As part of a series of amendments to the GP contract as a result of the COVID-19 pandemic, practices in England are required to make one appointment for every 500 registered patients available for NHS 111 to book into between 30 March 2020 and 30 June 2020. This is an increase from the one appointment for every 3,000 patients practices originally had to make available under the contract.
The appointment slots are used by the new COVID-19 Clinical Assessment Service (CCAS) to transfer patients who require further assessment from their GP into the practice's workflow.
However, many practices have found that the majority of these appointment slots are not being used.
During a webinar on Thursday (7 May), director of digital primary care at NHSX Dr Masood Nazir said that practices in this position could reduce the number of slots that they make available, providing they regularly monitored the number of referrals they were receiving from CCAS.
Monitor appointment availability
'You can [reduce the appointments] as long as you monitor that list,' Dr Nazir said. 'As soon as the number that you offer gets full and you add additional ones, then yes you can do that.'
He said that if practices found more slots were being taken by CCAS, then they should increase the number available, potentially up to the original amount they had set, to ensure that they could meet demand.
Under the current system, patients with symptoms of COVID-19 are advised to contact NHS 111 as a first point of access. NHS 111 will either advise patients to stay at home and self care, coordinate an urgent hospital admission in those with severe symptoms, or they could refer some patients onto CCAS for a remote consultation.
CCAS is staffed by clinicians, primarily GPs, and following this assessment, the patient could either be advised to stay at home and self care, be directed to hospital or booked into an appointment with their practice. The patients are not given a specific appointment time, but simply told that they are being 'transferred' to their own practice for further care.
Practices are expected to look at the patient's details and then arrange a phone or video consultation to provide advice, which could then potentially result in the patient attending the surgery.
During Thursday's webinar NHS England director of primary care strategy Ed Waller said that over 950 GPs were currently available to work for CCAS, the majority of which were retired GPs who had come back to work during the pandemic. He said that since the service had launched it had dealt with 38,000 patients.