NHS 111 failures have 'let patients down', NHS England admits

Interim deputy chief executive Dame Barbara Hakin today also questioned whether the services should have been commissioned nationally, rather than by local organisations.

About half of the country missed last month’s deadline to go live with the new non-emergency phone number, while in many areas where the service did launch, patients struggled to get through.

The launch of the service has also in many areas been blamed for increases in inappropriate ambulance call outs and attendances at emergency departments.

At today’s NHS England board meeting its chief executive Sir David Nicholson said: “We’ve had serious difficulties in relation to people being able to get through… and a large number of people in some places who have had to give up and try again later.

“That’s clearly unacceptable and we’ve let some of our patients down.

“We need to think really carefully about the lessons we can learn and also more importantly about getting the service up and running.”

Contingency services are continuing to operate, he said, and are improving, although NHS England is continuing to monitor “one or two areas where we’ve still got issues we need to deal with”.

“We also need to reflect in time around what we should do around some of the failures we’ve had, particularly around the providers of service who have simply not delivered what was expected, and we need to think more long term about what is the kind of service we want for our patients.”

NHS England will need to have a “deep reflection” on what it could have done better, Sir David said.

The biggest implementation failures were in the North West and West Midlands, both areas where NHS Direct was awarded the contract.

• Update - 15 April, 10am: A statement issued by NHS Clinical Commissioners this morning has called for the NHS 111 roll out to be halted.

The body, which represents clinical commissioning groups, said that comments from NHS England “clearly demonstrate the concern regarding 111 within the NHS”.

“Local commissioners have raised concerns about the roll out of NHS 111 and that top down imposition has overridden local worries. Local commissioners are keen to ensure that patients have access to high quality, accessible urgent care, and it is clearly not acceptable that patients may be put at risk and their calls may not be answered.

“There is an urgent need for issues surrounding 111 to be resolved.

“NHS England must call a halt to the further roll-out of NHS 111 until each region has been rigorously tested and assurances can be given that the system is resilient and patients will receive appropriate advice.”

Dame Barbara said NHS 111 problems raised three questions.

“Firstly, was the design and specification of this service right to deliver what we want for patients”, she asked.

“Secondly, was it commissioned appropriately? Was it commissioned to specification and was there more that could have been done on a national level rather than on a local level?

“There are many benefits to locally commissioning these services, but we need to think about what support [they need].”

Finally, Dame Barbara said, the problems raised the question of what should be done where providers had not delivered what was commissioned.