By Mark Smulian | 30 July 2013
Hasty procurement of NHS 111 contracts led to the service’s ‘abject failure’, doctors have said.
The British Medical Association attacked the government’s handling of the bidding process and called for an end to competitive tendering for the service’s provision after NHS Direct yesterday said it would pull out of its nine remaining 111 contracts.
NHS 111 replaced the old NHS Direct service, giving a single number that people could call for medical advice.
It was intended to divert people away from unnecessary visits to hard-pressed accident and emergency departments.
Contracts were awarded to provide the service across different localities.NHS Direct retained 11 of the 46 contracts, later resigning from two of them.
Now it is to withdraw from the other nine, arguing that they are financially unsustainable.
BMA GP committee chair Chaand Nagpaul said the implementation and planning of NHS 111 had been ‘an abject failure’.
Its problems had arisen despite written assurances to the BMA from the Department of Health that safeguards would ensure that NHS 111 providers had the clinical and financial ability to provide a safe, effective service.
Nagpaul said: ‘If this failure can occur with NHS 111, there is no reason why it could not happen with other parts of the NHS, as demonstrated by the recent investigation into the provision of out-of-hours services in Cornwall.
‘There must be a firm commitment — in light of this failure — from ministers that the procurement process across the NHS meets strict quality standards and happens safely and effectively.’
Ministers should review the competitive tendering approach used to set up NHS 111 ‘and instead look towards an integrated model based on co-operation between local services’, he added.
NHS Confederation chief operating officer Matt Tee said the idea of a single phone number for health advice was sound but the announcement by NHS Direct was a ‘sad reflection on the inadequacy of the design, piloting, procurement and implementation of the 111 service’.
He said the piloting and procurement had been ‘shoehorned into an impossibly tight timeframe’.
Tee added: ‘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.’
NHS Direct chief executive Nick Chapman said the NHS 111 contracts had proved ‘financially unsustainable’.
He said: ‘We will continue to provide a safe and reliable NHS 111 service to our patients until alternative arrangements can be made by commissioners.
‘Whatever the outcome of the discussions on the future, patients will remain the central focus of our efforts, together with protecting our staff who work on NHS 111 to ensure that the service will continue to benefit from their skills and experience.’
NHS England is working with clinical commissioning groups and ambulance trusts to try to get alternative NHS 111 providers put in place.
The Department of Health said: ‘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.
‘There is widespread consensus — including among the leaders of the BMA — that NHS 111 is in principle a good idea...so of course it's disappointing that there have been problems with its implementation. But these are flaws that can and will be overcome.’
