Just eight clinical commissioning groups have asked the Department of Health for an extension to the deadline for the rollout of NHS 111, despite widespread calls for the process to be slowed down.
Between them the eight CCGs cover just three procurements for the new non-emergency phone number.
The Department of Health announced in June it would accept applications to extend the April 2013 rollout deadline by up to six months following representations from health unions and other interested parties. Unlike NHS Direct which it will replace, NHS 111 is being procured locally at PCT cluster or regional level.
Two CCGs – North, East and West Devon and South Devon and Torbay – decided to ask for an extension after the original preferred provider, Devon Doctors Ltd, pulled out. Leicester, East Leicestershire and Rutland, and West Leicestershire CCGs have asked for more time to ensure the service “fully meets the needs of local people”.
City and Hackney, Tower Hamlets and Newham CCGs have also asked for an extension. City and Hackney raised major concerns about the business case presented to them by the North East London and City primary care trust cluster.
Minutes of a meeting of City and Hackney CCG highlights concerns about direct referral to GP appointments and the protocol for helping unregistered patients who contact NHS 111 to register with a GP.
They also wanted reassurance on what could be done to mitigate increases in ambulance activity and A&E attendances, noting accident and emergency departments at Hillingdon Hospitals Foundation Trust and Croydon Health Services Trust had seen increases in ambulance arrivals of 7 and 17 per cent respectively.
John Horrocks, chief executive of Urgent Health UK which represents social enterprise out-of-hours providers, told HSJ more CCGs needed to be asking these kinds of questions as well as seeking assurances over the quality of the directory of services on which NHS 111 will rely.
“There are more than eight who are not ready and not sufficiently engaged in NHS 111. Commissioners are ill informed and there are lots of personnel changes,” he said.
He said that in addition to the lack of engagement the advanced nature of many of the procurement processes was likely to be why so few CCGs had applied for an extension.
So far contracts have been awarded in the North East; Yorkshire and Humber; South East Coast; all of the South West, except Devon, and much of the East of England and South Central. Announcements of preferred providers in the North West and West Midlands are expected imminently followed by the East Midlands next month.
British Medical Association lead on NHS 111 Peter Holden said every CCG should have applyied for an extension.
“We are trying to make [NHS 111] run before it can stand, let alone walk,” he said. “We have told the government we can’t make it work in the timeframe.”