PEOPLE in Wales are set to be asked in future to phone first before going to A&E, to avoid overcrowding and queuing outside hospitals, says health minister Vaughan Gething.

Emergency services in Wales will be remodeled as part of the response to the ongoing challenges coronavirus will pose for health services.

And that will likely mean people whose conditions are not life threatening or serious being advised via telephone triage of more appropriate services to treat their conditions or injuries, instead of everyone automatically seeking care at their local A&E department.

Such an idea will be trialled at Cardiff and Vale University Health Board, beginning next month and modelled on a successful Scandinavian scheme - and it is likely that all parts of Wales will adopt such a system in the not too distant future.

But it is being stressed that the emergency 999 service will not be affected by the changes.

“The NHS has had to adapt quickly to respond to the pandemic, while keeping staff and patients safe and continuing to deliver the urgent and emergency care services people need," said health minister Vaughan Gething.

“We have looked very closely at how people access urgent and emergency care services, in response to the risks and restrictions the pandemic has brought.

“Lockdown saw a sharp reduction in attendances at emergency departments, and a large increase in people accessing support and advice remotely via NHS 111 and online services.

“As attendances begin to return to more normal levels, these changes in how people have been accessing services over recent weeks is something leading clinicians say must be maintained.”


Evidence indicates that a proportion of people who come to emergency departments do not require the expert care provided there, and would benefit from either self care or accessing advice, healthcare or social care in other parts of the system.

Emerging evidence also suggests that a reduction in emergency department attendances over the course of the pandemic has related in a greater number to ‘lower risk’ patients, whose experience and outcomes would have benefited from accessing advice or care elsewhere.

But during the last month, as increasing numbers of people have sought treatment at emergency departments, some health boards have reported queues forming outside as a result of the reduced space introduced inside these departments to prevent the spread of coronavirus.

The Royal College of Emergency Medicine (RCEM) and the Royal College of Physicians have expressed concerns about the safety of people and staff if emergency departments become overcrowded.

The trial to be run by Cardiff and Vale University Health Board, announced last week and called the CAV 24/7 phone service, is designed to help people who want or need urgent care to access the right advice or treatment in the right place.

People who call the service will be directed to the most appropriate service for their need. This could mean people will be encouraged to self-care, be advised of a more appropriate services in their local community, or be directly booked in for a personal appointment in an urgent care centre or emergency department.

“People with life-threatening or serious conditions should continue to access services in the usual way but, with new physical distance measures in place, we need to better manage people with less severe conditions in their local communities or schedule urgent appointments to avoid overcrowding and queuing outside departments," said Mr Gething.

“We do not want to see large families or large groups of people congregating in departments, so we can protect people who are at risk, vulnerable or have been shielding, but we also recognise the need to ensure people get the right service for their needs. This can often be delivered in the community.”