Row brews over end of NHS Direct

The government has defended its decision to scrap NHS Direct and replace it with a new 111 number service.

News of the abolition of the website and nurse-led telephone service emerged during a ministerial visit to a hospital in Hampshire.

During the visit, health secretary Andrew Lansley told reporters that the NHS 111 service would be rolled out nationally and that when it was it would replace NHS Direct.

As E-Health Insider Primary Care reported earlier this month, the 111 number is being used in County Durham and Darlington, where it is supplementing NHS Direct and the 999 service.

Callers are put through to handlers using the NHS Pathways software, which allows them to direct people to appropriate local health services, using a directory of local services.

It is due to be piloted at primary care trusts in Nottinghamshire, Lincolnshire and Luton by the end of November.

The Department of Health told EHI Primary Care that the service would be “evaluated in stages to provide a much quicker understanding of the quality and costs of the service that is being delivered” than would be achieved by an evaluation after the pilot stage.

However, it appears that ministers have already taken the decision to push ahead with NHS 111 and the abolition of NHS Direct.

The advice service was one of the first technology-enabled alternatives to traditional health services when it was set up by New Labour, but it has never been popular with doctors.

Over the past few months, it has also come under pressure to make substantial financial savings, even though it was originally intended to save the NHS money by diverting people from A&E and out-of-hours services.

The service has also struggled with poor staff morale, and has recently experimented with allowing its nurses to work from home.

The Royal College of Nursing called the decision “short sighted” and said NHS Direct’s expert nurses had kept more than 1.5m out of A&E and saved the NHS more than £200m by dispensing advice over the phone.

“NHS Direct has developed over many years into a service that patients really value,” said chief executive Dr Peter Carter. “We would be extremely concerned if the expertise it offers is indeed under threat.”

News of the abolition of NHS Direct has sparked a huge row, with Lord Prescott setting up an internet campaign to trigger a debate in Parliament about the move, which many critics have portrayed as a purely cost-cutting measure.

On Sunday, though, ministers claimed the new service would not only be cheaper but better than NHS Direct, because it would allow people to be put straight through to a range of advice services.

Unlike NHS Direct, they pointed out that NHS 111 could book appointments with GPs and other services, and dispatch an ambulance without callers having to dial 999.

Nick Chapman, the chief executive of NHS Direct, also appeared to defend the move, telling the BBC: "More value for money doesn’t necessarily mean that something will be worse. It will be a more seamless service."