Exclusive: CCGs fear costs of NHS 111 collapse

NHS Direct has said CCGs will be reimbursed payment for failed NHS 111 services after a GP commissioner said money meant for general practice was under threat.

NHS Direct: CCGs will be reimbursed according to local circumstances
NHS Direct: CCGs will be reimbursed according to local circumstances

Bolton CCG’s clinical director for integrated commissioning, Dr Barry Silvert, told GP it was ‘inappropriate’ that money meant to improve general practice could be lost because of the problems with NHS 111.

NHS Direct, which holds the contract for NHS 111 in north west England and 10 other regions, said last month it was pulling the plug on its troubled services after they became ‘financially unsustainable’.

Dr Silvert said CCGs in the north west of England handed most of the NHS 111 operation over to GP out-of-hours provider, BARDOC, soon after the troubled launch of the service.

But despite only a small number of local people using the service provided by NHS Direct, Dr Silvert said the CCG was asked by NHS England to stump up 30% of the cost of the contract.

‘Our original contract was £684,027 with NHS Direct to provide the 111 service. NHS England has subsequently told all CCGs not using the 111 service that they will be asked to contribute 30% of whatever the original cost would have been.

‘So Bolton CCG is expected to contribute 30% of that £684,027, which is just over £200,000.

'And because we’ve contacted with BARDOC to provide the service, we face a cash pressure of somewhere in the region of £200,000.’

Dr Silvert said he had written to NHS England and the lead commissioner, Blackpool CCG, around six weeks ago to ask for discussions on renegotiating the payment, but had no response.

‘We haven’t said no we’re not paying a penny. We are prepared to be reasonable’, he said.’We would not object to making a small contribution. But 30% does seem rather extreme.’

But NHS Direct has now told GP that CCGs will be reimbursed according to local circumstances.

A spokeswoman said: ‘To date, all CCGs have been invoiced 30% of the contract amount for cash flow purposes. This will be offset or reimbursed when individual CCG amounts have been agreed based on the service they have received.’

A spokesman for the NHS England area team said: ‘CCGs will pay a variable amount to NHS Direct, dependent on the number of calls that NHS Direct has handled on their behalf’.

Other CCGs in the region told GP they also anticipated additional costs because of the collapse of NHS Direct’s service.

In Cheshire, Warrington CCG’s acting accountable officer, Stephen Sutcliffe, said reprocurement of NHS 111 ‘is likely to cost Warrington CCG money, but how much is uncertain’.

Eastern Cheshire CCG’s chief officer, Jenny Hawker, said problems with NHS 111 meant the CCG had to retain its out-of-hours service for the whole year ‘with consequential additional costs to the CCG’.

‘Negotiations are on-going regarding the management of these additional cost pressures’, she added.

A spokeswoman for South Cheshire CCG said it was ‘too early’ to assess or quantify the risk of additional procurement costs.

Blackpool CCG did not respond to repeated requests for comment.

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