HSJ's Recovery Watch: Are you ready to ‘call before you walk’?

Summary

NHS England is pushing plans to introduce a ’call before you walk’ model for accident and emergency by winter. But are the health service and the public ready for such a significant shift? HSJ bureau chief and performance lead James Illman tracks the prospects and progress in HSJ's Recovery Watch newsletter.

Content

HSJ revealed this month that the ’call before you walk’ model is being trialed in London, Portsmouth and Cornwall, with system leaders keen for a wider roll-out ahead of winter. 

In these trials, which have received the backing of the Royal College of Emergency Medicine, NHS 111 is being used as a “triage point” enabling patients needing urgent treatment, but not facing medical emergencies, to book access to primary care, urgent treatment centres or same-day emergency “hot clinics” staffed by specialists.

Emergency patients just walking in, or those arriving via ambulance, will be treated, in theory, as per the current system. Similar models are used in Denmark, Norway and the Netherlands where they have high approval ratings. But these are vastly different healthcare systems with better resourced out of hospital services.

So, can the model work in the English NHS? It is critical to view efforts to introduce ‘call before you walk’ in the wider policy context. The move is part of a far wider radical overhaul of emergency care pathways broadly designed to address the dangerous overcrowding seen in EDs in recent years.