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NHS 111 will cost CCGs over £150m to retender

NHS 111 will cost CCGs over £150m to retender


Commissioners have spent more than £150 million on NHS 111 contracts that will have to be retendered, a BMJ investigation has shown. 

Using Freedom of Information (FOI) requests, the BMJ gained details of the financial terms offered for 27 of the 46 NHS 111 contracts currently in operation. 

Sixteen areas refused to provide data because of commercial confidentiality and three were unable to provide figures. 

The investigation found that setbacks in launching the non-urgent emergency service – such as NHS Direct pulling out of contracts, treatment delays and staff shortages – could cost the NHS tens of millions of pounds. 

NHS England has already invested an additional £15 million to support NHS 111 services over the winter. 

One clinical commissioning group (CCG) has estimated that the reprocurement of NHS 111 will cost £500,000, with 13 contracts due to be retendered. 

However, CCGs have been advised not to retender any contracts until 2015. In many areas across the country, ambulance trusts have stepped in to provide the service where NHS Direct pulled out. 

Yet the BMJ claims this has led to further tensions over the future of the service, with GP out-of-hours cooperatives fearing a “landgrab” from ambulance trusts, which now provide NHS 111 services to 61% of the population. 

GP run out-of-hours services claim they are better placed to operate NHS 111 as the majority of queries would be better treated in primary care. 

And general practitioners who fail to treat patients referred through NHS 111 could be served breach of contract notices, the BMJ has revealed.

Email correspondence between senior NHS England figures shows the GP contract could be altered to make this change. 

But GP leaders say the plans would place additional pressure on already overburdened practices, as well as allowing GPs to be “dictated to” by call handlers. 

Peter Holden, lead NHS 111 negotiator for the British Medical Association GP Committee told the BMJ: “We’re already seeing 60 to 70 patients a day. We cannot do any more safely. 

“There’s no way we are going to be told we are obligated [to see patients sent via 111. What we do is re-triage and decide what we’re going to do. But we are not going to have some lay operative working a computer programme telling us how to practice medicine.” 

A spokesperson for NHS England said GPs were required to “care for patients as necessary” as part of their contractual terms.

The spokesperson added: “We are working with the BMA to consider a joint statement which ensures practices make sure they meet this obligation. This is vital if a patient has been triaged through the clinical algorithm and the practice can respond with appropriate and timely clinical response.”


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