GP commissioning leader defends CCGs over NHS 111 failure

At a meeting on Friday the board of NHS England agreed to commission two reviews, one examining the future sustainability of the NHS 111 service model and one looking at lessons to be learned from the NHS 111 programme.

More than a month after the original intended go-live date for the service, providers in almost half of the country are still relying on support from NHS Direct’s 0845 number to meet demand.

NHS England interim chief operating officer and deputy chief executive Dame Barbara Hakin told the meeting questions had to be asked about the commissioning process.

She said: “We need to ask how it was possible that contracts were awarded to providers who, on day one, patently couldn’t deliver the service.”

However, Mike Dixon, interim president of NHS Clinical Commissioners and a leading advocate of clinical commissioning, described Dame Barbara’s comments as a “bit rich”. He said that, although clinical commissioning groups were operating in shadow form during the period 111 was being procured, many were not involved in the process.

He said: “The problems were with the primary care trusts and it wasn’t altogether their fault; they were faced with a national specification, there wasn’t proper negotiation with CCGs and the feedback from the pilots [of NHS 111] wasn’t properly listened to. It was a car crash waiting to happen.

“The system came from the centre and they can’t start blaming frontline commissioners when it has gone wrong in some areas.”

NHS Clinical Commissioners were among the many organisations which previously called for the roll out of NHS 111 to be slowed down. The April 2013 deadline for the roll out gave commissioners just two and a half years to design and procure their service during a period the whole commissioning system was being reorganised.

Dr Dixon said NHS 111 was “fundamentally a good idea” but had been badly implemented. He agreed with Dame Barbara that there were some areas where NHS 111 was performing well.

Asked the NHS England board meeting what sanctions that organisation could impose on failing providers, Dame Barbara said CCGs held their contracts.

She added: “I know in certain areas financial penalties have been bought into play, the problem is that doesn’t help patients get a better service. We have to measure the balance in continuing to support a provider and at the same time looking at an alternative.”