NHS Direct

Last updated

NHS Direct was the health advice and information service provided by the National Health Service (NHS), established in March 1998. The nurse-led telephone information service provided residents and visitors in England with healthcare advice 24 hours a day, every day of the year through telephone contact on the national non-geographic 0845 46 47 number. [1] The programme also provided a web based symptom checkers on the NHS Direct website and via mobile, both as apps for iPhone and Android smart phones and a mobile website.

Contents

It was discontinued on 31 March 2014 and replaced by NHS 111. [2] As a part of the National Health Service, NHS Direct services were free, although the 0845 number was usually chargeable as a non-geographic number. Some landline providers allowed 0845 calls within "inclusive" minutes.

Users of the service, through whichever channel, were asked questions about their symptoms or problem. Common problems were often given simple self care advice, which they could follow, thereby avoiding an expensive visit to a health care professional. More complex problems were assessed by a nurse and could then be given treatment advice or referred on to another service within the NHS. [3]

As well as these core services, NHS Direct provided a number of commissioned services throughout the NHS, such as specialised support for patients with long term conditions, access to GP and dental healthcare out of hours, and a professional response system for times of public health anxiety.

NHS Direct only provided its service for residents and visitors in England, and there are corresponding public services covering Scotland (NHS 24) and Wales (NHS Direct Wales). Northern Ireland does not have such a service. [3]

Health and symptomatic advice

NHS Direct's core service was the provision of health advice to the public through the national telephone service or through digital channels including the website.

Telephone service

In England and Wales, the NHS Direct telephone service was available on 0845 46 47 and was run by a specially trained team of information handlers and healthcare professionals, including nurses and dental nurses. The service was equipped to deal with a huge range of health enquiries, from symptomatic queries that require assessment and treatment, to requests for local healthcare services and healthy living advice.

Every person that called NHS Direct feeling unwell was assessed to establish the severity of their symptoms, so as to re-route any urgent or life-threatening situations to the emergency services as quickly as possible. [3]

Other symptomatic callers were able to speak to a nurse practitioner, who asked about their condition in order to recommend the best course of action. This could be giving advice about treating the problem at home, suggesting a visit to a pharmacist, or advising an appointment with their GP, which, if in the out of hours period (when the GP surgeries are closed), could possibly be arranged over the phone. [3]

As many callers were advised to look after their symptoms at home without seeing their GP, the NHS Direct telephone service reduced the demand on NHS resources and helped to avoid unnecessary trips to the doctor, dentist and accident and emergency department.

The NHS Direct telephone service also provided a confidential interpreter service in many different languages, which could be accessed by stating the language required when the call was answered. For those who are deaf or hard of hearing, there was a textphone service available on 0845 606 4647.

Website

The NHS Direct website had a variety of symptom checkers, based on the same system used on the telephone service and could either give self care advice or direct a user to another NHS service. For more complex queries, the symptom checkers allowed the user to receive a call back from a nurse or to take part in a webchat for further information and help. [4]

All NHS Direct health advice and information on the website passed through a rigorous clinical check by medical professionals before it was published. [5]

Non-urgent health queries could be submitted to the NHS Direct online enquiry service and the website also offered a confidential webchat service for those needing advice about unprotected sex or emergency contraception.

Mobile services

NHS Direct offered its full range of symptom checkers optimised for mobile devices on its mobile website and also launched stand alone 'apps' for iPhone and Android smart phones, both available in the normal app stores. [6] [7]

Other services

Digital television channel

NHS Direct provided an interactive TV service via Sky Interactive until 31 March 2009, when the service was closed. [8]

The Freeview service, on channel 100 is now hosted by NHS Choices. [9]

The digital television service contained condensed versions of many of the most common and popular health encyclopedia topics and common health questions.

Commissioned services

Although it is not well known, NHS Direct supplies a multitude of additional commissioned services within the NHS.

NHS Direct supported many local health authorities in England, including primary care trusts (PCTs), helping them to deliver high-quality healthcare to people in each region.

These services ranged from dedicated projects in particular areas, such as the local telephone helpline set up for Sandwell PCT after a dental health scare, to schemes that were developed nationwide. These include a telephone-based pre and post-operative assessment for patients having surgery, and allocating care managers to give regular coaching and advice to those with long term conditions, such as diabetes and cardiovascular disease.

