NHS England urgently appeals to GPs to staff triage service

The national covid-19 clinical assessment service, or CCAS, serves a cohort of patients with coronavirus symptoms deemed by 111 as needing a clinical assessment over the phone or online.

An email to GPs from NHSE’s primary care directors on Friday evening said: “We urgently need more GPs help to staff this service, especially as covid-19 cases increase over coming days, because of your expertise and experience.”

The centre wants GPs who can “make a substantial time commitment” of two four-hour sessions per week, in shift patterns, ensuring the service is staffed 24/7. There is a particular need for doctors who can work “in normal working hours”.

NHSE said it would be “happy for practices to repurpose a proportion of current extended access hours to allow their doctors to support the service in normal hours”, subject to agreement with local commissioners.

Clinical commissioning groups will also “wish to ensure there is sufficient capacity locally for the CCAS to book into, for face to face assessment where needed”.

The work can be on a voluntary basis during the hours a GP is already contracted to provide, or in addition to them, and paid at £200 a session. They will receive four hours training and sign an “honorary contract with South Central Ambulance Service Foundation Trust to work as part of the CCAS”.

The doctors in the CCAS are working remotely either from home or their surgeries. It has drawn on the ranks of recently retired medics who have returned to work during the covid-19 crisis.

The new 111 algorithm sorts patients into four cohorts, with the most serious who need to go to hospital straight away and the least serious who need to self-isolate with mild symptoms. The CCAS service is directed at the second most severe cohort — symptomatic patients that need clinical assessment.

Patients in this cohort are then sorted again by the CCAS service as either needing to be pushed up to the top cohort and sent to hospital, pushed down to the cohort with mild symptoms needing to self-isolate, or as needing a follow-up.

These patients then either receive proactive monitoring from their GP with routine phone calls to track their condition, or they are sent for a face-to-face assessment with a clinician.