Nursing leaders are calling for a pause in the roll-out of the NHS 111, warning that a lack of qualified nurses working on the telephone helpline will undermine patient care.
NHS 111 is officially due to replace NHS Direct in England from April 2013, with ministers claiming will provide a simpler, more efficient system for handling non-emergency and out-of-hours calls to the health service than NHS Direct.
However, the RCN and Unison have demanded a halt to the extension of the service, citing concerns over a lack of clinician involvement in NHS 111 and fears that the new service will lead to an increase in patients visiting A&E or returning to general practice for advice.
NHS Direct employs around 3,400 people, 40 per cent of whom are qualified nurses. However, the first NHS 111 pilot, which launched in the north east of England in 2010, had only one nurse on duty at each of its two call centres.
Latest government statistics show that less than a third (31 per cent) of the total calls made to the NHS 111 pilots have been handled by a clinician.
In February, Independent Nurse revealed that one organisation competing to run NHS 111 services had been told to reduce nurse numbers as part of the brief it received from the DH.
Michael Walker, Unison officer for NHS Direct, said: 'We are very concerned at the reduction of qualified nurses providing information to patients. This will lead to a failure to diagnose patients' clinical assessments early, resulting in a huge increase in expensive ambulance call-outs, people going to A&E and presentations at GP surgeries.'
RCN general secretary Dr Peter Carter (pictured) added: 'We are aware of hundreds of nurses who are facing the threat of dismissal by NHS Direct as a result of being asked to undertake unworkable shift patterns as they prepare to bid for 111 services.'
A DH spokesman maintained that NHS 111 would bring significant benefits to patients.
'NHS 111 ensures patients get to the best service, from the right person, first time. If this means they should speak to a nurse, they will speak to a nurse - if they need to see a GP urgently, this will be arranged,' he said.
'We have received some representations asking for an extension to the roll out of NHS 111. We are considering this matter carefully and taking views from Clinical Commissioning Groups before any decision is taken.'