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What should replace NHS Direct?

17:42 UK time, Saturday, 28 August 2010

The NHS Direct helpline in England is being scrapped. What should replace it?

The government has confirmed that the 24-hour medical helpline NHS Direct will be scrapped and replaced with a new medical service.

Roughly 14,000 people a day contact the service by phone or internet for medical advice. NHS Direct also offers specialised support for patients with long term conditions, access to a GP and dental healthcare out of hours.

Critics claim the change would mean fewer qualified nurses answering calls, but Nick Chapman, chief executive of NHS Direct, told the BBC the new helpline would be better and more cost effective than NHS Direct.

Have you used NHS direct? What did you think of the service? What would you like to see replace it?

This debate is now closed. Thank you for your comments.


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  • Comment number 1.

    Typical conservatives wanting to scrap the national treasure of the NHS and convert it into the American equivalent where everything is privatised and profit driven (whereby doctors care more about money than peoples lives) and if you cannot afford the healthcare, you're left to rot and die. No thank you Mr Cameron, the UK is far better than that.

    A 24 hour service is brilliant, because accidents can happen anytime. Without this, people are left to wait!?

  • Comment number 2.

    Please, do NOT privatise healthcare.

  • Comment number 3.

    The Government appears to believe that you can replace trained nurses with call center workers.

    Presumably this will be based in India!
    NHS Direct has proven to be a useful and cost effective service,this on the cheap replacement will perforce be worse because the staff will not be professionally competent to offer the range of medical advice that qualified staff provide.

    If employees of this new organization have any sense they will of course refer any thing that can not be answered by rote to A&E services ,which will totally defeat the purpose of NHS Direct which was to provide an alternative which permitted hospitals to deal with acute care.

    It is another stage in the disbandment of what had become an internationally good and cost effective NHS, added to passing financial control to the single largest overpaid group in Public Services (GP's)this is another retrograde step which will come back to bite the Condems in 5 years time.

    Hope it doesn't kill to many people in the mean time.

  • Comment number 4.

    Replace NHS Direct? With what? A less qualified percentage of medically trained staff? With a large proportion of know little, less than thoroughly knowledgeable call centre temps? Are the government nuts?

    No, sorry, they are trying to save money, not provide an equally effective service that people will trust. Just wait until the horror stories hit the ether, and then those in power can justify getting rid of any parallel, complimentary service working in tandem with the 999 service.

    It's just a matter of time before we will be charged for turning up at A&E for anything other than an approved emergency, with no intermediary service like NHS Direct on hand, and then the crap will really hit the fan.

    Does anyone give a damn what is happening in our name???

  • Comment number 5.

    I'm not surprised.

    Just another lie from the ConDems that the NHS would not be touched.

    I have used NHS Direct on quite a few occasions for myself and my daughter and it has been so wonderful. It has also stopped me from running to A&E in the middle of the night, thus surely saving the NHS money on what were just night ailments or minor "new-mum" worries.

    I've gone from being disgusted when I hear these announcements to just resigned to the fact that this coalition wants to have US passports. Good luck.

  • Comment number 6.

    I always found them useless, the only thing they ever said was go to A&E or visit your Doctor tomorrow.

    Poeple need Doctors to visit them at their home when they need them out of hours not a voice at the other end of the phone.

  • Comment number 7.

    If it ain't broke don't try to fix it.

    The NHS direct is a clunky service yes but it has not been correctly utilised by the masses.

    This government just sounds like a spoilt child with a faulty toy - rather than fix it they would rather bin it and go and force the parents (or us taxpayers) to buy a new one.

    Maybe if the government realised that the NHS direct just requires tweaking rather than shooting then we can save some of this money that they freely gave away to their incompetent banker friends.

  • Comment number 8.

    Am totally shocked at the dismantling of NHS Direct.It is an invaluable service,and I have used it on a number of occasions,and received excellent service.Only last week I contacted them for advice on chemotherapy side effects and they were fantastic and saved a visit to the local A&E dept.The timing of this is very cynical,and where was the consultation or debate ?,this government is proving arrogant beyond belief,can't believe I actually thought this coalition would work.

  • Comment number 9.

    Ref. 'Rockingthejoint' comment.
    Having lived in the UK for 40 years under the NHS, and now living in the US for the past 27 years under US medical insurance, I totally agree with your comment. The USA has the latest equipment and advanced procedures in many cases, but the cost is prohibitive, so most people either cannot afford it, or go bankrupt when facing serious illness. Also, precare and aftercare is virtually non-existant!

  • Comment number 10.

    On the few occasions that I've called NHS Direct I found the service excellent.

    The knee-jerk reactions of some of the earlier responders here is both sad and laughable. Providing the replacement service offers the important features of NHS Direct, what is the problem? People are so quick to condemn on the basis of pure political bias without even giving any serious consideration to what is proposed. But that's nothing new, bigots reign supreme!

  • Comment number 11.

    Call me a radical, but how about doctors that are prepared to earn their huge salaries by getting off their lazy backs1des and going out to see patients who are ill ?

    Got to be better than 'phone your GP tomorrow' the standard NHS 24 response to everything!

    But then again, my suggestion isnt really radical is it? It's what used to happen!

  • Comment number 12.

    I am not disappointed as in my opinion any mistakes made by 'phone line diagnosis' could be fatal.
    Interesting that some posts here are straight on the 'condemnation bandwagon'. The announcement was that it is to be replaced with something more cost effective, and knowing the gross wastage of money in the NHS through bureaucracy, inefficient practices and inadequate training of nursing staff, not their fault, then the monies wasted on this service could well be astronomical. Improvements in efficiency should both save costs and improve the effectiveness of the delivered service
    When an alternative service, which I believe is necessary considering the limited hours GPs seem to cover, is introduced then I hope that it is more direct, possibly local centres with access to the online medical records which have recently been introduced. This should ensure better diagnosis and I hope will reflect local trends.
    I will then be able to make judgement on the whole change and not just a knee-jerk reaction on part 1 of the replacement process.

