NHS England wrote to CCGs and providers last week calling on them to suspend procurements while standards for a new integrated model are developed.
NHS England’s head of urgent and emergency care delivery Nick Hall said: ‘These planned changes to integrate NHS 111 and out-of-hours services will offer patients better access to urgent care 24/7. It builds on what commissioners have been asking for and will not disrupt the running of the NHS 111 services.’
The move follows a review of urgent and emergency care services by NHS England’s medical director Sir Bruce Keogh and the Five Year Forward View which called for a fundamental redesign of the urgent care ‘front door’.
Currently 18 NHS 111 providers hold 48 different contracts while 80 GP out-of-hours providers run over 100 contracts. NHS England expects the numbers of different contracts with providers to reduce as CCGs work together to plans urgent care services strategically. However the number of providers could remain the same.
NHS 111 integration
Commissioners say better integration could mean 111 callers are able to speak to clinicians right away or that appointments are made via the phone service.
GPC executive lead for 111 Dr Charlotte Jones said doctors’ leaders had been raising concerns over the service since before its ‘disastrous’ launch in 2013.
‘While improvements have been made, it is questionable whether NHS 111 has the resources nationally to meet patient demand and whether its call operators have enough training or sufficient support to be able to deal with patients’ health needs.
Dr Jones said: ‘Many GPs and doctors in A&E departments remain sceptical that all the cases being referred to them are appropriate. NHS 111 should be promoting effective, safe care, whether this via a clinician or through self-care, in the right circumstances.'
She added: ‘We are pleased that NHS England has listened to the BMA and will now be reviewing its procurement process, particularly rethinking the separation of the call handling system from GP out-of-hours services. A lot of work still needs to be done, but this is a step in the right direction.’