UPDATED: How HSJ has covered the NHS 111 rollout debacle

This week NHS Direct said it wants to withdraw from all 11 of its NHS 111 contracts. Four weeks earlier the provider pulled out of it contracts to run 111 in Cornwall and north Essex because the terms were “financially unsustainable”.

It will continue to provide a range of web, mobile and telephone health information services, with its contracts total value amounting to £30m, including some services in Australia.

The non-emergency telephone number has had a troubled rollout since Andrew Lansley first said it would replace NHS Direct in 2010, which has been extensively covered by HSJ (see timeline below).

NHS 111 rollout: 2010-2013

2010

• August: The government faced a backlash over its plans to replace NHS Direct with a new non-emergency number, 111. Critics such as shadow health secretary Andy Burnham and the Royal College of Nurses voiced concern that members of the public would no longer be able to speak to nurses with degrees but only call handlers who have “passed a 60 hour medical course”.

2011

• October: Andrew Lansley announced that NHS 111 would get a national rollout.
• December: Two NHS 111 pilots were delayed after commissioners decided they had not followed their own procurement procedures and could be at risk of legal challenge. The Inner North West London primary care trust cluster had approved two pilots for the service to go live that month.

2012

• February: GPs and nurses urged the government to slow the implementation of 111 amid fears it could actually increase pressure on services. Data from the most well established NHS 111 pilots showed attendances at A&E departments increased year on year at three out of the four sites. The BMA called on the government to “relax” the timetable for the rollout over concerns it could “destabilise” existing GP out of hours providers.
• June: In a letter to CCGs, the Department of Health national director for improvement and efficiency Jim Easton said the groups would be able to apply for an extension to the April 2013 deadline of up to six months.

2013 − UPDATED

• 28 February: An HSJ investigation found less than a third of England has fully launched the NHS 111 service, with just a few weeks to go before the national rollout deadline.
• 21 March: NHS Direct was asked to provide a contingency service in almost a third of England due to delays in rolling out 111, HSJ exclusively revealed.
• 26 March: GP out of hours providers were drafted in to handle calls that were due to be received by the 111 service across the North West and West Midlands. On the same day, the BMA wrote to Sir David Nicholson to highlight its concerns about 111.
• 12 April: NHS England interim deputy chief executive Dame Barbara Hakin said patients have been “let down” by “unacceptable” failure of some NHS 111 services.
• 25 April: NHS Direct abandoned plans to down-band frontline staff because it needs to retain people to run its NHS 111 service. A memo to staff, seen by HSJ, revealed up to nine NHS Direct call centres earmarked for closure could be kept open.
• 13 May: “Unprecedented” central pressure and a procurement process focused more on cost than quality were two of the biggest factors in the failure of NHS 111’s launch, according to a report by the NHS Alliance.
• 15 May: Health officials launched an investigation into NHS 111 after a number of potentially serious incidents, including three deaths, linked to the service.
• 17 May: It emerged NHS Direct may not continue to deliver the NHS 111 service beyond the end of this financial year. Asked by HSJ whether it planned to continue to provide 111 services beyond the end of the current financial year, an NHS Direct spokeswoman said discussions “were ongoing” with commissioners including about “future delivery options past 2013-14”.
• 22 May: NHS England’s director of patient safety, Mike Durkin, said 111 might have harmed patients.
• 20 June: Emails seen by HSJ show senior directors at NHS Direct warned it was not safe to go live with the West Midlands 111 contract but were overruled. HSJ also revealed NHS Direct is losing £1.5m a month and was likely to exit the 111 market by the end of the year.
• 11 July: A quarter of trust chief executives responding to an HSJ survey say the rollout of NHS 111 was a significant factor in the recent A&E crisis.