  • Comment number 13.

    It amazes me that people are complaining that NHS Direct is being scrapped, when it is not being scrapped but is effectively being re-branded and streamlined.

    The NHS Direct service, from my experience, have always said "Visit A&E" or "We'll transfer you to the out of hours doctor", and that's after waiting 2+ hours for someone to call me back. If the new service can give advice when you call them straight away, rather than simply taking details and then calling you back later then that will lead to a better service for the patient. It will also cost less to run.

    @RockingTheJoint: I would've thought the national treasure of the NHS was the fact you can walk into a hospital and be seen without having to get your wallet out first.

    We already do have 24 hour service available, accidents do happen and you can visit A&E, or you can contact your local out of hours service. I'm pretty sure that contact details for the out of hours doctors are easily available. Indeed, my local surgery has the out of hours number on their answer machine.

    Your comment seems to make it sound as though there isn't an average 2 to 5 hour wait for a call back. If you were truly concerned about your injury, you'd go to A&E and be seen in the same time frame, and furthermore, if NHS Direct are concerned that your injury needs a proper examination then you'd have the initial wait for the call back added to the wait in A&E.

    I'd like to see NHS Direct replaced with a non-emergency healthcare line. One that deals with minor injuries (sprains, cuts, burns etc) and provides practical, immediate advice over the phone. If it's a situation that requires more specialised care (i.e. 999) then they can arrange for an ambulance.

    Questions about medicines or finding a local NHS dentist can be easily handled by your pharmacist and the NHS website itself. Most GP surgeries either have a divert or provide the number of the out of hours doctor when they're closed.

  • Comment number 14.

    The alternative will be cheaper, so I assume inferior.

    My expectation is that you will dial a premium rate number and get the same standard of assistance that most helplines thiese days aim to deliver. I suspect you will hear....

    Thank you for calling.....Welcome to the National Health Advisory line sponsored by the National Association of GP Healthy Living Delivery Consortia.... Our members manage health care services for your GP although this helpline cannot proviode individual advice just general information about health. ....... At present all of our customer health advisors are busy answering other calls so there will be a short wait ........... your health is very important to us..... please note that we are experiencing an exceptional level of demand for this service at present so if its an emergency do call 999 where you can be assured of a more rapid response......our advisors are still busy answering other calls... as you are paying 40p a minute for this service you may care to call later or consult our web site at where you will find all of the information that we can provide on this helpine or you may prefer to wait for an appointment at your local Health Centre. You are now only 16th in the queue, and we anticipate your call will be answered by one of our highly qualified health care customer advisors in 22 minutes. Your call is important to us, we are committed to providing you with the right information to help you stay healthy are now 14th in the queue and can expect to speak to an advisor in 19 minutes.........your call is important to us....

  • Comment number 15.

    Here's a radical about walk in 24hr clinics? Or doctor's surgerys open at times that working people can actually get to them?
    Australia seems to manage this with the aid of the medicare card (nothing like the American equivalent) Or a database that allows one to use any doctor rather the one which your are registered at? (which may be near your home, but nowhere near where you work?) The bureaucracy involved in the NHS does nothing to prevent others abusing it, but clearly inhibits those users who perhaps have an ongoing condition that need monitoring, but perhaps cannot constantly take days off work, or plan illnesses in advance with an appointment.

  • Comment number 16.

    This government is a shambles.

  • Comment number 17.

    I bet the new "improved" telephone service will be run from a call centre in India!

  • Comment number 18.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 19.

    NHS direct huh what piffle
    last year I fell ill I rang the NHS direct and told the trained nurse my symptoms and I said I thought I had appendicitis she said it was nonsense and it was a tummy bug
    and to wait 24 hours but in the morning I was rushed into hospital with a burst appendix
    imho we should speak to doctors not nurses
    they are way to under trained to diagnose peoples illnesses over the phone
    we should return to doctors taking the calls as far to much time is lost going through that damnable business called NHS direct
    and it puts lives at risk

  • Comment number 20.

    I think sticking a nurse in a call centre is waste of a good nurse.

    Nurses are not hired to be a voice at the end of a phone but also to provide practical assistance.

    Medical expert systems exist and it is logical that technology should replace a trained asset.

  • Comment number 21.

    I am truly saddened by this announcement. The ConDems seem adamant in dismantling anything good about the UK.

    The NHS direct is an invaluable service which does not replace hospitals or GP but compliments it. I have used it on several occasions and had an excellent service. And i am sure there are thousand of people out here who feel the same.

    If the service need to be made more efficient, fine, but why get rid of it all together or even change the name? The infrastructure, staff, they are all there. And what do they intend to replace it with? A call centre in India? It may not happen now, but sure enough in few years time it will be transferred there.

    Please, someone stop them!

  • Comment number 22.

    Sad times ahead.Cutting costs priorty No.1..
    Everything on the "Hit List"
    Defence,Education.Health Service.
    All Public Services cost money.We could privatise any Public Service that costs money.
    Just look at the immense amount of money our population has saved by privatising the Gas and Electricity Industry.Add to that the money we have all saved by privatising our Railways.
    Guess our Postal Services are next in line for privatisation.Or perhaps our Inland Revenue and Customs services.
    HM Prisons are an ideal target.You can make an awful lot of money providing Full Board and Accommodation.
    And there is the key.No money to be made by providing a public service.
    Scrap all public services,sit back,and watch all the money roll in.
    Just make sure the users pay far more,for exactly the same service they always had..
    These guys are not stupid.They think we are.

  • Comment number 23.

    The two times I've had to use NHS direct they have been great.

    One of the times an elderly relative had been taken ill, the on call GP advised that she had just got a bug but would be ok in a couple of days with rest. Several hours later and her condition worsening we called NHS direct, they felt her symptoms were too serious to ignore and called an ambulance. It turned out she'd had a mild heart attack.

