Covid-19 NHS 111 & CCAS

Date sent: Friday 17 April 2020

*Update post message below - Changes to the GP Contract 1st October 2020

Until 31st March 2021 there will be a continuation of the temporary increase in the number of appointment slots that practices must make available for direct booking by 111 to 1 slot per 500 patients per day.

Email sent by Wessex LMCs, on Friday, 17 Apr 2020

We understand that there maybe some confusion about the new CCAS service (a sub section of NHS111) and the slots that practices are required to make available.

The current Primary Care SOP includes some details and a flowchart around the CCAS process at a national level. It is possible that CCG’s will need to amend this as necessary to localise the CCAS offering. (Details on page 12-14). If another SOP is published in the near future we will check this information for any contradiction.

*The GMS/PMS regulations have been amended to increase the minimum number of appointments that practices must make available for 111 direct booking. As per NHSE preparedness letter of 14th April 2020 , until 30 June 2020 all practices in England must make 1 appointment per 500 registered patients per day available for direct booking by NHS111. (Previously 1:3000)

We would also add that where practices have agreed to open at weekends there is no need to offer any CCAS or NHS111 slots as opening at weekends is not contractual core hours and it is for practices to agree with commissioners what service they will provide.

We suggest it is important to note that the “appointment” slots that CCAS books patients into at the practice are the method by which to add the patient to the practice triage list or booked “worklist” They are not necessarily for the practice to see the patient face to face nor are they meant to be an actual appointment slot – this is for practices to decide how to manage once added to the worklist/triage/appt list.

The paragraph below from the Primary Care SOP is helpful and tells us:-

To enable transfer of patients to local primary care services (for remote or face-to- face input), practices should:

• enable GP Connect for appointment booking and recording access
• ensure nominal appointment slots are available so that patients can be ‘booked’ into a worklist.

When NHS 111/CCAS books patients into a nominal appointment slot, they will be informed that their practice will contact them to arrange appropriate follow up, as required. They will not be given a specific appointment time. Practices should triage patients booked into these appointments based on the CCAS clinician assessment, and arrange ongoing management based on the degree of urgency, and on local systems for face to face consultation of patients with symptoms of COVID-19, as appropriate.

The post event message that practices will receive, is a tool for NHS111 to inform the GP that a Covid-19 assessment has taken place. We currently understand that these will enter the practice system in a similar way to other NHS111 reports/communications that practices currently receive of any patient interaction.

The GPC believe that in most areas the numbers transferred will be far fewer than were originally modelled, and which led to the 1:500 figure.

With best wishes

Dawn

Dawn Chalcraft

Assistant to Directors of Primary Care

Given the current Covid-19 situation, Wessex LMCs have made the decision to remote work until further notice. Please note that all face to face events have been cancelled until the 29th May 2020.

POST E-MAIL UPDATE

Since sending the e-mail above, we have now been advised that practices in Dorset do not need to enable GP Connect as there is a local solution different to that of the national one.

We are advised that the CCAS will route all calls to the Dorset IUCS that require a GP assessment / appointment, the IUCS will triage the patient and any face to face appointments needed will use the IAGPS slots which currently have capacity. Should the volumes start to exceed the IUCS/IAGPS capacity then patients may need to be booked in to PCN or Practice appointments but as Dorset is all (nearly) on SystmOne this, again, does not need GP connect enabled.