04.02.15
NHS 111 increasing pressure on GP and A&E services, warns BMA
Overstretched GP and A&E services are facing mounting pressure as referrals from NHS 111 have nearly tripled, senior doctors have warned.
Analysis by the British Medical Association (BMA), based on the latest NHS 111 minimum dataset from NHS England, revealed that in the last year calls referred through to GP services had gone up by 186%, and to A&E by 192%.
Comparing data from January-October 2013 with the same period in 2014, the BMA revealed that the number of calls referred to GP services went from 2.8 million to 8.1 million – an increase of 5.3 million.
Dr Charlotte Jones, BMA’s GP lead on NHS 111, said: “The BMA has consistently highlighted serious concerns about NHS 111 and how it is not delivering appropriate advice and outcomes for patients who call the service.
“Although there have been some improvements in capacity since its disastrous early introduction, this analysis of referrals over the past two years demonstrate that there has been a huge increase in the number of people put through to key parts of the NHS such as A&E and general practice.”
She added that GPs have reported to the BMA that patients have been referred to them with colds, sore thumbs or other conditions that could have been treated safely by sensible advice over the phone, advising a patient on how to self-care, such as picking up medication from a local pharmacist.
But NHS England claim that the figures “clearly show” that there is a massive demand from the public for the 111 service, and that it is looking at ways to make the service “more robust”.
The figures for A&E referrals are similar to that of GPs with the number rising by 718,461 from 374,506 to more than 1.09 million in the same 12-month period. It is also worth noting that these figures relate to the period before A&E services were faced by overwhelming demand pressure this winter, which led to scores of hospitals declaring ‘major incidents’.
Dr Mark Porter, BMA chair of Council, said a fundamental problem with NHS 111 is that it employs non-clinically trained staff who “follow a formulaic script” rather than using clinical judgement to assess how calls are dealt with.
“Understandably this is likely to lead the call handlers, with limited experience of medicine, to be cautious and refer patients to the NHS when a trained professional could have encouraged them to effectively self-care,” he said. “Key NHS services cannot afford to be taking on unnecessary work when they are struggling to treat the number of patients who do need genuine care.”
Figures from the Primary Care Foundation estimate that the number of calls designated as ‘self-care’ – where patients can safely treat their condition after advice from a call hander – may have declined from 48% in 2012 down to an average of just 15% in 2013 and 2014.
However, an NHS England spokesperson said: “To date NHS 111 has coped impressively with the demand pressure with the proportion of referrals to GPs and emergency services remaining steady despite the surge in demand.
“Given this popularity, however, we are continuing to look at ways to make the service even more robust including asking GPs to help support call centres and provide patients with the ability to get high quality medical advice as quickly as possible.”
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