NHS Direct reviews referrals and advice

NHS Direct is to review the clinical effectiveness of its referrals and the self-care advice provided to patients. A 12 week evaluation will aim to ensure these are “fit for purpose” in comparison with other patient pathways and that they are evidence-based.

The organisation will hold seven workshops across the country at which health and social care professionals will analyse the patient pathways experienced by people who call NHS Direct, based on the top ten reasons for people contacting the telephone helpline.

There have been persistent concerns from doctors that NHS Direct refers too many patients into other NHS services. Last year, the British Medical Association called for an inquiry into the service, arguing that because it referred two thirds of cases onto GPs or emergency services it was “putting a strain on the system.”

There have also been national and international concerns about the quality of advice given to patients by out of hours services.

The most recent review of urgent and emergency care services by the Healthcare Commission found they were working well against individual targets, but that the system as a whole was not working as well as it could. NHS Direct says the workshops will give professionals a chance to look at such issues.

Helen Young, NHS Direct clinical director, said: “The study will help us to ensure that the Department of Health targets for 2008/9 – 60% of calls completed within NHS Direct and fewer than 20% referred to an urgent pathway – are clinically safe and appropriate for the patient.”

The study will identify the most commonly used algorithms that contribute to the largest percentage of urgent, self-care and other outcomes within NHS Direct. A random sample of these calls will be anonymised and turned into case studies for discussion at the workshops, most of which will be held in the first week of December.

More information: NHS Direct is inviting GPs and other professionals to attend the workshops. For more information or to contribute to the debate contact helen.young@nhsdirect.nhs.uk