• How people access parts of emergency care in London is changing 
• People who need urgent, but not life-threatening, care are being asked to contact NHS 111 before going to A&E. This will reduce waiting times and support social distancing in waiting rooms 
• 111 First will mean from 1 December all Londoners can have an appointment booked for them at a nearby A&E if it’s needed  
• General Practice is open as usual for telephone, online, video and face-to-face appointments 

How people access parts of emergency care in London is changing, with ‘111 First’ helping them to get the right care, in the right place, more quickly.   

All Londoners are being asked to contact NHS 111 online or by phone first, before going to a hospital Accident and Emergency department (A&E/ED) if they have an urgent, but not life-threatening, medical need.   

The new arrangements will also help the NHS to better control the risk of coronavirus while space in A&E waiting rooms is reduced to ensure social distancing. 

From 1 December, NHS 111 can arrange an urgent face-to-face A&E appointment during an allocated time slot anywhere in London, if someone needs it – meaning shorter waiting times and fewer people in A&E.  Arrangements are also in place to let A&Es know if shielding patients are coming so they can be kept safe. 

NHS 111 can also make direct appointments online, by phone or face–to–face with a variety of health services, including Urgent Treatment Centres, a patient’s own GP, specialised mental health crisis services, dental services and pharmacists for urgent repeat prescriptions and advice.  If needed, an ambulance can also be despatched. 

NHS 111 online or by phone, which is being significantly expanded in the capital, is already available at any time of day or night with trained health advisers, doctors, nurses, paramedics or pharmacists able to get people the right NHS care quickly and in the right place.  

Arrangements will not change for people with life-threatening illnesses or injuries who should continue to dial 999 and anyone who arrives at A&E without calling NHS 111 will still receive medical care, with those needing emergency treatment prioritised.  

GP practices are open as usual.  Contact them first, as you normally would, if you need an appointment with your GP.   

Dr Vin Diwakar, Medical Director for the NHS in London said:  

“The NHS has put in place extra measures to prevent the spread of Covid-19 and we want to reassure patients that it is safe to come in for treatment when they need it.  However, the risk of catching Covid-19 is still here and it’s vital that we take additional steps to keep our patients and staff safe.   

“111 First will help reduce the waiting time to be seen in A&E; instead Londoners will get the treatment they need faster and in the right place.  

“General Practice is open to deal with patients with normal primary care needs, but it is essential that anyone who requires urgent, although not life-threatening treatment, contacts NHS 111 first to get the right care.”  

Dr James Ray, Regional Clinical Lead UEC London and National Clinical Advisor for 111 First, added:  

“This is great news for patients in London.  There are now more doctors, nurses, pharmacists, paramedics, dental nurses and trained health advisors within NHS 111 than ever before to respond to Londoners’ health needs and ensure they get the treatment they need, without delay, and without having to wait around to be seen.” 

Dr Katherine Henderson, President of the Royal College of Emergency Medicine and Emergency Medicine Consultant at a London hospital, said:  

“It’s now more important than ever that patients receive the care most appropriate to their needs, and expansion of 111 First will help enable that. By calling 111 first patients can potentially avoid waiting unnecessarily in an A&E waiting room, put their mind at ease and find the service that is right for their needs.”  

Bookable slots are already available at six hospital sites: The Royal London Hospital, North Middlesex University Hospital, Chelsea and Westminster Hospital, Queen Elizabeth Hospital Woolwich, Croydon University Hospital and Barnet Hospital.  

To support the 111 First initiative as we go into the traditionally busy winter period, capacity in the NHS 111 service is being expanded significantly.  

Around 2,500 staff look after Londoners as part of the NHS 111 service, 24/7 365 days of the year; this number will be expanded by 644, including 166 more doctors, nurses, pharmacists and paramedics. 

London’s approach has been developed by hospital consultants, GPs, nurses, paramedics pharmacists, social workers, mental health specialists, NHS 111 teams in the capital, using local knowledge and expertise.  This is similar to that being used across the rest of the country but the region has also spoken with a number of people from across the capital to get their views and considered their feedback as part of the design process, ensuring the approach works for Londoners.