NHS England (NHSE) is pressing ahead with setting up a new emergency care system, under the guise of reducing crowding in A&E departments.
Patients will be required to phone ahead, or to book on line, in order to get an appointment in A&E, rather than simply attend in person.
In the last 6 months the public have been instructed to contact ‘NHS 111’ call centres when they suspected they had the coronavirus, to manage their care.
NHSE is now taking this opportunity to require patients to use a similar type of system, called ‘111 First’, before going to the hospital as an emergency patient.
The call handler will ask patients for their symptoms and, with the aid of an algorithm, decide where best to signpost the patient, with options to book them a slot in A&E, to direct them elsewhere, or arrange for a return phone call from a nurse, paramedic, or GP.
Patients may still dial for a 999 ambulance. But, as part of this programme, more paramedics are to be employed to ‘see and treat’ patients in their homes, in order to ‘reduce conveyance rates’ to hospital.
Hospital trusts in Portsmouth, Cornwall, Newcastle and Blackpool have been named as pilots of the new scheme, as have all five Integrated Care Systems in London.
£40m of funding is to be provided for the extra 111 call centre staff and new technology, and £2m for each ambulance trust.
This new urgent care system, designed to keep and treat urgent patients in the ‘community’ rather than admit them to hospital, is a key pillar of NHSE’s 2019 ‘NHS Long Term Plan.’
It puts at the centre of the triage system for emergency patients, call centre clerks, with a remit to try and re-direct patients away from A&E departments, over the phone. It allows them to make treatment options for patients they don’t know, potentially preventing the patient seeing a doctor face- to-face in a hospital with full back up resources.
This policy places a dangerous barrier, to access to hospital medical care, for emergency patients.
Experience during the last 6 months of the Covid crisis, has demonstrated that the withdrawal of normal access to NHS services has greatly pushed up the death rate for patients with a range of conditions, including strokes and heart attacks.
Patients have found it difficult to access their GP and thousands of outpatients appointments have been cancelled.
Excess deaths at home, from non-Covid conditions have soared during the pandemic, compared to the five-year average. Recent Office of National Statistics figures show, that there were 6,491 excess deaths at home for patients with non-Covid conditions, from July 19th to August 21st. Deaths from high blood pressure, cardiac arrhythmias and diabetes went up significantly.
A large study based at Leeds University showed that 50% less patients attended hospital for a heart attack, than in a normal period, and there was a 40% increase in the death rate for heart attacks in the first two months after the lockdown.