NHS 111 expansion on hold

ALL negotiations over the running of local NHS 111 services have been suspended following a Daily Telegraph investigation that exposed serious safety risks to patients.

Health officials will issue a fresh blueprint this autumn promising a new model of care, and national standards on how the helpline should work with ambulances, out-of-hours GPs and urgent care providers.

NHS England’s chief operating offic- er has written to providers and commissioners of 111 services, calling for all current tender processes to be halted, until a new “functionally integrated” service has been designed.

The letter was issued last Friday, two days after The Daily Telegraph disclosed concerns about the way 111 helplines are being run. South Central Ambulance Service launched an inquiry after an undercover investigation found call

handlers being put under pressure to avoid sending ambulances. Some told how they phrased questions so as to minimise health concerns. A Daily Tel

egraph reporter, who spent four weeks training to work in the centre, found that the computer system did not dispatch an ambulance even when symptoms could be those of a heart attack.

The 111 helpline, run by ambulance services, private firms and social enterprises, has been dogged by controversy after a series of failings as it was rolled out nationally two years ago.

It was intended to relieve pressure on Accident & Emergency (A&E) departments and to help ensure patients were directed to the best place for help. However, senior doctors say the service is in fact fuelling an increase in A&E attendances, because call handlers without clinical training are advising too many patients with trivial health concerns to go to hospital.

Meanwhile, too many serious cases are being missed, patients groups say.

The letter from Dr Barbara Hakin, NHS England chief operating officer, orders the immediate suspension of all tendering processes involving 111 and out-of-hours services.

It promises a new model of care, to ensure a “functionally integrated urgent care access, treatment and clinical advice service” and national standards to ensure patient quality. The letter, seen by Health Service

Journal, says: “Further procurements of NHS 111 and out of hours services should be suspended, whatever stage of the procurement has been reached, until the end of September, to allow completion of the consultation and the release of the revised commissioning standards and supporting procurement advice for integrated services.”