Editorial: Involve GPs in the NHS 111 contract process

This week's GP magazine reveals exclusively that PCTs' most popular choice to win NHS 111 contracts is ambulance service providers.

This hotline for patients with urgent, non life-threatening health problems was set up as an alternative to calling 999.

In January GP reported the findings of an NHS Alliance survey of 51 clinical commissioning group (CCG) leads, which found that more than two-thirds (68%) disagreed with the statement: 'NHS 111 will ensure that patients get to the right service for their needs more quickly.'

Nearly 80% of commissioners whose CCG had procured the service said they had done so because the decision was made by their SHA or PCT cluster. More than a third agreed with the statement 'no real engagement - the decision was out of my hands' and 23% said 'I knew what was happening but had no say'.

GP revealed exclusively in January that a DH document showed that in four NHS 111 pilot sites, non-elective admissions rose by up to 7% in the last quarter of 2010/11.

In February the GPC wrote to the health secretary calling for the procurement process to be slowed down and seeking full pilot evaluation.

The GPC argues that non-GP providers of NHS 111 could lead to an increase in GP workload and reduce the quality of care. Is the DH confident that replacing triage by highly trained and experienced local clinicians with an algorithm process handled by non-clinicians would not be detrimental to urgent, unscheduled and emergency and out-of-hours services?

If the government is to ignore the GPC's warning and push on regardless with NHS 111 tendering, GPs need at the very least to be assured they will be involved in the decisions to award contracts - and not just left to pick up the pieces if problems arise.

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