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.

I think NHS Direct are great.

The most recent time I used them was on holiday this summer. 19mo DS woke up in the middle of the night puking. (Not baby-puking but real, nasty, unwell puking).

After 2 hours of on-off puking, I was really worried. I couldn't call our out of hours Dr as we were away from home. I phoned NHS Direct and they were brilliant. They got me to check for danger signs, none of which he had, and they were able to advise me on the phone that DS was OK.

Had I NHS Direct not been there it would have been a trip to A+E at 3 in the morning (wherever that was!)

News like this just makes me so sad. The cuts are ideological. The Tories don't believe in a welfare state, and they are dismantling it as fast as they can in front of our very eyes, without no real debate. They just keep feeding us the line that it's necessary.

Cuts are necessary, but there is choice over which cuts to make, how many, how quickly, how deep.

This is just so depressing.

thetraveller - WHO answers the calls now?

Why do they spiel off the same questions as on the website and why - if they have medical training why do you have to wait for a doctor or nurse to call you back

For those who think axing NHS Direct will save money, here is the response from NHS Direct (although I accept they are not necessarily the most objective judge!):

?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."

"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."

I agree with WMMC

MaMoTTaT - the intitial call handlers at NHS Direct do not have medical training. But they are able to refer directly to a qualified medical professional if there is any question-mark over your symptoms. I accept they go through the same questions that appear on the website, but presumably they do this as not everyone has home access to the internet and can check for themselves.

I don't think the current system is perfect, but at least there's a reasonable chance of getting through to someone properly qualified withing a reasonable period of time (for most people).

The alternative being proposed would leave call centres with only one over-burdened nurse. If the call centre operator has a question mark over your symptoms in future, s/he will have an option of referring you to that single nurse (presumably with hugely extended call-back times), or recommending you go to A&E / GP (which would presumably increase the burden on those service, sometimes unnecessarily). Of course, the cynical part of me suspects that call centre operators will come under pressure not to refer onwards, making diagnostic decisions themselves which they really aren't qualified to do. And the implications of that are pretty scary.

At the moment there are call handlers, the people who take you details, the root of your problem and put you n a cue to speak to a qualified nurse.
The qualified (undertaken at least a 3 year degree course) nurse usually has a lot of experience in such places as A&E ICU etc, and are able to advise you which course of direction gives the customer the best service. It may be A&E, GP urgent, GP next day or self help. either way it has been proven to reduce to work load in A&E and in GP's surgeries.
The proposed service will replace the qualified nurses with Unqualified health advisers, who will follow an algor rhythm (blindly) and tell you the conclution the computer has come to. They may not ask critical questions which may change the outcome of the decision.
This is really dangerous practice, they are playing with peoples lives.

We have something similar in Scotland - NHS24 and TBH it is pretty average.

One of my friends works there as a call handler, she is not medically trained and couldn't even pass her biology higher, but she has to triage all calls. I find the idea scary.

I would rather see the money spent on GPs as it is almost impossible to get an appointment where I live.

NHS direct is mostly crap. Ds is asthmatic, it's not severe asthma, whenever I call for advice then end up sending an ambulance It doesn't reduce A&E attendance (according to the BMA a couple of years ago), I worked in a childrens A&E, not one parent had used NHS direct, and it can actually be harmful, I've read more then a few threads on here from people with very unwell children who have contacted NHS direct who have told them to give them calpol or something stupid, one one occasion a mother was told that her baby had a sore leg because it had got it's leg stuck in the cot bars (psychic staff aswel!), ignoring the fact that it could be perthes/slipped ephsealplate/osteomielitis etc, I had to tell her to ignore the advice and take her child to A&E where the doctor went mad over the advice given by NHS direct. Alot of people who need urgent medical attention have a delay in recieving treatment because they have wasted valuble time talking to NHS direct.

Mumsnet is far better for advice, it's wrong but it is.

i don't get it - what is going to the difference between 111 and the current NHS direct service?

their advice is always 'call an ambulance' - they must cost the NHS a fortune rather than saving it.

