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Patients could be banned from A&E unless referred by a GP or the 111 NHS phone service – under plans considered by Health Secretary Jeremy Hunt .

The “talk before you walk” scheme would mean patients could not turn up at A&E for help without first seeking advice elsewhere.

Dr Helen Thomas, national medical adviser for integrated urgent care at NHS England, said it may test the scheme to cut A&E visits.

(Image: Roland Leon/Daily Mirror)

She told doctors’ magazine Pulse that talks were at an early stage but added: “Jeremy Hunt has mentioned to some of my colleagues, maybe we should have ‘talk before you walk’ and we may well pilot that.

“It’s been done in other countries where they’ve actually said you can’t come until you’ve talked about a referral.”

Speaking at the Urgent Health UK conference, she said that of 100 patients going to A&E “only 20 have called 111”.

She added: “The other 80: some will need emergency help but an awful lot won’t.”

But Dr Chaand Nagpaul, chair of the British Medical Association , said: “Trying to solve a problem in one part of the NHS by shifting it to another won’t work.

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“Pressure on emergency departments is down to seriously ill patients and a lack of capacity and NHS funding.”

He said GPs, now being brought in to A&E units as a “gateway to emergency care” were already overworked. And he claimed ambulances could face extra strain by people using them to get to A&E.

NHS Digital says 37% going to A&E are discharged without needing a follow-up, 20% are discharged to a GP and just 20% are admitted to hospital .

Mr Hunt has told MPs that up to a third of patients do not need to be seen in A&E.

A Department of Health spokesperson said: "There are absolutely no plans to pilot this approach – patients can be reassured that unprecedented planning has gone in to preparing the NHS for this winter, supported by an extra £100m for A&E departments and £2bn for the social care system.”