GPs in NHS 111 call centres would be a 'big mistake'

The idea is being considered in discussions NHS England is conducting on the future service model for the non-emergency telephone number.

The commissioning body needs to develop a revised specification for NHS 111 in time to allow CCGs to re-procure the service before the first of the existing contracts expire in a year’s time.

Key areas for discussion are whether there should be more GPs in NHS 111 call centres, how the service can be better integrated with GP out of hours services, and the scope for increasing NHS 111’s access to patient notes.

All three were commitments set out in NHS England medical director Sir Bruce Keogh’s review of urgent and emergency care.

The current specification says clinicians working on NHS 111 must be in the same call centre as the non-clinically trained call handlers.

However, South Coast Ambulance Service chief executive Will Hancock, who is representing the sector in discussions with NHS England, told HSJ that was uneconomical and too prescriptive.

Instead, he said, he would like to see hubs which could provide a range of clinical advice to patients over a large area.

Mr Hancock said it was important NHS England gave the “market an opportunity to think about how they respond to the new specification” once it had been agreed, particularly if this involved providers putting together joint bids.

John Horrocks, chief executive of Urgent Health UK, which represents not for profit GP out of hours providers, told HSJ it would be a “big mistake” to put GPs in NHS 111 call centres.

He said NHS 111 was “primarily a primary care service” and his members wanted to see a careful integration of NHS 111 and OOH services to “maximise the efficiency of both” without duplication.

In January, 48 per cent of callers to NHS 111 were recommended to attend primary or community care. The overall average call length was almost 14 minutes.

NHS England first promised a review of the future service model in April last year. However, external engagement has only gotten underway in earnest in the past six weeks.

In a letter to clinical commissioning groups, senior responsible officer Ian Greenwood apologised for the five month “gap” between initial engagement in September and the recent events.

A spokeswoman for NHS England acknowledged there had been a “gap” but did not provide an explanation when asked by HSJ. She said a new set of commissioning standards, to replace the specification, would be published at the end of April.