When it’s urgent but not an emergency by Dr Dave Flynn, A&E Consultant

As we all emerge from the pandemic we continue to help those patients that are in need of urgent care and for a number of reasons this group of patients is increasing.  Some may have ignored or dismissed early symptoms and are only now seeking treatment, some may be unclear which service they actually need so try a number of routes and some believe that going to A&E or calling an ambulance will get the treatment they need quicker. This and the incredible covid-19 vaccination programme all adds up to increased demand across the whole NHS set against a backdrop of fewer staff due to isolation and sickness and deployment to other duties.

As an NHS we need to encourage patients that need urgent care to use the NHS111 service. By answering a few questions the patient will end up with a recommendation on what to do next or a ‘disposition’.  The questions or algorithm were written by clinicians and the disposition will pull information from the Directory of Services for Lincolnshire. So, depending on their disposition, where the patient lives and day and time they could be directed to A&E, Urgent Treatment Centre, their GP or a pharmacy near them. Other services are available of course.

Work is going on behind the scenes for patients that need to be seen in A&E to be given a timeslot to arrive.  This helps us manage patient flow and keep patients and staff safe by minimising crowding in waiting areas.  Some counties can already book appointments with GPs and pharmacies and some are still working on that service. 

We are encouraging those patients that have the technology to use NHS111 online.  By logging onto https://111.nhs.uk/ users will be asked the same questions as they would by a call handler.  If they need an ambulance one will be called and if they need to speak to a clinician it will be arranged as a call back.  The NHS111 online service is also available through the NHSApp.  The call handlers are supported by GPs and nurses who sit with them and are able to help with any ambiguous symptoms or talk to the patient if needed.

The ambulance service also employs a number of clinicians such as GPs who can also advise on whether an ambulance needs dispatching.

By using NHS111 first we are working to keep ED for those that really need it.  And those patients that don’t need ED are more likely to get the right treatment for their condition using other services more suited to their symptoms.