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One, One, One or No, No, No!
The news is that NHS Direct who had won 11 of the 46 regional contracts for the new 111 service, covering 34% of the population, are struggling and want to withdraw from the service. This is a devastating blow to a service which was meant to be up and running by 1st April 2013. The Department of Health still has an absolute belief in the service according to a recent BBC article. A spokesperson for NHS England said: ‘111 will be rolled out to the whole of England. NHS Direct pulling out of contracts will not affect this. It’s a Government commitment and it’s in the mandate between the DH and NHS England.’
There is a big anomaly in the reasons for NHS direct`s problems. Some of the reported problems with the new service include long waits at weekends, poor advice and referral to the wrong follow-up service. Whereas the actual reason for NHS Direct`s demise is a poor take up of service, with fewer than projected calls which resulted in a loss of income for the organisation, about £2.8m at last count. So why aren`t the sums adding up?
An initial review found the cost per call of over £20 for NHS Direct’s 0845 service was too expensive and that in an effort to make savings the costs of the new service was set at an eventual figure of £7.50 to £8.50. It doesn`t take much of a business sense to wonder how an increased level of service can be achieved with a 60% cut in income. This doesn`t allow enough leeway for those times in any business when take-up is low. Those remaining service providers, such as the Ambulance Service, who are likely to be taking on the NHS Direct contracts will need to address this and they may end up funding the differences from their other service contracts.
To add to the 111 woes, 70% of doctors have no confidence in the clinical triage system, with some stories of dangerous delays. In addition, as many of you have found, the paperwork produced by 111 to accompany patients is onerously on those GPs that subsequently carry on care.