NHS 111 in ‘total meltdown’

The Manchester NHS 111 service went into “total meltdown” on its first night and the BMA’s General Practitioners’ Committee has called for a halt of further go-lives to protect patient safety.

The new urgent care telephone service had a soft launch in Manchester on 21 March, but reportedly crashed at 10.30pm meaning calls had to be reverted back to the previous provider.

In parts of South London, a series of delays to the go-live of NHS 111 has left GPs directing patient calls because the previous service contract was ended in February.

NHS 111 is due to go-live across England by April.

The GPC discussed the roll-out of the service at a meeting yesterday.

The committee’s NHS 111 spokesman Dr Peter Holden told EHI he was “extremely cross” to see the roll-out being rushed to meet political deadlines and the government should “put the brakes on”.

Services were going live before they were ready, putting patient safety at risk.

He said it was a serious problem that in many areas, the out-of-hours services were shutting down before NHS 111 was properly up and running, leaving GPs with no back-up plan if it failed.

He said the BMA had warned the Government not to attempt a national go-live and not to go-live around Easter time, but had been ignored.

“The concept we were not against, but it had to be properly piloted and slowly introduced instead of going for a politically convenient sound bite deadline.

“In the post-Francis era I’m going to say, ‘we told you so’. It’s time managers shut up and listen to doctors and their clinical judgment,” Dr Holden said, referring to a report released last month by Robert Francis QC about high death rates at Mid Staffordshire NHS Foundation Trust.

“This is yet another example of NHS management pandering to politicians’ whims,” he added.

“They have been saying they can produce a cheaper service that’s better and politicians have swallowed it hook, line and sinker and they haven’t and they can’t.”

Dr Holden said the LMC chair for Manchester, Dr John Hughes, described the service on Thursday night as being in “total meltdown”.

Information sent to EHI from the BMA says the Manchester NHS 111 service, provided by NHS Direct, crashed at about 10.30pm on 21 March owing to call volume, meaning calls were not being answered.

The OOH provider that previously supplied the service had to start taking calls and local ambulance services were affected as some calls were diverted to them.

The BMA information also says the launch of the 111 service in South London, covering 2m patients across Lambeth, Southwark and Lewsisham, has been delayed three times over the past two months.

The most recent delay was this week when the system was judged as being unable to handle the expected call volume.

The next launch date is 9 April, but this has not been confirmed as IT tests will need to be successfully completed shortly before the system goes online.

The constant delays have resulted in confusion amongst GPs and other health workers, as well as extra workload and drastic delays for patients awaiting care, the information says.

Local GPs ended their OOH call handlers service on 18 February, the first launch date, and since then GPs and other doctors have been doing the work intended for this service, including directing patient calls and manually allocating calls to the right services.

This is causing delays of up to five hours before patients get a call-back about their treatment and has led to concerns about patient safety.

The BMA information says that figures are not confirmed, but it is estimated that the cost of providing cover from on-call GPs could be £400,000.

A spokesperson for NHS South East London Commissioners said there was a phased approach to the launch of NHS 111 in the area and the expected launch in Lambeth, Lewisham and Southwark was after Easter.

“Commissioners are confident that by daily monitoring and working closely with NHS Direct, out of hours providers, emergency departments and GPs, we can ensure a safe and responsive service is delivered for patients,” the spokesperson said.

“Implementation of this complex programme is challenging, and the focus is ensuring a robust approach to patient safety.”