NHS Direct to be scrapped

Another promise broken Dave?

The health secretary, Andrew Lansley, has let slip that the government is planning to scrap NHS Direct, the hugely popular medical telephone helpline.

Chatham is one of the major centres for NHS Direct employing a large number of staff in its Quayside House in the Chatham Dockyard.

The Conservatives promised in the election not to re-organise the NHS but have since made a significant u-turn with expensive structural changes leading to cuts in services and medical headcount.

While touring Basingstoke and North Hampshire hospital on Thursday, Andrew Landsley revealed that the phone service – which this year cost £123m to run – is to be axed.

Until Lansley's apparent indiscretion, the official government line was that a new free telephone service, NHS 111, would not replace existing local telephone services or NHS Direct but might do so in the longer term if a pilot scheme is successful.

The Department of Health has confirmed that NHS 111 would replace NHS Direct within three years. The new service is undergoing trials in County Durham and Darlington.

"When NHS 111 is rolled out nationally, it will replace the NHS Direct 0845 4647 telephone number," the department said yesterday. People can dial 111 to get health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24-hour chemists.

Although the new number is free, it is expected to be far cheaper to run than NHS Direct because it is likely to employ fewer medically trained staff. The department said it did not know how much NHS 111 would cost but admitted that it had a responsibility to save money.

"It is important that we deliver the best possible service for the public and, in the economic climate, deliver the best value for money," said a spokeswoman.

The NHS has been told to find up to £20bn of savings by 2014, even though the health service is due to see rises in its budget in the coming years.

According to the government, one way to cut costs is to hire cheaper staff. Forty per cent of NHS Direct's staff are trained nurses, but anyone dialling 111 will speak to non-specialist "call advisers" who have completed a 60-hour course rather than a degree.

The course, which is the same as that taken by 999 call operators, includes "specific education around anatomy, physiology and clinical features of injury and illness to enable them to provide a high-quality assessment of symptoms," said the health department spokeswoman. She added that difficult calls will be referred to a doctor or clinical supervisor.

Cuts to clinical staff in favour of non-medically trained people. A risky strategy which could harm patients.