Evaluating NHS Direct

Early findings raise questions about expanding the service

The creation of NHS Direct reflects a number of different political and policy concerns. One is consumerism and the growth of the 24 hour society.1 2 Another is the need for demand management against a background of growing demand for primary and emergency care and problems in recruiting and retaining nurses and general practitioners. Is the recently announced expansion of NHS Direct supported by its preliminary evaluation?3 This has been reported as showing that it is a success,4 but a closer look at the detailed results reveals a more equivocal picture.

NHS Direct is a telephone triage system operated by nurses to advise callers on the most appropriate form of care. The evaluation has so far looked at three aspects of the service in the first three pilot sites: a descriptive account of the organisation and users of NHS Direct; caller satisfaction; and a “before and after” assessment of its effects on other services.3 This last aspect is important because at least part of the rationale for NHS Direct is to reduce unnecessary demand on other NHS services.

The results to date show lower call rates than expected, with only one third of the predicted total number of calls over the first eight months. This volume might, however, increase as the service becomes better known. Rates of calls …