Exclusive: NHS Direct abandons cost cut plans following 111 debacle

A memo to staff, seen by HSJ, also reveals up to nine NHS Direct call centres earmarked for closure could be kept open.

The decisions are a sign of how badly NHS Direct miscalculated the capacity it would need to provide the NHS 111 service in the North West and West Midlands, its two biggest 111 contracts.

NHS Direct is currently only handling about 30 per cent of the NHS 111 calls it should be taking in line with the contract, and is still providing its 0845 service in a number of areas under separate contingency arrangements which last until the end of June.

NHS Direct had earlier planned to close 24 of its 30 call centres, and to reduce its pay bill by changing staff bandings. It had planned to move band 6 nurses to band 5 and band 3 call handlers to band two.

The memo said all staff will now retain their original banding “by right” so that NHS Direct could retain “the skills and expertise of our most experienced front line health advisors and nurses”.

The sites which could remain open are Stockton, Nantwich, Liverpool, Mansfield, Hull, Sheffield, Stafford, Bedford, and Ilford, although final decisions have not been made.

NHS Direct chief executive Nick Chapman admitted there had been “capacity shortfalls” when the service went live.

Asked how NHS Direct had got it so wrong, he told HSJ: “The biggest single explanation is that the length of the calls staff were dealing with and the proportion of calls referred to nurses was much higher than had been planned for. We have recognised we need to have more staff therefore it seemed to be a very sensible action [to reverse the downbanding] to try and retain staff.”

Mr Chapman, who earlier this year moved moved his focus to winding down the 0845 service while new managing director Trevor Smith led the NHS 111 roll out, has now returned to a role leading the whole organisation. He confirmed the “likelihood” was NHS Direct would continue to provide the 0845 number as contingency beyond the end of June and discussions were taking place with NHS England about additional funding.

HSJ has also learned Deloitte has been asked to investigate why the launch of NHS 111 by NHS Direct went so badly. The review has been commissioned by NHS England, the NHS Trust Development Authority and the non-executive members of the NHS Direct board.

Mr Chapman said there were serious questions to answer.

Asked why the NTDA was involved he said: “The failure to mobilise the 111 service has a potentially significant impact on NHS Direct itself as an organisation. Therefore it’s appropriate the NTDA are involved.”

Unison national officer for NHS Direct Michael Walker welcomed NHS England’s involvement.

He said: “The rescinding of the closure of so many NHS Direct centres just weeks before they were due to close, while welcomed by many staff, it will be acutely difficult for those who have already sought jobs elsewhere or had planned their exit based on redundancy pay.”