The NHS 111 is a 24 hour helpline designated for ‘urgent but not life-threatening’ health issues, and is currently in a pilot stage in County Durham & Darlington, Luton and the East Midlands, i.e. Nottingham and Lincolnshire in the UK. It is supposed to be rolled out nationally by April 2013, when the number will replace NHS Direct. Contract tenders and procuring providers to run the service for other regions are currently underway.

On Friday, the BMA has urged the Government in a letter to the Secretary of State, Andrew Langley, to apply a flexible deadline for the rollout of the new, non-urgent, NHS 111 phone number. The letter highlights serious misgivings the progress made to date. The BMA supports the principle of NHS 111, which provides patients with easy access to a telephone number for urgent health problems, yet BMA members have pointed out some serious problems that occurred during the pilot. The letter and its associated document list their concerns, such as:

  • A sufficient evaluation time is required for the pilots, given that feedback from GPs indicate a number of remaining unresolved issues
  • Obtaining providers to run NHS 111 in non-pilot areas is being hurried through, without careful reference to the pilots
  • Clinical commissioners who will ultimately be responsible for NHS 111 in their area are not being included in the decision making

Dr. Laurence Buckman, Chairman of the BMA’s GPs Committee, explained in a comment:

“GPs have been telling us for quite some time about problems with the way the NHS 111 is being rolled out and the wider impact it could have on the health service. For example, in Shropshire GPs are worried that patients will actually receive lower quality care as the clinicians who triage all calls to their out-of-hours provider are to be replaced by non-clinicians when NHS 111 takes over.

If there was a more flexible deadline in place, then local commissioners would have time to work out a solution with NHS 111, so that this option could be kept for their area. The results of the pilots are due to be published imminently, and we are worried that the strict deadline in place at the moment means lessons from these won’t be learned and mistakes will just be repeated.

If there isn’t a pause then the Government could end up implementing something, which doesn’t work to the benefit of all patients, which could unnecessarily overburden the ambulance service and GP surgeries, reduce the quality of existing out-of-hours services and ultimately cost the taxpayer a lot of money. More flexibility would allow clinical commissioners to get properly involved in how NHS 111 is being rolled out in their area, making sure it is sensitive to local need. GPs are happy to work with NHS 111 to iron out any problems, but they need time in order to do that.”

LETTER TO ANDREW LANSLEY RE NHS 111

Dear Andrew

NHS 111

I am writing to express our serious misgivings about the rolling out of the new NHS 111 service. Our key concerns include specific problems in some of the pilot areas; failure to ensure a smooth transition or to address the impact on existing services; fitness for purpose of the new service; value for money and local sensitivity; and finally a rushed procurement process that could leave CCGs little choice of provider. I am enclosing a short paper that develops these issues.

We seek your assurance that the procurement of NHS 111 services will be slowed down, to allow for proper evaluation of the pilots; and that you will adopt a flexible deadline for full implementation of the service to ensure that fledgling clinical commissioning groups can play a full role in procurement decisions. We are concerned that a failure to do this could lead to serious unintended consequences that could be avoided with a more flexible approach.

I would be happy to discuss this further with you or your officials if that would be helpful.

Yours sincerely

Dr. Laurence Buckman

Written by Petra Rattue