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BMA calls for national launch of 111 urgent care hotline to be halted

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2077 (Published 28 March 2013) Cite this as: BMJ 2013;346:f2077
  1. Gareth Iacobucci
  1. 1BMJ

The launch of the government’s new 111 urgent care hotline across England must be delayed until the system is “fully safe for the public,” the BMA has warned, amid growing reports that the service is in chaos ahead of the planned rollout next week.

The BMA’s General Practitioners Committee has reported widespread problems with the new non-emergency telephone line—which has already been “soft launched” in parts of England—including inappropriate delays in treatment, slow response times to calls, and ambulances being called unnecessarily.

The reports have prompted the committee to write to David Nicholson,1 chief executive of NHS England (formerly the NHS Commissioning Board), to urge that the rollout be delayed until concerns about patient safety have been fully dealt with.

The government has confirmed that the launch has been delayed in parts of England after a string of problems were reported with the service, which was initially targeted to go live nationwide from 1 April. In these cases “contingency” plans are in place for NHS Direct to continue to deal with calls on its 0845 number until the new systems are ready.

But the General Practitioners Committee said that the rollout had descended into a “chaotic mess” and called for a halt to any further local launches of the system and for “pressure to proceed with implementation” to be lifted.

In his letter to Nicholson, Laurence Buckman, the committee’s chairman, said that “major difficulties are being experienced at local level” and urged NHS England to “delay any further launches or development of NHS 111, to give the services sufficient time to ensure that they are completely ready before taking on this important responsibility.”

Buckman said, “We cannot sacrifice patient safety in order to meet a political deadline for the launch of a service that doesn’t work properly.

“There have been widespread reports of patients being unable to get through to an operator or waiting hours before getting a call back with the health information they have requested.

“In some areas, such as Greater Manchester, NHS 111 effectively crashed because it was unable to cope with the number of calls it was receiving.

He added, “The chaotic mess now afflicting NHS 111 is not only placing strain on other already overstretched parts of the NHS, such as the ambulance service, but is potentially placing patients at risk. If someone calls NHS 111 they need immediate, sound advice and not to be faced with any form of delay.”

Buckman said that the committee was particularly concerned that new clinical commissioning groups, which will assume control of local urgent care arrangements from 1 April, will struggle to cope with “the worsening crisis now gripping NHS 111.”

He said, “The BMA has been warning the government about the problems with NHS 111 for almost two years. They must act soon to ensure that patient safety is protected.”

NHS Direct said that it was currently providing a contingency service in many regions,2 including the West Midlands; South East Coast; North of Tyne and Tees; Liverpool; Bedfordshire and Luton; Cambridgeshire and Peterborough; Leicestershire and Rutland; Berkshire; Cornwall; and Devon.

The health minister Lord Howe said, “Over the coming months this new service will replace the existing NHS Direct telephone advice line. To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable.

“The NHS Direct 0845 4647 service will continue to be available to callers in areas where the NHS 111 service is in the process of being introduced.”

Notes

Cite this as: BMJ 2013;346:f2077

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