    Another half baked idea by this shambles of a government along with the GP consortia plans. While I didn't expect any better from the idealogically driven Tories the lib dems should be ashamed of themselves.

  • Comment number 24.

    what are this unwanted government doing now! do they conisder how much this service helps people who can not contact a doctor or are unsure if going to A&E is mpt realy needed which saves the nhs money anyway! I have two young children who just happen on most occasions that when they have ever gotten seriously ill it has been either through the night or early hours of the morning, thanks to nhs direct they have aways been there to give me the advice and support that i needed when i was unsure. what possible type of service can they offer that is better than this? all because they say it will be saving money, mabey they should go back to the drawing board and work out how much money it acualy saves the nhs and over stretched A&E departments know that you can contact someone before going to that stage. are we realy going to let this government turn us into the same state as america's health system

  • Comment number 25.

    NHS Direct only started in 1997. We all survived quite happily without it before 1997 so the chances are we will all continue to survive quite happily should it disappear.

    It should be remembered also that doctors themselves have called for the abolition of NHS Direct.

  • Comment number 26.

    This is typical of new Governments who "hit the ground running". Blair was just the same. They make sweeping announcements of change based on perception and prejudice but without proper consideration of the facts and the likely consequences of their actions. This government scares me even more than the last one.

  • Comment number 27.

    ConDems Direct. You phone a non urgent number: 666 1313 for example. You then say who Daddy is, who manages your trust fund and what your tax avoidance status is. You then describe your symptoms and the call centre locates which queue you need to jump and what premium you will be expected to pay. A simple check to make sure you went to the right school and bank with the right bankers. In serious cases you will actually speak to the consultant directly on the golf-course. If the check fails your call will be diverted via premium rate line to the call centre in Tehran and you will be given an estimate of both the month and the year when you may expect a nurse to contact you. This service will not merely replace NHS Direct- it will also make a profit!

  • Comment number 28.

    Whatever replaces it MUST do the job and - to use that daft pseudo-political cliche - fit for the purpose!

  • Comment number 29.

    londonmumof2 - You call the current government "unwanted". No one was wanted less than Slave Labour - the party that never obtained the support of 75% of the adult population of the UK!

  • Comment number 30.

    Stop all this emotional nonsense. NHS Direct was never very good. I used it twice for totally different things and the only advice I got was to go to A&E. It turns out that that was their standard advice they gave to lots of cases.
    Everyone on here will fall into one of the following categories.
    1. want to bash the current parties in power regardless
    2. hang onto anything with the letters NHS in the title regardless
    3. think NHS Direct was a brilliant service and well worth the money
    4. think it was rubbish and want something that works and is good value for money

  • Comment number 31.

    I am so angry that the government should be getting rid of NHS Direct. Since having my first baby I have needed to phone the helpline a number of times when my child has been ill. The information given was always helpful and reassuring. You don't always want to take a sick child to A&E in the night, if it's not needed, as the trip will probably make them worse. I've phoned NHS Direct about my own symptoms and for other members of the family when they are suddenly ill. It's particularly helpful at night or when the doctor's surgery is closed. The bankers greed and incompetence was the reason for the credit crunch and recession. Why is the government still allowing bankers to take bonuses? Make the rich financial sector pay, not ordinary citizens. This government is so ready to cut back on school building or other services that affect ordinary people, but not so ready to get some of the tax payers money back from the banking institutions. I bet that the service they replace the NHS Direct with will be inferior.

  • Comment number 32.

    Anyone who voted the Tories in should stop complaining - we all knew what they were capable of. They've never been fans of the NHS and never will be. Why do you all seem so surprised that this could happen?

    As for NHS Direct, I personally never found it very helpful and I hated having to wait for a call back from them but having said that, out of hours care in this country is appallingly bad and people need to know there is a helpline you can contact in an emergency with qualified nurses at the end of the phone.

    Happy complaining under the ConDems!

  • Comment number 33.

    How about we scrap the current government instead? These measures are not about making savings. They are about tearing down the state healthcare system in order to rebuild it as a privately run enterprise to make money for Cameron's business buddies here and in the US.

    These savage, ideologically cuts to public services must be resisted at all costs. Make no mistake: the insidious privatisation of the NHS will mean that the most vulnerable in our society will be deprived of the care they need, and will put lives at risk.

    Nobody voted for this. We must all make a stand before it's too late.

  • Comment number 34.

    Hey folks, in many respects the NHS is already 'privatised'. With its career-focused managers and clinicians, business managers and accountants the main focus of only too many of the people in it is to protect their own public purse wages, their professional status, their publicly funded pension and keep their own butts in jobs irrespective of the gain, or otherwise, to patients and their relatives.

    In fact, some of the attitudes - and ruthlessness - you will find in senior management teams in Health Boards and Trusts are more akin to what most folk on the street would expect from banks and multi-national financial concerns.

    Many have a bullying culture which, of itself, ensures people end up being more focussed on keeping their heads 'below the turrets' and keeping themselves in jobs rather than delivering quality customer outcomes to patients and their families.

    Of course, it varies as you go around the country, but in some places the NHS has severely lost the plot, as has surely been made clear by the interventions that have had to be made in such places as mid-Staffordshire.

  • Comment number 35.

    Scrapping NHS Direct will cost money; implementing a replacement service will cost money. The chances of the new system being as effective as the existing system is remote.

    So this 'cost saving' measure will be expensive and provide a poorer service.

    Political dogma - nothing else.

  • Comment number 36.

    my advice is do not bother with these services
    after using them and being let down by them I now ring my doctors surgery for an out of hours doctor or just ring 999
    at least you don't get put in a queue and the advice you get from the doctor is good advice
    lives have been lost using NHS direct
    it needs disbanding NOW as it leads you to believe you can put your trust in it at a time when you are most vulnerable

  • Comment number 37.

    It is very difficult to triage a person over the phone without seeing them, therefore NHS Direct follows a series of flowcharts to determine the action to be taken based on the patients response to certain questions.

