Ambulance trusts step into breach to provide NHS 111

The news follows months of talks to find organisations to step into the breach left after NHS Direct announced back in July it was pulling out of its 111 contracts because they were “financially unsustainable”.

NHS Direct’s board meeting on Monday heard commissioners had appointed a “range of step-in providers” to deliver the non-emergency telephone service until a full procurement process identified replacement providers to take over in 2015.

HSJ understands ambulance services lobbied hard to be given the NHS 111 service when it was development. However, the then health secretary Andrew Lansley announced in 2010 that it would be procured by local commissioners.

North West and West Midlands ambulance services will take on the bulk of the 111 provision for their regions, London Ambulance Service will provide the service in South East London and South Central Ambulance Service Foundation Trust will take over the Buckinghamshire contract.

South West Ambulance Service Foundation Trust will step into the breach in Somerset, as well as in Cornwall, where NHS Direct did not even manage to attempt to launch its planned 111 service.

Commissioners in the West Midlands and the North West – the largest of the 11 contracts – told HSJ contracts had not yet been signed. However, HSJ understands this is likely to take place in the coming weeks.

The remainder of the contracts went to GP out of hours providers, including Harmoni in Worcestershire and the London borough of Sutton and Merton, the Partnership of East London Co-operatives in East London and the City, Integrated Care 24 in North Essex and and Staffordshire Doctors Urgent Care in Staffordshire.

NHS Direct chief executive Nick Chapman told HSJ the providers had been chosen “pragmatically and sensibly”.

NHS 111 was supposed to have completely replaced NHS Direct’s 0845 number by the end of June this year.

However, the board was also told the contract to continue running the old 0845 number as contingency in areas where NHS 111 is not operating at full capacity has been extended until the end of February. As well as many of the areas where NHS Direct won 111 contracts, the 0845 number is still providing extra capacity in a handful of areas where providers are struggling including South Essex, Lincolnshire and Cambridgeshire and Peterborough.

The report to NHS Direct’s board said discussions were taking place with the NHS Trust Development Authority, the Department of Health and NHS England about its future as a stand alone organisation.

Mr Chapman said the most likely outcome was that the remaining £30m worth of services provided by NHS Direct, such as online health and symptom checkers, would be hosted by another organisation. The organisation recently won a contract to provide the checkers in Australia.

Mr Chapman added: “The service itself continues to be viable but it may be the corporate entity [changes].”