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Future of NHS Direct becomes more uncertain

Nurses working for NHS Direct face yet more uncertainty as it emerged that their employer may not continue to deliver the new NHS 111 service beyond the end of next March.

The provider has also cancelled a planned reprieve of redundancies and call centre closures. 

Providing the new non-emergency phone line makes up the bulk of the NHS Direct’s business after 111 replaced its own 0845 service in April. As a result, losing the NHS 111 contracts could have a catastrophic effect on its future.

Asked by Nursing Times whether NHS Direct was planning to provide the 111 service beyond the end of the current financial year, a spokeswoman said discussions “were ongoing” with commissioners including about “future delivery options past 2013-14”.

The organisation won contracts to deliver the NHS 111 service to about a third of the population. But following a disastrous launch, NHS Direct is still not handling all the 111 calls it is contracted for.

NHS England has previously said 111 contracts, which are due to last for up to five years, should be revoked if providers were not delivering an adequate service.

In an email to staff – seen by Nursing Times – NHS Direct chief executive Nick Chapman warned staff there could be “speculation” about the future of the 111 services that it currently provides.

He added: “There is a clear commitment from the board of NHS Direct, NHS England and our local commissioners that these services will continue to be provided in a safe and stable way. Each of these bodies recognise the very valuable contribution that all staff involved are making.”

About 750 NHS Direct nurses and call handlers were put at risk of redundancy at the end of last year, but the provider then found it did not have sufficient staff when it went live with the 111 service.

At the end of last month, Nursing Times revealed that NHS Direct was planning to cancel the redundancy offers and was considering keeping open up to nine call centres to make up the shortfall. But Mr Chapman’s email revealed these plans had now been shelved.

Mr Chapman told staff the board had decided it would not be “appropriate” to ask staff, including many nurses, to stay on.

An NHS Direct spokeswoman said the organisation now had “clarity over staffing requirements to meet our immediate priorities”.

Readers' comments (64)

  • This is a total catastrof*ck!!!

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  • tory privatisation at its best

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  • NHS Direct did they really believe it would work.
    Basic that is the answer Basics.
    Doctors, nurses, carers, hospitals, porters,
    skilled professionals, hospital kitchens, hospital laundry, cleaners,students, operating theatres, stock room and staff,ambulances and staff,care in the community, love and support.
    Lets get back to the BASICS.

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  • nurses belong in direct patient care doing what they have been trained to do and not in call centres and not sitting in an office all day or at computers or filling in outsized mountains of paperwork! no wonder there is a lack of care and money being poured down the drain.

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  • Why does the "privitisation" word always come up?. Surely the NHS is already an organisation that subcontracts? GP's have a contract, 111 is a contract, so are many other organisations contracted to provide services to the NHS, free at point of delivery to the public.

    The key difference between the NHS and an insurance based system is it is free at point of contact i.e. you do not pay the service direct as you do in any other European health service.

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  • Anonymous | 18-May-2013 8:34 am
    sensible comment. there seems to be a lot of misconception about 'privatisation' and the NHS reforms.
    everybody who can afford it pays through income tax or up front. there is no model which offers free healthcare to all.

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  • Anonymous | 18-May-2013 8:34 am
    Anonymous | 18-May-2013 10:01 am

    It is fairly obvious to me that "privatisation" in the sense that it is used here means the process of transferring ownership of a public service or public property from the public sector (a government) to the private sector, to a business that operate for a profit.

    That is what is happening within the NHS. The misconception is all yours.

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  • Anonymous | 18-May-2013 10:28 am is right.
    also, whilst public services are being handed over to private firms, staff lose jobs, services are diminshed and (this is key) accountability becomes even more vague than it is at present. expect further assaults on pay and conditions and less money spent on patient care as profit is syphoned off into the pockets of shareholders. already happening.

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  • there seems to be a misconception among health service workers about how the labour market and the economy works.

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  • To Anonymous at 8:23
    NHSDirect will be sorely missed by the patients, they recieved first class assessments from the nurses and empowered to care for themselves at home. Most people want to do the right thing and not bother anyone unnecessarily.
    Already front line services, who were always sceptical of the service provided by NHSDirect, are feeling the impact of the demise of this service. Too late to save it now.
    Please don't demean the skills of NHSDirect nurses, you had to be there to understand the complexity of the job!! Try assessing someone with your eyes shut and you'll have a small insight into the skills required.

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  • Anonymous | 18-May-2013 12:19 pm


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  • Anonymous | 18-May-2013 12:42 pm

    the system is flawed. Frankly, if nurses were working in direct patient care which they were trained to do to qualify they wouldn't need to be working with their eyes shut.

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  • Anonymous | 18-May-2013 10:28 am

    You are completely correct.

    The Health and Social Care Act removes the UK government’s obligation to provide universal healthcare in England, something so fundamental it amounts to the abolition of the NHS.
    Dr Jacky Davis, co-chair of the NHS Consultants Association stated: "After the passage of the unwanted, unneeded and deeply undemocratic NHS bill, we no longer have a national health service."