    This usually results in the patient being told to call an ambulance and attend the Emergency Department, hence NHS Direct being rechristened NHS Redirect.

    The problem with 111 is that it is only one nuber removed from the European standard emergency number 112, which also works in this country.

  • Comment number 38.

    I am a normally a Tory voter, but every 10 years a new government takes control and spend millions trying to 'improve' matters with re-structuring.

    Labour has improved the health service but only by spending 3-4 times mores than in 1997, however most agree that it has not improved by 3 times.
    Why doesn't the torys accept the improvements and keep what works and just improve what doesn't making small incremental steps on the way rather than the "big plan"

  • Comment number 39.

    A really good service removed for no reason, more people will go to A&E, when my wife was giving birth they talked me through it and she was more comfortable because she could stay at home until she was going to have our child (Sean by the way!), it is a good service to reassure people just knowing it is there and is also well used, we do not all have private Doctors this should not be removed.

  • Comment number 40.

    I suppose it's easier to spin this as "a new replacement for NHS Direct" than it is to admit that, actually, all we're really doing is cutting back on qualified staff. But wait - we're getting a new name and a new phone number and a new logo.... it must be a new improved service!

    The BBC have inadvertently played right into this scam by reporting it in the way they have, as a 'replacement'.

    It's not. It's NHS Direct with cuts.

  • Comment number 41.

    17. At 7:07pm on 28 Aug 2010, RTFishall wrote:
    I bet the new "improved" telephone service will be run from a call centre in India!

    Careful, you're giving him ideas we may regret.

  • Comment number 42.

    Not sure how long Nick Chapman has been in his job and what he gets paid but his comment regarding the telephone number is a classic!
    Perhaps he should have suggested some time ago that the tel no. for NHS Direct be changed to 111.

  • Comment number 43.

    it just one more phone call to make , when i needed urgent help for my husband it took 3 phonecalls to different people ! ok it was in the early hours but hey we were on the list of terminally ill, i felt like screaming get someone over here , it was just questions questions then another call from someone else asking the same questions .. i was crying in frustration in the end ... and yes my love did die that early morning ; maybe i did not explain myself properly who knows ..but phone calls are not the answer .

  • Comment number 44.

    Next move from the Con/Dems will be a Call Center in India.
    'Make it Cheap' seems to be the future for the plebs....but what else can we expect from the Tory coalition party.
    You have a lot to answer for all you who voted Lib/Dem and ended up with a Tory government....I am one of them, but I will not be fooled twice!

  • Comment number 45.

    NHS Direct needs to be overhauled but not replaced!

  • Comment number 46.

    re post 43 .. what i meant to say was that any service which relys on a phone call to make a diagnosis do`s not work .

  • Comment number 47.

    At 7:12pm on 28 Aug 2010, pete21 wrote:

    "NHS direct huh what piffle
    last year I fell ill I rang the NHS direct and told the trained nurse my symptoms and I said I thought I had appendicitis she said it was nonsense and it was a tummy bug
    and to wait 24 hours but in the morning I was rushed into hospital with a burst appendix
    imho we should speak to doctors not nurses
    they are way to under trained to diagnose peoples illnesses over the phone
    we should return to doctors taking the calls as far to much time is lost going through that damnable business called NHS direct
    and it puts lives at risk"
    Pete21 you are clearly living in the past when nurses were doctors handmaidens.
    Doctors cannot diagnose illness over the phone either, they need to perform a physical examination, I doubt that a doctor would have diagnosed your appendicitis either. Also if you were convinced that it was appendicitis then why not admit yourself through the ED?

    Some of my nursing colleagues can and do diagnose illness and implement treatment without recourse to a doctor.

  • Comment number 48.

    there are two main kinds of helpdesk system.
    The first is where you have highly paid professionals waiting around to take calls and the second is where you have a call logging system which notes your call and then passes the details onto 2nd line support.
    In an ideal world, and money was no object, then type one is fine.
    however, in a world of competing resources, type two is preferable.
    If anyone is very ill, then call 999. If not, and you only need advice and guidance, call NHS-Direct.
    I agree with the comments that the GP's should be doing more and not operating 9-11 and 16 - 18 if you are lucky and can get past the receptionist.

  • Comment number 49.

    NHS Direct saved my life last year when I had meningitis, and based on the symptoms I described, within 10 minutes I was in an ambulance on my way to being cared for!

    I doubt call centre staff - however well intentioned - would have been able to get me the same standard of care in quite the same time - presumably they would have had to get someone else involed, and wasted valuable time!

    This is a service that genuinely works, and it is reassuring to know that you are speaking with a healthcare professional - I's hate to think we might end up with a "your call is important to us, and is 5th in the queue" system!!

    Wake up Government - yet another step in the wrong direction!!

  • Comment number 50.

    I assume that GPs will be working with patents out of hours and have a call line for the local area... yeah right. I've taken a real disliking to some points of view from some GPs.

    We can also assume more people will be dialing 999 and showing up at casualty when not needed.

    I'm sickened and disgusted though not surprised. "Our" government is a sham and is attacking the NHS despite promises to ring fence and protect

  • Comment number 51.

    >> 1. At 6:09pm on 28 Aug 2010, RockingTheJoint wrote:
    "Typical conservatives wanting to scrap the national treasure of the NHS and convert it into the American equivalent"

    Typical lefty comment. Ignorant and devoid of any truth.

    NHS Direct has a very mixed record. Many GPs have been saying it should be replaced and current Chief Exec. says the new system can be a better service and cost effective.

    Of course, we could keep pouring £millions of our taxes into it but that was spending strategy that built up this deficit.

    How about looking for a better, more efficient service?

  • Comment number 52.

    No Problem - I will have my emergency shopping trolly ready, with all I will need for a hospital stay including reading material, something to eat and drink and a comfy cushion. As soon as I feel poorly I shall call for an ambulance and head for A&E. As much as I sympathize with the Government in saving money, it won't be at the risk of my life. Recently a friend of mine died behind the wheel of his car on the way to the hospital - so it will have to be an ambulance if I can't trust the assessment I am given over the phone.

