Nick Chapman; chief Exec NHS Direct – now just 34 per cent of NHS 111 Pic courtesy: ehi.co.uk

Next April the NHS Direct service relied on by millions to get instant professional medical advice in emergency will cease to exist. Instead a cheaper localised services known as NHS 111 will take its place with varying quality and money will be made by companies handling their calls.

Now Nick Chapman, the NHS Direct, has admitted in a private memo that it has lost bids for 66 per cent of the population and will  decline dramatically as a result. On December 3 a consultation will begin on the future of over 1,200 of the 2500 staff who will either lose their jobs or be transferred to other organisations. Read the story and the memo in full at http:///www.exaronews.com .

Chapman says: “The new organisation will look and feel very different to the current NHS Direct. The type and number of jobs at each of the new 111 sites – both for front line and supporting staff, and the processes for appointing staff into these, has not yet been finalised but we do know that the overall number of jobs in NHS Direct will be substantially lower than it is currently – most probably less than half the current number.”

He also admits that where people are being transferred to either out of hours doctors’ services or to profit-making company, Care UK Ltd which has won 12 contracts, there are no guarantees for staff pay and conditions.

As he put it: ” movement of staff to non-NHS providers (such as GP out-of-hours providers) have encountered legal problems relating to the protection of employment rights. We have sought a resolution of these problems with the Department of Health but have not been able to find one. This is no reflection on the non-NHS providers and is not of their making; indeed many of these providers are very keen to have NHS Direct staff transfer to them to help with their own mobilisation of the 111 service. The position which I can now confirm is that the movement of staff in the areas won by non-NHS providers will proceed now on a volunteers-only basis.  Only staff who volunteer to move to non-NHS providers (in the full knowledge of what employment protection rights they do have) will do so.”

In other words Jeremy Hunt and Andrew Lansley, health secretaries, have deliberately wanted worse conditions for  transferred staff.

I must say I am highly suspicious of this move which is happening without the general public realising what is going on. I agree with Glenn Turp, Northern Director of the Royal College of Nursing, who said:

“The public don’t realise that this Government is abolishing NHS Direct. They may have heard of 111, but they think it is basically a rebranding exercise, and that it will still be NHS Direct on the phone. It will not.  This is a completely misguided, ill-conceived plan, that is wrecking another excellent NHS service. It’s not simply a change of phone number, the new service from 111 is significantly inferior.”

Research from Sheffield University into the first pilot  suggests this could be true and  it is not clear yet whether this will be a saving or end up costing taxpayers more. The report said : “Assuming 7.8 million NHS 111 calls per year, the estimated monthly cost impact to the NHS would be a saving of £2.5million, although his could vary between a saving of £12million and an additional cost of £7 million. These estimates are based on considerable assumptions and limited cost data and should be treated with caution. ” As clears as mud, I would say.

The  main reason for increased costs is that the service is leading to increased use of the ambulance service because people can’t get the right advice. As it says

“One year after launch, the [111] pilots had not delivered the expected benefits in terms of improving satisfaction with urgent care or improving efficiency by directing patients to urgent rather than emergency care services. There was evidence of a reduction in calls to NHS Direct but an increase in emergency ambulance incidents.”

Anecdotally I can add to that. My  one year grandson  who is recovering from scarlet fever was referred by Nottinghamshire ‘s out of hours service to accident and emergency. The doctor not knowing my daughter has a journalist as a father said they had received 154 referrals that night from the service – who incidentally had wrongly diagnosed it as eczema. I gather doctors there routinely refer people to  hospitals to avoid being sued. And these are the services  who are going to run  many NHS 111 services. I hope for millions of patients this is sorted out, or Jeremy Hunt will get a deserved bloodied nose.