Ambulance director warns trust could pull out of Norfolk 111 helpline because of funding shortfall

PUBLISHED: 08:13 20 June 2014 | UPDATED: 09:51 20 June 2014

East of England ambulance control centre in Norwich. Call handler.  Photo: Bill Smith

East of England ambulance control centre in Norwich. Call handler. Photo: Bill Smith

Archant © 2013

Bosses from the region’s ambulance service have warned that they could pull out of running an NHS phoneline because of a major funding shortfall.

Officials from the East of England Ambulance Service admitted earlier this year that it was £2m over budget for the Norfolk 111 service.

The NHS trust launched the non-emergency helpline at the end of 2012 and has a contract to deliver 111 until 2015. However, the ambulance service has called on Clinical Commissioning Groups (CCG) in Norfolk to increase their funding to meet the shortfall and has warned the contract could be terminated this year.

In a report to the ambulance trust board, interim director of finance, Stephen Day, said the Norfolk 111 service was running at a “significant loss” and “despite continuing negotiations with CCGs, adequate funding has not yet been secured for 14-15. Unless funding can be secured there remains the potential that this contract could be ceased in 14-15.”

The 24/7 Norfolk 111 service, which replaced NHS Direct, is run from the ambulance service’s Norwich control room in Hellesdon and deals with around 5,000 calls a week.

History of 111

■ The East of England Ambulance Service began providing the Norfolk 111 service in December 2012 as a pilot. Its Norfolk 111 contract expires in 2015.

■ However, the roll-out of the service across the country has been plagued by controversy after NHS Direct pulled out of 11 contracts because of financial problems.

■ NHS Direct withdrew from 11 out of 46 111 contracts last year in the North West, West Midlands, London, Somerset, Buckinghamshire, North Essex and Cornwall last year after getting into £26m of debt.

■ Commissioners say the Norfolk 111 service is working well and meeting targets.

■ An anonymous senior manager at the East of England Ambulance Service, said earlier this year that the trust was using call handlers in Bedford to answer Norfolk 111 calls.

In a statement, Anthony Marsh, East of England Ambulance Service CEO, said: “We are holding discussions with commissioners about ongoing funding.”

“Our performance in 111 is excellent. I am pleased to report that good levels of progress have been made in this 111 service and an assessment by one of our CCGs into auditing and frequent callers led to a ‘full achievement’ mark which is down to hardworking and committed staff.”

Ann Donkin, the chief executive of NHS South Norfolk CCG, added: “Norfolk CCGs and the East of England Ambulance Service are committed to ensuring that the combined 111 and out of hours contract delivers a responsive and affordable service for our patients. It is our intention that EEAST should continue providing these services to the end of the contract.”

“Finances are tight in all NHS services and we have acknowledged that the Norfolk 111 service is no exception - the entire NHS is working hard to deliver care to patients within existing budgets. The CCGs recognised the improvement in both quality and volume of performance in 2013-14 by a making a small additional investment. Negotiations for 2014-15 are continuing and should be concluded shortly.

“The service is well regarded and is meeting its quality targets. Of course, we shall continue talking with EEAST to ensure the 111 service is delivered, and performs well.”

What are your experiences of Norfolk 111 service? Call Adam Gretton on 01603 772419 or email


  • Douglas, I understand why the service came into being, my point is that now you have up to 5 individuals being paid over a longer amount of time when one person could have done the job in one call. I also understand that doctors are working longer hours and can make dangerous mistakes. We need more doctors or less people, in terms of cost it would be interesting to see the financial information regarding how much it would cost if one doctor made the call compared to sometimes 5 people or more being involved (especially when the patient ends up in hospital for something a doctor could have dealt with at home), and the financial aspect of the NHSLA when it goes wrong because of a wrong diagnosis over the phone, or because somebody had to wait 18 hours before getting to hospital because of NHS111. Again, my point is that it still has a high financial cost. Maybe a good start would be decreasing benefits to the jobless to less than if they were working for minimum wage so that there would be an incentive to go to work and pay taxes, to make everybody pay for their prescriptions, and to charge for missed appointments whether you are employed or not. We all have a lot to answer for for allowing our government to get away with what it does.

    Report this comment

    Shannon Hoskison

    Saturday, June 21, 2014

  • Shannon, the NHS 111 Service is the result of the giving GP's the option of opting out of providing an out of hours service to their patients. However, that was essential because GP's were working far too many hours to be effective or safe. The attempts to try to reorganise the NHS were and will fail because no political party wants to admit that in its present form it is impossible to afford without major changes to its funding. Whilst it is unpalatable to accept a free NHS is no longer viable. Extra revenue has to be found and regrettably until charges are brought in for some (if not all) services the situation will continue to deteriorate. The NHS 111 service is simply one of a number of services which are in meltdown due to spiraling costs and it can't be fixed without more money which needs finding from somewhere. That somewhere will be extra taxes or charges, either way it will need to be found!

    Report this comment

    Douglas McCoy

    Friday, June 20, 2014

  • Having used the NHS 111 service on many occasions with the elderly in the community I believe the service is not only costly but woefully inadequate at best and downright dangerous at worst! Let's go back to a system where you speak to a GP and then the GP takes responsibility for what happens next. At present you call up and are assessed over the phone, then a doctor will call you back, usually, and I quote, "sometime in the next 6 hours". Once the doctor has returned the call and if you can understand their directions over the phone, this can be very difficult with some foreign doctors, then they make a clinical decision whether to visit or tell you to see your GP the next day. If the doctor decides that a visit is necessary then they will be out within the next 6 hours, and if they decide then that you need an ambulance it will be within the next 6 hours. This is not good enough! Most people will not ring 111 unless they have real concerns but think they are not deemed Ito be life and death situations by the person themself, who is not clinically qualified to know that. An 18 hour wait for somebody who is very confused and usually has no carer or several carers during that time can become very distressed and may compromise their own safety during that time scale, especially when they cannot be funded for the care to be present during that wait. In my opinion the only time the service is adequate is if somebody has a minor illness and can be given advice over the phone like take 2 paracetamol and rest, and let's face it, before 111 was introduced we had common sense to tell us that!

    Report this comment

    Shannon Hoskison

    Friday, June 20, 2014

The views expressed in the above comments do not necessarily reflect the views of this site

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