Editorial: Goodbye to NHS Direct and good riddance

Question: What costs £123 million a year yet transfers almost a quarter of its work to GPs?

Answer: NHS Direct.

This week, GP newspaper looks at the reaction to the news that the NHS Direct telephone service will be scrapped and replaced by a new 111 non-emergency number and the implications for GPs.

NHS Direct was launched in 1998 after the New Labour government, buoyed by its emphatic election success, identified a need for a telephone health advice line staffed by nurses.

GPs were unhappy about the loss of their gatekeeper role and concerned about the effects of NHS Direct on the NHS.

A decade on and official figures for 2009/10 show that NHS Direct cost £123 million yet only dealt with 56 per cent of calls in-house. A total of 22 per cent of its five million calls a year were sent to GPs as urgent or next day cases.

A 2007 poll of doctors even found that almost half thought NHS Direct increased workload by referring on too many patients compared with 16 per cent who thought workload had been reduced.

My experience of NHS Direct is that it could, at best, be described as well-meaning and marginally more helpful than Google. Is it any wonder that NHS Direct is near the top of the coalition government's cuts list?

NHS Direct is at pains to point out that the 111 service will replace only its telephone service.

GPs believe the new system will offer better value for money and direct people to the appropriate service more quickly than its predecessor.

Could there have been anything more emblematic than NHS Direct of the previous government's wilful overspending and undermining of GPs?

And what of the future? GPs are right to urge that the use of lay staff by NHS 111 will have to be 'evaluated properly'.

But who should run 111? Perhaps out-of-hours providers and GP commissioning groups would be a better fit than the skeleton NHS Direct which will remain.

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