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People may no longer be able to walk-in at accident and emergency (A&E) units at hospitals, unless they have prior authorisation from their doctor, or have been told to do so by the NHS 111 helpline.

This new approach to A&E services has been suggested by senior health official, Helen Thomas, national medical director for integrated emergency care at NHS England.

She had discussed piloting the idea with some hospitals but NHS bosses have insisted that there are no agreed plans for the trial to be implemented yet.

Health secretary, Jeremy Hunt, has discussed a “talk before you walk” scheme, Dr Thomas told a conference.

“It’s been done in other countries where they’ve actually said you can’t come into A&E until you’ve talked on referral or you have to have that sort of docket that you’re given by having talked on the phone that you do need to come,” she said.

According to Pulse magazine, Dr Thomas told the Urgent Health UK conference: “I think that’s politically quite a hot potato, but there are places that have said they are willing to pilot it, and if we could just pilot it in one area we could get some really interesting information.”

NHS England denied that this would happen. A spokesman said: “It is wrong to suggest or imply that the NHS will do anything other than continue to provide A&E care for all patients who need it, nor are there any plans to prevent patients from visiting A&Es.”

However, a campaign to urge people without life-threatening injuries to phone the NHS 111 helpline before going to A&E is in planning, as many patients could be treated by out-of-hours GPs or pharmacists.

Chaand Nagpaul, chairman of the British Medical Association’s council, said that overstretched GPs would not be able to make such a scheme work. “All this proposed system would do is add an extra layer of bureaucracy for patients and an extra burden on the NHS, GPs or other clinicians,” he said.

“It could also have the added effect of increasing the burden on the ambulance service as people could instead just call an ambulance to get a place in A&E.”

A Department of Health spokeswoman said: “There are no plans to pilot this approach. Unprecedented planning has gone into preparing the NHS for this winter, supported by an extra £100 million for A&E departments and £2 billion for the social care system.”

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