General practitioners in England have called for practices to “turn off” NHS 111 referrals when practices are overwhelmed with demand.
The English LMCs conference also heard that the service is “not serving the purpose” as people are often booked into GP slots for non-urgent issues.
Overall, 98% of respondents agreed that the service causes delays in the GP office, ambulance and emergency room for issues that can wait that GP practices need to be able to turn off direct bookings when they are under pressure.
Dr. Paula Newton of Cambridgeshire LMC said she recently advised the parents of a child with symptoms of upper respiratory infection, including a PCR test.
About 30 minutes later, the child appeared on the direct booking list of NHS 111 because the parent did not want to do PCR and requested to be seen.
She told the conference, “Can you imagine a secondary care counseling, which is probably also far away, being hijacked this way.
“How can this be a safe and effective way to get a health care provider on their knees?”
Dr. Carter Singh, speaking for Nottinghamshire LMC, said the general practice has become the “dump of 111”.
“The workflow for fulfilling the requirements in our practice corresponded at times to an additional full-time general practitioner,” he said, so that patients can play the system and have access to the doctor on duty via the back door if they have chronic routine problems.
He said local attempts to fix the problem had not worked. “We need the clout of our GPC to negotiate, to either withdraw this service or to design it in such a way that it is manageable and interlinked with general practice in a way that increases quality and quality.
When bringing the motion to the conference, Dr. Peter Holden, Member of the Derbyshire LMC, said GPs shouldn’t be the answer to the Amazon Prime culture.
“In general practice, there is simply no spare capacity to provide urgent, unscheduled relief, and therefore 111 should not be allowed to transfer cases to general practice other than for routine bookings.
‘111 has become the way pointy elbows come to the front of the line regardless of clinical need.’
Dr. Ben Molyneux, GPC’s policy lead on the matter, said he supported all of the requests, but especially the ability to change direct booking.
General practitioners’ practices must make an appointment for every 3,000 registered patients per day, which can be booked directly from the NHS 111.
During the pandemic, this was increased to one appointment per 500 registered patients per day, but this temporary mandate ended on September 30th.
Movement in full
10 AGENDA COMMITTEE PROPOSED BY DERBYSHIRE: This conference in relation to NHS 111:
(i) Believes that General Practice is not an emergency service and cannot safely take one / two hour dispositions from NHS 111 services and requests that they cease FILES
(ii) recognizes that it has become a channel for the flow of patients, causing delays for emergency services, A&E departments, and the NHS general practice in the event of non-urgent issues FILES
(iii) Asks for its full review to ensure that the minutes, staffing and funding are appropriate FILES
(iv) Requires that all direct NHS 111 bookings to the NHS GP practice be suspended if the practice has reported an OPEL4 / Red Alert (or equivalent). FILES