Evaluating NHS Direct

NHS Direct – a telephone helpline for England and Wales

“…Results from the three pilot sites found a low rate of calls, a six-fold difference in the calls over the sites, but high caller satisfaction. Calls were received mainly out of hours and there were substantial differences across the three sites (Florin & Rosen, 1999). Results at the end of the first year showed that 72% of calls were received opinion & debate out of normal working hours and 22% were about children under 5 years .…”

“…However, concern has been expressed that NHS Direct may miss potential emergencies, give inconsistent advice and make unnecessary referrals to over-stretched A&E departments (Guardian, Tuesday 8 August 2000; Farrer Lawson et al, 2000). Florin and Rosen (1999) have suggested that it highlights the tension between policy goals of consumer responses and the management of demand, and were concerned that continuity of care may be affected. They were wary of extending NHS Direct because``the impact of this plethora of health services on need and demand for NHS care is little understood and there is a danger that these services will foster inefficiency.…”

“…The development of NHS Direct was underpinned by two major policy concerns (Florin & Rosen, 1999): consumerism and the growth of the`24-hour society' ; and the need to manage the growing demand for primary and emergency services. Its overt purpose is to providè`e asier and faster advice and information for people about health, illness and the NHS so that they are better able to care for themselves and their families'' (Department of Health, 1997).…”

Systems for emergency care

“…The recent development of triage and advice telephone services, such as NHS Direct,3 has further complicated the picture, and now the government proposes 36 walk in centres (with more under consideration) to “offer a service to the public, when the public need it and where the public need it.”1 These services, based in shops, health centres, and hospitals will be nurse led, with access to general practitioners in some cases, and will offer extended opening hours, including evenings and weekends—but how do they fit into the changing emergency care environment?…”

NHS Direct: here and now

“…£280 million (US$450 million) has been committed to it and to complementary projects over the next three years, on top of the £40 million (US$64 million) already spent. The justification for all this has been criticised3 but the political imperative that has given it such momentum, and the resources already committed, suggest that NHS Direct is here to stay.…”