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GPs implore government to delay NHS 111

GP leaders have urged health minister Earl Howe and NHS Commissioning Board chief executive Sir David Nicholson to delay the launch of NHS 111.

BMA GPs committee chair Laurence Buckman, in a letter sent after the GPC’s March meeting last week heard reports of problems with NHS 111 implementation, writes: ‘We have repeatedly asked for the implementation of NHS 111 services not to be rushed and stressed that a smooth transition is essential for patient safety. As yet, many areas seem not to be ready for that transition and, from some of the examples reported, I am worried that patients may be put at risk.’

Dr Buckman, in a statement today, added: ‘We cannot sacrifice patient safety in order to meet a political deadline for the launch of a service that doesn’t work properly. There have been widespread reports of patients being unable to get through to an operator or waiting hours before getting a call back with the health information they have requested. In some areas, such as Greater Manchester, NHS 111 effectively crashed because it was unable to cope with the number of calls it was receiving.’

Provider collective

NHS 111 is a new telephone triage service designed to direct people with urgent but non-life threatening conditions to the right part of the NHS within the appropriate timeframe. It is supposed to replace the former NHS Direct 0845 4647 and over the past two years a mixture of GP OOHs (out-of-hours) co-operatives, private companies, NHS Direct and hospital and ambulance trusts have secured bids to run NHS 111.

Manchester Local Medical Committee honorary secretary John Hughes said a ‘soft launch’ for NHS 111 across Greater Manchester had been planned for March 21. However, signs of trouble emerged when a carer reported that she had been waiting with a 90-year-old woman for 90 minutes for a call back from NHS 111, he said.

‘Shortly afterwards, it became apparent that the same thing was happening right across Manchester,’ Dr Hughes said. ‘There were significant delays. People were waiting hours for calls back. There was also information from the North West Ambulance service that they were being completely overwhelmed by 999 calls because people were fed up waiting or couldn’t get through.’

He said OOHs organisations such as GP co-ops, which had given up call handing as NHS 111 was launched, then decided to take it back ‘on the basis of safety’. He warned of extra costs as some staff had to be recalled and GP surgeries had to change their telephone systems.

Workload confusion

A relaunch is unlikely for at least two weeks and CCG (clinical commissioning group) leaders are asking GPs to help to run satellite clinics at GP practices over the long Easter weekend to provide extra capacity to see OOH patients.

The appeal led the GPC to issue advice that GP practices should get formal contractual arrangements in place before providing extra capacity.

It states: ‘Without formal arrangements, practices could be left in a vulnerable position, particularly in relation to indemnity.’

Dr Buckman said: ‘The chaotic mess now afflicting NHS 111 is not only placing strain on other already over-stretched parts of the NHS, such as the ambulance service, but is potentially placing patients at risk. If someone calls NHS 111 they need to be able to get immediate, sound advice and not be faced with any form of delay.’

Health minister Lord Howe said: ‘To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable. The NHS Direct 0845 4647 service will continue to be available to callers in areas where the NHS 111 service is in the process of being introduced.’

A spokesperson for the NHS commissioning board, which will change its name to NHS England from April 1, added: ‘NHS England is aware of some difficulties in the introduction of the NHS 111 service in some areas, but we are confident that measures now in place will ensure resolution of these early problems … Many sites are already up and running, but in areas where NHS 111 is not yet available we will make a thorough assessment of readiness before new sites are introduced.’

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