Information on the UTC transition to an 'equitable access' model

The below is a letter recently sent to UTCs asking them to change to an ‘equitable access’ model, and is for your information only.

URGENT ACTION REQUIRED: London Transition to 'Equitable Access' UTC Model

We would like to confirm the criteria to be applied for managing patient access to all Urgent Treatment Centres (UTCs) in London during the next phase of our COVID-19 response. These criteria are in line with the actions outlined in the letter from Sir Simon Stevens and Amanda Pritchard, issued on 17th March 2020.

UTCs play a key role in the face-to-face assessment of patients with urgent medical needs, whether or not they have suspected COVID-19 symptoms. We are aware that, in some areas of London, UTCs have asked for face-to-face appointments booked by the NHS 111 telephony service to be converted to appointments for telephone consultations, so that UTC clinicians can manage any COVID-19 risk for staff and other patients.

Whilst we understand the need for this telephone consultation process, we are also aware that UTCs need to continue to offer walk-in access for all patients with an urgent medical need, particularly those with non-COVID-19 clinical presentations. This is especially true in London, where the majority of UTCs are colocated with Emergency Departments and already perform a ‘front door triage’ function, and where utilisation of the established NHS 111 Online assessment tool is on the increase. (NB Users of the NHS 111 Online COVID-19 assessment pathway are not directed to attend a UTC.)

We would therefore ask all UTCs in London to undertake a transition to the following model, which is in line with the actions outlined in the letter of 17th March:

  1. For all walk-in patients, whether or not they have been referred by NHS 111 – segregate all patients with respiratory problems (including presumed COVID-19 patients) by introducing measures such as appropriate local signage and further clinical assessment by suitably protected staff at the front door.
  2. For all UTC-type dispositions referred by NHS 111 – continue to allow direct booking of face-to-face appointments (via 111 telephony) or walk-ins (via 111 telephony or online), and follow the local segregation process (see 1. above) once patients arrive at the UTC. With direct booking, patient expectations will need to be managed around longer waiting times at times of increased pressure on the UTC – this can be done at the time of booking and/or on arrival at the UTC.
  3. For all primary care dispositions referred to UTCs by NHS 111 – consider introducing a clear process for offering telephone consultations only (i.e. no walk-ins) so that UTC staff can manage these patients safely over the phone. This may involve advice only, or advice with electronic prescribing, or – where appropriate – attending a face-to-face appointment at the UTC. Direct booking of appointments for telephone consultations may be considered here, alongside direct booking of face-to-face appointments (see 2. above).

We require you to implement this model across all your UTCs (including making appropriate changes to the UEC Directory of Services) by 10am on Friday 27th March 2020 to ensure equitable access for all patients, whether they have called NHS 111 or used NHS 111 Online. Please respond to to confirm that you have received this letter and that you will complete this work by 10am on Friday 27th March 2020.

Thank you for your continued support in these challenging times.