  • Comment number 53.

    I guess I shouldn't be surprised that they propose to do this since it goes with their ideology. If the new service doesn't have a nurse or doctor answering enquiries nobody will trust it and so all that will happen is that A & E will become inundated with the people who would previously have contacted NHS Direct first. Yes, sometimes they say go and see the doctor or go to A & E but not always - so NHS Direct has justified its existence. It's true we all managed before 1997, but we didn't have the unreliable (and occasionally down right dangerous) out of hours cover then that we do now. Hopefully, this Coalition will fall soon.

  • Comment number 54.

    I had cause to make use of this excelent service about 30 months ago which I can't praise highly enough as they saved my life.

    I hadn't been feeling well for a few days & had been suffering a bout of shivers & sweats along with uneexplained throbing pains in various joints of my body. When I woke one Sunday moring, I was soaked from the previous evenings bout of sweats & the pain in my back was excruciating. My fiance at the time (now my wife) had gone to work and advised me to call NHS Helpline. After calling the service I was advised to contact the out of hours doctor at my local practise. Shoertly after ending the call with them, they called me back to say I was to call an ambulance immediately & they would put me through to the emergency services. Long story shoort, after a day & a half in casualty, I was diagnosed with Toxic Shock having contracted Septisemia & my wife was informed had I not called at the time I had, I would have likely have been dead within 24 hours.

    Needless to say, I can't praise them highly enough in any way to show how grateful my family are for the action they took.

  • Comment number 55.

    The cost to the NHS as a whole, of NHS Direct answering a telephone call is higher than the cost of seeing a GP for a face to face consultation. This has always been the case and is a fact which cannot be questioned by anyone. Nurses at NHS Direct cannot diagnose or prescribe whereas clearly a GP can and does do both. The organisations claims of saving money are very, very questionable to say the least as the high number of 999 referrals each and every day which are not needed as the patient does not receive any treatment and is not taken to hospital is not taken into account - this is just one example. A further point to note is that the organisation states lots of our callers would have gone elsewhere for treatment, but does not take into account the fact that lots of their callers have already gone elsewhere for treatment already, and are using it to gain a second, third or fourth opinion. It is a very expensive service with very questionable benefits. Therefore in light of the extended services within the NHS available nowadays, the only question is how has it lasted for a over a decade when the cost to the NHS is cheaper for someone to see their GP face to face (due to the hundreds of background staff at NHS Direct).

  • Comment number 56.

    What should replace it? That which divides us all, a bit of common sense.
    Nanny state on the decline, hooray.

  • Comment number 57.

    Before NHS Direct we had just as good a health service. There are times when you need a home visit out of hours but one assumes this will be available through the 111 helpline. My only criticism is that we are again replacing an existing service with something similar, which costs more money. You know, redundancies, new stationery, and recruitment costs. It's called the civil service disease, if it works, fix it so it does'nt.

  • Comment number 58.

    I've used NHS direct a good few times. I'm a diabetic, on insulin, with a good few complications. Believe me, things do not conveniently go wrong in office hours! NHS Direct works well! Having fewer nurses is going to damage the effectiveness of the service...And that will cost more, not less! The additional cost will show up elsewhere, that's all!

  • Comment number 59.

    In addition, I have used the service many times and have always been put through to the OOH GP service where I have always spoken to a nurse from the OOH service. Never once have my symptoms needed me to speak to a GP at the OOH so the idea of speaking to a nurse at NHS Direct and then speaking to a nurse at the OOH service is clearly a total waste of money. Also people seem to think NHS Direct has doctors which it does not and never has had. People seem to think that their will be less doctors when there wasnt one to start with. Also it is a fact that non healthcare professionals are now undertaking clinical tasks within hospitals, community settings, ambulance services etc so NHS Direct is no difference. Nurses there earn lots and lots and lots of money for questionable advice and limited patient benefits in my honest thoughts.

  • Comment number 60.

    29. At 7:40pm on 28 Aug 2010, Upemall wrote:
    londonmumof2 - You call the current government "unwanted". No one was wanted less than Slave Labour - the party that never obtained the support of 75% of the adult population of the UK!

    Quite right the correct terminology the "least unwanted"

    Those of us who are not convinced of the sincerity of the ConDems, and the role of their once liberal crutch, its natural to fear the worst and see this as the first step in privitisation/dismantling the NHS. However, while I believe that this is the case, so far there is little evidence that this is what is intended and little evidence that its not?

    NHS Direct is a non-emergency service, as will be the new 101 service, so the question is how quickly will the new service be to use, in terms of getting authoratative advice?; will it be a charged for service? and will it still be an effective service?

    While I agree with 36......
    36. At 7:53pm on 28 Aug 2010, pete21 wrote:
    my advice is do not bother with these services
    after using them and being let down by them I now ring my doctors surgery for an out of hours doctor or just ring 999

    .............I wonder how long it will be before the 999 and out of hours GP services have more hurdles to jump over to access them.

  • Comment number 61.

    Replacing NHS Direct with a clinically inferior call centre beggars belief. It has been so succesful that the highest paid doctors in Europe feel threatened by it. The coalliton are showing once again in their short life that those they claim to champion are bottom of their list. I doubt they will have done their homework about the impact this will have on the poorest and marginalised in our nation. Such thoughts don't seem to enter the heads of those who have money and only think about money.
    The total amount of money to be saved can be quantified, the lives that will be lost and the pain and suffering that will have to be endured longer will not be part of any statistical analysis. That is knowing how much something costs, but not having a clue as to its value.

  • Comment number 62.

    Hello there angry loony lefties, unfortunately your previous government left us in the worse EVER DEFICIT. This means we have to save money. All well and good blaming those 'evil' Tories but it is NUlabour who have forced these cuts to be made. It's like all those who complain about those 'poor miners', living in Doncaster at the time, my father was in fact a miner and although he never voted for Thatcher, he did see the reasoning behind the nationalisation. Some people on here are frankly away with the fairies.

