NHS England facing uncertain future as 111 helpline verges on collapse


  By a Newsnet reporter

The future of the health service in England is growing increasingly uncertain as yet another NHS service south of the border comes close to collapse.

This week medical professionals said that the NHS 111 non-emergency helpline service was in need of urgent overhaul after NHS Direct, operators of the service in much of England, announced that it was withdrawing from their contract.

The 111 phone number was introduced by NHS England in April as a replacement for NHS Direct and was intended as the number to call for urgent but non-emergency care.  However the service has drawn numerous complaints, with patients saying that calls are going unanswered, medically dubious advice is being given, and calls are being diverted to centres remote from the patient.

The helpline is run by different organisations in different parts of England.  Contracts are held by private companies, local ambulance services, with NHS DIrect holding about a quarter of contracts.  The private healthcare company Harmoni holds about one third of the contracts.

Harmoni are this week subject of an investigation to be broadcast by Channel 4’s Despatches programme.  The programme found that the service was often unsafe, with untrained staff being filmed giving health advice to callers, and some calls left unanswered for longer than 10 minutes.

One call centre manager secretly filmed by the reporters admitted:

“We had a very bad service. Realistically, on the weekends we still are unsafe. We don’t have the staff to deal with the calls that are coming in.”

With private sector providers coming under heavy criticism, the public sector provider NHS Direct announced this week that it is seeking a “managed transfer” of its contracts to run the 111 helpline.  A spokesperson for NHS Direct said that the contracts were not financially sustainable.

Speaking to the Independent newspaper, Dr Clare Gerada, chair of the Royal College of General Practitioners, said that the helpline had been dogged by delays in answering calls, and there was widespread concern amongst health professionals about the quality of the service.  Dr Gerada put much of the blame down to a “monumental, expensive, unnecessary, appallingly-executed reorganisation”, saying that the introduction of 111 had “destabilised” a system that was functioning well under NHS Direct.

Dr Gerada added: “The big problem about 111 is of course money. It was the lowest bidders on the whole that won the contracts… If you pay £7 a call versus £20 a call you don’t have to be an economist to see that something’s going to be sacrificed. What’s sacrificed is clinical acumen.”

Meanwhile the Royal College of Nursing said that parts of the helpline service were “in chaos” and added that “urgent action” was imperative in order to avoid “tragic consequences” for patients.

The equivalent service in Scotland, NHS 24, remains run and operated by the public sector.  As a devolved matter under the control of the Scottish Parliament, NHS Scotland is protected from most UK Government changes. 

However fears have been raised in Scotland that changes imposed on the NHS in England may have a knock-on effect in Scotland.  The creeping privatisation of NHS England may result in a cut to UK Government funding for NHS Scotland.

Commenting, SNP MSP Mark McDonald who sits on the Health & Sport Committee in the Scottish Parliament said:

“The shambolic situation engulfing NHS 111 in England is just the latest example of the problems that come with trying to asset strip the NHS.

“It has been entirely caused as a result of trying to break bits of the NHS in England apart in order to make a profit, yet it seems that the lessons of NHS 111 are not being learnt in Westminster with a further £5 billion of NHS contracts out to tender.

“The role of the National Health Service is to give medical care to those who need it, not to bump up the profits of private companies engaged in empire building.

“That is something we fully understand in Scotland and the SNP remains utterly committed to keeping the NHS in the public sector.

“Unlike the problems being faced in England, the NHS in Scotland delivers its NHS 24 service efficiently and effectively through the public sector.

“The stark contrast in what is happening north and south of the border is the clearest demonstration possible of why we have been right to keep NHS Scotland in the public sector where it belongs.  This sorry episode shows how we are better off making decisions for Scotland in Scotland, instead of Westminster being in charge.”