NHS Direct withdraws from 111 service

NHS Direct has revealed it is to withdraw from providing NHS 111 services across England.

NHS Direct: 111 services 'financially unsustainable'
NHS Direct: 111 services 'financially unsustainable'

The largest provider of services for the troubled phone triage service said in a statement it was seeking to agree a managed transfer of its remaining NHS 111 service and staff as the service was 'financially unsustainable'.

Nick Chapman, NHS Direct chief executive said: 'We will continue to provide a safe and reliable NHS 111 service to our patients until alternative arrangements can be made by commissioners. Whatever the outcome of the discussions on the future, patients will remain the central focus of our efforts, together with protecting our staff who work on NHS 111 to ensure that the service will continue to benefit from their skills and experience.'

GPC chairman, Dr Chaand Nagpaul, said the announcement revealled 'worrying flaws' in NHS tendering and contracting processes.

NHS England said it would support CCGs and oversee the transition of services to new providers. Deputy chief executive, Dame Barbara Hakin, reassured patients that services would be maintained throughout the transition.

NHS Direct announced earlier this month it planned to withdraw from contracts in North Essex and Cornwall where services have yet to go live.

Now it will pull out of services in Somerset, Buckinghamshire, east London and the City, south-east London, Sutton and Merton, West Midlands, Lancashire and Cumbria, Greater Manchester, Merseyside and Cheshire.

In a report presented to the last board meeting of the organisation, Mr Chapman admitted its NHS 111 contracts were 'financially unsustainable', raising questions over its long-term viability.

GP revealed how NHS Direct identified concerns about understaffing and call volume forecasts weeks before the troubled roll-out of its 111 services.

Internal documents obtained by GP showed NHS Direct's clinical lead for NHS 111 in the north-west of England moved to a new role the day after it went live, leaving it without a full-time top clinical official.

In June NHS Direct said it was expecting financial penalties performance report showed it was answering less than a third of its contracted calls and running a £1.5m deficit.

Dr Nagpaul said: 'The DH gave the BMA written assurances that there would be strict safeguards in place to ensure that NHS 111 providers would have the clinical and financial ability to deliver a safe, effective service to patients.

'A number of local GPs and the BMA raised concerns during the tendering process about the low nature of some of the successful bids which were ignored.

'If this failure can occur with NHS 111, there is no reason why it could not happen with other parts of the NHS, as demonstrated by the recent investigation into the provision of out-of-hours services in Cornwall.'

Dr Nagpaul called for the government to investigate the tendering and procurement process, and for 'proper funding' of the 111 service.

Dame Barbara said: 'We are working closely with the Trust Development Authority and the board of NHS Direct to ensure that NHS Direct continues to provide a safe, high quality service to patients while alternative long-term providers are secured. We have been in discussions with NHS Direct for some time over this issue and they have assured us they are committed to continue to provide services.

'We are also having constructive discussions with a number of potential new providers who could take on these contracts, specifically with the local ambulance trusts who have experience and a strong track record in provision of similar services.'

'I want to reassure callers to 111 that, regardless of today’s announcement, a full 111 service will be available throughout the transition. The public should not feel any detrimental effects of changes in the providers of the service.'

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