Enfield Clinical Commissioning Group (CCG), together with Barnet, Camden, Haringey and Islington CCGs, are proposing to commission NHS 111 and GP out-of-hours as a combined service. They are inviting members of the public to give feedback.
The CCGs' preferred option is to let a contract with a single provider who would cover both services for patients in all five boroughs. They consider that this solution would take account of the following findings based on monitoring of NHS 111 since it was first set up:
- Combining NHS 111 and GP out-of-hours services under a single contract helps patients get to the right service quicker, with less time spent being passed from one call handler to another.
- Nurse, GP or pharmacist input early on may help patients get the right advice or treatment more quickly
- When an NHS 111 call handler directly books appointments for patients with the right service, such as a GP appointment, this works very well and improves patients’ experience
- NHS 111 services could make much better use of local community services
- NHS 111 services need to develop better online access
Currently the NHS 111 service in all five boroughs is provided by a single company – London Central and West Unscheduled Care Collaborative (LCW), a GP-led not for profit organisation.
In Camden and Islington GP out-of-hours services are provided by a for-profit company - Care UK. In Barnet, Enfield and Haringey the provider is Barndoc, also a for-profit, but one that claims to reinvest all profits in improving its services.
The "engagement document" seeks to allay concerns that a contract of this size would inevitably be won by a large for-profit firm:
Isn’t it true that only big, private companies would be able to bid for the contract?
We are required to treat different types of provider fairly in any procurement process. The contract must be awarded based on the ability to deliver a high quality service at an appropriate cost. However we are working very hard to ensure that a range of types of provider, including NHS organisations, GPs and voluntary sector organisations are able to participate, and it is anticipated that the eventual service would be delivered by a number of providers working together. As part of the procurement process, potential lead providers would have to demonstrate how they would work with other providers.
However, the key phrase here is probably "appropriate cost". This might result in the CCGs being forced to choose the bid with the cheapest upfront cost, which might turn out not to reflect the true cost once it becomes clear that some adjustments need to be made to the service. Nor can one rule out the possibility of some CCG members having links to the firms that bid for the contract.
The deadline for comments and feedback is 31st July 2015, either by emailing or by using the online questionnaire.
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