NHS Direct
Saturday, 22, Nov 2008 03:52
What is NHS Direct?
NHS Direct is a nurse-led telephone information service, which provides basic healthcare advice to callers and directs those with more serious complaints to the appropriate part of the wider NHS. It is accessible 24 hours a day, seven days a week, and is the largest telemedicine service in the world.
The service was launched in 1998, as a means of extending public access to healthcare services, to relieve pressure on increasingly hard-pressed GPs and accident and emergency departments, and to iron out regional inequalities in service provision. It formed a key part of the Labour Government's 'The New NHS' White Paper.
In April 2007 NHS Direct became an NHS Trust, giving it the opportunity to apply for foundation trust status. The new NHS Direct Trust employs almost 4000 staff and handles over 22,000 calls per day.
NHS Direct in England and Wales can be contacted by phone on 0845 46 47. For Scotland, NHS 24 provides a similar service and is available on 08454 24 24 24.
There is also a website which provides healthcare advice, directory and medical dictionary services. In addition NHS Direct Interactive is available to over 18 million households with either Sky Digital TV or Freeview.
Background
NHS Direct was first established in March 1998, as part of the New Labour Government's plans to reform the health service. It was originally launched in three pilot areas: Newcastle, Preston and Milton Keynes. The concept of a complementary online service was introduced under the 1998 NHS Information Strategy, with the objective of providing a companion website for the telephone service by autumn 1999. The website was fully operational by December 1999.
In November 2000, NHS Direct was expanded to cover the whole of England, following the success of the pilots, which had been gradually expanded upon throughout 1998 and 1999. NHS Direct Wales was launched in April 2001.
NHS Direct was originally organised on a local basis, with individual sites (there were 24 in England and Wales in 2002) and staff located within 'Host Trusts', which were mainly Ambulance Trusts.
In April 2004, NHS Direct in England was consolidated into a single national provider, a Special Health Authority. Local NHS bodies commission services directly from the SHA.
The change to NHS Trust in 2007 established NHS Direct as an integral part of NHS frontline services.
Controversies
At its launch, concerns were voiced that NHS Direct was designed to keep patients away from overburdened doctors' surgeries and emergency departments, offering them a 'call centre' service instead. The qualification of nurses to give medical advice was also questioned in some quarters.
Much of this criticism stemmed from the Government appearing not to take into consideration some of the concerns raised by stakeholders during the extensive consultations that preceded implementation.
However, public satisfaction with the service is said to be high - monthly surveys routinely record rates of around 97 per cent. Moreover, NHS Direct claims that between two and three per cent of its callers are unaware of the severity of their symptoms and are immediately referred to emergency services.
Critics of the clinical service provided have suggested that diagnoses err on the side of caution, and the service has yet to suffer any heavily publicised errors.
Within the NHS and the Treasury, there was concern about the effect of the development of NHS Direct on human resources. The absence of an HR strategy was seen to threaten nurse recruitment and retention in the vicinity of NHS Direct sites.
Statistics
• NHS Direct handles over 8 million calls a year of which five million are to the core service (0845 46 47).
• The NHS Direct Online website (www.nhsdirect.nhs.uk) receives around 21 million visits a year.
• NHS Direct receives approximately £150 million funding annually from the Department of Health to run the 0845 4647 telephone service, the website and digital TV services.
Source: NHS Direct 2008
An evaluation of over four and a half thousand calls to NHS Direct carried out by IFF Research over a two-week period (11th -7th February and 3rd -9th March 2008) found that:
41% of callers were advised to treat themselves at home
11% were referred to A&E
28% were referred to a GP (10% for urgent appointments)
5% were referred to walk-in centres
4% were referred to a dentist
3% were referred to a pharmacist
In addition, 73% of callers said they would have gone to their GP or A&E if they had not been able to phone NHS Direct.
Source: NHS Direct news release 11/06/08
Quotes
“Our patient satisfaction ratings are very high compared to almost any health, call-centre or online service. We know there are huge opportunities for further use of telephone, internet and TV in healthcare…"
NHS Direct chief executive Matt Tee 11/06/08