    PS, NHS Direct was not good, the NHS is not that good, we can bang on about the US having to pay insurance for health care, but in fact, they end up paying less (with an average insurance cover) tax AND health care, as so much of our tax goes to the NHS.

  • Comment number 63.

    all this talk that we are losing a valuable service is rubbish
    imho the NHS direct was put there for neurotic parents worried about children's growing pains and hypochondriacs
    it is a waste of money we don't need this service or any other like it
    we need direct contact either with a house call from a doctor or a visit to a hospital

  • Comment number 64.

    The comment from batandball 1 at 20:38 are totally questionable. "It has been so successful that the highest paid doctors in Europe feel threatened by it". No they have been fed up of seeing thousands of people each month visit them in their hospital / surgery / OOH session who have not needed their advice that they have realised the only way to stop this happening is to get rid of it. We have all always had an OOH service so all of us can ring a GP led service either in-hours or out-of-hours across the entire 24/7 period in the whole of England. Use them instead as why double the work and consequently double the cost!! I do.

  • Comment number 65.

    We managed without NHS Direct for long enough. GP's still act as gatekeepers to secondary care in the UK as they always have. What was so wrong with that. I was one of the first IT Project managers for NHS Direct - You would not believe the money that was wasted, a waste which was compounded not only by the incompetence of higher management but also the corrupt practice of the host organisations.

  • Comment number 66.

    The government is dismantling the NHS and other vital public services bit by bit trying to do it without us noticing. Before we know it we'll have one A&E department per county and one GP per practice the way this government is going about things. I honestly believe we are due for another recesssion which will be twice as bad as the last and with the constant reduction to public services, benefits and the threat of thousands more people being made redundant, I can't see how this country will recover for years.

  • Comment number 67.

    62. At 8:42pm on 28 Aug 2010, Smurf-Wrong-Phillips SUFC wrote:

    Smurfer!!! You beat me to the Thatcher reference! I was going to record my disappointment that 60 contributions in to a debate involving the NHS nobody had blamed her yet.

    I agree with everything you say. Having lived in Europe and Canada, there are far superior health care systems than the 'envy of the world' NHS.

  • Comment number 68.

    Another England only cut.

    After years of England being underfunded by Labour (Barnett Formula) now England has to bear the brunt of the ConDems cuts.

    Cuts in Scotland and Wales deferred for 12 months as well.

    They say we are all in this together. We're not. The people of England are getting screwed by the British government and establishment.

    Home rule for England.

  • Comment number 69.

    "all this talk that we are losing a valuable service is rubbish
    imho the NHS direct was put there for neurotic parents worried about children's growing pains and hypochondriacs"

    Very true. They told you to go to A&E anyway.

  • Comment number 70.

    "Smurfer!!! You beat me to the Thatcher reference! "

    Well according to most people on HYS, she is in fact worse than the world's worst dictators! What do you expect though from such out of such loony lefties!

  • Comment number 71.

    NHS Direct is a brilliant service The Tories wanting to replace it can only mean change for changes sake not because it needs improving. Cameron was in a number of private meetings with Nurses for Reform before the election and the private health care companies donate to the party. They are obviously expecting favourable consideration in return.this no doubt is the start. It can't possibly be in order to save money as the service is already in place and changes always involve expense. It must be for political purposes and is probably the thin end of the privatisation wedge

  • Comment number 72.

    Let GPs cover their own patients they always used to. GPs earn around £100,000 per year, GPs are more than capable of getting together to set up a CALL DOC service for their catchment area most have already done so. If one feels they NEED medical help more a than medical "chat" I would suggest they dial 999 and get an ambulance.

  • Comment number 73.

    Tried it, couldn't believe we were paying for it. Tried it again, no better. I think we need to shut it down and spend the money on something useful. The idea is good but the actuality is not.

    The NHS is a vital part of our culture, which is why, contrary to socialist propaganda, all govts spend above inflation on it.

    It isn't perfect though, and needs serious and urgent reform based on my family's experiences over the past few years. To treat it as a sacred cow is to stop progress.

  • Comment number 74.

    "although he never voted for Thatcher, he did see the reasoning behind the nationalisation"

    Sorry i mean to say PRIVATISATION. Ooops. Anyway, since we're on the subject of nationalization, I imagine most on here will want: British Airways, British Gas, British Telecom all re-nationalized? Maybe you could add some other successful 'evil' big business to that list as well. Hey, it maybe awful and its workers might always be on strike, but at least it will be owned by the people!

  • Comment number 75.

    I have used NHS Direct on several occasions and the advice has always been to go to my doctor or to A&E. Since this is what I would have done had NHS Direct not existed, to me it is little more than a waste of time and money, and does not even need to be replaced.

  • Comment number 76.

    I liked NHS Direct. What is the point of spending money we don't have on replacing an existing service with a very similar service?

  • Comment number 77.

    38. At 7:58pm on 28 Aug 2010, irondoctorglennjones wrote:
    I am a normally a Tory voter, but every 10 years a new government takes control and spend millions trying to 'improve' matters with re-structuring.

    Labour has improved the health service but only by spending 3-4 times mores than in 1997, however most agree that it has not improved by 3 times.
    Why doesn't the torys accept the improvements and keep what works and just improve what doesn't making small incremental steps on the way rather than the "big plan"


    if this was your average Tory voter what chance did we ever have?

    The Tories and Labour (not new labour) are FUNDAMENTALLY different. They wont build on what Labour did because they dont believe in it; it is against everything they believe in.

    It comes down to a simple choice State vs Anti state.

    Put simply Conservatives dont believe that you should be entitled to a National health service; if you cant afford it you shouldn't get it. They wont to privatise (As did new labour, working within the NHS we arn't far away from it the infrastructure and ethos is basically there).

