The news broke at the weekend that NHS Direct is to be scrapped by the Coalition Government, and replaced with a new service – 111 – a move anticipated in July’s Health White Paper, in which it was promised to:
Develop a coherent 24/7 urgent care service in every area of England that makes sense to patients when they have to make choices about their care. This will incorporate GP out-of-hours services and provide urgent medical care for people registered with a GP elsewhere. We will make care more accessible by introducing, informed by evaluation, a single telephone number for every kind of urgent and social care and by using technology to help people communicate with their clinicians
The new service, a party press release today tells us, is being piloted in four areas before being rolled out in 2013. It quotes Lib Dem health minister Paul Burstow welcoming the move:
“NHS 111 will build on NHS Direct but will go further providing a much more integrated service for the public.
“Unlike NHS Direct NHS 111 will be free to call. Where NHS Direct can only signpost other services NHS 111 will be able to book a GP appointment and go straight through to local out of hours services. If you do need an ambulance the 111 service will cut out the need to go through the 999 service assessment.
“NHS 111 will ensure people are put in touch with the right health professional first time. By doing that the new service will reduce the pressure on 999 services and A&E departments.
“This is a simple, cost effective idea: from 2013 people can ring 111 for non life threatening health concerns and 999 when it is a matter of life or death.”
Our poll asking whether Voice readers agree with the Coalition decision is still open:
The last time I looked at the tally, it was pretty much neck-and-neck with the slimmest of leads for the Coalition decision.
(Note to journalists: Voice polls are open to any reader, whether Lib Dem or not, to vote.)
Follow @libdemvoice.org on Bluesky
Like us on Facebook
Subscribe to our feed
Sign-up for our daily email digest
Why non-fiction books need their indexes
Changes in status: Local Elections wrap up
What should the Liberal Democrats stand for?
How many councillors has Reform UK lost since the May 2026 elections?
Ed Sanderson
Jack
Matt (Bristol)
John Grout
Mick Taylor
14 Comments
I’m a bit confused as to the main thrust of this idea. It was billed as a cost-cutting measure, but how will it be cheaper if it makes the phoneline free and the service do more? And if it doesn’t cut costs significantly, is it worth messing around with it in what sound like some fairly minor ways?
I heard it said on the news somewhere that there would be fewer actual medical staff on the line and more purely admin staff. Is that accurate? I can see how that would cut the phoneline’s costs, but if people lose faith in the diagnosis they get, they’ll probably go to their GP instead which could bump up actual NHS costs. Plus it risks downgrading a trustworthy source of medical advice for elderly or immobile people who prefer to stay at home.
I know our Conservative partners will repeat the “better service, less money” mantra, and I’m not saying that can’t ever be true but in this case I’m sceptical – it sounds a bit like reform for the sake of it. I’d hate to see NHS Direct reduced to a glorified appointment-booking service.
In principal, I have no large objections to the proposals regarding the concept behind the 111 service; but I do have a number of reservations re implementation. Not least is the level of staff training proposed, which, if reports are correct, will be the sixty hours basic triage training given to 999 operators but with backup from experienced medics/mostly nurses, providing clinical backup but at a fairly low ratio in clinical to “frontline” operator numbers.
A plus point is that at least it is to be piloted, which is something that cannot always be said about various reorganisations proposed and carried out within the NHS.
More importantly though, as I understand it, these proposals are part of the Coalition White Paper “Liberating the NHS” which is out for consultation until October. So why is implementation being announced before even consultation is theoretically complete?.
More importantly I am disturbed as to how the whole issue of NHS “reform” has not appeared higher on the radar of Lib Dem Voice. Having now read the document and it’s accompanying “clarifications”. Far from being “reform” in the progressive sense, it is nothing more than a schematic for dismantling the NHS as envisaged by Beveridge and passing the whole exercise over to the private health corporations, mostly American. A system of healthcare provision that manged to contrive the situation wherin upwards of forty million US citizens had no meaningful access to decent healthcare. Are we really proposing as Lib Dems to be part of that?
The importance of NHS Direct is that its advice is given by QUALIFIED NURSES NOT CALL HANDLERS
111 was always meant to be addition to NHS Direct, not a replacement
so how can sacking 1,000 nurses from NHS Direct
make 111 a better service ??????
