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Easing the pressure on GP and A&E services

11 Jun 2008

The study was carried out by London-based IFF Research. They found that over a quarter of callers to NHS Direct who were advised to self-care would have gone to A&E. Nearly half of callers would have gone to their GP.

Research results

The results of the study reveal:

• In 2007 NHS Direct’s core telephone service took 5 million phone calls.
• 73% of callers would have visited A&E department or their GP if they had not been able to call NHS Direct – 44% would have gone to their GP and 29% to A&E.
• 41% of callers to NHS Direct were advised to self care at home.
• 11% of callers were referred to A&E.
• 28% of callers were referred to their GP – 10% for urgent appointments.
• 5% of callers were referred to walk-in centres.
• 4% of callers were referred to a dentist.
• 3% of callers were referred to a pharmacist.

NHS Direct Chief Executive, Matt Tee said: ‘These figures quite clearly show that NHS Direct is helping take the pressure off GP surgeries and A&E. And what is particularly significant is how many of the callers advised to treat themselves at home would have otherwise gone to doctors’ surgeries and A&E.

‘It is also clear that the public like the service they get. Our patient satisfaction ratings are very high compared to almost any health, call-centre or online service. We know there are huge opportunities for further use of telephone, internet and TV in healthcare, but it’s good to know that what we do today has such a positive effect and is appreciated by the public.’

NHS Direct referral process

IFF Research evaluated a total of 4,554 calls to NHS Direct. They found:

• 93% of callers felt the referral process which included giving self-care advice was efficient.
• 93% of callers said NHS Direct ‘helped me deal with the issue I was calling about.’
• Of the 4,163 callers who followed NHS Direct’s advice, 95% were satisfied.
• The speed NHS Direct can be contacted ‘compared to how long it takes to book an appointment with GP or other provider’ was one of the main reasons for satisfaction among callers.
• NHS Direct offers reassurance to callers. It prevents them ‘panicking’ and gives them confidence they are ‘accessing the correct service.’
• NHS Direct’s service is trusted and callers do not tend to question advice they are given.
• There are 3 main reasons people call NHS Direct – 65% had a new health concern (illness or injury); 22% wanted general information and 12% had an existing concern or complaint which was getting worse.

Mark Speed, IFF Research joint managing director said: ‘These are very positive findings for NHS Direct – with very high levels of caller satisfaction in terms of the way the call was dealt with, the appropriateness of referral and the efficiency of the process.’

Healthcare providers

In addition to the research on caller satisfaction, IFF Research also carried out in-depth interviews with 35 healthcare providers. This was a cross section of healthcare providers and not a representative sample. Their research will support a series of related studies that NHS Direct is involved in with our academic partners.

IFF found that whilst there was a good degree of positive feeling among the healthcare providers, and that referrals were appropriate and timely, NHS Direct has a tendency to err on the side of caution.

Healthcare providers were found to understand why NHS Direct was cautious but felt improvements to NHS Direct’s referral system may help to improve this.

Matt Tee responded: ‘Following this research, we are examining a number of options including highlighting how many calls are diverted away from each provider to counterbalance providers’ experience of inappropriate referrals. We are also considering providing an increased quality of referral documentation which would help counteract claims of those who feel NHS Direct duplicates existing services.’