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NHS Direct confirms withdrawal from all 111 contracts

NHS Direct has announced it is seeking to pull out of all 11 of its contracts to provide NHS 111, as they have proved “financially unsustainable”.

The organisation’s leadership said it was seeking to agree a managed transfer of NHS Direct’s 111 services, and the frontline and other staff who currently provide them, to alternative providers.

The move confirms fears about the continued involvement of NHS Direct in the new phoneline service. Nursing Times reported in May that there were doubts over whether NHS Direct would continue to deliver NHS 111 beyond the end of March 2014.

Earlier this month the organisation, which has the status of an NHS trust, confirmed it was pulling out of contracts in Cornwall and North Essex.

In its annual report for 2012-13, published today, chief executive Nick Chapman confirmed the organisation was seeking to withdraw from the remaining nine 111 contracts.

It is currently delivering NHS 111 in: Buckinghamshire, East London and the City, South East London, Sutton and Merton, West Midlands, Lancashire and Cumbria, Greater Manchester, Merseyside and Cheshire and Somerset. These account for about one third of England by population.

NHS Direct will continue to provide a range of web, mobile and telephone health information services, including a contract to deliver online health and symptom checkers in Australia.

Mr Chapman 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.”

The annual report said although the board had agreed to bid for contracts at a cost of between £7 and £8 per call it was “now clear that the trust is not able to provide the 111 service within this lower cost range”. NHS Direct operated at a cost of closer to £20 per call.

The report added: “It is clear from the work done so far that it is financially unsustainable for the trust to continue to provide the 111 service within the agreed cost envelope.

“The ongoing discussions [with commissioners] are now aimed at agreeing a plan for the managed exit of NHS Direct from the 111 contracts.”

The Royal College of Nursing said it was concerned at the announcement. Peter Carter, RCN chief executive and general secretary, said: “This is the latest in a series of very worrying developments.

“We remain concerned that patient care may suffer if the person who takes calls is unable to quickly and easily access clinical expertise or escalate relevant calls to senior staff who are able to make decisions about the care needed.

“Despite the best efforts of their staff, some parts of the NHS 111 service are now in chaos, and urgent action is needed to prevent this from having tragic consequences for patients.”

Unite national officer for health Barrie Brown said: “There was no logic for the government to replace the successful single service NHS Direct, which was highly rated by users, with a fragmented NHS 111 set up with 46 different contracts.”


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Readers' comments (14)

  • Well, now that the Tories have been proven wrong providing a (privatised) service, with untrained personnel, and in addition, they are briefing left, right and centre against nurses, who will they turn to, to rescue the failed 111 service?

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  • This is another step along the road to backdoor privatisation of our country's healthcare system.

    I cannot believe that any NHS Direct trials showed the contracted cost per call set for NHS Direct 111 contracts was a realistic one and Management ought to have known this from the outset.

    My guess would be that they knew it was unrealistic and therefore that further private tendering would follow.

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  • Dispatches programme last night on Channel 4 reported that private sector 111 provider Harmoni is understaffed with clinically trained staff and is unsafe and dangerous.

    Harmoni was reported to be a major private sector 111 provider.

    So Government is content to transfer more 111 work out to the private sector now . This suggests an alarming disregard for patient care in my view.

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  • what do you expect with the tories in charge of the nhs

    they dont care a jot about the will all be privatised in the next few years..but at least these private companies who bankroll the tory party will have keep thier shareholders happy!!!!!

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  • michael stone

    David Baird | 29-Jul-2013 6:09 pm

    It seems in some regions Ambulance Services are doing it much better.

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  • 111 were so woefully underprepared in 2 counties, they were phoning up the staff they'd just made redundant the next day because it was falling apart at that point! In answer to David's post, the big companies with huge funding reserves but equally questionable workings, Virgin, Serco, G4S, .....
    People on the receiving end of health services are not educated enough and aware that there is no longer an NHS. Every patient through my door when enlightened that our service is separate to the NHS is shocked and confused as to why they don't know about this. If we actually want this to change we the clinicians have to educate the public we see about what the changes mean to the service that will be available when they are at their sickest and most vulnerable.

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  • NHS Direct fault? - time will tell if other providers can deliver a quality service at 35% of the original cost of NHS Direct before 111. Why would anybody in their right mind let 46 individual contracts for a service that could easily be delivered regionally or even nationally?

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  • tinkerbell

    Anonymous | 30-Jul-2013 11:00 am

    Totally agree, it has all been conveniently & deviously hidden from the majority of the general public who sadly are clueless. I have tried at every opportunity also to get the message out there but unfortunately without the media being involved it will be too little too late if we are just relying on word of mouth.

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  • Tinkerball,

    I don't have a lot of time right now, but use the Internet, facebook and YouTube

    Nurses can stop this , can brek this aprt if they get organised and start campaigning

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  • "Tinkerball"

    good one!

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  • tinkerbell

    Anonymous | 31-Jul-2013 10:12 am

    well spotted. I never noticed.

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  • tinkerbell

    I think maybe we should all get together, you know organise to meet up and go to Hyde Park and get on a soap box if the media aren't going to cover this and then invite the press along. It's a long shot but................................

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  • tinkerbell

    i'm waiting for some new glasses from specsavers, the optician expressed concern about how I was managing with the ones I currently wear, obviously badly.

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  • I think we have to be suspicous of our unconscious motivations to 'do something' which translate in the reality of politicians and management as 'can be over-ruled'
    I would argue that the more we as a group try and 'do something' in isolation and in possibly advocacy of those perceived s unable, the more disunited the response will actually become. The only way this will be successful, if at all, is when the people of this country become aware of what the current machinations mean in their lives, not on the news or watching other people not connected to them waving banners in the streets.
    It suits the current govt for isolated groups to be doing what their doing at the moment. When people move en masse is when things will change. I would argue it is necessary to educate out patients as part of their care interactions, about what is happening to the service they already own but is being sold off. Their silence is their consent.

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