Accessing Urgent and Emergency Care: NHS 111 Help Us Help You
North Central London (NCL) is part of a national Urgent and Emergency Care (UEC) restoration programme for which London will be an early adopter. The NHS 111 Help Us Help You (HUHY) programme aims to support and develop UEC services as we move into the second phase of the Covid-19 pandemic response.
As the number of people needing specialist care for Covid-related illness gradually reduces and lockdown restrictions ease, we can expect to see increased numbers of patients using UEC services. We need to ensure that patients are given the care and support they need, in the right care setting, while maintaining physical distancing and infection prevention control measures.
On average, 70% of Emergency Department (ED) attendances are made up of walk-in patients, the rest being ambulance arrivals. The majority of walk-in attendances are also during the day and early evening. With social distancing being likely to continue for some time, the possibility of a filled waiting room will no longer be safe with the ongoing risk of nosocomial spread. Clinical triage and prioritisation will need to be undertaken remotely in most cases to assist the public with a new approach to UEC care.
To achieve this, the NHS111 HUHY programme will deliver a change to the streaming of non-urgent patients away from EDs and Urgent Treatment Centres (UTC) into other care settings and promote this to the public as the best route to care.
Central to this approach, we will encourage residents and patients to access UEC services through their GP surgery or NHS 111, either over the phone or online. This will help ensure services are resilient and flexible should there be another surge for services and will help to manage the risk of infection and demand. We will also be able to reassure patients that healthcare settings are as safe as possible and residents can seek support and help when they need care.
We have been working with NCL’s NHS 111 provider, London Central and West (LCW), to ensure that they can operate an enhanced service to manage an expected increase in demand, with more clinical and non-clinical trained advisors available to help with a range of issues. NHS 111 can already book appointments into a range of services, such as UTCs, in-hours GP services, extended and out-of-hours GP services and community pharmacies. The HUHY programme will build upon and extend this offer by enabling direct referral to a number of additional services such as Same Day Emergency Care (SDEC), provider outpatient ‘hot-clinics’ and mental health crisis services, whilst also increasing the number of direct referrals to primary care where it is appropriate to do so.
For patients, this approach means they are directed to the right care setting, ensuring that they can get timely and appropriate care. Patients will be offered a range of options depending on their circumstances and clinical urgency, such as a video consultation with a GP, a face to face appointment at GP surgery or UTC, or self-care tips from a trained advisor. If patients are showing possible Covid-related symptoms, NHS 111 can also direct them to specialist care or arrange a home visit.
As a result of these changes, A&E departments and UTCs will see fewer walk-ins from patients with conditions that can be more effectively treated elsewhere. This will help make infection control and social distancing more manageable and protect all patients and NHS staff.
Patients with serious or life-threatening symptoms, such as loss of consciousness, sustained fits, chest pain, severe bleeding, severe allergic reactions, severe burns or scalds, stroke or major trauma should still call 999 or go to A&E.