History and background

NHS Direct was launched in 1998 after the government identified a need for a telephone health advice line staffed by nurses as part of its plans to modernise the NHS. [10]

The aim of NHS Direct, as stated by the government in the NHS White Paper, The New NHS, was "to provide people at home with easier and faster advice and information about health, illness, and the NHS, so that they are better able to care for themselves and their families". [11]

The NHS Direct telephone service began taking calls in three contact centres in Lancashire, Northumbria and Milton Keynes in March 1998. [12] These original sites were set up as pilots but soon proved successful, reaching over 1 million people and earning highly positive feedback. Additional waves of pilots were established in contact centres around England until the whole country was covered by the NHS Direct telephone service in 2000. [11]

NHS Direct added a website to its services at the end of 1999, allowing users to find clinically accurate health advice and information anonymously. Since its creation, the NHS Direct website was steadily improved and developed, attracting more users. By 2008, there were over 1.5 million visitors to the website every month. [11] NHS Direct's services continued to expand and improve. It had been said that this has made the organisation "the largest and most successful healthcare provider of its kind, anywhere in the world". [13]

It was reported that each call made to NHS Direct cost £25 to answer - an earlier official report had put the total at £16. [14]

In April 2007, NHS Direct became an NHS Trust, giving it the opportunity to apply for foundation trust status. [1]

In August 2010, the BBC reported that David Cameron's coalition government was planning to scrap the NHS Direct 0845 46 47 helpline telephone service in favour of the cheaper NHS 111 number. This intention was set out in the white paper, but was portrayed in the media as a 'leak' by the Conservative Health Secretary Andrew Lansley. [15] The service was shut down on 26 March 2014. [16] [17] A copy of the website was archived a few weeks before the official closedown. [18]

Abolition of NHS Direct helpline (England)

The Department of Health confirmed that NHS Direct's telephone number was to be phased out in favour of the new non-emergency NHS 111 number, following three pilots in the North East, East Midlands and East of England. NHS 111 is intended to work in an integrated way with local GPs, out-of-hours services, ambulance services and hospitals, for the benefit of patients and to help the NHS become more efficient. NHS Direct was intended to have an ongoing role, along with other providers, in helping to deliver the NHS 111 Service and, in the interim, continued providing local and national telephone and web-based services on behalf of its commissioners.

Closure

It was announced in October 2013 that NHS Direct would be closed down in 2014. [19] after the organisation became entangled in and failed to deliver correctly a number of contracts to deliver NHS 111. [4]

Related Research Articles

<i>British National Formulary</i> Pharmaceutical reference book for the UK

The British National Formulary (BNF) is a United Kingdom (UK) pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicines available on the UK National Health Service (NHS). Information within the BNF includes indication(s), contraindications, side effects, doses, legal classification, names and prices of available proprietary and generic formulations, and any other notable points. Though it is a national formulary, it nevertheless also includes entries for some medicines which are not available under the NHS, and must be prescribed and/or purchased privately. A symbol clearly denotes such drugs in their entry.

<span class="mw-page-title-main">999 (emergency telephone number)</span> Emergency number in several countries

999 is an official emergency telephone number in a number of countries which allows the caller to contact emergency services for emergency assistance. Countries and territories using the number include Bahrain, Bangladesh, Botswana, Eswatini, Ghana, Guernsey, Hong Kong, the Republic of Ireland, the Isle of Man, Jersey, Kenya, Macau, Malaysia, Mauritius, Poland, Qatar, Sudan, Saudi Arabia, Singapore, Trinidad and Tobago, Seychelles, Uganda, the United Arab Emirates, the United Kingdom, and Zimbabwe.

<span class="mw-page-title-main">Telephone numbers in the United Kingdom</span>

In the United Kingdom, telephone numbers are administered by the Office of Communications (Ofcom). For this purpose, Ofcom established a telephone numbering plan, known as the National Telephone Numbering Plan, which is the system for assigning telephone numbers to subscriber stations.

119 (one-one-nine) is an emergency telephone number in parts of Asia and in Jamaica. From May 2020, 119 was introduced in the United Kingdom as the single non-emergency number for the COVID-19 testing helpline in England, Wales, and Northern Ireland. From January 2022, 119 was introduced in Romania as the single non-emergency number for reporting cases of abuse, neglect, exploitation and any other form of violence against the child.

<span class="mw-page-title-main">Welsh Ambulance Service</span> NHS trust and ambulance service in Wales

The Welsh Ambulance Services NHS Trust is the national ambulance service for Wales. It was established on 1 April 1998 and as of December 2018 has 3,400 staff providing ambulance and related services to the 3 million residents of Wales.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

NHS 24 is Scotland's national telehealth and telecare organisation. This special health board runs a telephone advice and triage service that covers the out-of-hours period. The telephone service allows people who feel unwell or those caring for them to obtain health advice and information if it is not convenient or possible to wait until they can visit their general practitioner when the practice is next open. The advice line is not intended as a substitute for obtaining an emergency ambulance service via 999. The telehealth services provided by NHS Scotland fulfil some similar functions to NHS Direct Wales and the NHS 111 scheme in England.

A non-geographic number is a type of telephone number that is not linked to any specific locality. Such numbers are an alternative to the traditional 'landline' numbers that are assigned geographically using a system of location-specific area codes. Non-geographic numbers are used for various reasons, from providing flexible routing of incoming phone calls to generating revenue for paid-for services.

