BMA calls for inquiry into NHS Direct referrals

The British Medical Association has called for an inquiry into the NHS’s information and advice service, NHS Direct, claiming it is ‘putting a strain on the system’.

The move has been backed by the NHS Alliance and Association of Professional Ambulance Personnel who feel that call handlers are referring too many patients to GPs or emergency services.

A BMA spokesperson told E-Health Insider: “What is concerning us is that two-thirds of callers get referred to their GP or out-of-hours service, in what appears to be NHS Direct erring too much on the side of safety.”

NHS Direct currently receives half a million calls each month, and statistics show that half of them result in patients being referred to a GP or casualty ward.

The service’s aim is to try and deal with as many call as they can themselves offering the best possible clinical advice and providing patients with a dedicated nurse or trained call handler who can offer them medical advice and tips, triaging calls based on following a series of software algorithms.

The latest government statistics show that this is happening for 34% of incoming calls. The other 66% are told to contact other services or call for an ambulance immediately in an emergency.

An NHS Alliance spokesperson said the service was proving to be too cautious: “NHS Direct refers patients on as an urgent or emergency when doctors doing out-of-hours or in A&E would not recognise them as such. It puts strain on the system as it means we have to see the patients quickly, which could be a risk to patients who are real emergencies.”

NHS Direct told EHI that phone treatments inevitably involved some degree of caution and it was in the best interests of patients to direct them to another NHS service.

However, a spokesperson for the Association of Professional Ambulance Personnel disagreed: “The number of referrals are too high and in some cases unnecessary. I would like to see the Audit Commission or one of the other watchdogs have a look at how this can be reduced.”

Hamish Meldrum, chair of the BMA’S GPs committee added: “One does have concerns when you see two thirds get referred on somewhere else. I would like to see a full independent view.”

The DH, however, said that it was wise that NHS Direct was cautious in its approach: “NHS Direct will continue to work to ensure that only appropriate callers are referred but it is important that patient safety is not compromised.”