News Extra [these Stories Appear Only On The Web]

NHS Direct lays out plans to expand into monitoring and social care

BMJ 2005; 331 doi: (Published 24 November 2005) Cite this as: BMJ 2005;331:1228
  1. Andrew Cole
  1. London

    NHS Direct, the national patients' helpline, spelt out plans last week for a much expanded service that would place it at the heart of the latest healthcare reforms. Speaking at the organisation's conference in London to discuss the forthcoming white paper on out of hospital care, medical director Mike Sadler said that the recent public consultation highlighted people's desire for better access to health care, better information, and improved coordination of services.

    NHS Direct could help achieve all of these objectives. More than two million patients a month were now using its services either on the telephone, the internet, digital television, or by using the self help guide in Thomson local directories. But, he said, “I believe we can do much more.”

    He suggested several ways that NHS Direct could expand its services, including an interactive social care forum on its website, a “virtual contact centre” to put people in touch with any other part of the service, and a monitoring system that would trigger alerts about the condition of home based patients.

    He also believed it could play a role in extending Choose and Book—the electronic appointments system—by allowing patients to get information and advice about their treatment before booking and also receiving prehospital assessment and follow-up by phone.

    NHS Direct was “not a million miles away” from many of these initiatives now, he said. “It's just a question of making it happen.”

    The conference heard that NHS Direct is improving its clinical sorting performance, with the number of callers that are directed to emergency departments, the ambulance service, or urgent GP callouts falling from 45% to below 30% in the past two years.

    Dr Sadler acknowledged that in the past the organisation was often criticised for clogging up the system by making inappropriate, safety first assessments. “We do now recognise that we have to share our burden of the risk,” he said.

    Earlier, the chief executive of the NHS Confederation, Gill Morgan, challenged NHS Direct to stop “sitting on the sidelines” and become a “real driver” in rolling out the new reforms.

    Information was key to a new relationship between patients and professionals in which power was shared, and NHS Direct could be the portal for making that information available to people in a simple unbiased form.

    “People need help to navigate to find their way through a system that will become increasingly complex to ensure multiple choices don't become a fragmentation of care.”

    Slogans, such as patient choice, might look “very nice and sexy on political hoardings but it could be harmful to those people we serve,” she warned.

    NHS Direct now fields 6.5 million calls a year from the general public as well as receiving nine million visits to its website. It answers 80% of all calls within 60 seconds and assesses the vast majority within 20 minutes. Patient satisfaction rates are consistently over 98%.

    View Abstract