EdgarAllenPop - main difference will be that they are replacing qualified nurses with call centre operators with 60 hours training. There will be one nurse per call centre, so you won't stand a hope in hell of getting through to them within any sort of reasonable time-frame. Under the new system, we might as well all get ourselves over to A&E. I will have no confidence in accepting the medical judgement of someone with no proper medical training.

agree with herbietea and belle. NHS direct imo (and DH's who is a doctor) is crap. Their advice is far too often send for an ambulance/go to A and E, and their answers are straight off the website. Pointless and expensive imo.
Guardian ideologically opposed to caolition government so will use any excuse to bash them (i'm a guardian fan as well but i find their current govn bashing really irritating as a lot of the current problems are not of the current govs making)

Looking at this thread it seems that I must have been unlucky. Every time I have ever called them they have been absolutely useless. They have never said anything to me other than call your OOH GP service or go straight to A&E or GP surgery. Maybe it is because when I have called them it was because I knew something was wrong with ds but didn't think it was worth calling an ambulance.

Loshad - but according to the stats 66% of callers to NHS Direct are not referred on to A&E / their GP. Instead they are given advice on self-treatment at home. So this saves the NHS money. And lots of people, especially the most vulnerable, do not have home access to the internet.

I've only ever had excellent advice and service from NHS Direct so I for one am very sad at the news today.

I've rung them often for the children - things like minor head injuries I wanted advice on, items they have swallowed. The best call I ever had was when DS1 choked on a piece of apple.It was the scariest moment of my life, and took 3 sets of hard slaps on his back to get him breathing again. The NHS Direct line was excellent, put me straight through to a nurse (instead of a ring back) who talked me through it all, reassured me, told me what to expect in the next few days (bruising, painful throat etc) and was excellent. I didnt need to waste a GPs time at all, and felt the service was excellent.

thetraveller - but where do they find the number?

as whenever I've rung them I've always looked the number up on line

Choose well campaign and posters/billboards?

thetraveller - those are NHS Direct figures though, not independent figures I think?

I am fairly sure that a significant proportion of people who are not 'referred' by NHS Direct still end up either going to their GP in the morning, or heading to A&E that same night. There was a thread on here only a couple of weeks ago where NHS Direct had recommended self-treatment for a very young child with breathing difficulties. The mum posted on here because she didn't trust the advice and ended up going to A&E on the advice of some medics on here.

So not only are they useless, they are bloody dangerous.

I know lots of Drs, and I don't know a single one that has anything good to say about NHS Direct - so they can't be doing that good a job at reducing workloads on GPs and hospitals.

Also, on average it takes 40 minutes to get a call back by a nurse on NHS direct here when I call. Were it life threatening I don't think I'd bother waiting TBH.

If you aren't actually really sick I'm of the 'take two paracetamol and wait two hours' school of thought. You'll probably get better.

But hardly surprising people don't know when to call for help if they are not taught basic healthcare and anatomy properly.

Here (from two weeks ago) is one of the over 60% of cases that NHS Direct are congratulating themselves over giving self-care advice. Except that to quote the child's mother (after MNetters had persuaded her that NHS Direct were wrong and she should go to A&E) "Triage nurse was livid at shit advice from NHS Direct. We were rushed straight through a&e waiting room to resus room."

Persuading people who are seriously ill to stay at home while advising those who have nothing much wrong with them to go to A&E is not actually a success story. Statistics on what advice has been given are useless without an idea of whether or not it was good advice.

(I see AliBaba already mentioned that incident. But it's far from the only one I've seen on Mumsnet, and it's not as though I spend much time reading the health threads)

mostly good experiences with NHS direct but every call has resulted in being sent to the OOH gp, which i can now call directly.

although one fairly useless experience with them.. badly sprained my ankle, home alone, with 4 DCs as had niece and nephew to stay, advice included me waking up the oldest child to get me some paracetomal. which was a great idea, but i had explained i could not walk , if i could walk, i would have walked to the cabinet, to get the meds, not to wake a child up

anyhoo.. i think an overhaul is a good thing, certainly nothing wrong with scrutinising the system anyway

I remember another mumsnet one recently where someone's son had wheezing and was told it was a cold by NHS direct. He was only 20 months IIRC. We said 'sod that go to A&E' and he was admitted immediately. Was that the same one? I remember getting quite irate that someone would just accept that this was a normal reaction to a cold.