Under the 2020/21 GP contract, practices were required to make 1 appointment per 3,000 registered patients per day available for direct booking from 111.
However, this was expanded in March to 1 per 500 patients as part of the response to the COVID-19 pandemic - with the extended requirement in place initially until June, and later extended to 30 September.
The direct booking requirement, which means the average practice in England must make around 18 appointments per day available via 111, could now be extended beyond the end of this month after the DHSC confirmed it is 'under review'.
NHS 111 expansion
The direct booking plans come as the government unveiled a £24m investment in NHS 111 to increase call handling capacity and 'have more clinicians on hand to provide expert advice and guidance'.
The government is piloting a system that would make 111 the NHS 'front door to urgent care' - in a drive to reduce unnecessary A&E attendances. If successful, the model - which would see 111 'build on its role during the pandemic to direct patients to the most clinically appropriate service, including emergency departments, an urgent treatment centre, a GP or mental health professional' - could be rolled out nationwide from December.
The plans suggest a recruitment drive could target more GPs to support the service - but the government did not confirm how many would be brought in.
Investment to expand 111 ahead of this winter comes as the government announced £150m in funding to expand and upgrade 25 A&E departments - on top of a previously announced £300m investment spread across 117 emergency departments.
In a letter to GP practices earlier this year explaining the decision to extend the 1 per 500 patients threshold for 111 direct booking, NHS England said access to these appointments was 'necessary to support phase two of the NHS response, in particular the important role NHS 111 is playing in reducing the face-to-face transmission risk for patients and NHS staff'.
Appointments made available by practices for 111 booking are normally released two hours prior to the appointment time if not used. NHS England has made clear that where bookings are made via 111 practices 'should clinically assess the patients remotely and arrange their ongoing management'.
Health and social care secretary Matt Hancock said: 'During the peak of the pandemic we saw millions of people using NHS 111 to get the best possible advice on COVID-19, and other urgent NHS services. These pilots will build on this and test whether we can deliver quicker access to the right care, provide a better service for the public and ensure our dedicated NHS staff aren’t overwhelmed.'