NHS Direct given good report by CHI
NHS Direct, the National Health Service's 24-hour telephone helpline for England and Wales, provides good quality advice and reassurance and is appreciated by the people who use it. This is the conclusion of the Commission for Health Improvement in its first report on the service.
One criticism of NHS Direct concerned the complexity of its management
arrangements |
Jocelyn Cornwell, acting chief executive of CHI, said: “Success,
however, has meant increasing demand for the service and capacity problems
for some call centres. There are also complex management arrangements,
which can create confusion over the development of policy, practice and
performance and a lack of clarity over roles and responsibilities.”
The report warns that the service is so popular that some call centres
are failing to meet their targets of answering 90 per cent of calls within
30 seconds, triaging 90 per cent of symptomatic calls within 20 minutes
and having less than 5 per cent of calls abandoned by callers. But call
centres are meeting their targets to assess or act on 90 per cent of
health information calls within three hours and to have fewer than one
call in a thousand receive an engaged tone.
The CHI investigation was akin to its clinical governance reviews of
NHS trusts and hospitals. As such, it considered the procedural arrangements
of NHS Direct and the quality of its service, rather than the quality
of the advice callers actually received. The investigation found that
at some sites staff had a tendency to depart from the fixed algorithms
they should follow without making use of systems that are in place for
modifying algorithms in the light of experience.
On clinical effectiveness, the report says: “Integral to establishing
whether NHS Direct is providing clinically effective services is the
need to develop performance indicators that focus on patient outcomes.
These would enable the service to assess what happens to patients after
they have received care or information from NHS Direct and may help with
the integration of NHS Direct in the local health community. They may
also enable the service to better assess [sic] patient satisfaction with
the care and information they receive from NHS Direct.”
NHS Direct now handles 500,000 telephone calls and 500,000 internet enquiries
monthly across England and Wales. Most calls are made outside doctors’ surgery
hours and a quarter relate to young children.
The Department of Health said that it was already working with CHI to
ensure that NHS Direct could meet its targets and to improve its complex
management arrangements.
Anne Joshua, national pharmaceutical adviser for NHS Direct, said: “NHS
Direct is an efficient way of using NHS resources. By referring callers
with minor symptoms to pharmacists, who are highly trained
professionals, other services such as GP
co-operatives and accident and emergency departments can concentrate
their efforts where they are most needed.” |
