As many as 300 frontline jobs may be at risk at NHS Direct, according to trade union groups.
The Royal College of Nursing has warned that NHS Direct plans to introduce new roster arrangements to cut costs as they begin moving towards the new NHS 111 services, due to be rolled out through this year and next.
This follows an extensive consultation period with the RCN and other trade unions, who oppose the changes.
According to the RCN, those staff who are not able to work on the revised shift patterns will be dismissed with the option to reapply for the remaining shifts. This will include staff who have flexible working arrangements, such as carers of young children and those who currently work fewer than 15 hours per week.
Commenting on the changes, RCN Chief Executive & General Secretary Dr Peter Carter said: "What we are seeing here is a clear example of quality being compromised in a bid to make short-term savings. NHS Direct has developed over recent years into a service that many patients really value. Nurses have led the way in making this a service which can offer reassurance and advice that on many occasions avoids GP referrals and unnecessary trips to hospital."
Evidence suggests that expert advice provided by NHS Direct has kept one and a half million people out of A&E, and saved the NHS £213 million a year.
The RCN says it is worried that NHS Direct will start offering a ‘stripped-back service’ from NHS 111, with more patients being advised to dial 999 or go to A&E.
NHS Direct is not the only organisation tendering to deliver NHS 111 services. The new system will allow private and GP out-of-hours providers and the ambulance service, among others, to deliver this service.
Dr Carter said: "Not only will this fragmentation lead to yet more postcode lotteries across the country, we will also lose the highly beneficial national picture that NHS Direct statistics provide. I would urge the board of NHS Direct to take the time to think through this process and while they may be under pressure to make savings, there could be other means of doing so. Equally, the Government would do well to look at the long-term cost effectiveness of NHS Direct and the service it provides, rather than attempting to steamroll in a cheaper alternative that compromises patient care. The RCN will be supporting all members employed by NHS Direct who are currently going through this distressing upheaval."
But speaking to OnMedica Tricia Hamilton, Chief Nurse at NHS Direct refuted the RCN’s claims.
“The RCN is wrong to suggest that 300 frontline staff could lose their jobs because of our plans to introduce new roster arrangements. There are enough spaces for everyone to be allocated to a new roster pattern. The driving force behind the plans has always been to ensure our staff are available when our patients need them. This change is not driven by a need to make cost savings,” she said.
However, she added: “We have seen a change in the profile of our calls since the introduction of NHS 111. Early evidence from the pilots we are leading on shows that this will be a more ‘out-of-hours and weekend’ service than the 0845 46 47 service since it will be the front door to all GP out-of-hours services. Because of some long-term issues with rostering, the organisation is not able to guarantee that it can meet this changing demand effectively, and we need to rectify this.”