A report presented by NHS England deputy chief executive Dame Barbara Hakin at the organisation's board meeting last week said the integration of out-of-hours services had instead been organised by local commissioners who felt it appropriate to avoid duplication.
GPC negotiator Dr Peter Holden disputed this claim and Manchester LMC secretary Dr John Hughes said instructions to switch out of hours to 111 came via the former NHS North of England SHA cluster.
Dr Hughes said: ’All out-of-hours providers were told they had to make their call handlers redundant and all calls would be handled through 111. It was driven from the regions, but it is extremely difficult to believe it wasn’t coming from the centre, from DH.’
Birmingham GP Dr Fay Wilson, chief executive at out-of-hours provider Badger, said her organisation had been informed by the CCG that opted-out practices would all be moving over to 111, although she did not know where the instruction originated.
She said: ‘That was non-negotiable, and what they were expected to do’ she said. ‘It was quite clear, and has been for well over a year, that [practices] have been under that impression.’
Dr Wilson said practices had been instructed via PCTs to give out the 111 number to patients for out-of-hours services. ‘I believe that PCTs were instructed to give instructions to practices; I believe that they don't all think that’s a sensible instruction, but I believe they have all done what they’ve been told.'
She added that her service had continued to operate its out-of-hours phone line and had informed practices they could continue to give that number to patients rather than 111.
The Hakin report, accepted by the NHS England board, proposed urgent reviews to examine the sustainability of the service model and consider the actions of ‘predecessor organisations’, including how contracts had been awarded to providers who could not provide the service.
Dame Barbara warned failing providers faced fines or contract cancellations.
GP leaders suggested the review had come too late and that the chaotic launch of NHS 111 could have been avoided if their concerns had been listened to.
Dr Holden said the roll-out of NHS 111 had been 'outrageous and completely cavalier, careless in the truest sense of the word'.
'It was without common sense and utterly reckless,' he added. 'They have been dicing with patient safety - and we warned them.'
Derbyshire LMC secretary Dr John Grenville said the GP out-of-hours service which holds the local NHS 111 contracts had been required to implement the service in one of its areas earlier than they felt was safe, putting stress on the organisation.
He said: ‘They had a lot more calls and had not had time to get everything they needed in place, so there were problems getting calls completed. The political imperative to get it started on Easter bank holiday weekend was a crazy idea in the first place.'