The botched launch of the NHS 111 helpline is set to cost the health service millions of pounds in additional fees arising from abandoned call-centre contracts.
The service designed to lessen the burden on hospital casualty units by assessing non-emergency cases was thrown into chaos last summer when NHS Direct, one of the main providers, pulled out of its contracts saying it could no longer afford them.
An investigation by the British Medical Journal has now established that the cost of re-tendering the contracts is likely to run into millions as managers attempt to reshape the service to meet concerns that it is diverting people to hospitals and needs to improve access to trained clinicians.
In the West Midlands, just one of 11 regions where NHS Direct had won contracts, the cost of securing a new operator has been put at £500,000, leaving the health service with a potential bill of £5.5m if the charge is repeated across the country.
Doctors’ leaders and Opposition politicians said that the public was paying the price for the premature launch of NHS 111 and problems persist with the quality of call handling and an over-reliance on computer algorithms. NHS England said it had acknowledged initial difficulties and insisted 111 was now “a stable and improving service”.
Andrew Gwynne, a Labour Health spokesman, said: “It is now clear that ministers wasted millions on flawed contracts. We warned the Government at the outset that 111 was fundamentally flawed but they pressed ahead with the rollout regardless.
“Now, profits are being put before patient care as private companies run the advice line – with call-centre operators directing too many to A&E. Patients in large parts of England still face uncertainty over their 111 line.”
NHS Direct, which ran the original health service helpline, won nearly a quarter of the 46 contracts across England to provide the 111 service from Merseyside to Cornwall. But it announced in July that the contracts, which covered more than a third of the population, were “financially unsustainable”.
The organisation, which will now close after running up a £26m deficit, denied that it had deliberately underbid for the contracts despite evidence unearthed by the BMJ that it had underpriced the cost of running NHS 111 by as much as £30m and launched in some areas with a quarter of the recommended staff.
Dame Barbara Hakin, chief operating officer at NHS England, acknowledged that at the launch of the service some NHS 111 call centres had not been properly staffed and there had been an increase in A&E attendances but the issues had been “very shortlived”.
She added: “NHS 111 is now a stable and improving service and we are confident it will continue to get better.”
The award of the new contracts has been delayed until 2015, leaving a number of “step in” providers, dominated by NHS ambulance trusts, to manage 111.
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