Exclusive: NHS Direct is to be paid £8.4m to continue providing its telephone helpline until June for patients in areas which have so far been unable to roll out the NHS 111 urgent care number, amid reports from GP leaders of continuing problems with the troubled service.
The Department of Health has earmarked the contingency payment to ensure patients have access to an urgent care advice line from 1 April – the date NHS 111 was due to be deployed across most of the country.
The additional funding means NHS Direct’s 0845 number will remain in use in many areas until 30 June, with delays and problematic launches having prevented it being rolled out to more than half the patients in England.
GP leaders have called for greater openness from NHS England on the problems with the NHS 111 rollout, with some claiming the service had suffered ‘meltdown’ over the past week.
In Birmingham, the out-of-hours provider BADGER decided to take control of triaging calls over the Easter weekend after concerns that the NHS 111 service did not have enough capacity to cope.
Birmingham LMC executive secretary Dr Robert Morley said: ‘The situation was the worst we have ever experienced on Good Friday because of the 111 service.’
‘The out-of-hours services provider had to make a unilateral decision to inform practices and patients to contact them directly, rather than using 111.’
He said that GPs were having to pick up the slack: ‘Patients who haven’t had their calls answered or experienced unacceptable delays or were unhappy with their advice are starting to appear in GP practices.
‘I expect this will inevitably increase.’
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In south east London, GPC member and local GP Dr Stewart Kay said the service had also encountered severe problems over Easter.
He said: ‘There was meltdown over the weekend in South East London, with 111 directly referring untriaged calls to out-of-hours providers and also referring after-triage calls that should be dealt with elsewhere such as district nursing or dental services.’
‘This is beginning to impact on in-hours service as no calls seem to be finished after being referred to out-of-hours or to GPs in-hours with silly time scales.’
However a spokesperson for the London office of NHS England said: ‘There was no “meltdown”.’
‘In south east London, and across the capital, NHS 111 performed well over the Easter break. Good Friday was a busy day, but we had planned for this and GP out of hours providers quickly increased their capacity and worked in partnership with 111 providers to meet demand. The rest of the weekend was a little quieter and NHS 111 continued to work well.’
NHS England said yesterday that it had always been the case that areas would only be able to go live with the NHS 111 service when they were ‘thoroughly tested’.
A spokesperson added: ‘This testing will now be further expanded to cover the providers’ ability to meet the peaks and demands of operating the service during times of highest demand.’
‘Many areas in England already have an excellent responsive NHS 111 service for patients and the public. The remainder of the service for England will go live in the next few months.’
Tricia Hamilton, clinical director at NHS Direct said: ‘We are experiencing some problems as the service beds in but we are confident that any issues can be resolved quickly and effectively.
‘This period is extremely busy for all urgent and emergency care systems, so it is important that NHS 111 helps to ease the pressure rather than add to it.’
But GPC deputy chair Dr Richard Vautrey said: ‘We really need to have greater openness and honesty from NHS England on the situation. Where there are problems they must work with us to resolve them.’
‘What is now happening is that the full rollout of 111 is being delayed in most of the country, although NHS England does not want to admit it. The key is to recognise the scale of the problem and be honest about it rather than talking of teething problems.’
Minutes from NHS Direct’s board meeting on 25 March state that ‘in a limited number of areas NHS Direct has been asked by the NHS Commissioning Board to continue to provide the 0845 service for a period up until the end of June 2013, where public launch of the 111 service has not yet fully occurred’.
A spokesperson for the DH said the cost of the contingency funding would be £8.4m.
He added: ‘We confirmed last year that the NHS Direct service would continue to be available within those areas that were given an extension to fully rolling out their local NHS 111 service. The important thing is that patients in those areas have access to a high quality service when they need it.’
