BMJ  2006;332:305 (4 February), doi:10.1136/bmj.332.7536.305

Letter

NHS Direct did not emerge from an evidence free void

The first 150 words of the full text of this article appear below.

EDITOR—The claim by McDonnell et al, that the implementation of NHS Direct ran ahead of the evidence has little basis.¹

Preceding the observational study cited by McDonnell et al, a wide range of evidence existed about the successful operation of similar services both in the United Kingdom and internationally.^{2 3} There was also survey evidence of strong public demand for such services, plus additional design and evaluative work.⁴

The observational study provided valuable information about the limited initial impact of NHS Direct on immediate care but was not focused on measuring wider impacts such as general practitioners' routine consultations. Useful evidence on these was, however, provided by survey and monitoring work. These indicated that a sizeable proportion of callers appeared to be contacting NHS Direct instead of their general practitioner.

McDonnell et al say that one finding of the National Audit Office study of NHS Direct, that not all . . . [Full text of this article]

Department of Health, Leeds LS2 7UE geoff.royston@dh.gsi.gov.uk

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