Agenda item

To receive an update on recent issues relating to capacity issues and staff shortages in relation to the operation of the NHS 111 Service, and to difficulties experienced by users of the service accessing translation services.  

The Commission received an update from Sara Prema (Chief Strategy and Planning Officer, Leicester City Clinical Commissioning Group) on recent issues relating to capacity issues, staff shortages in relation to the operation of the NHS 111 Service, and in difficulties experienced by users of the service accessing translation services.

During the update the following was noted:-

a)         The contract covering Leicester, Leicestershire and Rutland was provided by Derbyshire Health United (DHU) and West Leicestershire CCG had the lead role for the contract which was commissioned by all 3 CCGs in Leicester, Leicestershire and Rutland.

b)         DHU were contracted to provide a 24/7, 365 day a year NHS non-emergency telephone advice and triage service to direct patients to the best medical care that meets their needs.

c)         DHU also provided services to other CCGs in the region.  

d)         The issue had arisen following allegations in the media from a former DHU employee which related to the Derbyshire call-centre and not the Leicestershire call-centre.  At peak times, however, both call-centres could take calls on behalf of each other if one call-centre was experiencing particularly high levels of calls.  The allegations in the Derbyshire call-centre included low clinically trained staffing levels, service targets missed on answering calls, lack of clinical support to non-clinical call handlers and calls being avoided by call handlers.

e)         In addition to the ongoing contract assurances process, local commissioners and regional commissioners were seeking assurances in relation to the concerns raised.  The Provider was also providing assurances to concerns raised.

f)          West Leicestershire CCG held monthly contract meetings with DHU where quality, finance and performance issues were reviewed and discussed.   The CCG had undertaken a visit in March 2015 that highlighted that DHU provided a safe, effective, caring, responsive and well-led service.

g)         Following the recent allegations, West Leicestershire CCG made an unannounced visit to the Leicestershire NHS 111 site to review staffing levels, planned staffing levels, sickness and absence levels, recruitment processes, staff experience and safety and quality.  There was no evidence from the visit, or the documentation provided, that supported the issues raised.   Further assurances have been received from DHU and North Derbyshire CCG based upon their preliminary findings from their investigations.  To date no escalation has been made.

h)        Due to a number of CCGs commissioning services from DHU assurances on the issues raised was being managed at regional level.  North Derbyshire CCG were leading an external investigation focusing on staffing levels and warm transfer of calls.  The review included a review of staffing levels for a 13 week period from 29 June to 27 September 2015.  A Reginal Investigation Group had also been established to support the CCG with its investigation.  The final report was expected to be available at the end of November 2015.

i)          DHU are also conducting their own internal investigation led by the Director of Nursing, Director of Performance and Director of Finance, which is due to be completed in December 2015.

j)          Following the completion of the two investigations, the Oversight Group would review all the information and if appropriate, action plans would be developed and subsequently monitored through the contractual process.

k)         In relation to the access to translation services, DHU used Language Line and they had experienced an issue where a small number of calls were delayed due to work on the Language Line telephony platform.   This was expected to resolved before the end of October.  However, DHU had also taken the decision to have a second source provider to increase the availability of interpreters at times of increased activity and to make the service more robust.   

In response to a Member’s question Sara Prema and Richard Morris confirmed that they would seek to locate the Equality Impact Assessment that was undertaken for the service.  It was thought that that this was a national EIA.  The Chair requested that if the national EIA was not readily available, a local EIA be prepared to take account of the technical issues which had led to the recent problems.  

AGREED:

1)    That the comprehensive and re-assuring update be received and that the outcomes of the two investigations by North Derbyshire CCG and DHU be submitted to a future meeting of the Commission.

2)    That the national EIA be forwarded to the Commission, or failing that, a Local EIA be prepared taking into account the recent technical issues.