Too early to draw conclusions

EDITOR—Florin and Rosen's observations about the limitations of the data published on the performance of NHS Direct were well made.1 Because the sites are still being established it will probably be another year before meaningful data can be produced for analysis.

The variability in the advice given by the different sites is inevitable given that NHS Direct uses three totally different triage systems Certain key ingredients are needed for consistency of outcome and demand management which are not present in all of the current systems in use. These features must be included in the national specification given to suppliers.

The consistent outcomes produced over 15 years in the United States by the system used in Hampshire and Newcastle (Personal Health Advisor, Access Health UK) gives confidence that a correctly designed tool, properly applied, does manage demand. It also produces consistency in clinical standards and delivers 24 hour access to services at levels that are appropriate and not demand led. Will NHS Direct do the same? By next …