Healthcare providers hang up on helpline

Only local, state-funded ambulance trusts and Harmoni, a subsidiary of the privately owned HWH Group, remain in the running. Harmoni has been trialling the scheme and is one of the biggest out-of-hours providers for the NHS.

The national 111 helpline is scheduled to replace NHS Direct from April next year as the first port of call for all non-emergency care and advice.

But doctors at the BMA last week called for the government to delay implementation amid concern that patient safety would be at risk.

The growing opposition will come as a further blow to Andrew Lansley, health secretary, who hopes the 111 service will ease pressure on 999 calls and reduce patient numbers at emergency departments.

But GPs fear that the service's reliance on call handlers – who will have received just 90 days' training – rather than medically trained staff, will increase the number of referrals. The BMA said this would add to pressure on accident and emergency and GP services, and would risk patient safety because the call handlers would use computer algorithms to make assessments.

Trained advisers, supported by nurses, will assess symptoms and book appointments with GPs, community nurses or emergency dentists. However, doctors at the BMA's national GP conference this week registered "serious concerns about the design and precipitous introduction of the 111 model".

Dr Laurence Buckman, chairman of the BMA's GP committee, said: "A potentially dangerous version of NHS 111 is set to burst forth upon an unsuspecting public from April. Patients may end up being sent to the wrong place, waiting longer, blocking A&E and using ambulances needlessly, when a little more consideration might make it all work properly."

Private sector operators are also critical of the rollout. With the 111 service run on a local rather than national basis, they say they would be unable to draw on staff in another district should call volumes in one region be overloaded.

Andy Parker, joint chief operating officer at Capita, said the government should have improved NHS Direct. "There were too many commercial risks [with 111] particularly around call volumes and uncertainty around transfer of staff," he said.

"We believe it would have been a better option to transform the current service, particularly around an integrated digital solution, which would meet future demand and keep in line with government policy to encourage digital by default."

Simon Burns, health minister, said: "NHS 111 is being introduced to make it easier for people to get the healthcare advice they need or to get to the right healthcare service, first time – 24 hours a day, 365 days a year.

"Local NHS organisations are working with GPs and other clinical professionals to decide who should provide their local 111 service. They will make their decision based upon who will give the best service for patients and the best value for money for the taxpayer."