Future of NHS "depends on speedier healthcare outside hospitals" Senior doctors at NHS England acknowledged the problems the service has experienced, but said changes would be made to improve the service, and to increase the amount of clinical input into calls, so patients could speak directly to a nurse, doctor or other health professional if need be. In future, call centre workers would be able to access electronic patient records, so they could tailor advice more closely, the report says, while officals said they would also be able to "book" emergencies into A&E so they could be seen more quickly. Prof Jonathan Benger, National Clinical Director for Urgent Care at NHS England said: "Over the Easter period there were some difficulties with 111 but at the moment it is workign well with high levels of satisfaction... the vision is that it becomes a more comprehensive serivce moving from advice to something much more definitive." He said "more scrutiny" would be given now to working out how clinical input into calls would be increased. Last night patients groups expressed concern at the role being given to a service which had struggled to cope with the demands placed on it, and has been blamed for extra pressures on A&E last Easter, when problems with the phonelines were at their peak. Katherine Murphy, chief executive of the Patients Association, said: "Whilst we acknowledge the role that NHS 111 could play in relieving the pressure on A& E, its present performance is woefully inadequate and we are concerned that true reform of the way it works, and the skills and experience of its staff, has to occur before it is expands." Prof Keith Willett, national director for acute episodes of care, said: "This is very much an enhanced 111 system - ensuring they get the right clinical help, whether its a nurse, a dental nurse, a doctor, or maybe a pharmacist." The report says: " The NHS will enhance the NHS 111 service so that it becomes the smart call to make, creating a 24 hour, personalised priority contact service. This enhanced service will have knowledge about people's medical problems, and allow them to speak directly to a nurse, doctor or other healthcare professional if that is the most appropriate way to provide the help and advice they need. Officials said the service should "resolve" patients needs rather than just providing them with advice, and should ensure that the care they required was arranged for them. Paramedics told to treat more patients on the spot Paramedics will be told to treat thousands of patients on the scene, instead of routinely taking 999 cases to hospital, under the plans. NHS officials said up to half of all emergency calls could be safely treated without patients being taken to A&E, if staff were given more training, and ambulances turned into "mobile urgent treatment services." Prof Keith Willett, national director for acute episodes of care, said that large numbers of patients with non life-threatening conditisions were being taken to hospital unnecessarily, when they could have been given treatment or reassurance on the scene, if ambulance staff were given the right training, and closer links forged with community nurses and GPs. The report, which says the NHS "is at the limits of its capacity" and is based on an out-dated model, says: "We know that paramedics can now deliver treatments that would only havd been done by doctors 10 y ars ago, whilst with the suppor tof improved community services they can safelty manage many more people at the scene. This give sus more options to treat people at home, and to travel further to reach specialist care. The report also says more use should be made of pharmacists to advise patients, and that a plethora of centres which deal with minor injuries - which can be called walk-in centres, minior injury units, or urgent care centres - need to be given the same name, to reduce confusion among the public about what is on offer. Patients to have same-day access to GPs, seven days a week, under the plans Patients should have same day access to see a family doctor, seven days a week for routine appointments, including phone consultations, the report says. Ministers have indicated that they want to change the ways GPs work to improve the quality of care at weekends and evenings, and to make it easier for patients to get an appointment any day of the week. Later this month Prof Sir Bruce Keogh will publish a second report, which will look at ways in which the NHS should change so that it provides better care in and out of hospitals, on a "24/7" basis. Today's report says that pressures on hospitals can only be relieved if patients are confident that they can get help from their local GP, when they need it. However, officials said demands on family doctors have risen significantly in recent years, and that the amount of bureaucracy placed on them must be reduced, to free them up to see more patients. Jeremy Hunt, the Health Secretary, has said a GP contract introduced by Labour, under which most family doctors abandoned responsibility for out-of-hours care, made it harder for patients to access local care at evenings and weekends, increasing pressures on A&E. The Urgent and Emergency Care Review says an ageing population, with increasing numbers of people living longer with a multitude of serious conditions, has added to the workload of family GPs around the country.