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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