NHS 111 launch 'to cost millions'

The bungled launch of the NHS 111 service is likely to cost the health service millions of pounds.

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NHS Direct said the contracts were 'financially unsustainable'

The bungled launch of the NHS 111 service is likely to cost the health service millions of pounds.

The service was thrown into turmoil last July after one of the main providers, NHS Direct, announced it was planning to pull out of its contracts due to severe financial problems.

The cost of re-tendering the contracts for the non-emergency telephone service is likely to cost the health service millions of pounds, according to a British Medical Journal (BMJ) investigation.

In just one region affected, the West Midlands, the re-procurement process will cost half a million pounds, the BMJ found.

"M ore problems arose when NHS Direct, which secured contracts to operate the new helpline in around a third of the country, withdrew from all its contracts in July - just months into its tenure, after admitting that it lacked the appropriate funding to operate the services safely," the article states.

" As a result, more than a third of 111 contracts (valued at more than £150 million in total) are having to be re-tendered, a process that NHS England said must be carried out in 2015.

"Clinical commissioning groups, which will have to oversee this costly process, estimate that re-procuring one contract alone in the West Midlands would cost £500 000.

" As NHS Direct had 11 contracts with the NHS, this implies that millions could be spent across England correcting the mistakes made in the initial tendering process."

The NHS 111 line, which replaced NHS Direct as the number to call for urgent but non-emergency care, has been riddled with controversy since its inception on April 1 last year.

The line suffered many teething problems, with patients complaining of calls going unanswered, poor advice given and calls being diverted to the wrong part of the country.

Just a month after its launch, leading medics warned that the "problematic" roll-out of the system left many patients not knowing where to turn.

And NHS England was forced to launch an investigation into the advice line after a number of potentially serious incidents, including three deaths, were linked to the service.

NHS Direct originally won 11 of the 46 contracts across England to provide the 111 service.

But in July last year, it announced it would be unable to provide the service in North Essex, Cornwall, Somerset, Buckinghamshire, east London and the City, south east London, Sutton and Merton, West Midlands, Lancashire and Cumbria, Greater Manchester, Merseyside and Cheshire.

A spokeswoman for NHS Direct said the contracts, which covered more than a third of the population of England, were "financially unsustainable".

In October, the organisation announced that it is to close after projecting a £26 million deficit for this financial year.

Dame Barbara Hakin, chief operating officer at NHS England, said: "NHS 111 is now a stable and improving service and we are confident it will continue to get better.

"I have been impressed by the way that the staff providing these services across the country have turned the situation around on behalf of the public.

"NHS 111 provides a good service with high levels of public satisfaction. Calls are answered promptly and more people are getting access to the service as we move to full coverage in February 2014.

"The recent urgent care review identified the important role that 111 can play. The concept of calling for advice first is essential for patient care outcomes and we are committed to ensuring 111 plays its full part in this."

Labour's shadow health minister Andrew Gwynne said: "It is now clear that ministers wasted millions on flawed contracts. Labour warned the Government at the outset that 111 was fundamentally flawed but they pressed ahead with the roll-out regardless.

"David Cameron is responsible for its shambolic introduction. The destruction of NHS Direct - a trusted, national service - is one of his worst acts of vandalism.

"Now, profits are being put before patient care as private companies run the advice line - with call centre operators directing too many to A&E.

"Patients in large parts of England still face uncertainty over their 111 line. Ministers must re-instate a national, nurse-led service providing reliable advice in all parts of the country."

Dr Chaand Nagpaul, Chair of the British Medical Association's (BMA) GP committee said: "The continued problem with NHS 111 is the variable and in some cases inadequate quality of call handling and triage, with an over reliance on computer algorithms.

"It is vital this is addressed as a priority with greater clinician presence so that recommendations from NHS 111 are clinically appropriate. There also needs to be greater integration between NHS 111 and other parts of the urgent care system.

"Many of these problems are a result of NHS 111 being launched prematurely in April 2013, despite warnings from the BMA. The result was a chaotic shambles where NHS 111 was taken offline in many areas of the country because it was unable to cope with call demand or appropriately refer patients.

"Not only was patient safety compromised because the public could not get health advice, but other already overstretched NHS services had to take on NHS 111's workload, such as GP practices, emergency care departments and ambulance units.

"The Government needs to ensure that we learn from this. All new services need to be properly planned and staffed, and should not be launched to meet politically driven deadlines.