NHS Direct's decision to pull out of providing the NHS 111 helpline in Cornwall and north Essex could be a "blessing in disguise", paving the way for pharmacists to play a bigger role in providing out-of-hours care in the areas, Cornwall LPC treasurer Graham Brack has said.

NHS Direct "was not in a position to mobilise the 111 services" for the two areas because the contracts were "financially unsustainable", according to papers released from the provider's latest board meeting on Monday (July 1).

The call volumes on NHS Direct's nine live 111 services were between 30 and 40 per cent of the contracted levels, but staffing levels were at or above those planned to handle the full 100 per cent of contracted calls, chief executive Nick Chapman said in a report to the board. In a statement released after the board meeting, Mr Chapman said NHS Direct was working with NHS England to agree a plan to deliver safe and stable services in those nine areas.

NHS Direct said its 111 service contracts were "financially unsustainable" and pulled out of Cornwall and north Essex prior to launch in these areas	More on NHS 111 GPs and pharmacists split over NHS 111 inquiry NHS 111's pharmacy blind spot undermines drive       to slash A&E admissions NHS 111 concerns prompt further calls for pharmacy       referrals MORE NEWS

Kernow CCG and West Essex CCG were expected to make arrangements for alternative providers for the 11 service in Cornwall and north Essex respectively, Mr Chapman said.

Cornwall LPC's Mr Brack told C+D that the introduction of NHS 111 without a clear commitment to involve pharmacy fully was unfortunate. "We could have helped to ease pressure in the system," he added. "Many of us have doubt about the NHS [111] model, because most patients think all their calls are urgent, and this may prove a blessing in disguise if it encourages a bolder approach in which pharmacy can play a part."

Mr Brack said he looked forward to working with Kernow CCG "to help them achieve their aims for patients".

North Essex LPC chief executive and former NHS Direct employee Ash Pandya said pharmacists could learn important lessons from the provider about tendering contracts and pricing services.

It highlighted the importance of research, data handling and analysis, projected activity and contractual structures, he said. "Pharmacists really need to be able to work out a return on investment on service delivery and not be afraid to pull out if it becomes unviable," he added.

Kernow CCG told C+D this week that NHS 111 was initially due to launch this spring but was put on hold because of "winter pressures" and norovirus.

In north Essex, the 111 service was also initially due to go live in April but was put on hold. A spokesperson said the work it had done so far would enable the CCG to "mobilise relatively quickly" when it found an alternative provider.

Mr Chapman apologised for the delays caused to service rollout.

NHS Direct currently runs nine of the 46 111 services in England.

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