want to see your GP, then see your GP.
There are simply numerous patients out there that are not sure if they require hospital and simply want advice because it’s a weekend and they can’t get to see their GP until the Monday, but they’re informed they must see a GP.
GP’s usually handle risk well, however NHS 111 doesn’t handle risk at all, see GP! Furthermore, there have been numerous horror stories about NHS 111 and nobody can efficiently determine anything over the telephone, if that were the situation we would be going online and diagnosing ourselves and we wouldn’t require NHS 111 at all.
Really, it’s far safer to take yourself to A&E or to your doctor’s surgery, if it’s open just to be safe and it’s far safer to spend 4 hours in A&E, than wasting time on the telephone about any concerns you might have, essentially talking to a call centre.
What nincompoop in the NHS conceived this absurd plan and then NHS England gets a sexy gratuity for this idea and who in their right mind believes that NHS 111 is more able of coordinating GP appointments than the practice that truly knows their patients?
This will of course end in tragedy and of course, GPs will get the blame as normal.