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Update on Local CAS Provision

Publication date: October 2021

For Yorkshire and Humber, the 111 service is provided by YAS and, as part of this, a Clinical Assessment Service (CAS) using nurses and paramedics (and a subcontract with Vocare for additional clinical support) is provided for patients who need advice from a clinician.

This service supports decision making to ensure patients reach the right disposition/triage outcome for their need as described in the call to 111 or use of 111 online. Patients go through to this clinical assessment service if the disposition is unclear or if NHS pathways tool recommends a clinical review.

The local CAS – an enhanced offer of the existing HCV wide service – is now managing Primary Care 1 and 2 hour “speak to” dispositions through NHS 111.

This part of the service went live on Monday 27 September, with further ED and online dispositions to go live in the coming weeks.

This means that all NHS111 calls (during core GP hours) - for which the outcome is the need to speak to Primary Care within 1 or 2 hours - will be triaged initially by a GP working on behalf of the CAS service.

  • The advantage of this approach is that 70% of volumes are either closed as self-care or redirected to alternate provision for face to face (e.g. UTC).
  • Using GPs to deal with this primary care call ensures consistency of approach and seamless services, leading to a reduced number needing physical face to face care.
  • The service will operate between Monday to Friday 8am to 6pm, in line with primary care core access.
  • This service is expected to handle 150 cases per week and redirect / close 70% of these (105 cases) that would historically have atttended and called upon primary care GPs.

Ultimately the CAS should reduce the number of GP one and two-hour dispositions from NHS111 to primary care, and ensure that those which are signposted to General Practices genuinely require a face-to-face appointment.

The new pathways should work as below:

New CAS Pathways

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