British Medical Association calls for long, slow rollout of NHS 111

The British Medical Association (BMA) has written to health secretary Andrew Lansley over concerns about the implementation of the NHS 111 24-hour non-emergency phone service.

The letter, written by Dr Laurence Buckman, chair of the BMA's GPs committee, expresses "serious misgivings" about the roll out of the NHS 111 service.

"Our key concerns include specific problems in some of the pilot areas, failure to ensure a smooth transition or to address the impact on existing services, fitness for purpose of the new service, value for money and local sensitivity," Buckman wrote.

NHS 111 is being piloted in in seven primary care trust areas: Central Lancashire, County Durham and Darlington, Nottingham City, Isle of Wight, Lincolnshire, Luton and Derbyshire County. The service is due to be rolled out nationally in April 2013.

An evaluation of the pilots by the University of Sheffield is due to be published this spring. The BMA said it was also is concerned that the new service was being developed without a proper assessment of the pilots and adequate input from local clinicians, however.

The tendering process for providers is already under way, but the BMA said this was being rushed through. It is calling for a more flexible deadline so that fledgling clinical commissioning groups (CCGs) can play a full role in procurement decisions.

Buckman commented: "GPs have been telling us for quite some time about problems with the way the NHS 111 is being rolled out and the wider impact it could have on the health service.

"For example, in Shropshire, GPs are worried that patients will actually receive lower quality care as the clinicians who triage all calls to their out-of-hours provider are to be replaced by non-clinicians when NHS 111 takes over."

He said that a flexible deadline would allow local commissioners to work out a solution with NHS 111 and ensure the best option for their area.

Public health minister Anne Milton said: "We will consider the BMA's concerns. We agree that any long-term decision should be made with full approval from local commissioning groups. They should be fully engaged with the approach to delivering NHS 111."

Jo Webber, director of the Ambulance Service Network, agreed with the BMA's concerns about NHS 111. "A headlong rush to implementation will not necessarily benefit patients. It is vital to have buy-in first from clinical staff and future clinical commissioners," she said.

"This takes time to develop and the initial results from the pilots suggest that NHS 111 is really delivering where strong working relationships have been in place for some time."

This article was originally published at Guardian Government Computing.

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