The end of NHS Direct.

Hangin’ on…

The Largest provider of the NHS England ‘111’ non-emergency telephone service is walking away from its contracts.

NHS Direct used to cover the whole of England with its fine telephone advice service – provided by nurses. It got the axe to save money (thanks to Sir David Nicholson).

The creating of the ‘111’ service has been one big problem, as this Blog has reported before and as these  two stories today confirm;

NHS Direct won 11 of the 46 regional contracts for the new service, covering 34% of the population.

In June it pulled out of two areas, Cornwall and North Essex but now says the remaining nine are "financially unsustainable" as well. It had complained that the volume of calls at North West and West Midlands had fallen short by 30 to 40% of the contracted amounts and the service was now  "financially unsustainable". There haven’t been enough calls to make it pay (people don’t trust the service) and the calls take too long (unqualified staff).

Here’s the real problem;

NHS Direct used to be paid more than £20 per call while the payment to the new 111 call centres is only between £7 and £9 per call. This reflects that NHS Direct was based on advice from nurses, the new service uses call centre staff and a computer check list.

 

 NHS Direct has lost £2.8m since April and was "heading for a deficit of £26m if we continue to run the same volume of 111 services until the end of this financial year".

 

The organisation is now seeking a "managed transfer" of its 111 contracts, which have between two and five years left to run, to another provider.  

NHS Direct's current 111 services are;

Buckinghamshire

East London and the City

South East London

Sutton and Merton

West Midlands

Lancashire and Cumbria

Greater Manchester

Merseyside and Cheshire

Somerset

 

‘111’ was supposed to be running in April, some areas won’t now have coverage until next year – the NHS Direct areas will have a pretty uncertain future until a new operator can be found.

 

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There’s no harmony at ‘Harmoni’, a private ‘111’ provider. Channel 4’s Dispatches programme has been doing some snooping and found  ‘staff shortages, long waits for callers and some cases of ambulances being called out unnecessarily.’

 

One call centre manager is recorded saying that ‘the service was "unsafe" at weekends because there were too few staff to deal with the calls coming in.’

NHS Direct was a real success story, appreciated by all of us who used it. It gave good, helpful advice and saved unnecessary visits to A and E which was saving the NHS money and saving patients unnecessary problems as well.

NHS Direct walking away from the ‘111’ contracts kills off the remainder of the organisation and ensures that it won’t be economically viable to revive it. So, while we will regret it, I doubt NHS England will.

Meanwhile, I’m sure Nicholson, so keen on leaving behind his ‘legacy’, can chalk this one up as another victory – I don’t.

 

Neil Harris

(a don’t stop till you drop production)

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