Out-of-hours phone calls with GPs could 'ease crisis in A&E': Review of emergency care says current system is 'unaffordable and unsustainable' The review of emergency healthcare is bid to tackle mounting NHS crisis Some experts claim could lead to the system collapsing within six months Many patients are turning to emergency care services for minor conditions Getting telephone advice could be the key to putting the brakes on soaring patient demand on A & E, according to a review of emergency healthcare in the NHS. It warns the current system is "unaffordable, unsustainable and consuming NHS resources at a greater rate every year." The review is a new bid to tackle a mounting crisis that some experts claim could lead to the system collapsing within six months. Getting telephone advice could be the key to putting the brakes on soaring patient demand on A & E, according to a review of emergency healthcare in the NHS Patients face "fragmented" services, are confused over where to get care out of hours and often contact more than one NHS service for help. Many patients are turning to urgent and emergency care services for conditions that could be better treated in primary care because they cannot get, it says. At least 100 million NHS calls or visits are made for urgent and unplanned care each year - about one-third of overall NHS activity - with rising emergency admissions to hospital. Poor care in hospitals at weekends - including lack of senior emergency doctors 24 hours a day - is to blame for the loss of 4,400 lives a year in England, says the review. But inadequate staffing in Accident and Emergency units mean a 24/7 service is not currently possible, it says. Telephone-led care could ease the pressure, preventing many unnecessary attendances at NHS hospitals, walk-in centres and GP practices, says the review. It claims telephone consultations are becoming increasingly popular and are less "resource-heavy" for general practice than face-to-face consultations. Jeremy Hunt said 'huge pressures' in A&E reflect other problems in the health service because it acts as a barometer for the whole system "However some patients lack confidence in telephone advice and are likely to pursue a second opinion inappropriately, leading to duplication of service provision," says the review by NHS England. Following the example set in Australia and North America, where doctors are involved at an earlier stage as call handlers, could help reduce the number of patients sent to hospital. Critics claim the botched introduction of the non-emergency 111 telephone line in some parts of the country in April has also undermined patient confidence. The review says patients often "default" to A&E units and the 999 ambulance service because of their reliability and ease of access. But around one-quarter of A&E attendances could be treated elsewhere, with the remainder being serious or life-threatening conditions. The review signals the start of a public consultation to produce new ways of organising urgent and emergency care. Professor Keith Willett, chairman of the review's steering group, said "We know that A&E is the pinch point of the health and care system and that staff are working very hard to provide the care they know the public need. Telephone-led care could ease the pressure, preventing many unnecessary attendances at NHS hospitals, walk-in centres and GP practices, says the review To relieve the pressure and design a system that is sustainable and fit to meet future challenges, we need as many patients, doctors, nurses and NHS colleagues as possible to get involved. Earlier this month the Health Secretary said NHS leaders are creating a "vulnerable older people's plan" to help alleviate the stress on accident and emergency wards. Jeremy Hunt said "huge pressures" in A&E reflect other problems in the health service because it acts as a barometer for the whole system. Professor Norman Williams President of the Royal College of Surgeons, said "For many patients Accident and Emergency departments are the go-to place where they know they will be seen and treated at any time of the day or night. This has led to rising pressure that has put the system under enormous strain. It is important that a sustainable urgent and emergency care system emerges from the review so that hospitals can focus on treating some of the sickest patients, about a fifth of whom will require urgent surgery. We need some innovative and workable solutions that deliver high quality care seven days a week and this will require all parts of the system working cohesively. Dr Mark Porter, Chair of council of the British Medical Association, said "This review recognises the complex pressures on urgent care and as such is more likely to produce sustainable solutions. So far the Government's response to this has been overly simplistic, with the blame being put squarely on individual parts of the health service. Emergency care providers are facing high levels of demand that are only going to increase in the years to come, and become more complex as the population grows and people live longer. Andy Burnham MP, Labour's Shadow Health Secretary, said "The Government's botched implementation of NHS 111 has resulted in trust in the telephone service being eroded. On top of that, since 2010, walk-in centres have been closed and evening and weekend opening by GPs has fallen. At the same time, the Government has slashed council budgets resulting in more and more older people left without the care and support they need to help them remain at home or to return home after a hospital stay. Mike Farrar, chief executive of the NHS Confederation, said "We need to look at transformative ways to improve the whole service in the long-term so people get the right care, and know where and how to access it."