Now they're going to axe NHS Direct...

[thetraveller]

So now NHS Direct up for the chop www.guardian.co.uk/politics/2010/aug/27/nhs-direct-health-phone-service

I've found NHS Direct to give excellent service on the few occasions I have spoken to one of their nurses with concerns about my baby son. No way would I have any confidence in the judgement of an "adviser" who has done a 60 hour course (the proposed alternative for a health line which can save money). I'm afraid I would be clogging up the local A&E Department instead. If lots of other did the same, surely this would increase rather than decrease costs.

Aaagh. Everything Lansley says makes me so mad (and I'm usually a relatively calm person!). I dread to think what our health service is going to look like in 5 years time.

Thanks for posting this link. I'd no idea before I read it that GPs had called for the abolition of NHS Direct as it did not meet its stated objectives.

Sounds like an overhaul was long overdue. The NHS111 pilot got quite a lot of publicity earlier in the week. I suppose the requirement for how many nurses or other clinicians will be refined during the trial.

I'll feel much safer if this brings about a system with which GPs are satisfied.

Lansley is a walking disaster area: I'm hoping he won't last long as it's clear you can't have much faith in his public pronouncements.

The article states that NHS Direct's objectives were to ease pressure on A&E wards and GP surgeries. It infers that this objective hasn't been met because 12% of callers go to A&E or are put in an ambulance, and 22% are sent to their GP as urgent or next-day cases.This still leaves 66% of callers who don't go on to clog up A&E or their GP surgery - a pretty good result I would have thought. Inevitably some people who call will need to go to hospital.

What next...

I've used NHS direct many times over the last years & have found it extremely useful. Every single time we've called, we've avoided going to A&E! I really can't see, on a logical level, what alternative people will have if it gets cut either than going to A&E! Madness.

It was the BMA who called for the scrapping/major review of NHS Direct, though they recommended keeping the website.

They're the experts in clinical care, and that's the aspect which would concern me most.

I found more info on the BMA website

It's being replaced. I've had good and bad advice from NHS Direct. But if GP's and the BMA think it doesn't do what it's meant to do then it's a waste of money and needs to go. Don't see what the problem is as it's being replaced.

Callisto - it's being replaced by a system which will replace the nurses who currently offer advice with call centre advisers who have had 60 hours training. The new call centres will each have up to 25 "advisers" on duty at weekends, but only one nurse. I suspect 6 hours for a call-back from a nurse will start to look extremely good in comparison. And I would really not be happy taking medical advice from someone who has only 60 hours training.

I agree that the current system isn't working well if people have to wait up to 6 hours for a call-back from a nurse. My personal experience is a call-back time on all occasions of less than 5 minutes.

I would be interested to know more about why the BMA want to scrap NHS Direct. I tried looking on the BMA website bout couldn't find anything obvious on this. Onimolap - so you have a more direct link?

I've only ever had useless advice from them so I for one am not sorry to see them go.

I'm on a gadget and can't do long links (not sure if it's the gadget, or me).

You should be able to find more via the page's search function; and in the press release section there's the fuller version of the release from which parts of the text of the newpaper article (above) has been lifted. It's interesting how many initiatives are considered, by doctors, to be of little/no value.

Dh phoned them this morning. i told him not to. they are so useless. nice but uselss. DR did phone back within 5 minuets though,s o that was good. they advised us to go to a&e, which we have just done. but they are totally pointless. either go to a&E or don't.

My experience of NHS Direct has always been excellent. I have never had to wait for more than five minutes for a call back. I will be sorry to see it go... I'll also be interested to see how those GP practises (like mine) that use NHS Direct for Out Of Hours service will replace it. Not happy having "advisers" for out of hours. Not that my opinion will matter in the least.

It could really backfire. The whole point of NHS Direct was that was one was able to speak to a nurse or someone medically trained, and to be a filter for a non urgent query. If they are going to cut medically trained people who are able to advise, then the waiting times are going to increase and lack of confidence with the service resulting in A & Es and GP's surgeries being used as the first point of contact.

