30.07.13
‘Worrying flaws’ in NHS 111
Following NHS Direct’s announcement that it not continuing with its NHS 111 contracts because they are “financially unsustainable”, a number of professional organisations across the health service have reiterated their warnings about the flaws in the new service.
NHS England has pledged to support commissioners of the NHS 111 services after NHS Direct said it was unable to deliver the service within the agreed contract price.
A Department of Health spokesman said: “The majority of the country has a high quality NHS 111 service, but we know that NHS Direct has struggled to meet the standards required, and it is only right that NHS England take action to ensure patient safety is not compromised.”
Dame Barbara Hakin, NHS England’s deputy chief executive said: “Over 90% of NHS 111 calls are now answered in under a minute and patients are rating the service highly. Our immediate focus is to ensure that this level of service and improvement is delivered consistently.
“We are working closely with the Trust Development Authority and the Board of NHS Direct to ensure that NHS Direct continues to provide a safe, high quality service to patients while, alternative, long-term, providers are secured. We have been in discussions with NHS Direct for some time over this issue and they have assured us they are committed to continue to provide services.
“We are also having constructive discussions with a number of potential new providers who could take on these contracts, specifically with the local ambulance trusts who have experience and a strong track record in provision of similar services.”
Dr Clare Gerada, chair of the RCGP, said: “The big problem about 111 is of course money. It was the lowest bidders on the whole that won the contracts…If you pay £7 a call versus £20 a call you don't have to be an economist to see that something's going to be sacrificed. What's sacrificed is clinical acumen.”
Dr Chaand Nagpaul, chair of the British Medical Association's GP committee said: “The decision by NHS Direct to seek a withdrawal from its contracts to provide NHS 111 reveals worrying flaws not just with the tendering process for NHS 111 contracts, but for how contracts are awarded and monitored throughout the NHS. A number of local GPs and the BMA raised concerns during the tendering process about the low nature of some of the successful bids, which were ignored.”
NHS Confederation chief operating officer Matt Tee called it “a sad reflection on the inadequacy of the design, piloting, procurement and implementation of the 111 service”.
He said: “The piloting and procurement of 111 was shoehorned into an impossibly tight timeframe, and the rollout driven forward against a background of massive organisational change for the NHS.
“For a service like 111 to deliver high quality support to users at the right time and be a sustainable service, there must be a balance between the scale of provision and the local knowledge that gives real value to patients.
“Clearly some providers have bid to run the service at a price that would not cover their costs. Others may have based their bids on winning a larger number of contracts than they did.
“We fully back the idea of a single portal for accessing healthcare, which could be an excellent way of supporting patients and the public to overcome some of the confusion many feel about where to access care. But a single portal can offer more than one route in, and the absence of an online presence, or other tools like smartphone apps, for accessing 111 means many people's preferred methods of accessing information were left unaddressed.”
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