NHS Direct faces uncertain future

Ambulance trusts and GP out-of-hours providers will take over NHS 111 services from NHS Direct by the end of November. NHS Direct is now in discussions with government agencies about its future.

The provider announced in July that it was withdrawing from all of its 111 contracts as they were "financially unsustainable". NHS England has been working with local commissioners to find alternative providers for the urgent care telephone triage service.

A paper presented to NHS Direct’s latest board meeting by its chief executive Nick Chapman says that by the end of November, the contracts will be transferred. "As the board is aware NHS Direct gave formal notice of its withdrawal from the 111 contracts that it has been providing since March 2013, on the grounds that these were financially unsustainable," says the paper.

"In the light of this, NHS England and local commissioners have now appointed a range of step-in providers to take over the services by the end of November 2013."

The NHS 111 roll out has been plagued by delays and problems. In March, EHI reported that the Manchester service went into "total meltdown" on its first night, and earlier this year the chair of the BMA’s GP Committee chair Dr Chaand Nagpaul described the implementation and planning of NHS 111 as an "abject failure".

Greater Manchester has been working on a wider North West NHS 111 procurement and the contract for the North West will be taken over by North West Ambulance Service NHS Foundation Trust.

West Midlands, which also experienced several "technical and operational issues" when it went live with its 111 services in March had already put interim arrangements in place through other out-of-hours providers.

The contract will now be taken over by West Midlands Ambulance Service NHS Foundation Trust. In North Essex and Cornwall, which were the first two contracts NHS Direct cancelled, the 111 service never went live. The contracts will be taken over by Integrated Care 24 and South West Ambulance Service NHS Foundation Trust respectively.

In South London, London Ambulance Service NHS Trust takes over provision of services and in East London and City, the Partnership of East London Co-operatives will step in. The Buckinghamshire service will to go the Central Ambulance Service NHS Foundation trust, the Somerset 111 service goes to South West Ambulance Service NHS Foundation Trust and Sutton and Merton will be taken over by Harmoni.

NHS 111 was due to take over from NHS Direct’s 0845 out of hours telephone service by April this year, but the 0845 number has been used as a contingency back-up across the country.

EHI reported earlier this year that a National Audit Office Report said that the decommissioning of the 0845 service had cost nearly £70m. However, the paper presented to NHS Direct’s board meeting says the service will now be extended until February. It adds that due to the withdrawal of the contracts, the organisation is in discussions with the government about its future.

"In the light of the transfer of the trust’s 111 services, which account for the substantial majority of the trust’s secured income beyond March 2014, the trust is now in discussion with the NHS Trust Development Authority, the Department of Health and NHS England about its future as a viable independent organisation," it says.