NHS Direct should be considered as a potential casualty of cutbacks in health spending, GPs have said at a conference.
The telephone service's effectiveness has been questioned by the British Medical Association (BMA) at its annual conference, where it has been claimed the service delays patients getting healthcare. However, GPs expressed concerns about the possibility of scaling back community services.
Although the health service is due to have its budget increased in the coming years, the NHS has been told to find up to £20bn of savings by 2014. Doctors urged ministers to target the savings, which have been seen as inevitable, at the most wasteful areas of the NHS.
The telephone service of NHS Direct and not the website was highlighted by the chairman of BMA's GP committee Dr Laurence Buckman. He said: "It is an interposition between the patient and healthcare. It stops them getting through to nurses and has ended up an expensive telephone service."
Dr Buckman said if it was to go patients could contact their out-of-hours GP service instead, although he acknowledged in some areas this would need improving.
He also said there were "unnecessary" tiers of management which could go, while new hospital building schemes funded by private money through PFI, walk-in centres and polyclinics should be stopped.
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"I would ensure there was a standard for the patient journey first contact ensuring that health services – social care and medical – have a plan for the fastest course of action for any event. NHS Direct is the most useful service but (not sure if it is) it should be able to be transferred to or from a GP surgery/ emergency services at first contact. All appropriate calls should go through one system. Management is an issue within a call centre situation but because there are so many different ways of getting treatment there should be just one point of access rather than go to the GP, call NHS Direct, go to a walk-in clinic, walk into coucil offices or go to the hospital. Single access and management systems. My experience is going to hospital and waiting five hours to be treated. On the other hand I called NHS Direct – they sent us to hospital, treated immediately (same condition, similar symptoms). NHS Direct works in Greenwich London" – Chris, London
"Whilst I agree with this, I also feel that money could be found elsewhere. Why are we providing paracetamol, simple lintus, cotton wool on prescription when they can be cheaply brought at any supermarket? Everyone other than 65 or 5 should pay 50pence for a prescription rater than the minority paying £7.20 per item" – June Bond, West Midlands
"I agree with scrapping NHS Direct with immediate effect. It is one of the money draining holes created by the last government, not fit for purpose. Patients end up calling me for minor self-limiting illnesses that they could have managed by themselves given the right telephone advice. Often, they were advised by NHS Direct to see GP within 24 hours. Decision making at NHS Direct is by a software algorithim; the place of sound advanced clinical/telephone consultation skills cannot be taken by a software that bounces patients round the system" – Tina Chigbo, London