    Thats fair enough if thats their opinion its just not mine. It just surprises me that people have been taken a back by all of this.

    Back to the question.

    I just thought it was unnecessary anyway. Dont be surprised if the new system gets outsourced to India.

  • Comment number 78.

    The figures don't add up - it costs £ 24 per call !!! Surely that is an absolute waste of money to have a nurse triage service. Assuming that a doctor can deal with 6 calls an hour (if not more) - i.e. £144/hour - can we not interest a bank of GP's to take this service on instead, to make it more cost effective?

  • Comment number 79.

    I have never heard a good word said about NHS Direct. It takes too long to get through and when you do talk to someone they tell you to either go to A&E, take some pain killers or phone teh out of hours doctors service.
    Why dont you just call the out of hours service and then they can tell you to go to A&E if necessary. I think we tried it 3 times and gave up after that as there was no point to it.
    It was a typical banner waving project that was a waste of time and effort to 90% of people who use it.
    A good way to start saving money.

  • Comment number 80.

    Once again, more typical Tory policy, look after the rich and to hell with everyone else. After all, the rich can afford BUPA and so on...

    I think we should all just stop paying NI and see what David Cameron thinks of that!!

  • Comment number 81.

    At 7:22pm on 28 Aug 2010, londonmumof2 wrote:

    what are this unwanted government doing now!

    What do you mean "unwanted"? They have the most voted seats in Parliament.

  • Comment number 82.

    some people on here just spout total nonsense eg 62..this has nothing to do with miners nothing to do with America and totally nothing to do with is to do with the leanings of a juvenile Tory party to reduce our country in stature ...they want to privatise the NHS and are doing it by stealth because they do not have the guts to be up front and tell us the truth..this new organisation will be a call centre with the usual call centre rubbish pumped out to us from someone reading from a script...if you have recently had a telephone or broadband problem you will know what I not be fooled into believing that it is to do with the deficit...all decisions taken by this government are to benefit their ideology so let them from now stop trying to blame others the current decisions are theirs and theirs alone so in a couple of years they will suffer the consequences of a very disgruntled country

  • Comment number 83.

    I hope those on this board who criticise the NHS never get sick if they ever visit the USA!

  • Comment number 84.

    62. At 8:42pm on 28 Aug 2010, Smurf-Wrong-Phillips SUFC wrote:
    " we can bang on about the US having to pay insurance for health care, but in fact, they end up paying less (with an average insurance cover) tax AND health care, as so much of our tax goes to the NHS. "

    Have you any idea what you are talking about. The health care in the US is brilliant for a few but there are millions reliant on charity. I can assure when you live there health care is a huge worry. Often as soon as you are made redundant your cover goes with the job. If your care looks to be long and expensive the health care company go through your details with a toothcomb looking for an escape route to avoid paying. Many join the army purely in order to get the health cover for their family.
    The peace of mind and freedom from worry given by the NHS is wonderful, a close family member had a child with a servere birth defect, that child can now walk and take part in sport thanks entirely to the NHS and it didn't cost them anything. In the US that child could never be insured and would be confined to a wheel chair unless you were very wealthy or found a charity to help. When you go out for an evening there are collection boxes begging for financial help, with very sad stories attached. It is so hard to spend and enjoy yourself knowing your money could be better spent. You have to become immune to pleas it is very unpleasant

  • Comment number 85.

    Re 75 why do you keep going back then ??

  • Comment number 86.

    The country is going like America, because large parts of the NHS are being scrapped. The NHS Trusts, and now the NHS helpline NHS Direct and soon NHS front line services are being scrapped because there is such a shortage of cash for the wars in Iraq. I wrote a blog post last week calling the PM a fraud, and I would still write it again, possibly a thousand times. What does the PM say about a doctor being scrapped for his baby? If his baby, heaven forbid got an illness that was life threatening and the doctor was taken away or the treating him? The £200000 salary is going, MR Cameron, and when the British people have their say, your government and the Liberal Democrats doing the dirty work will be history.

  • Comment number 87.

    Not too sure about this one, however I had reason to use the the service not so long ago and I was told to go and see the out of hours GP at a named hospital NHS Direct took all my details so I went along to the hospital , not my nearest one I might add when I arrived I duly waited as there were no reception staff just a nurse who said if you're wating to see the doctor take a seat, eventually I was the only one there people had arrived after me and been seen and the doctor had seen that I was there, after a while I plucked up courage an knocked on the doctors door only to be greeted by Ms Arrogance herself, 'Im not seeing you you're not on my list' But NHS Direct sent me they took all my details says I ' I don't care they don't pass them on you'll have to ring NHS something else to see me theres a phone in the entrance' So off we go ring the other dept give them all the details again and I can see the doctor in an hours time, because they're busy whicjh they were not. Now why can't NHS direct deal direct with out or hours GP and scrap the other line as this seems to be just a non job

  • Comment number 88.

    The only complaint that people are making is that the NHS direct tell you to go to A&E, if you have an emergency what else can they do... and what else do you think this other option could offer that could be any better?....nothing! The point is at NHS direct they are highly qualified, trusted staff who know their stuff and they would not suggest you go to A&E unless they really think you need to.

    I have used them a few times but one time in particular stays with me. I am the mother of premature twins born at 25 weeks. Premature babies often get dreadful chest infections in the first few years of life. My son was about two years old and had yet another chest infection, which I was used to dealing with by that time. This one seemed worse though and I phoned NHS direct, she asked to hear him breathing and told me to take him straight away to A&E. On top of that she contacted our local hospital, told them we were on our way and requested that he was seen at once! This was the middle of the night and the point is, if I had not had that expert, trusted, proffessionals help at hand I may not have called!

    Please please don't do it... especially so that a private business man can open or continue a call service centre and be paid a nice fat amount of money, employing a load of seriously under trained people to give what could be life saving advice. Also the A&E department will be swamped if this goes ahead as i'm sure the advice of 'go to A&E' will rise, as the new 60 hr trained staff will not know what they are talking about and send far more people as a precaution. Mind you Mr. Cameron will love that as the next thing will be that the A&E is over run.. next we'll be paying to go there!