It also puts people in rural locations at a disadvantage. It's fine for me, as I live in a city and if NHS Direct are slow, and I'm really concerned, then I'll take them to A & E, but not everyone has this luxury.

When I've been able to get through I've had good advice, but too often I've not been able to get through so have been on my own with deciding what to do anyway, and I have seen some truly shocking examples of advice given by NHS Direct to posters on MN (I assume those people who are told there's nothing to worry about but who actually have something seriously wrong so wind up in A&E later are included in the "66% who don't go on to clog up A&E or their GP surgery" figure?)

I've only had good experiences with NHS direct. When I call about the children they don't muck about and get an our of hours GP to call me back within 30 mins max, about half the time we are sent up to the out of hours GP at the hospital for them to give them a check up.

If they bin NHS direct they have to replace it with a properly staffed out of hours GP service.

Mind you we now have our normal GPs, an 8am - 10pm walk in doctors and appointment only 24 hours GP at the hospital plus A&E - which has now been renamed the Emergency Department.

what training do the initial call handlers have in the current NHS?

Every time I've rung they've read me off the same list of questions you can find on the website....

Surely all those call centre handlers aren't medically trained are you? Otherwise why would you have to wait for a nurse/dr callback???

My question is, are those nurses who are no longer going to be employed by NHS Direct going to be employed elsewhere in the Health Service or just end up unemployed? If its redistribution of valuable resources then fine but its more likely this is just cost cutting. So employ a load of cheap under qualified labour while the qualified end up on the dole. Brilliant.

NHS Direct isn't a health advice service as such. It's remit is to tell people how to treat their complaint I.e at home, with gp when available or go to a&e immediately. It is expensive for that.

have to say if they're doing the same 60 hour course that 999 call operators take I'm not too concerned - I mean I don't have any worries about my call not being dealt with if I ring 999.....

I would rather see the NHSDirect cut and the resources put into GP care - GP out of hour care for example and more emergency GP appointments will ease the pressure on A&E.

I don't know of any other country with a system like NHS direct but I do know that in Belgium it is far easier to get a GP appointment, and that is what the UK needs.

OK, according to my google searches, the BMA is against NHS Direct because it "is an interposition between the patient and healthcare. It stops them getting through to nurses and has ended up an expensive telephone service." Their proposed alternative is that all patients are able to access an out of hours GP service.

I agree that in an ideal world we would all be able to access an out of hours GP service, but this would presumably be massively more expensive than the current filter system which NHS Direct operates.

Lansley is not (as far as I can tell) proposing an out of hours GP service as an alternative to NHS Direct, but is instead proposing a call centre system on the cheap which will replace medically qualified professionals with people who have had 60 hours training. So we will get a worse service, not a better one.

MaMoTTaT - I could be wrong, but I don't think that 999 operators are required to make a judgement on whether your symptoms require an ambulance ride to A&E. I assume they are required to send an ambulance if requested, and to offer basic first aid advice if required in the meantime. The potential for a call centre adviser with 60 hours training making the wrong descision is huge.

Hoochie - thanks for the link. I have signed the petition.

I have never had any advice from NHS direct other than 'go to hospital immediately'. Either the out of hours GP service or casualty. In these cases, surely it is just an administrative burden. I could call the OOH service direct and they would advise me to come in or go to casualty. I'm unlikely to ring with a stubbed toe etc. and the people who are likely to do this would just call an ambulance anyway

I don't find NHS direct in any way useful and will be glad to see the back of it. And you don't always talk to nurses on NHS Direct - you talk to call screeners first and in all but one of our cases this has resulted in me being called back by the OOH GP not a nurse (and the nurse told me to go to Casualty as 'I can't assess you over the phone').

I think actually all kids should be trained in first aid and health management and be taught in schools what to do in an emergency because frankly, a lot of the drain on resources is self inflicted minor injuries and long term illnesses which are not emergencies and the sooner people learned what to do for themselves the better.