What do people think about the new 111 service?

Does it have a name? Neither of the obvious domains, www.nhs111.nhs.uk and www.111.nhs.uk, are valid. There is nothing on the NHS Choices homepage about it. 


I understand that it will deal with calls for out of hours GP services, so no longer will there be a need for each area to have its own number. I am concerned by reports that staff answering calls will not be medically qualified, unlike with those on NHS Direct.

Those taking calls on the National Pandemic Flu Service weren't qualified either and just read from flow-charts prepared by doctors. Was this considered a success and do we think that this has played its part in the design of the new 111 service?

I think that professional advice being available over the phone is an indespensible property of NHS Direct.

mc661 wrote on Oct 30^th, 2010 at 11:33pm:

The telephone advice and information service on 0845 4647 is one of a number of services provided by the NHS Direct NHS Trust. This is a national service for England. The NHS Direct NHS Trust is commissioned to provide many other national and local services, including the web site that carries its name.

The 111 service will be commissioned / provided locally, by whoever is responsible for providing primary care to each locality. At present this is the PCT, under the proposals in the White Paper this would be the GP Consortium.

Provision of the 111 service may involve a number of commissioned bodies. The pilots include involvement from Ambulance Trusts and from the NHS Direct NHS Trust. Whilst the 111 service will have to include the same basic triage that is undertaken when calling 0845 4647, or any out-of-hours GP service (both of which it will replace for initial call handling) it is not essentially proposed to offer the same level of advice and information by telephone that is currently provided on 0845 4647.

Whilst qualified nurses may need to be available to support trained call handlers with tricky triage situations, the intention was (and perhaps still is) not to provide the detailed advice which NHS Direct nursing staff are currently providing by telephone. There are both clinical and economic arguments against this approach. It could be that some consortia will offer a full advice and information service, equivalent to the present "NHS Direct" service. It could be that they would commission the NHS Direct NHS Trust to provide it, or they could choose another body from any sector to provide this service. Once the experience of the pilots has been evaluated, and assuming that the reforms go through, it will be for the Commissioning Board to lay down the mandatory service standards for the 111 service.

It has been suggested that the NHS Direct service on 0845 4647 will be retained until the 111 service has been rolled out throughout England and this this will take 3 years. We will have to see whether GP Consortia will be compelled to commission and implement their 111 service within a particular time frame. Given the difficulties that are likely to be encountered in passing over responsibility for vital existing services from people who face redundancy to a wholly new type of organisation, I anticipate a considerable delay in getting 111 up and running. Achieving the necessary coordination between various different bodies, on which 111 relies, was going to be difficult enough anyway in some areas. Giving the job to a group of people who have been deliberately chosen because they are novices in the role of managing public sector provision for a community is likely to present serious problems for the creation of a new complex integrated structure.

Like any commissioned NHS provider, the NHS Direct NHS Trust is fighting to maintain its share of the market and trading on the reputation associated with its brand. It has made it clear that it hopes to take a leading role in the provision of the 111 service wherever it is rolled out. It will however have to bid for this work alongside competitors from all sectors when each local contract is put out to tender.

When the SHAs are abolished, national services (for England) will be commissioned directly by the Department of Health - that could already be the case for the NHS Direct website. NHS Choices is currently run directly by the Department of Health. Had it been the intention to abolish the NHS Direct NHS Trust, I am sure that this would have been announced. As the NHS Direct NHS Trust is itself a provider in the NHS marketplace it is obviously unsuitable to undertake the operation of NHS Choices. When given Foundation Trust status, along with all other NHS bodies, after its previous attempt to bid for this was blocked by the previous government, who knows how it will seek to grow its role in the NHS.

I hope that this is as clear as it could be, and helpful.

There seems to be a NHS 111 Page here but it doesn't seem to give much info that's helpful. 

Indeed Sherbert,

Perhaps someone in the "available" areas can test this?

CJT-80 wrote on Oct 3^rd, 2011 at 3:23pm:

I have checked this out with a number of telcos - all of which seem to be on the ball, although not all are advising of this in their published tariffs.

