NHS Direct has come under fire from doctors and ambulance crews, who say they are struggling to cope with too many unnecessary referrals the service makes to GPs and hospital A&E departments.

Born in 1998, NHS Direct was set up as a 24-hour, nurse-led health hotline, providing not only a first port of call to anyone concerned about their health but also a means of diverting some of the pressure from overloaded GP services. Fast-forward 10 years, and the service now also offers an authoritative health website and a digital TV service which, it says, is one of the largest interactive services in the UK. Over two million people now access NHS Direct every month.

But now the service is being criticised for placing an extra strain on an already stretched health system, especially by categorising minor ailments, such as high temperatures, as urgent, according to media reports.

Dr Hamish Meldrum, chairman of the British Medical Association's GPs Committee, called for a full independent review while speaking on BBC Radio 4's Today programme earlier this week. “The evidence we have is that NHS Direct errs too much on the side of safety,” he explained.

But NHS Direct, which takes 500,000 to 600,000 calls a year, has strongly defended itself against the criticisms, boasting a 97% patient satisfaction rate and pointing out that it currently refers 32% of symptomatic callers to emergency services, which is bang on government targets set last year. And speaking to PharmaTimesUK News, a spokeswoman said that year after year the service continues to reduce the number of calls it diverts to emergency care.

Doctor’s concerned

Summing up the BMA’s position on the issue, Dr Meldrum said in a statement: "We have always been in favour of a much fuller and more comprehensive evaluation of NHS Direct, including its impact on other NHS areas such as A&E departments, ambulances and GP surgeries.” He claimed that the service’s pilot scheme was introduced nationally before a “proper evaluation” had been carried out, and said “doctors have always had concerns about whether NHS Direct was the best and most effective way of spending scarce NHS resources. It really does beg the question as to how useful the service is if NHS Direct is having to refer on such a high proportion of people.”

But the Department of Health has rejected call for an inquiry. “Ensuring people get to the right services quickly can save lives,” a spokesperson for the DH said. “NHS Direct provides an increasingly popular and important service helping people with health care advice and information. Their highly trained and skilled nurses and call handlers can refer people to urgent and emergency services if they determine that a caller's need is best met by those services,” he stressed.