NHS Direct to get central role in NHS 111

Just 10 new pilots have been approved to start this year following a call for expressions of interest last December, with five more areas in the process of developing plans. They will join the four existing pilots covering County Durham and Darlington, Nottingham, Lincolnshire and Luton.

However, as the service is commissioned at primary care trust level this means large swathes of the country have no plans in place, less than two years before the service is due to be rolled out nationally in 2013.

A letter to the service from deputy NHS chief executive David Flory and national director for improvement and efficiency Jim Easton last week invited areas that have “not yet committed to go-live or procurement dates for NHS 111, to confirm their plans”.

The letter continued: “The NHS Operations Board have agreed that any area not able to confirm a go-live date for either piloting or procurement will be automatically opted-in to a service provided by NHS Direct, in partnership with local ambulance trusts and out of hours organisations, until such a time that they are able to make alternative arrangements.”

Strategic health authorities have been asked to send any confirmed go-live or procurement dates to the department by 23 September. They must have approval for the plans from clinical commissioning groups.

The procurement date, the date by which all arrangements for the service are in place, should be six months before the go live date meaning there is just over a year left for commissioners to put in place plans.

Commissioners are free to commission the service from a provider of their choosing providing it meets the service specification which includes the ability to dispatch an ambulance.

NHS Direct chief executive Nick Chapman told HSJ it was “good news” for the service, whose future viability depends largely on winning NHS 111 contracts.

However, he stressed the service would be provided in partnership with local ambulance trusts and out of hours services.

“If 111 is as successful as we hope it will be we will need the capacity organisations that are willing and capable of handling 111 calls can bring. We will need the close co-operation of all parts of a local health community

He added: “The department is clearly aware that in order to have a service up and running in every part of England by 2013 commissioners need to get on with bringing forward their plans.”

NHS Confederation deputy policy director Jo Webber questioned whether the DH should be encouraging commissioners to go out to full procurement before the evaluation of the pilots was fully finished and CCGs were fully established and while primary care trusts and SHAs were trying to “reinvent themselves”.

She told HSJ a more pragmatic approach where the service is rolled out first and procured afterwards could be better.

“It’s so important that we get this right and it has the confidence of patients,” she added.