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Independents' Day

Commissioners forced to retender contracts after NHS Direct hangs up on NHS 111

CCGs will be expected to put all NHS Direct’s remaining contracts for NHS 111 out for competitive tender after the provider announced it wanted to withdraw from all its contracts to run the urgent care phoneline as they were ‘financially unsustainable’.

In a major blow to the rollout of NHS 111, the company said it would seek a ‘managed transfer’ of all NHS Direct’s 111 services, and the frontline and other staff who currently provide them, to alternative providers.

As it tried to limit the damage from the pullout, NHS England said that the national rollout would continue and that although new providers may take over the service short-term, all long-term NHS Direct contracts would have to undergo a full competitive tendering process, despite opposition from the GPC.

NHS Direct said that it would continue to provide the service until alternative arrangements could be made by commissioners.

The provider already pulled out of two contracts in North Essex and Cornwall, and it is running a very limited service in its two biggest regions, the West Midlands and the North West after out-of-hours groups were required to take back responsibility of call handling.

In a statement released this morning, Nick Chapman, chief executive of NHS Direct, said that it would be seeking to divest itself of the remaining nine contracts it holds for NHS 111.

He said: ‘NHS Direct is seeking to withdraw from the NHS 111 contracts it entered into as these have proved to be financially unsustainable.

‘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.’

A document leaked to Pulse earlier this year, written by the Deloitte consultancy firm, said that losing contracts in the North West and the West Midlands would ‘impact the overall viability of NHS Direct nationally’.

The review found the cost per call of over £20 for NHS Direct’s 0845 service was perceived as ‘too expensive’ and that commissioners responded to ‘strong pressure’ to find savings and that providing the service at the eventual figure of £7.50 to £8.50 per head of population was not tested sufficiently.

A spokesperson for NHS England said: ‘111 will be rolled out to the whole of England. NHS Direct pulling out of contracts will not affect this. It’s a Government commitment and it’s in the mandate between the DH and NHS England.’

Health minister Earl Howe told an emergency session of the House of Lords that NHS England will ‘recommission NHS Direct’s 111 contracts and will transfer staff who currently provide them to alternative providers. Patients should be reassured that they will continue to receive a high quality service when they call 111.’

Dame Barbara Hakin, chief executive of NHS England, said that ‘constructive discussions’ had already been held with potential new providers to take on these contracts, such as local ambulance trusts.

But Dr Chaand Nagpaul, chair of the GP, urged a new approach to tendering these contracts, saying the whole process had been an ‘abject failure’.

He said: ‘The Government must review its competitive tendering approach and instead look towards an integrated model based on cooperation between local services.’

This is the latest controversy to hit the troubled helpline, following severe problems with the rollout in some regions that led to out-of-hours providers having to take back control of triaging, a number of serious untoward incidents in its first months. A Pulse survey also revealed that only 8% of doctors think the triage process is safe.

Dr Amanda Doyle, chief clinical officer of Blackpool CCG, the lead commissioner for 111 in the North West, told Pulse that the service will not be live until this time next year.

She said: ‘We’re hoping that within 12 months we will have reprocured the service. We’ll be in a position to have a detailed service specification available pretty quickly.’

Dr Doyle, who is also the co-chair of the leadership group at NHS Clinical Commissioners, said commissioners would not be able to reject the rollout of 111 in their area. She said: ‘NHS 111 remains national policy. The problems we have had have mainly been about the provision. The principle remains the same.’




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Readers' comments (15)

  • pay peanuts get monkeys.....or no monkeys in this case

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  • What I like to know is - why isn't Hunt & Government being held to account for this fiasco?

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  • What "other providers"? The whole system stinks.

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  • What the obvious answer is to get GPs wives back answering the phone like in the good old days when GPs had nothing better to do than be up all night visiting folk who knew their rights and were entitled to their home visits - I blaime what's happened to poor old NHS 111 on all this modern mumbo jumbo about work life balance and seeing your family - bring back real GPs in tweed jackets and broque shoes who kept an ashtray in their top right desk draw so they could have a cigarette between patients and if needs be a tot of whiskey from the bottom draw if needed - and then a whiz off in the Bentley to see Mrs Snookes for afternoon tea - and you tell the youngsters these days and they just don't believe you - why then do Daily Mail readers believe the same tory tales they print?

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  • Vinci Ho

    The most wicked conspiracy theory is the government had already calculated this outcome as they wanted to get rid of NHS Direct anyway( the legacy of Blarism).With them withdrawing from 111 entirely , the chance of NHS Direct continuing to exist is declining if 111 is to stay........

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  • Isn't it hilarious that 4 calls to NHS Direct cost the same as 1 yr of GP service including face-to-face consultations AND phone calls!

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  • I'm sorry why are companies allowed to withdraw from contracts unilaterally? Its interesting how private companies are able to write this into their 'contracts', it would be interesting if we could renegotiate halfway through an agreement.

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  • NHS direct will most likely be liable for breaking their contract , however , if they don't find it financially viable , i wonder whether other provider will be able to sustain a decent service at the current rate..

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  • And the public response is to bring in the GPs.The following comment from the Daily Telegraph pretty much sums it up:
    "Where are the GPs in all this ? A practice with several GPs could surely provide a 24/7 service on a rota basis. I am sure the worried patient would rather talk to a doctor than a totally unqualified person ( who is likely to refer them to A&E anyway) Perhaps pharmacists could step in to help. I see signs that many now are functioning as quasi GPs - they can often give useful advice "

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  • This Tory led NHS reorganization has been a complete botch job.Are we going to see Jeremy Hunt resigning soon?

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