Need to engage CCGs with NHS 111 service

The new NHS 111 number could be in danger of getting 'lost in translation', the NHS Alliance has warned in a report published today.

A survey suggested that clinical commissioners have a lack of engagement with the service and feel that it demonstrates 'top down' policy rather than local innovation.

NHS Alliance is recommending support for an objective peer learning exercise, opportunities for whole system support for discussion, encouragement for local CCGs to take more active leadership and allow CCGs to 'pause' current procurement processes that have not yet been concluded if they feel there is not enough local flexibility built in to existing specifications.

Additionally, the Alliance states that best use must be made of the information from the first four pilots.

Rick Stern, urgent care lead, of the NHS Alliance, said: "We remain supportive of the idea and want to work in partnership with the Department of Health and other national partners to ensure that local commissioners are actively involved in the development of NHS 111.

"However, our members currently feel disengaged and believe there is little room for local flexibility. We need to take steps to address this now, as otherwise both the 111 programme and the credibility of local clinical commissioning will suffer. While there is support for NHS 111, in principle, there are substantial concerns about the speed and style of implementation."

Commenting on the NHS Alliance discussion paper, Dr Brian Gaffney, Medical Director for NHS Direct, said: "The NHS Alliance survey reflects significant concerns from GPs about the level of clinical engagement in developing and commissioning NHS 111 services. These concerns need to be taken seriously, not least because Clinical Commissioning Groups (CCGs) will inherit NHS 111 contracts and be responsible for the service in their local area.

"GPs have highlighted there is 'no real ability to affect decisions' and there is 'little scope for local clinicians to shape this service to meet local needs'. From our experience of leading four of the seven pilots, we know that local clinical engagement is imperative for NHS 111 to deliver benefits to local health economies.

"We know from our pilots that NHS 111 supports fewer patients to self-care than the 0845 4647 service, and refers more patients to face-to-face urgent care services. There is a danger of NHS 111 leading to substantial additional costs across the health system if it is not commissioned as part of the local urgent care services. The expertise for taking this forward lies with local clinicians and they need to be fully involved immediately.

"NHS 111 has the potential to improve access to urgent care and the actions proposed by the NHS Alliance need to happen very soon to influence the national roll out."

A DH spokesperson said: "The NHS 111 services will bring significant benefits to patients and the majority of clinical commissioners are engaged with it. The pilots are enabling us to provide a basis for local design of solutions, and clinical commissioning groups are already positive about how this will enable them to improve access to emergency and unscheduled care.

"We will ensure that although planning will go ahead for roll-out from April 2013, this will be achieved with CCGs in a leadership role."

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