NHS Direct’s response to BMA criticism at 2010 LMC Conference
Dr Laurence Buckman, chairman of the BMA's GPs committee, questioned the value of NHS Direct at the annual LMC Conference on 10 June 2010.
Whilst he accepted the NHS Direct website was a useful resource which should be retained, he called for the cost-effectiveness of other parts of NHS Direct to be reviewed.
“The results of analysis with our commissioner (the East of England Strategic Health Authority) show that in 2008 NHS Direct saved the NHS £162m in efficiency savings. This includes £106m through reduced demand on emergency care (including A&E and 999), and in the order of £56 million in other primary care. Our analysis shows that 1.7 million GP consultations were avoided through the use of NHS Direct’s core service."
In response to Dr Buckman’s comment that “NHS Direct still refers many of its patients on to GPs or accident and emergency departments”, Dr Gaffney says:
“This simply isn’t true. Over 60% of patients who call us will be given self-care advice for their problem, which means they can treat themselves at home without the need to access other health services. We know that almost half of patients given self-care advice would have gone to their GP and a quarter would have gone to A&E if they had not sought advice from NHS Direct."
Dr Gaffney adds, “We have also completed a study to compare our clinical sorting to that of other providers which showed that, in the most urgent cases, GPs and other health professionals agreed with the level of care we advised. In cases where further discussion was needed, this tended to be around timings associated with ‘GP urgent’, ‘GP same day’ and ‘GP next day’ which appear to have inconsistent meanings when used by different clinicians”.
NHS Direct can also work directly with practices to help GPs manage their time and resources. Dr Gaffney explains: “NHS Direct recently ran a pilot with a GP practice in North West England, where we provided in-hour nurse triage to help them manage requests for appointments. Over the nine month pilot, we reduced demand for same-day appointments to one third of all calls. Out of the calls we triaged, one third of patients were happy with self-care advice or using their pharmacy (equivalent saving of 4,000 appointments per year). The rest were either given a routine appointment and a small number were advised to call 999 or go to A&E.”
Dr Brian Gaffney, NHS Direct’s Director of public health, is keen to hear from GPs about their views and experiences of NHS Direct. Email brian.gaffney@nhsdirect.nhs.uk.