<span class="mw-page-title-main">Healthcare in the United Kingdom</span> Overview of healthcare in the United Kingdom

Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences have developed between these systems since devolution.

NHS Direct Wales is a 24-hour telephone and internet health advice service provided by NHS Wales to enable people to obtain advice when use of the national emergency telephone number does not seem to be appropriate but there is some degree of urgency; it also functions as a confidential advice service for some medical matters which a patient might be reluctant to discuss with their own General Practitioner (GP) and has subsidiary helplines for specific health matters such as human papillomavirus (HPV).

The Patients Association is an independent charity operating in the UK that aims to improve patients' experience of healthcare. Established in 1963, it became a registered charity in 1991. The Patients Association works with patients directly: they are its members and supporters, and also the people who benefit from the organisation's help and advice services. The Chief Executive is Rachel Power, Julie Thallon is the Acting Chair.

The Royal Wolverhampton NHS Trust runs New Cross Hospital and West Park Rehabilitation Hospital in Wolverhampton and Cannock Chase Hospital in Cannock.

111 is a free-to-call single non-emergency number medical helpline operating in England, Scotland and Wales. The 111 phone service has replaced the various non-geographic 0845 rate numbers and is part of each country's National Health Service: in England the service is known as NHS 111; in Scotland, NHS 24; and in Wales, NHS111 Wales.

Online doctor is a term that emerged during the 2000s, used by both the media and academics, to describe a generation of physicians and health practitioners who deliver healthcare, including drug prescription, over the internet.

<span class="mw-page-title-main">NHS Pathways</span>

NHS Pathways is a triage software utilised by the National Health Service of England to triage public telephone calls for medical care and emergency medical services – such as 999 or 111 calls – in some NHS trusts and five of the ambulance services in the country. In its emergency capacity, it has replaced the Advanced Medical Priority Dispatch System for some trusts, and in non-emergency telephone triage it is found in many medical care triage systems, such as NHS 111.

Electronic consultation is an aspect of telemedicine which involves remote communication between patients and clinicians, or between clinicians and specialists.

Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.

Patient record access in the United Kingdom has developed most fully in respect of the GP record, because computerisation in that field is almost universal. British hospitals were slower to move into electronic records. From 1 April 2015 all GP practices in England have to provide online services to patients, including access to summary electronic medical records.

Babylon Health was a digital-first health service provider that combined an artificial intelligence-powered platform with virtual clinical operations for patients. Patients are connected with health care professionals through their web and mobile application.

Healthdirect Australia, otherwise known as just Healthdirect and formerly the National Health Call Centre Network, is the national health advice service in Australia. Funded by the Australian Government and all state and territory governments, Healthdirect provides a number of 24/7 health helplines to all Australians.

References

  1. 1 2 Shaw, Joanne (2012). "What is NHS Direct?". politics.co.uk. Archived from the original on 21 April 2014.
  2. "What is NHS Direct?". NHS Direct. Archived from the original on 10 July 2010.
  3. 1 2 3 4 "NHS 111 - All you need to know". Politics.co.uk. Retrieved 26 October 2021.
  4. 1 2 "NHS Direct to close down next year". BBC News. 24 October 2013. Retrieved 26 October 2021.
  5. "Clinical Supervision Policy". NHS Direct. Archived from the original on 6 March 2009.
  6. "NHS Direct mobile app". NHS Direct. Archived from the original on 6 June 2011.
  7. "App of the day:NHS Direct". Pocket Lint. Archived from the original on 30 May 2011.
  8. "Digital TV". NHS Direct. Archived from the original on 22 March 2009.
  9. "Home Channels Interactive NHS Choices". Freeview. Archived from the original on 5 July 2009.
  10. "The New NHS: Modern, Dependable". Department of Health.[ dead link ]
  11. 1 2 3 "History of NHS Direct". NHS Direct. Archived from the original on 17 December 2008.
  12. "Evaluation of NHS Direct first wave sites first interim report to the Department of Health". Department of Health. Archived from the original on 11 August 2007.
  13. "Developing NHS Direct: Strategy Document for the next three years" (Foreword)". Department of Health. Archived from the original on 1 March 2012.
  14. Devlin, Kate (24 October 2008). "Every call to NHS Direct costs £25". The Telegraph. Archived from the original on 18 September 2009.
  15. "Government confirms plan to scrap NHS Direct helpline". BBC News. 28 August 2010. Archived from the original on 28 August 2010.
  16. "NHS Direct holding page". NHS Direct. Archived from the original on 30 March 2014.
  17. "NHS Direct: closed for business". Good to Know. IPC Media Women's Network. 28 March 2014. Archived from the original on 26 April 2014.
  18. "Archive Copy of NHS Direct Website". National Archives. 20 February 2014. Archived from the original on 20 February 2014. Retrieved 24 October 2004.
  19. "NHS Direct to close down next year". BBC News. 24 October 2013. Archived from the original on 24 October 2013.