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Wednesday 23 May 2012
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Cost of 111 bids forces out-of-hours providers to partner up

By Andrew McNicoll | 28 Oct 2011

Exclusive Out-of-hours providers are being forced to form large partnerships to tender for contracts to run the new 111 urgent care number, amid fears that ‘prohibitive costs' are preventing smaller providers from launching independent bids.

GP-led social enterprises and cooperatives in the North West and the Midlands, and Harmoni, a private firm which operates urgent care services in 15 areas across England, told Pulse they were teaming up with other out-of-hours services and NHS Direct to bid for NHS 111 contracts. With the 111 regional tendering process imminent, GPs said joining forces was ‘the only way' of getting involved in 111 as they did not have the financial muscle to launch solo bids.

National coverage of 111 is scheduled for April 2013 following regional pilots.

In the North West, a coalition of 10 GP out-of-hours social enterprises has joined forces with NHS Direct and ambulance services to apply to run 111 across Greater Manchester, Liverpool and Cumbria.

Dr John O' Malley, medical director at one of the GP providers, Mastercall Healthcare, said:

‘Because of the prohibitive costs, the only way a social enterprise can get involved in 111 services is by getting together with other providers.'

‘We can share finance directors, data analysts and other costs. If we don't do this the service will just be run by a private company.'

BADGER, a GP cooperative out-of-hours provider in Birmingham, is planning a similar partnership with ambulance services, NHS Direct and other out-of-hours providers including Harmoni.

Mike Barradell-Smith, marketing director of Harmoni, said: 'The 111 service delivery model is very susceptible to economies of scale and is likely to be procured at a scale significantly greater than all but a few out-of-hours providers. The scale of the procurements is encouraging a lot of potential partnering activity with out-of-hours providers, NHS Direct and ambulance trusts all talking to each other.'

‘Out-of-hours providers should be bidding for 111 services as they currently deal with 60% of the anticipated volumes.'

Rick Stern, urgent care lead for the NHS Alliance, said: ‘Developing positive alliances and partnerships across urgent care organisations is absolutely a good thing. On the other hand there was meant to be a level playing field for 111 and if there have been proved to be financial bars to smaller organisations competing then clearly that is a worry.'

READERS' COMMENTS

Vinci Ho, GP Partner,
28 Oct 2011
We all know the advantages and disadvantages of getting too big but with the state of the economy , it is the only way forward . 111 is fundamentally flawed but if it can be administered by a union of existing OOH providers , we may just find a way through . Obviously , it is important not to create a long tortuous clinical pathway from the moment a patient rings up . The early it can involve GP triaging the better...
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Anonymous, PCT,
31 Oct 2011
Surely the statement "111 is fundamentally flawed" needs some justification and some evidence.

You may argue that there is not yet enough evidence to show that it works but that is different from eveidence that it doesn't work! Simply restating a predudice doesn't make it fact.
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Anonymous, Sessional/Locum GP,
31 Oct 2011
As an OOH GP who already has to put up with the fallout of NHS In-Direct and some of the fallout of the re-named NHS In-Direct (i.e. 111) on a daily basis, I totally agree with Vinci Ho's comment: OOH services are going to get much worse!

We know why (constant interference by politicians and by our clipboard clutching friends at the PCTs), and we also know who will NOT be taking the blame (politicians and our clipboard clutching friends at the PCTs...)

I am old enough to have seen a few NHS 'reforms'.

Unfortunately, I am young enough to have to put up with a few more...
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