Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

NHS Direct abandons downbanding plans following 111 debacle


NHS Direct has abandoned plans to down-band frontline staff because it needs to retain people to run its NHS 111 service.

A memo to staff, seen by Nursing Times’ sister title Health Service Journal, also reveals up to nine NHS Direct call centres earmarked for closure could be kept open.

The decisions are a sign of how badly NHS Direct miscalculated the capacity it would need to provide the NHS 111 service in the North West and West Midlands, its two biggest 111 contracts.

NHS Direct is currently only handling about 30% of the NHS 111 calls which it should have under earlier plans, and is still providing its 0845 service in a number of areas under separate contingency arrangements.

NHS Direct had earlier planned to close 24 of its 30 call centres, and to reduce its pay bill by changing staff bandings. It had planned to move band 6 nurses to band 5 and band 3 call handlers to band two.

The memo said all staff will now retain their original banding “by right” so that NHS Direct could retain “the skills and expertise of our most experienced front line health advisors and nurses”.

The sites which could remain open are Stockton, Nantwich, Liverpool, Mansfield, Hull, Sheffield, Stafford, Bedford, and Ilford, although final decisions have not been made.

NHS Direct chief executive Nick Chapman admitted there had been “capacity shortfalls” when the service went live.

He said: “The length of the calls staff were dealing with and the proportion of calls referred to nurses was much higher than had been planned for. We have recognised we need to have more staff therefore it seemed to be a very sensible action [to reverse the downbanding] to try and retain staff.”

A review of why the launch of NHS 111 by NHS Direct went so badly has been commissioned by NHS England, the NHS Trust Development Authority and the non-executive members of the NHS Direct board.

Unison national officer for NHS Direct Michael Walker said: “The rescinding of the closure of so many NHS Direct centres just weeks before they were due to close, while welcomed by many staff, will be acutely difficult for those who have already sought jobs elsewhere or had planned their exit based on redundancy pay.”

The Royal College of Nursing chief executive and general secretary Peter Carter said he was pleased NHS Direct had agreed not to downband staff in order to “retain its skilled and experienced workforce”. 

But he added: “News that NHS Direct will be remaining open to support NHS 111 highlights our serious patient safety concerns about NHS 111, and emphasises the need for a complete review of the service.

“Since the launch of NHS 111 a number of worrying problems have come to light which have not only compromised patient safety, but have piled pressure on already over-stretched emergency departments,” Mr Carter said.

“If NHS 111 is to continue without the support of NHS Direct it must be a nationally commissioned service which is led by properly trained nurses, rather than the current fragmented model which is damaging for patients, staff and the health service as a whole.”


Readers' comments (14)

  • Surprise, surprise! Although unlike Cilla and her show, this was not the unexpected hitting us right between the eyes. From an admittedly limited knowledge base, the feeling is that non clinical big wigs have gone out to obtain these contracts and promised commissioners that the world can be delivered at a fraction of the cost. This has led to the attempts to downgrade front line staff paybands, reduce wage bills, close sites and reduce estates costs WITHOUT once again an analysis of the effects of this and whether or not the promises made could be fulfilled. Worrying about the length of calls pales into insignifance when staff rushing to end the call for out of fear of being brought to brook end up causing a patient safety incident. Once again the NHS has failed to learn any lessons from previous re organisation of services. The only word to use unfortunately is shambolic. As a HCP myself I have advised my family if unwell and not life threatening not to dial any other number but mine day or night

    Unsuitable or offensive? Report this comment

  • Those who made the original disasterous decisions should lose their jobs, if not their heads over this debacle. Of course, that is just wishful thinking on my part, isn't it?

    Unsuitable or offensive? Report this comment

  • Gosh, who would've thought all those projected cost savings would evaporate in the cold light of running the service in the real world, instead of on a spreadsheet? At least now when some idiot asks me what's wrong with local competitive tendering for NHS services I can just point them to this.

    Unsuitable or offensive? Report this comment

  • Anonymous | 26-Apr-2013 3:28 pm

    you'd think we would all be wise to it by now!

    Unsuitable or offensive? Report this comment

  • "...led by properly trained nurses, rather than the current fragmented model which is damaging for patients, staff and the health service as a whole.”"

    maybe politicians and NHS managers will wake up and come to realise this is the case right across the NHS and do something about it before it is too late.

    Unsuitable or offensive? Report this comment

  • Operational Solution Architect (Band 8a)
    Based at: Future site
    Hmmmmm........ perhaps money could be saved if management stopped making up these ridiculous jobs!!!!

    Unsuitable or offensive? Report this comment

  • "Operational Solution Architect (Band 8a)
    Based at: Future site"

    I am sure nurses couldn't possibly manage to take 111 calls or nurse their patients at the front line without one of those indispensables!

    I wonder why the NHS bother to train and employ nurses anymore with all of these fancy pants around.

    Unsuitable or offensive? Report this comment

  • As someone who has always worked in the emergency/acute/out of hours scenario, we used to refer to NHSD as NHS RE-direct.
    We now take that back unequivocally.

    111 are appallingly bad, bad, bad. They are everything we feared. The out of hours services are overwhelmed with 'urgents' and 'emergency' appointments for the worried well. ED's are desperately trying to sort the wheat from the chaff as queues often spread out of the front door. Ambulances are attending toothache/coughs/knee pain for 3 yrs (real incidents last night) etc etc, on the 999 system.
    Meanwhile some poor clinician is going to be hung for 'missing' the real urgent/emergency amongst all the minor long standing problems; and the creeping privatisation of our health service is gathering pace to the benefit of private companies' pockets.
    The Government is replacing trained clinicians of what ever grade with telephone operators following algorhythm's on a computer screen.
    Kerrrching to this governments multi millionaire mates.

    Unsuitable or offensive? Report this comment

  • Anonymous | 28-Apr-2013 12:21 pm

    not directly to do with the issues here but nursing in general and my thoughts are triggered by your last sentence, it seems to me that the government and health administrators see nursing as a basically task oriented job (possibly subordinate to medicine) of which many but by no means all of some of the simpler skills can be taught to anybody in a few hours = :-). This makes them smug in their perceived canny (but highly ineffective and sometimes highly risky and dangerous) corner cutting and cost saving.

    what these people seem to ignore totally is the vast and increasing knowledge and skill and experience base nurses have in their possession in more advanced procedures and care and not least the compassionate and empathetic interpersonal relational skills which are a vital integral part of the care and the healing and health educational processes that nurses administer to their patients. These are learned in training and further developed through years of experience and cannot be taught to non-qualified nursing assistants or call operators in a matter of a few hours, days or even weeks!

    Maybe in the days modern industrial management applied to healthcare these views are outmoded and no longer deemed necessary as staff with such skills are simply too costly but I know I would only have confidence in those with those above mentioned values and skills to advise and to deliver their care.

    Unsuitable or offensive? Report this comment

  • 111 may be poor....but so is NHS Direct.
    I saw a child yesterday who has had a sore throat for 5 days....mum came in by ambulance after taking advice from NHSD. Sent home within minutes of being seen.
    Every child who vomits is advised to attend hospital it seems - even if they only vomited once.

    A&E Depts are sinking under the pressure inflicted by the morons dishing out phone advice.

    Unsuitable or offensive? Report this comment

Show 1020results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.