The Royal College of Nursing (RCN) has warned that up to 300 frontline staff at NHS Direct could lose their job with the introduction of the new 111 number for non-emergency services.
The new 111 number will run alongside NHS Direct in the short-term, but in the long-term it will become the single number for non-emergency care.
New shift arrangements are being brought in to accommodate the 111 number. The RCN has said that workers unable to join the new shift pattern will lose their job.
Other staff who could lose their job are those with flexible working arrangements already in place, and those working less than 15 hours a week. The RCN also expressed fears for the future of disabled staff working at the service.
Staff affected will have to reapply for any remaining shifts.
The RCN said that it and other unions had been consulted on the changes and opposed them, but they are still going ahead.
The new system will allow private and GP out-of-hours providers and the ambulance service, among others, to deliver the service. This fragmentation will lead to more postcode lotteries across the country.
The RCN urges the government to look at the cost-effectiveness of NHS Direct rather than bringing in cheaper alternatives that sacrifice patient care.
RCN chief executive Dr Peter Carter claims that NHS Direct has kept one and a half million people out of A&E, and saved the NHS £213 million a year. He said:
"Our fear is that patients, who can often be extremely worried or distressed, will receive a stripped back service from NHS 111, with more being advised to dial 999 or go to A&E, which is far more costly.
"At a time when the NHS as a whole is under pressure to make savings, it seems nonsensical that one part of the health service is in effect picking up the tab for another.
"We know that NHS Direct is in a difficult position at the moment, however many of the staff have worked there for years and are naturally very worried and upset about the future.
"NHS Direct also employs higher numbers of disabled workers who may not be able to cope with the physical demands of a hospital ward, yet are still able to provide sound clinical advice to patients.
"If these workers lose their jobs they may struggle to find future employment within a healthcare setting and as a result the NHS will lose their expert skills."
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