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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)

  • Peter Swinyard

    What a shambles! Communications back from 111 also dire with vast expanses of useless verbiage and any salient facts well hidden. I'm off to West Wales for a week at Easter. At least there should be a doctor contactable there if I have an MI etc.

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  • Patients we have spoken to like the single point of contact idea in principle, but I await the outcome of the roll out of 111 in our area with trepidation. Reports thus far suggest extensive delays .... I agree with H Blumenthal that effective triage needs to be done by experienced clinicians . Electronic communications which consist of streams of protocol verbage, from which it's very hard to sort out the wheat from the chaf, are at best unhelpful and at worst add to the risks..

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  • Can someone explain to me why this has not hit the national news? Or are the press only interested when they can blame GPs?

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  • In answer to John O'Malley, the reason this has not hit the national news is simple.
    This is the largest foreseeable mess that the medical profession leadership has been warning about since inception.
    To run a story that confirms the clinical concerns where genuine , altruistic , patient focussed conflicts strongly with the "cold war "denigration campaign that successive governments have run.

    It seems worryingly clear that the political strategy to answer to the conundrum of how you run an NHS with "costly" highly trained medical staff is to get rid of the medical staff.
    This highlights the fact that when you do the quality plummets.
    In a just world this should be front page news and certain red tops backed off the medical profession forever.

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  • Silly me thinking this is the sort of issue the Press were fighting to be able to report on in the future.

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  • Patient care has been grossly compromised in this foolhardy rollout of a system.There is a clear lack of understanding in the leafy pastures of the Home Counties of the huge demand being thrown at Primary care & particularly Unplanned care across the country.And to think somebody somewhere thinks that this service can also manage"in hours" calls to GP practices! At what point will we be listened to?

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  • OOH in my opinion should be dealt with by the patient's own GP service. Money should be made available for practices to finance this instead of call centres/OOH/ NHS Direct / inappropriate A and E attendances and 999 calls. I am sure this would be far more cost effective. They could arrange a rota service as most are in group practices. Not only would you have access to all the patient data you would likely know the patient. This would be far safer. People who abuse the "OOH" system could be educated regarding their actions-- like they used to be told prior to new contract. GP's could learn what is needed from their local services--For instance if the reason for high level of night calls is due to poor day time access and other services. Unless OOH care returns to GP'S the situation year on year will get worse. I do not know how the country affords all these costly services. We have a system currently where many of the public do not know what to do or where to go--despite multiple options. I also feel strongly that GP's/Health Professionals should educate re minor illness and self management and advise patients to take responsibility for repeat scripts-- especially at holiday periods so OOH is not further stretched by inappropriate calls. It seems since the new contract GP's feel it is no longer their responsibility ? as they do not pay for service. Employing another GP in every practice would no doubt be cheaper than the implementation of 111--OOH etc. Why do administrators never talk to the people at grass root level?

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  • Why do intellegent people not look at any new suggestions like 111 and see the potential for disaster if not organisated from the bottom up and look at every level for potential problems. It seems that intelligence goes out the window. Who will deal with this failure -the long suffering practices!!!

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  • I agree with anonymous at 1:13. We need as GPs to take back OOH care for our own practices, much better deal for patients and eventually for the doctors as well

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  • 111 is the gateway to GP out of hours service.... but only if you are the patient, or you are standing next to the patient. If you are not with the (elderly) patient then "no assessment can be made". No alternatives are offered. So the caller then has to travel to the patient - by which time the patient may be much worse.

    Did the designers of the 111 service not consider this scenario. My elderly parents will struggle with this service - they are hard of hearing and technophobes. If I try to call from distance I will be blocked from accessing the out-of-hours service.

    Perhaps I should do the "wrong thing" and call 999 each time?

    Hallelujah! Progress in our time.

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