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NHS 111 implodes as GPC withdraws support for urgent care hotline

The GPC has warned that the launch of the Government’s flagship urgent care hotline will go ‘very badly’ from 1 April, with launches of the service in London, Manchester and Birmingham already descending into chaos.

GP leaders across the country are warning that patient care is being hampered by the service due to improperly trained staff, a lack of personnel, long waits and out-of-hours GPs having to take on extra work.

The GPC will write to the NHS Commissioning Board and the Department of Health to request that the national launch of the service to replace NHS Direct from 1 April is delayed.

GPC chair Dr Laurence Buckman said he was concerned that unless the launch was delayed, it would go ‘very badly’.

He said: ‘We are very concerned that when the service goes live on 1 April, it will not be able to cope with what will happen. It clearly can’t cope in Manchester and Birmingham, how is it going to cope when London goes live?’

‘On 1 April everyone will be forced to use it and we think it will go very badly.’

In Manchester, BMA representative and LMC chair Dr John Hughes said a ‘soft launch’ of the NHS 111 system in his area failed last night, with waits of up to 90 minutes.

He said: ‘The service soft launched yesterday. Things were reasonably quiet until early evening. I spoke to one doctor who was working his shift at the out of hours service. At 9.30pm, they realised they were getting very few calls through.

‘They then got a call from a carer who had been on hold with NHS 111 for 90 minutes who was with a 90-year-old patient. She had to cancel appointments with her other patients because she did not want to leave. Shortly after that, it became clear that the ambulance service was becoming overwhelmed by calls.

‘The out-of-hours service across Manchester rightly took the view that the situation across Manchester was very dangerous and they took back control of the call handling. But they are not resourced to do that as many of their staff were [transferred] to NHS Direct. 

‘I don’t think the services will cope from 1 April. We didn’t think it would cope with the soft launch.’

Dr Stewart Kay, the GPC’s lead in south London, said the situation in areas across London was a ‘shambles’.

He told Pulse: ‘The soft launch in Lewisham, Southwark and Lambeth was supposed to start last Thursday.

‘With 24 hours’ notice we were told that this launch had been cancelled for the third time. This time it was because NHS Direct were not able to handle the call volumes for Bromley, Bexley and Greenwich. The Lewisham, Southwark and Lambeth population is at least twice that.’

‘They have wrecked the system that was hitting all its targets on times and delivering a good service and put in a service that doesn’t work at all.’

The NHS 111 rollout has been beset with problems. Last year, official figures from pilot sites showed an 8% rise in ambulance attendances in areas of the country that piloted the Government’s new urgent care number over a year, compared with 3% in non-NHS 111 sites, leading to GPC criticism of the ‘indecent haste’ the scheme had been rolled out.

The DH also invited CCGs to apply for a delay to the rollout last year after expressed by the GPC, NHS Direct and other providers that the April 2013 deadline for the rollout of the new service was too tight for some CCGs.

Pulse revealed earlier this week that GPs were being dumped with following up any patient who contacts the Government’s new urgent care hotline more than three times over a certain period, in what amounts to a ‘charter for queue jumpers’ according to the GPC.

Health minister Lord Howe said: ‘To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable.

‘The NHS Direct service will continue to be available to callers in areas where the NHS 111 service is in the process of being introduced.’

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Readers' comments (41)

  • "Health minister Lord Howe said: ‘To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable."

    Lord Howe, you're talking utter claptrap - in the usual incompetent fashion so characeristic for politicians...
    And, more importantly, you - yes, YOU!!! - are among the people responsible for putting patients' health and life at risk!

    I have been a dedicated OOH GP for the last eight years. It doesn't matter whether I like NHS 111 or not - I hate it!!! What matters is what sort of care the patients get.

    What I have seen over the last few days - and what is inherent in NHS 111 - is very, very scary!!!

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  • I repeatedly raised at local 111 meetings that I felt they wouldn't cope with potential peak demand only for my views to be poo-pooed and reassured that suitable modelling had assured the commissioners that they would cope!!!!! With 25 yrs plus out of hours experience including a flu epidemic I am now sad to see my misgivings being proved correct. In our area they have also changed out of hours provider from the 1st April. I am glad I no longer have to respond to the screams for help over the Easter holiday that will eminate from the Health service locally.

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  • The fundamental misconception politicians have about triaging is that for them it is a 'bottom up' process, non-medical unqualified people passing up problems to qualified professionals dependent on severity. The opposite is true however. Triaging should be done by the most experienced clinician and passed down the 'chain' according to expertise and experience. That would of course be unaffordable within current systems, which is why NHSD and 111 and whatever they will be replaced by in due course will be destined to fail.

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  • NHS 111 is just the canary in the mine.

    Wait till 1st April and beyond when everything starts to fall apart.

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  • Vinci Ho

    Keep sending your comments about 111 throughout the weekend.
    Editor , please let people do so before 1/4/2013
    All are welcome......

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  • It is a dangerous disaster waiting to happen. I wonder who the Daily Wail will blame

    A) taking up to an hour to triage complex cases such as dysuria and frequency.

    B) If certain 'key words' are used by the callers such as ' I've been coughing and have a TIGHT chest' this will trigger a 999 call. The Ambulance Service will grind to a halt.

    C) Irate patients then blame the GP who has chosen to offer his/her services to the system. GPs will give up OOH in droves unless it is their only source of income.

    I really don't think politicians HAVE ANY IDEA AT ALL just how finely balanced the system currently is. It could all implode at an astonishing rate.

    I retire early in 2 weeks time. Good luck to those left to carry on.

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  • The 111 concept is fatally flawed, NHSD has never got through a winter without their systems collapsing at times of peak demand. Up to now GP OOH services have been able to flex their resources in responses to levels of demand up to 3 times normal, usually during the winter flu season and bank holidays. Not only is the Pathways system less efficient at managing demand, the onerous training needed means that no provider will be able to train, and keep trained, enough staff to cover peak times. But once 111 is rolled ot there will be no more OOH call centres to cope when the big call centres are flooded. Heaven help the ambulance and ED services.

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  • It is a disasteous concept in practice. Principles are excellent.
    issues:
    1. system clogged up by repaeat prescriptions
    2. OM fro e.g slotted as urgent appointments and when real urgent cases need to be see- pts are double - tripled booked
    3. triage staff- inexperienced....pathway disposition in question. e.g pathway say contact GP in nxt 12 or 24hrs- pts regardless are booked ito same day slots.
    4. more disposition to 999
    5. walk-in an issues as teh delay mounts, pts walk into centre. Then there is ' hilaruious' situation where these pts neeeds to be seen with 20mts!!!

    we blamed NHS redirect, this is worse.

    Something needs to be done, but who is brave enough to challenge? my proposition--> all OOH drs to withdraw their services and this will concentrate DOH's mind.

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  • I worked for a PCT led OOH - all longstanding local doctors committed to a quality service, on the day that NHS111 was introduced we were TUPEd to a social enterprise . Hard to tease out which bit is causing more problem - suffice to say the patients are waiting far far longer than before ..

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  • It is also causing problem in the surgery too.

    We've just had to dedicate my office manager to check on email (which I'm told will be sent to us by 111 to alert us of their advice to patients to contact us in X hours). So, instead of concentrating on something useful like ensuring phones are being answered and managing receptionists, she'll have to keep 1/2 a mind on checking emails. How wasteful is this!

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