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Medicopolitical Digest

Local medical committee conference

BMJ 1999; 319 doi: (Published 03 July 1999) Cite this as: BMJ 1999;319:61

News p 12

NHS Direct should be properly piloted

Representatives of the 35 000 GPs in the United Kingdom have strongly criticised the NHS Direct advice centres run by triage nurses, although last week's conference of local medical committees stopped short of calling for the project to be abandoned.

The chairman of the General Practitioners Committee (GPC) told the meeting that in England NHS Direct was being rolled out “like there's no tomorrow, well before the evaluation has revealed any convincing evidence of more appropriate use of the NHS, the lack of harm to general practice, improved health outcomes, and value for money.”

The conference deplored the government's failure to evaluate the pilots properly and called for consultation with the profession before the scheme was extended. Doctors want clarification of where NHS Direct's responsibilities end and GPs' begin. They believe that the scheme will damage the role of the primary care team and the GP as gatekeeper and will increase patient demand and GP workload.

Dr John Higgie (Somerset) provides medical advice to NHS Direct in south west England and said that one of the reasons NHS Direct was set up was in answer to doctors' pleas for help with dealing with trivia. But he failed to persuade the meeting that it should support the potential of NHS Direct as an advice service to save time and direct patients to appropriate care.

Time will not be saved

Most speakers disagreed with him. Dr John Machen (East and North Hertfordshire) said that a survey in one area showed that the service led to an increase in the number of patients demanding same day GP consultations. Whose time was being saved? The computer generated triage took as long as 40 minutes to come to a conclusion. “I hope they can cope over the millennium,” he said. In his practice 54% of the callers …

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