NHS Direct

Following the reports about the problems with NHS Direct's contacts for NHS 111 services, I spotted this:-

NHS Direct announced in June that it was pulling out of two areas - Cornwall and North Essex - even before the services were launched.
And earlier this month, it warned that the volume of calls in its remaining nine areas was 30-40% lower than expected, leading to lower income and leaving its whole 111 service "financially unsustainable".

Hang on... weren't NHS Direct the people running the service for the whole country until recently? How do you run a service and find your call volume is 30-40% lower than you predicted?