NHS Direct awarded lions share of 111

After being selected by NHS South East London, NHS is now the preferred provider for NHS 111 in nine areas of England, covering 30 per cent of the population, and will provide call handling, clinical assessment and referral to an appropriate service. It has been awarded preferred provider status in the West Midlands; Greater Manchester; Cheshire and Mersey; Cumbria and Lancashire; Cornwall and the Isles of Scilly; Somerset; North Essex; and Sutton and Merton. For the most recent South East London contract, NHS Direct will partner with Bromley Healthcare and GRABADOC.

The majority are due to be awarded by mid-September. Health Secretary Andrew Lansley had ordered an England wide rollout of NHS 111 by April 2013. But in June the deadline was extended by up to six months for parts of the country which could prove they needed longer. This came after plans faced extensive criticism. GP leaders said they were worried there would not be adequate clinical engagement and that the rushed rollout would undermine the safety and reliability of the new service. Eight Clinical Commissioning Groups (CCGs) applied for the delay,

The British Medical Association had also warned about a hasty rollout of the service, which it said risked patients being sent to the wrong place, waiting longer, blocking A&E and using ambulances needlessly. Its lead on NHS 111, Peter Holden told Health Service Journal: “Every CCG should have applyied for an extension. We are trying to make [NHS 111] run before it can stand, let alone walk.”

The Royal College of Nursing said at the time it still had “deep reservations” because the service meant patients only speaking to clinically qualified professionals “around a third of the time”.

Not-for-profit GP-led organisations have won just five of the 26 NHS 111 contracts awarded so far. Dr Nigel Watson, chief executive of Wessex LMC and a GP in the New Forest, said the low numbers did not reflect the concern on the ground about the speed of the rollout. He said: “There are quite a number of people who are concerned about how 111 will work, what the pilots have shown and whether it provides value for money. For a lot of the CCGs going through authorisation it is not the number one thing on their agenda. In some areas, there are concerns but they will make the best job of it. It does not show that everyone supports it.”

NHS Direct chief executive Nick Chapman said: ‘We are delighted to have been selected as the preferred provider for the NHS 111 service in a number of areas so far. We are looking forward to working with those commissioners and local NHS organisations to provide the NHS 111 service for their patients.’

“The national coverage provided by NHS Direct’s 0845 4647 service will no longer be required when NHS 111 is rolled out across the country, and the future NHS Direct will be focused on meeting the needs of the local commissioners and their communities.”

Official figures show an 8 per cent rise in ambulance attendances in areas of the country that piloted the new urgent care number over the past year. This compares with a 3 per cent increase in ambulance attendances from January 2011 to February 2012 across the rest of the country, and comes after warnings from the GPC that the rollout is processing too quickly. The figures also show visits to A&E have increased by 3 per cent in those areas where NHS 111 has been rolled out, compared with 2 per cent in non-pilot areas in the 12 months preceding February 2012. GP out-of-hours, urgent care and walk-in centre visits were lower in areas with pilot NHS 111 schemes across the same period, with a 6 per cent rise compared with 17 per cent across England.

Speaking at the NHS Confederation annual conference, Lansley stated: “The essence of it is the ability not only to put a directory of services behind the call, but joined up flexible, responsive services that mean we have got a much more effective urgent care system that delivers the right care at the right place at the right time.”