As with the implementation of 03, if we find that some telcos have got it wrong, it is likely that they will swiftly fall in line.


I have many reservations and doubts about 111, although not about the cost to callers. As many people can now call a geographic or 03 number without any call charge it is disturbing that the NHS is going to be paying the telcos for connecting every call, as well as for the complex technology required to route each call to the correct local centre.

In some areas there are going to be major problems, as the area information available will not be sufficiently precise to identify the correct local centre.


I also have major concerns about the cost of the service at a time when budgets are being tightened. The original idea was to have something that was cheaper than the NHS Direct advice and information service and swiftly directed patients to the most appropriate local service. I fear that we will end up with something that is more expensive than NHS Direct and ends up sucking money out of the proper services to which it was intended to direct people.

A hideous worst case scenario is that 111 will end up being all that is left of the NHS at the front door, because (along with the NHS Direct on-line service) it will have consumed all of the NHS Primary Care budget, so that most of us will have to pay if we actually want to see someone initially. (Pedestrian access to A&E will be via a phone booth.) In true Tory style, special arrangements will be made to provide free access to GPs for the "most needy", but that is not the universal NHS which many of us love and fight for.

http://www.bbc.co.uk/news/health-18450428

http://www.bbc.co.uk/news/health-21922711

Doctors are questioning the safety of a new non-emergency NHS telephone advice line that is due to launch 1 April.

The 111 service, which will replace NHS Direct in England, is being piloted in some regions ahead of a nationwide launch but has proved problematic, with some callers left on hold for hours.

Dr Laurence Buckman, the British Medical Association's GP committee chair, says rollout should be stalled.

The Department of Health says it is giving some areas extra time to launch.

It has already sanctioned an extension of up to six months of the original April 2013 deadline for regions struggling to set up the new service.

The BMA is seriously concerned that these failures are not only having impact on other, already overstretched NHS services, but potentially putting patient safety at risk”

The NHS Direct 0845 4647 service will continue to be available to callers in areas where the NHS 111 service is in the process of being introduced, Health Minister Lord Howe insists.

These include: North of Tyne and Tees, North Essex, Bedfordshire and Luton, Cambridgeshire and Peterborough, Leicestershire and Rutland, Berkshire, Cornwall and Devon.

But the British Medical Association is concerned that many of the places which are set to launch in the coming week are ill-prepared, putting patients' lives at risk.

The BMA says it has been receiving widespread reports of NHS 111 failures

Some of the pilot regions have been unable to cope with call volumes or have suffered catastrophic IT failures.

In Greater Manchester the entire system crashed, meaning calls went unanswered.

One elderly patient had to wait 90 minutes for a call back from NHS 111.

Problems led to a surge in ambulance callouts and casualty visits as callers have resorted to other measures to get seen by a healthcare professional.
'Reconsider rollout'

Dr Buckman said: "The BMA is seriously concerned that these failures are not only having impact on other, already overstretched NHS services, but potentially putting patient safety at risk. Patients need to have their calls answered immediately and correctly and not be faced with any form of delay.
Continue reading the main story      
NHS 111

    The free one-stop number is for patients with urgent, but not life-threatening symptoms
    This includes people needing fast medical help, but who are not a 999 emergency
    Trained advisers who answer the phones offer basic health advice and direct the caller to the most appropriate service for their needs - A&E or GP out-of-hours services, for example

"The Department of Health needs to reconsider immediately its launch of NHS 111 which clearly is not functioning properly. They must ensure that the system is safe for patients before it is rolled out any further."

Lord Howe said: "NHS 111 will help patients access the whole of the NHS through just one simple number.

"Over the coming months this new service will replace the existing NHS Direct telephone advice line. To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable."

Heinz wrote on Mar 26^th, 2013 at 10:06am:



Technically there isn't an issue, the reason as far as I can see for changing from NHS Direct and it's 0845 number to NHS 111 and it's service is COST.  Basically it's cheaper to run NHS 111 overall than run NHS Direct!

Welcome to austerity! It now affects the NHS' front line telephone support roles, which were designed to reduce the numbers of people attending A&E with "minor" injuries.