    In addition to removing the universal right to healthcare, which has existed since 1948, the HSC Act also opens the door for charges without limit for NHS services. It permits private providers to take over any NHS services. And it allows up to 49% of the business of NHS hospitals to be private. Quite apart from the fact that the intention is almost certainly to eventually increase this percentage to 100% - ie: create a US-style insurance-based system - this will create a health system with two queues: one for the poor and one for the rich. In a cash-strapped system, a rich person with a minor ailment will be treated over a poor person with a more serious ailment.
    "Care will never again be according to need but ability to pay." This from Dr Clare Gerada, Chair of the Royal College of GPs.

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  • Anonymous | 18-May-2013 12:19 pm

    The Faculty of Public Health's risk assessment of the HSC Act warns of 1) Loss of a comprehensive Health service, 2) Increased costs, 3) Reduced quality of care, 4) Widening health inequalities.
    In a nutshell: the NHS is integrated, comprehensive, cost-effective, accountable. A mix of providers is fragmented, unaccountable, expensive, only profitable services." ‘Integrated’ means that data is shared – something which was not the case with the private companies involved with the recent breast implant scare – and that patients receive care from a multi-disciplinary team of doctors, nurses, physios, district nurses, and so on. ‘Comprehensive’ means that all people and all ailments are treated. ‘Accountable’ means that problems are made public and not concealed by commercial contracts.

    At a time of severe financial pressure, huge sums of money – estimated at more than £3 billion - are being diverted from patient care to fund the reorganisation necessary to implement the HSC Act.
    Not only does a private company cherry-pick profitable services but it gains infrastructure paid for by the taxpayer. It can also give preferential access to equipment such as kidney machines, blood and organs that were specifically donated by the public to the NHS for use by everyone.
    Trusts are getting together in cartels to force down nurses' pay, though nurses have experienced a pay freeze (ie: pay decrease, taking into account inflation) for several years now. Dr Peter Carter, Chair of the Royal College of Nurses is predicting the loss of 56,058 nursing jobs.

    NHS services must be put out to tender. The core business of the transnational corporations that are bidding is winning government contracts, as they have the experience, deep pockets and legal expertise to do so. Small enterprises and local GPs cannot compete with them in tendering for services as has already been seen in the Virgin takeover of community services in Surrey and children’s' services in Devon. When private companies fail, such as the company with the contract for GP services in Camden, London, patients are high and dry.

    Some of us dumb nurses understand a lot more than your patronising and inaccurate comment suggests.

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  • The foundation this organisation was built was not stable. Doctors like me warned authorities but our concern was ignored. Offering advice to patients based of algorithms without clinical knowledge or experience is like jumping into a river not knowing the currents or a whirlpool.

    Two papers published in Arch Dis of Childhood speaks volumes of primary care. The authors have been blunt and pointed finger at GPs, OOH, NHS Direct and the A&E department. This is the proof that doctors like me have been waiting for and one every nurse aspiring to work as nurse practitioners and prescribers must start thinking. Offering advice to patients is the more difficult than advising your own children. No person on earth can ever do this job without years of clinical experience.

    If the algorithms were safe, do you think doctors like me would have hesitated to develop a software to replace our own job? I would have because its is my duty to alleviate pain and suffering.

    Please read this article (Its free to access in the internet)
    (1) Do we need to change the way we deliver unscheduled care?
    (2) Increase in emergency admissions to hospitals for children aged under 15 in England 1999-2010.

    If the politicians continue to implement changes without proper evaluation, they will soon bankrupt the nation and bring shame to medical profession.

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  • Anonymous | 18-May-2013 1:49 pm

    Of course, if doctors like you would actually EARN the considerable amount of public money paid to you and provide a decent GP and OOH service, then the public wouldn't have to wait 3 weeks for an appointment and resort to using A&E services inappropriately!

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  • Anonymous | 18-May-2013 12:52 pm

    If you think that all nurses should just be involved in "direct patient care", should there be no nurses involved in research, education, management, advanced positions, etc?

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  • Dear Anonymous 0n 18/05 08.14 am.

    This service is needed, wanted and helps to direct people who for whatever reason are unsure of where to go or who to see about their condition such as emergency dental treatment or health information.

    Have you also not considered that there are many health professionals who become disabled and are unable to carry out any amount of physical work so have to give up general nursing. Do you think we should all be put out to pasture?

    Telephone triage provides an additional service to nurses like me who want to carry on caring but in a different capacity.
    As a person who has worked in both a 999 Call Centre and NHS Direct as a clinician, they both provide a very much needed service to the public.

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  • I challenge those who think all nurses belong in hands on try doing an NHS Direct nurse's job!

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  • scrap it and put the nurses back on the wards and in A&E departments where they are most needed.

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