Letters

NHS Direct audited

BMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7356.164 (Published 20 July 2002) Cite this as: BMJ 2002;325:164

NHS Direct is value for money and improving

  1. Mike Sadler, medical director ([email protected])
  1. NHS Direct Hampshire and Isle of Wight, Strawberry Fields, Berrywood Business Village, Hampshire SO30 2UN
  2. Birmingham Children's Hospital, Birmingham B4 6NH
  3. Department of Primary Care and Population Sciences, University College, London N19 3UA
  4. McKesson Asia-Pacific, PO Box 4069, Lane Cove, NSW 2066, Australia
  5. Health Direct, PO Box 450, Leederville, WA 6903, Australia

    EDITOR—George selectively highlights negative points from the positive report by the National Audit Office on NHS Direct, drawing conclusions which merit further scrutiny.1

    He notes no visible effect on demand for NHS services since NHS Direct started. Reducing demand was not its primary objective. It aimed to provide the public with a confidential, reliable, and consistent source of professional advice 24 hours a day with easy access to comprehensive health information.2

    He later comments that the “inevitable consequences” of nurse telephone advice is “to fill a health system with people who do not need to be there,” directly contradicting the overall unchanged demand he cited earlier. The key is appropriate use of of healthcare services. NHS Direct undoubtedly advises some callers to access NHS services who would not have done so in the absence of the telephone advice service. Equally, there is frequent redirection of callers from a previous intention to call their general practitioner or attend accident and emergency department to self care. The net numerical effect may be neutral, but the movement of callers above and below the waterline of the “iceberg of illness”3 should increase appropriate use of services. Early evaluation did not address this, but such investigation is now under way.

    Service use and awareness is not universal, but in a service that has only been nationally available for 18 months, this is not surprising. Specific campaigns targeted at hard to …

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