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Evaluate, integrate, or bust...
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The gradual introduction of NHS Direct, the 24 hour health telephone helpline due to be a national service by the year 2000, is a small but important symbol of the modern NHS.1 It has been designed to respond to the fastest growing influences on service industries: consumerism and technology.2 NHS Direct aims initially to do for the health service what cash machines have done for banking: to offer a more accessible, convenient, and interactive gateway. Its longer term aim should be to help the NHS change its predominant ethos from paternalism to partnership.3
This method of delivering services is not particular to health care.
Telephone services in other sectors have been one of the fastest growth
areas in employment in the United Kingdom. However, the speed of
planned growth of NHS Direct (pilots launched March 1998, more bids
invited May 1998 and announced in July 1998, 19 million people (40% of
England's population) to
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