Clinical Commissioning Group (CCG) representatives have called for a halt to the rollout of the NHS' new urgent care number on growing fears over patient safety and overstretched A&E services.

NHS Clinical Commissioners has called on NHS England to "call a halt to the further roll-out of NHS 111 until each region has been rigorously tested and assurances can be given that the system is resilient and patients will receive appropriate advice".  

Local commissioners have raised concerns about the launch of the new service and that "top-down imposition has overridden local worries", after reports of huge delays and abandoned calls, putting patients at risk. 

A leaked, internal report, revealed by Pulse, showed that some patients were being made to wait for more than an hour for a call back from NHS 111 - with one patient waiting 11 hours in the worst case - and that 40% of calls were abandoned in some areas of the country.

One anonymous Pulse reader commented: "NHS 111 in our area (North East) is already resulting in very significant increase in the use of ambulances. From the 111 letters we receive these are almost always inappropriate. This will inevitably result in increased risk to people who genuinely need emergency services". 

Indeed, over the weekend, East Kent Hospitals Trust was forced to switch to internal major incident procedures following an "unprecedented number of exceptionally unwell" patients placing huge strain on A&E services across the region, according to media reports.

Spokespeople for the Trust said the direct cause of the surge in demand could not be pinpointed, but elsewhere the introduction of NHS 111 is increasingly getting the blame for the crisis.

GP and local CCG member John Ribchester said at a recent public meeting that the new 111 service could not cope with call levels because the number of call handlers had been slashed from 70 to 11, according to the Canterbury Times, prompting patients unable to get through to go to A&E instead.

Similar surges in demand for A&E services have also been reported around the country, with staff at the South East Coast and South Western Ambulance Services noting significant increases in workload and having to deal with inappropriate cases referred by NHS 111, according to the Brighton Argus and Daily Mail.

Local solutions

Commenting on the situation, Steve Kell, co-chair of the NHS Clinical Commissioners Leadership Group, said that while a single national number may be an appropriate way for people to access urgent care, "local commissioners must be given the ability for ensuring that when the system is accessed the public in their area are provided with an appropriate localised solution," and "this will work best if the solution reflects local provision and local knowledge".

David Thorne, Managing Director of Blue River Consulting, agrees. "The key to implementing 111 is to ensure that the local urgent and emergency care system is a true system - there is no point putting on a phone line onto a dysfunctional and fragmented local position," he told PharmaTimes UK News. "If the local system is not sorted all 111 does is expose the weaknesses, not resolve them".

The British Medical Association also previously said the introduction of NHS 111 should be delayed, with Laurence Buckman, chairman of the BMA's GP Committee, saying the 'chaotic mess' of the telephone service was 'lacing strain' on the NHS.

Inquiry to be launched

The matter is now being considered by ministers - Stephen Dorrell, chair of the House of Commons Health Select Committee, told the Daily Telegraph he would launch an inquiry into emergency care. 

“The concerns we are hearing about 111 - that too many cases are being referred to emergency services, and that the most serious cases are not being identified - are one of the main reasons that we have decided that we need to look at the whole of the system of emergency care, and whether A&E departments and ambulance services are becoming overloaded," he told the paper.