Intended for healthcare professionals


GPs back call for independent review of “dreadful” NHS 111

BMJ 2013; 346 doi: (Published 24 May 2013) Cite this as: BMJ 2013;346:f3437
  1. Gareth Iacobucci
  1. 1BMJ

GPs’ leaders have urged the government to commission an independent inquiry into the rollout of the NHS 111 urgent care telephone helpline in England.

Representatives at the annual conference of local medical committees in London on 23 May expressed anger at how the introduction of the new system had been handled and unanimously backed a motion calling for an inquiry into the “debacle” of the rollout.

NHS England recently announced that it was to carry out its own review of the management and implementation of the new non-emergency service,1 which has been beset with problems since its launch last month, including slow response times to calls and patients being sent inappropriately to hospital accident and emergency departments.

But doctors’ leaders said that this did not go far enough and lamented the fact that warnings from GPs that the system was not ready in parts of the country had been ignored.

John Hughes, a GP in Manchester who said that he had seen at first hand the chaos caused by the new system, spoke in favour of the motion.

“This was an absolute mess,” he said. “We warned and warned again, but we were told it was non-negotiable. This has put patients at risk. We need to demand a public inquiry.”

The vote came after Peter Holden, negotiator on the BMA’s General Practitioners Committee, had urged GPs to unanimously support the motion.

Holden said, “We want not just what NHS England is offering, an external review of lessons learnt, because the usual external review will be consultants on a daily rate who will give them the answers they want.

“This [review] has to be both independent and external. We need to uncover the managerial attitudes which are incompatible with Francis’s recommendations.”

Representatives also passed an extension to the main motion insisting that any inquiry must “specifically address the wholly inappropriate application of triage by the least qualified, contrary to evidence based practice.”

Bill Beeby, a GP in Middlesbrough, who proposed the addition, said, “Triage should be the remit of senior experienced medical staff. The fundamental working structure of 111 should be questioned.”

The debate on 111 came after Laurence Buckman, chairman of the General Practitioners Committee, criticised the government’s handling of the rollout of the 111 service during his keynote speech to the conference.2

Buckman told GPs, “Two years ago we told the current government that the idea of NHS 111 in England was all right but that they could not keep people out of hospital by doing it on the cheap with a call handler to nurse ratio of 10 to one. The 111 pilots proved our point, with hospital A&E [accident and emergency] departments seeing even more inappropriately referred patients brought in. We said, ‘Why don’t you have more trained nurses handling the calls in 111 and some GPs close behind?’

“Now we have the dreadful spectacle of patients suffering due to a greater failure to implement NHS 111 properly. We warned the government that this would happen. They did not listen.”


Cite this as: BMJ 2013;346:f3437