Patients could be banned from A&E unless a healthcare professional refers them

The "talk before you walk" scheme could see patients barred from using A&E without first seeking healthcare advice elsewhere.

Under "talk before you walk" proposals, patients would need to gain approval from either their GP or the NHS 111 advice line before self-presenting to an accident and emergency department and could be turned away without this.

The scheme is intended to improve compliance of the 4-hour target by sign-posting patients to more appropriate services.


The news comes as health services prepare, for what many experts claim will be, the "worst winter on record" for emergency care services.

Dr Helen Thomas, National Medical Advisor for Integrated Urgent Care at NHS England, said:

"Jeremy Hunt has mentioned to some of my colleagues, maybe we should have a 'talk before you walk' and we may well pilot that.

"I think it's been done in other countries where they've actually said you can't come to the emergency department until you've talked on referral or you have to have that sort of docket that you're given by having talked down the phone and being told you should come in."

But the British Medical Association (BMA) said forcing ill patients to go through an extra layer of bureaucracy would cause further delays and could compromise emergency care pathways.

A spokesman for NHS England said there were no current plans to go ahead with the scheme.

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