Up to 300 frontline staff at NHS Direct could lose their jobs as the service tries to cut costs, according to the Royal College of Nursing (RCN).

New shift arrangements are being brought in as the new 111 number for non-emergency services is phased in, the union said on Friday.

Workers unable to do the new shifts will lose their jobs, including those with flexible working arrangements, such as those caring for children or working less than 15 hours a week.

The RCN also expressed fears for the future of disabled staff working at the service.

Those affected will have an option to reapply for any remaining shifts.

The RCN said it and other unions had been consulted on the changes and had opposed them.

In the short-term, 111 will run alongside existing local telephone services and NHS Direct, but will eventually become the single number for non-emergency care.

The RCN’s chief executive, Dr Peter Carter, said patients value the service, which could cut referrals to GPs and unnecessary trips to hospital.

“The evidence suggests that this expert advice has kept 1.5 million people out of A&E, and saved the NHS £213m a year.

“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.”

Carter said NHS Direct was 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 compete for it.

“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,” he said.

“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.”

http://www.guardian.co.uk/society/2012/jan/27/300-nhs-direct-jobs-at-risk