    I am not overly into politics, but I have never felt so angry about what is happening to this country since this new government was bodged together!

  • Comment number 89.

    "totally nothing to do with Labour"

    I see...

    "Tory party to reduce our country in stature ...they want to privatise the NHS and are doing it by stealth because they do not have the guts to be up front and tell us the truth"

    And this confirmed my suspicions.

    Do you also think that we are being ruled by the masons? That we are being watched by aliens? And of course that it was the CIA as opposed to some insane lunatics that collpased the twin towers. Finally do you believe that Gordon Brown should be made a saint, and that Harriet Harman is the best person ever to have lived?

  • Comment number 90.

    Call it "National Health and Welbeing Helpline".

    ( For advice on your medical needs ) If it's an emmergency dial 999

  • Comment number 91.

    Who will run the new quango? Oops, sorry. The new service? Knowing this government, it will probably be yet another (after Field, Hutton and Milburn) failed Blairite minister. I have heard that Stephen Byers "is available for hire".
    Jobs for the boys.

  • Comment number 92.

    83. At 9:16pm on 28 Aug 2010, RTFishall wrote:
    I hope those on this board who criticise the NHS never get sick if they ever visit the USA!
    Yawn!! The standard of medical care in the US is superior to Britain. Try looking at established data. If you're actually banging on about the usual funding nonsense then it so happens healthcare in the US is also cheaper. The method of payment may be different but you're still paying for it.
    Of course NHS staff do a great job, I'm not knocking them, but the bureaucracy and inefficiency in a 100% direct taxation funded system comes from the perception 'free at the point of delivery' actually means free full stop

  • Comment number 93.

    To Lucy Clarke.

    I have in fact spent a year in the USA and while I agree its health service is not adequate for all, the NHS is hardly the world's shining beacon. My father for instance, went in with lung cancer and managed to come out with additional illnesses. They were so incompetent, he was left outside for FOUR HOURS in the freezing cold, alone, waiting for an ambulance and he caught a nasty virus that ended up taking his life. When I asked immediately after following this incident, the nurses were most unhelpful, telling me he (and I am not lying) that 'he should have walked and asked for assistance'. My father passed away last December and I would never, ever want anyone, not even a loony lefty to go through what incompetence and pain my father suffered. He ended up dying in a private, charity care hostel in Sheffield.

  • Comment number 94.

    I am heartened to see that NHS Direct will be changing as I found it a total waste of time and money when I worked there as a manager for several years.
    I had written to the then Labour Secretary of Health to suggest how it may be improved and never even had a reply.
    If I could change NHS Direct I would disband it and get the nursing staff to be based within their locality, working in A&E, MIU, GP and GPOOH depts where they take the calls from local people, understand the local health provision and then see a proportion of those people needing treatment or direct review.

    This is far better than dealing with all calls nationally from a single queue where the nurse never actually sees a patient or has never visited the area where the patient resides.

    I am unclear about what the new Goverment will do with NHS Direct but if you agree with my comments then please acknowledge them positively

  • Comment number 95.

    Mmmmmm! I have loads of experience with the NHS - admittedly as a patient - but if you don't need medical qualifications - I should apply for a job as an advisor. Ooops! I forgot, my oncologist has only given me until the New Year to live - but what does he know anyway?

  • Comment number 96.

    This is the best thing that the new government has come up with.
    As a working GP, NHS direct is overrated,expensive and simply unable to sort the wheat from the chaff.Too many patients are redirected to A+E/GP for no reason.
    We really need a comprehensive out of hours system to triage calls (often from the worried well) and sufficient funding for the daytime GP practices (who have access to the patient's records) to deal with all queries.
    Successive governments have encouraged people to phone about any problem, 24 hours a day and I am afraid we, the nation, cannot afford a system to deal with some of the frankly ludicrous "emergencies".
    I think a change is long overdue.

  • Comment number 97.

    How about putting the money into mainstream health services (doctors, hospitals, etc.) instead? Likewise this new 111 service - save the money that is needed to launch, publicise and staff this, and instead pay for more people to staff the usual 999 emergency service. Not only does that return all the marketing money to more useful activities, it also avoids confusing people in a situation where they can't be expected to be thinking clearly.

  • Comment number 98.

    Do admit I have had to use NH 24 helpline.Do admit that the response has been prompt.Do so wish I could shake the feeling.that the person at the end of the line cared far more about my problems. That they cared.
    Perhaps they do..
    But why can they never put you in touch with your local GP?

    Why is your GP no longer available when you need him/her most.

  • Comment number 99.

    Point 88 Julie Williams writes they do not send you to A+E unless necessary. Unfortunately there is a difference in what NHS Direct nurses feel is necessary and what nurses in A+E, Urgent Care, OOH Services etc etc etc see as necessary. As NHS Direct is in the minority they must be wrong. I went to A+E with a friend of mine who had rung the service and as soon as she arrived she saw a nurse and was out of the department in less than five minutes as the nurse knew instantly there was no need for my friend to be there (as both my friend and I suspected from the start but when a registered nurses states you 100% need to go to A+E you must assume they know best. What most people forget is that before NHS Direct you could ring your local A+E department and receive telephone advice about whether you needed to attend and this was done across all departments. This worked very well so why set up such an expensive service to start with is the question. Think of the billions it has cost.

  • Comment number 100.

    I only used the phone service twice. The second time was extremely helpful as the nurse instructed me on how to clean my eye with severe conjunctivitis and an allergic reaction to the anti-biotic prescribed. I used to find the website very useful for checking symptoms, but since they changed the site sometime in the last year, it's almost impossible to check for anything specific, especially when using the search tool...

    Therefore, I hope that whatever replaces NHS direct will be of the same standard as my phone experience and a better standard than the now completely useless website.


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