NHS 111 was rushed through without lessons being learned from the pilot sites or the risks involved being fully appreciated, an independent review of the service has found.

The launch of the non-emergency telephone advice service coincided with massive changes to the NHS and crucial pitfalls were overlooked, revealed papers released before the NHS England board meeting today (July 18).

Although the government did grant some local extensions to the launch date in April, the review – carried out in May and led by independent advisor and former regional director for the NHS Executive's Northern and Yorkshire Region, Peter Garland – identified "widespread problems" with the service, caused by underestimating the resources needed and failing to learn from the pilot.

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	NHS England pledged to "reflect on, learn from and act upon" the review, which criticised management teams, local commissioners and providers involved in the NHS 111 rollout.

The service has come under fire from pharmacists since its pilot in 2010, as less than 3 per cent of callers in the initial sites were referred to pharmacy.

The evaluation of the four pilot sites, released in August 2012, found NHS 111 had failed to meet expectations of improving efficiency and satisfaction within urgent care. But the decision had already been taken to roll out the service nationally and there was limited evidence these findings had prompted "any substantial debate or rethink of the programme", the review found.

The timing of the NHS 111 launch, as PCTs were abolished, meant the level of expertise at a local level was "not always as high as would otherwise be the case", it said. But the review also questioned whether the NHS 111 programme board itself had understood the "inherently high risk" of rolling out the service. The board had failed to flag the risks with the NHS England board, despite early concerns over its potential to go wrong coming from "a number of quarters", it said.

The review, the first of several commissioned by NHS England into NHS 111, also named "strong pressure to find savings" at a local level as contributing to the problems. Commissioners attached varying importance to quality, it found. The review also uncovered pressure to reduce the cost of a call from more than £20 under NHS Direct to £8 under NHS 111.

NHS 111 providers also "significantly" underestimated how long calls would last, leading to a lack of resources and failure to meet targets of answering 95 per cent of calls in less than a minute, it said.

NHS England set out an action plan in response to the review. The body pledged to look at its risk identification, procurement processes and role in projects with local commissioners.

Earlier this month, Cornwall LPC treasurer Graham Brack said the fthe delay tp rollout of NHS 111 in his area could be a "blessing in disguise" because it could enable pharmacists to play a greater role in out-of-hours care.