Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
NHS Direct should provide a national telephone interpreter service
- Peter Leman (23 October 1998)
-
Untitled
- Nina Booth-Clibborn (27 November 1998)
|
|
|||
|
Peter Leman, Specialist Registrar in A&E St Thomas' Hospital, London
Send response to journal:
|
EDITOR, The planned national expansion of the new NHS Direct telephone advice service is to be welcomed [1]. Whilst great emphasis has been placed on the seamless integration of primary care providers it should be remembered that Accident & Emergency (A&E) Departments also provide a great deal of telephone advice [2]. The 24 hour open access nature of the A&E Department allows patients with language difficulties who would otherwise have difficulty speaking to their GP or GP co-operative via telephone to receive medical care. In one inner city A&E Department 17% of patients did not speak English as their primary language [3]. This problem is not limited to the inner city however and 42% of A&E Departments across the UK had to use interpreters to communicate with their patients over a seven day period [Leman P., unpublished data]. These patients may well have difficulty accessing the new NHS Direct service. It is now well recognised that a national telephone interpreter service is required to enable all health care providers to improve communication with their patients [4]. The use of technology to link a telephone interpreter in one part of the country to a nurse advisor in another and the patient in a third is a cost effective use of resources. The NHS Direct service is well placed to co-ordinate a national network of interpreters to provide not only intepreting for the advice line but a telephone interpreting service for the clinical setting. A seamless consultation for the non-English speaking patient would be a call to NHS Direct where an appropriate language interpeter would be involved. The patient could then be directed to an appropriate health care setting where their face to face consultation could be interpreted using the same off-scene telephone interpreter. This would the begin to approach equality of access to health care for all. [1] Pencheon D. NHS Direct: Evaluate, integrate or bust... BMJ 1998;317:1026-7. [2] Dale J, Williams S, Crouch R, Patel A. A study of out-of-hours telephone advice from an A&E department. British Journal of Nursing 1997;6:171-4. [3] Leman P. Interpreter use in an inner city accident & emergency department. Journal of Accident & Emergency Medicine 1997;14:98-100. [4] Jones D, Gill P. Breaking down language barriers: The NHS needs to provide accessible interpreting services for all. BMJ 1998;316:1476- 80. |
|||
|
|
|||
|
Nina Booth-Clibborn
Send response to journal:
|
EDITOR- The main role of NHS Direct (David Pencheon, BMJ 1998;317:1026-27, 17 October) is to provide advice and information to the public, but it could also inform the future provision of health services and the generation of new knowledge. The NHS R&D Health Technology Assessment (HTA) programme is one example of a national 'needs-led' research funder that is trying to involve consumers in setting its research agenda . Through monitoring the enquiries made to NHS Direct, HTA and other programmes might better be able to respond to the information needs of the public. We must act quickly if the most useful information is to be collected from the outset. Perhaps this is the sixth challenge facing those developing and evaluating NHS Direct: to ensure that the information flow through the gateway is not one-way. A national network of Health Information Services (HISs) were established in 1992 to provide health information directly to the public through a freephone number (0800 665544). Several HISs are now involved as partners in NHS Direct pilots. The Help for Health Trust has recently completed a study (funded by North Thames R&D) looking at the quality of information provided by the services. As part of this study, we examined the nature of the enquiries to the HIS to identify key areas of information need amongst the public. Treatment enquiries to 23 HISs were logged over a 6-week period. The ICD-10 was chosen to code the enquiries by treatment area. There was insufficient information to code one-third (n=427) of the 1,290 enquiries, but brief details about the enquiry were recorded for the remainder. The table shows the most common areas of treatment enquiry. Most common treatment enquiries by ICD-10 chapter heading ICD-10 Chapter heading Number % Infections and parasitic diseases139 10.8 Genitourinary system 103 8.0 Pregnancy, childbirth and the puerperium 84 6.5 Neoplasms 81 6.3 Musculoskeletal system and connective tissue 76 5.9 Mental and behavioural disorders 71 5.5 Coding not possible 427 33.1 This illustrates the potential of NHS Direct in outlining broad areas of public information need. The approach has clear limitations: the objective was to look at the quality of the information provided by the HIS to the caller and not to provide the most useful information to the HTA programme. Attention therefore needs to be given to the many ways in which information collected from NHS Direct can be of use widely within the NHS. Nina Booth-Clibborn* Horizon Analyst National Horizon Scanning Centre University of Birmingham Sarah Buckland Research Manager Help for Health Trust Winchester Ruairidh Milne Scientific Director National Coordinating Centre for Health Technology Assessment (NCCHTA) University of Southampton * At the time of the study Nina Booth-Clibborn was a researcher at the NCCHTA |
|||