Has Mr Burstow visited NHS Direct ??? Has Mr Lansley
Does the Lib Dem Governmnet really want to sack 1,000 NHS Direct nurses ????
Does
Please expalin
axing nurses will simply mean more patients turning up at overloaded A&E Depratments, as they cannot get advice from GPs especially at weekends, evenings and holidays
Im worried if they go by the pilot scheme the staff will have max 60 days training and a laminated sheet to go with .One nurse per call centre per shift ,this cut can,t be LIBERAL ,don,t believe the hype this is a good service ,just check first how many people it helps 96% of people who use it are happy
andy edinburgh
>axing nurses will simply mean more patients turning up at overloaded A&E Depratments, as they cannot get advice from GPs especially at weekends, evenings and holidays
I don’t by the “overloaded” argument; there are too many different channels and they are partly “overloaded” because noone knows where to go.
Having been to outlets such as MIUs (Minor Injury Units) and out of hours services as well as casualty, these services can have tumbleweed in them on a Saturday night. And this is without mentioning, Polyclinics, Walk in Centres and NHS Direct.
As I said, too bloody complicated – because of too much fiddling from the centre.
Part of the solution is to claw back resources thrown at GPs for no gain in 2005/6, and to clarify it all. If the extraneous setups go, then good.
We’ve had initiative-itis leading to Grand Complication; that needs reversing.
I have a concern about 111 though; it has a seat-of-the-pants feel in the way it is being implemented.
Say what you like about 111, but with no advertising cost, most of the UK now knows the phone number. Which is more than can be said about NHS Direct!
And the 111 service is not seat of the pants, the whole thing is Labour policy started last year.
I personally, like others have no real objections to this change – and like LDK stated it was a Labour policy which was piloted in England for around 5 years until December 2009 when OFCOM gave the go-ahead signal for 111 to become the new number for accessing 24 hour non emergency services. In 2009, Labour were already planning a transition from NHS Direct the new 111 service piloted by NHS Pathways.
Apparently one of the system’s strengths is the system’s ability to integrate often fragmented out-of-hours, urgent and emergency care services thus making them easier for people in need to access and then referring callers to the most appropriate service nearest to them.
If this is the case, then as someone who is largely (or who has become) spectical of Lansley’s health plans as a whole, may I say that I would not have second thoughts about supporting this transition.
Here’s the link for those interested in the plan way back in 2009:
http://e-health-insider.com/news/5491/111_becomes_number_for_nhs_services
I see the Lib Dem spin machine is in full effect. Services are going to be improved by abolishing them. Is there going to be another car crash of a press conference? Labour’s manifesto 111 policy did not involve abolishing the NHS Direct service.
what about the planned sacking of 1,000 nurses at NHS Direct
yes always planned to move to 111 as better number NOBODY OPPOSES THIS MOVE
its the sacking of 1,000 registered nurses,that was NEVER in the original plans
How can sacking 1,000 nurses, giving quality advice to patients improve the service to patients
Whilst I can see the benefits from the new 111 service in terms of the actual hands on help for those patients who genuinely need it, what about those patients who need the advice service NHS Direct was providing ? Whilst it is right to talk about the costs of a public service, in terms of assessment process for a VFM exercise this cannot be done without an assessment of the benefits a service provides as well. The advice service is where NHS Direct had a tangible benefit by stopping people unnecessarily blocking up GP, and A&E services thereby saving time and money for both.
If 111 is not going to provide this service are we happy for patients with genuine concerns to now troop to their Local Out of Hours GP service?
I am sorry Paul B but your comments are from the oversimplistic, soundbite era of politics which we hopefully have just dumped in favour of more considered thinking on issues. We are all now locked into public sector reform debate whether we wanted to be or not by the banking crisis et al
That would be the large supply of urgently needed extra nurses for the NHS, who can stop spending time answering phones and start dealing with real patients. This one is a win all round.
The problem with NHS Direct is that it mostly just directs people to visit their GP for examination, so all it accomplished was to tie up a bunch of nurses.
The news didn’t break, Lansley put his foot in it again. Is this news management at it’s best?