News Release

NHS Direct has had little impact on the demand for urgent health care

Peer-Reviewed Publication

BMJ

Impact of NHS Direct on demand for immediate care: observational study

During its first year of operation, NHS Direct had no effect on the use of emergency care services, although it may have restrained the increasing demand for general practitioner out of hours services, according to a study in this week's BMJ.

Researchers in Sheffield University's Medical Care Research Unit examined the activity of ambulance services, accident and emergency departments and out of hours general practice services in the year before and the year after the introduction of NHS Direct, across three areas in England. Overall, NHS Direct has not "reduced the pressure" on the NHS as was hoped when the service was announced in December 1997. The authors found no effect on use of emergency ambulances or accident and emergency departments, although NHS Direct may have restrained the increasing pressure on general practitioner out of hours services - from rising by 2% per month before the introduction of NHS Direct to falling by 0.8% afterwards.

The authors warn that observational studies are open to different interpretations. For instance, we can also say that there is no evidence that NHS Direct has been associated with any increase in demand for immediate care. However, if NHS Direct "has improved access to health care for those who need it," conclude the authors, "then the fact that this has been achieved without increasing demand on other services seems encouraging."

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Contacts:

James Munro, Clinical Senior Lecturer or Jon Nicholl, Professor of Health Services Research Medical Care Research Unit, University of Sheffield, Regent Court, Sheffield S1 4DA Email: j.f.munro@sheffield.ac.uk


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