NHS Direct staff are preparing for significant job losses and numerous call centre closures as the service’s 0845 contract comes to an end.

The UK’s largest union, Unison, claims NHS Direct is halving its workforce and closing 24 out of 30 call centres in a the move it describes as “disastrous” for patients and staff.

However, NHS Direct says it has not confirmed that any of its sites are closing.

It sent a letter to staff today confirming which six of its 30 sites will be delivering NHS 111. These are Middlebrook, Carlisle, Dudley, Exeter, Milton Keynes and London.

The government is scrapping the 0845 nurse-led health advice telephone service provided by NHS Direct in favour of NHS 111 – a service provided by predominantly non-clinical staff – from April next year.

NHS Direct has won a number of NHS 111 contracts, covering around one third of the country; but many have also gone to ambulance services or GP out-of-hours providers.

NHS Direct chief executive Nick Chapman said home working will be an option for some nurses rather than working from one of the six 111 sites.

NHS Direct is also working through a process whereby front-line staff will be transferred to the new NHS 111 provider in the regions where it was unsuccessful.

Transfer is mandatory if the non-urgent telephone service is going to another NHS provider such as an ambulance trust, but voluntary for non-NHS providers such as GP out-of-hours.

A significant number of back office staff may have to be made redundant depending on whether NHS Direct is contracted to provide other services by the NHS Commissioning Board.

“The future of other NHS Direct sites has not been decided. We are in discussion with the Department of Health and the NHS Commissioning Board about the future of other non-111 services that we could be asked to deliver before making decisions,” Chapman said.

Unison claimed NHS Direct is axing 50% of its 1,500 staff.

Sandra Maxwell, UNISON Convenor at NHS Direct, said: "Hundreds of dedicated nursing and NHS professionals are to be made redundant at a huge cost, when their skills could be used within the new NHS 111 service if only the Department of Health took some decisive action."

UNISON national officer for NHS Direct, Michael Walker, said health secretary Jeremy Hunt should “step in and stop this disaster immediately.”

"Axing dedicated hard working nurses is never a good idea at any time, but this will directly impact on patient care. There is no doubt that patients will suffer as a result of this move,” he added.